Living with Drugs

Michael Gossop

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781351153706
• Edition: 6
• Topic: Psicología
• Subtopic: Adicción en psicología

Now in its sixth edition, Living with Drugs continues to be a well-respected and indispensable reference tool. Michael Gossop has updated this new edition to take account of new laws and practices that have come in to place since the previous edition, published in 2000. Written in an accessible style and providing a balanced perspective, the book is ideal for non-specialists in training, such as student nurses and social workers and for anyone with an interest in this complex, ever-present and emotive issue.

Chapter 1
The Chemistry of Everyday Life

Every society has its own drugs. People have always used drugs to alter their states of consciousness, eagerly seeking out whatever naturally occurring substances can be used as drugs, and wherever possible deliberately cultivating them. Every part of the Earth that is capable of producing drugs has been used for this purpose, and even where the land is not available, other technologies have been invented to support the production of drugs. Vast areas of Europe are covered by vines. The cannabis plant flourishes in Africa and Asia; and from the Middle East down through Asia the opium poppy grows - both in its wild state and under cultivation. In the cooler, wetter climate of the British Isles some of the best arable land in the country is turned over to the production of that most English narcotic, the hop. In the colder countries of northern Europe where the winters are long and the growing seasons are short, spirits are distilled. In the Americas there are plantations of the coca plant, tobacco and cactuses containing mescaline, and throughout the world there are mushrooms containing other hallucinogenic drugs. The only people with no traditional drug of their own would appear to be the Inuit, who live in a land so bleak and uncompromising that it does not permit the cultivation of any intoxicant.

Drugs play an important part in the lives of every one of us. Drug taking is an almost universal phenomenon, and in the statistical sense of the term it is the person who does not take drugs who is abnormal. Many readers are likely to react against any suggestion that they are drug takers, to see it as some sort of accusation. The comfortable but quite mistaken orthodoxy insists that the 'normal' people who make up the majority of our society do not use drugs: set in sharp contrast to this sober normality are the 'abnormal' minority who do.

The term 'drug taking' conjures up an image of syringes, needles, heroin and all the paraphernalia of the junkie dropout. It is surrounded by all manner of sinister implications which reinforce the view that the use of drugs is a strange, deviant and inexplicable form of behaviour - possibly even a symptom of mental illness. We have been encouraged to regard the junkies who are such a conspicuous part of the city centres and urban wastelands of New York, London, Amsterdam and Zurich as some sort of alien breed. Consequently, we are tempted to feel that our own use of cigarettes, of alcohol, of sleeping tablets or of tranquillizers is quite different from their use of heroin. But are the two sorts of drug taking really so dissimilar?

The emotional reaction that is so common whenever drugs and drug taking are mentioned is quite unwarranted, and it presents a serious obstacle to our efforts to understand this issue. Tea and tobacco contain drugs (caffeine and nicotine). Alcohol is a drug; heroin and cocaine are drugs. All are drugs in the same sense of the term, though that does not mean that all drugs are the same or that there are no differences in the risks associated with using these different substances.

Dictionaries are particularly unhelpful in clarifying precisely what we mean by the word 'drug'. There are few satisfactory definitions of any of the terms that are used in this area. The traditional definitions of a drug tend to emphasize the chemical properties and the medical values of a specific substance. In Butterworth's Medical Dictionary, for instance, a drug is defined as 'any chemical substance, synthetic or extracted from plant or animal tissue and of known or unknown composition, which is used as a medicament to prevent or cure disease'. This definition is hardly adequate for the actual way in which doctors use drugs, much less for the purposes of the present discussion. Here we are concerned most especially with the psychological (psychoactive) effects of drugs.

It is extraordinary that so little attention has been paid to the mind-altering properties of drugs. Throughout history, men and women have made strenuous efforts to discover and to invent substances and techniques which will help them change their psychological states. Another definition of drugs is needed which does cover their psychoactive effects. A psychoactive drug may therefore be seen as any chemical substance, whether of natural or synthetic origin, which can be used to alter perception, mood or other psychological states.

As dehnitions go, this is reasonably acceptable. I he difhculty with trying to provide a definition of drugs is that drugs have no intrinsic property that sets them apart from other substances. Certainly, there is no objective characteristic which can be used to distinguish them from non-drugs. People have become drunk on water which they were told was gin; they have swallowed salt tablets and shown clear signs of sedation; they have smoked inert material which they have been told was cannabis and become stoned. Should these otherwise inert chemicals therefore be classified as drugs? Certainly, they were able to produce a definite psychological effect on the person who took them. In the final analysis, the concept of a 'drug' is a social artifact. What we regard as a drug depends as much upon its social meaning and the way in which people use it as upon its pharmacological or physiological properties.

An important part of what is generally called the drugs problem is the set of attitudes that society maintains towards drugs and drug taking. Much of the damage that is associated with drug taking is a result of mistaken laws and policies, and of hypocritical and self-deluding attitudes. We live in a society which tries to reconcile its disapproval of the use of drugs for non-medical purposes with the fact that vast amounts of psychoactive drugs are consumed in this way. The term 'drug taker' is used as a condemnation, as a way of identifying someone who is involved in a strange and deviant form of behaviour. There is a continuing reluctance to face up to the fact that drugs and drug takers are a part of our everyday life. Many people find it too threatening to acknowledge this, including a sizeable number of scientists, doctors and other 'experts'. Society is not made up of drug takers and non-users. We all take drugs in one way or another. The essence of the drugs problem seems to be that other people sometimes decide to take different drugs for different reasons.

When people are faced with inconsistencies of this sort, they frequently use psychological defence mechanisms in an attempt to reconcile the conflict. One of the most common of these defence mechanisms is called 'denial'. In order to resolve their conflict people deny that their own use of alcohol, tobacco or whatever else it might be has anything in common with the illicit drugs that are used by the people they like to think of as 'drug takers'. The general reluctance to recognize that tea, coffee, alcohol and tobacco really are drugs is a reflection of a widespread, completely irrational, fear of drugs. Of course, this is not to deny that many people are badly damaged by the way they use drugs. But the generalized fear of drugs is misplaced. There are sensible as well as stupid ways to use drugs. It is a reasonable expectation that no drug should be considered completely safe; and even the least dangerous of drugs can be used in a way that is likely to be damaging to the person who is taking it. But since there is no chance that people will stop using drugs, it is imperative that we try to understand what sort of process drug taking really is. We can only do this if we re-examine some of the basic misunderstandings that surround the whole issue. At the very centre of the muddled thinking is this refusal to acknowledge that we are all drug takers.

As a continuation of this basic misconception, society clings to the notion that some of the substances we use are 'good' drugs whereas others are 'bad' drugs. LSD is a 'bad' drug. Heroin and crack cocaine are, supposedly, the worst of the 'bad' drugs. Prozac, Librium and Valium are 'good' drugs: alcohol tends to be classed as a 'good' drug even though we are becoming increasingly aware of the risks that can be associated with its misuse; and tobacco has fallen fairly rapidly from the 'good' towards the very 'bad' category. Some substances escape the 'drug' classification altogether and are regarded as non-drugs - like tea and coffee. Sometimes the 'good/bad' distinction becomes synonymous with that of 'safe/dangerous'. Society would like to believe that our good drugs are all safe, or at least comparatively safe, whereas the bad drugs should all have sinister and dangerous effects. In this way, scientific questions about the actual effects of a particular drug become entangled with issues of personal morality and subjective beliefs. This has led to some quite absurd pronouncements on the part of otherwise respected scientists and physicians: the need to justify their belief in the badness of certain drugs seems to have been so powerful that they have lost the ability to think straight on those matters. By presenting personal opinions and moral views in the guise of incontrovertible scientific fact they have done more than anyone to perpetuate the myths and misconceptions about drug taking.

These 'good/bad' and 'safe/dangerous' classifications vary from time to time, and from culture to culture. The decline and fall of smoking, for example, has taken place within the lifetime of this book. During the 1960s young people seemed to be turning to drugs in a quite unprecedented manner. LSD and cannabis were taken by millions of people. During the latter part of the decade and into the 1970s, other more sinister names such as methedrine, barbiturates and heroin began to be heard more often. The reaction of the press and of the mass media was one of righteous indignation. It seemed as if some completely new form of evil had suddenly descended upon the world.

A similar response was provoked by the appearance of crack cocaine in the US. One of the first newspaper references to this was in the Los Angeles Times in November 1984. Soon after this, America began to experience increasing levels of social problems associated with crack, and the drug served as a convenient focus for President Reagan's 'war on drugs'. In a nationally televised address to the nation the president claimed that cocaine was 'killing a whole generation of our children' and 'tearing our country apart'. Words like 'plague' and 'crisis' had become standard terminology for discussion of the use of smokeable cocaine.

The Americans lost no time in passing on the message and in telling the UK that what America has today the rest of the world gets tomorrow. The UK's news media saw the emperor's new clothes and duly discovered non-existent horrors in 'the crack of doom' which threatened our cities (Daily Star), 'an epidemic of the killer drug crack' (Cambridge Evening News) and 'crack highway to oblivion' (Liverpool Echo). More appropriate headlines might have been 'Newspapers Overdose on Outrage'. Few better examples could ever be found of the sort of moral panic which is so regularly provoked by drug taking. These drug scares do not deter people from taking drugs. If anything they are likely to advertise and promote the behaviour that they claim to be preventing. The frequency of teenage suicides goes up after news reports about them, and in a piece entitled 'How to Launch a Nationwide Drug Menace', Brecher tells of how exaggerated newspaper reports and televised police raids starting in 1960 actually functioned as promotion and advertising for glue sniffing.

The term 'Bohemian' is often used to refer to someone who acts and dresses in an unconventional way. Few people know much about the original group of Bohemians except indirectly through Puccini's opera La Bohème. The Bohemians belonged to Paris of the 1840s. Like the hippies of a later age, the young men let their hair grow long, and they dressed in a manner which seemed shocking to their middleclass critics. They espoused unconventional, non-materialistic philosophies, lived in comparative poverty and flaunted their unconventional patterns of sexual behaviour. As with the hippies, drugs played an important part in their lifestyle. As well as drinking large amounts of alcohol, they horrified the public by their enthusiasm for a particular stimulant which they consumed in large quantities. A medical textbook published in 1909 by Sir T. Clifford Allbutt and Dr Humphrey Rolleston warned against the excessive use of this drug: 'The sufferer is tremulous and loses his self command; he is subject to fits of agitation and depression. He loses colour and has a haggard appearance ... As with other such agents, a renewed dose of the poison gives temporary relief, but at the cost of future misery.'This drug which so shocked public opinion was coffee.

A reversal of roles of a different sort has taken place with regard to opiates such as heroin and morphine. Few people nowadays would hesitate in naming them as the most dangerous of drugs. Yet, in the US, it seems to have been a common medical practice during the early part of the 20th century to treat alcoholics by prescribing morphine for them.

Drug Taking – A Wider Perspective

It is impossible to be certain how long people have been using drugs to change their states of consciousness; certainly the systematic use of drugs dates back many thousands of years. It seems likely that the earliest drugs to be used would have been those that occur naturally. About 4,000 plants are known to yield psychoactive drugs, but only about 40 of these have been regularly used for their intoxicating effects. Interestingly, very few seem to have been known in the Old World. Prior to the voyages of exploration, Europe had comparatively little choice in its drugs. There was no tea, no coffee, no tobacco, little opium, little or no cannabis and virtually no hallucinogens ... only alcohol. As a result, alcohol had to fill a very wide range of functions. It was used as a social beverage, as a tranquillizer, as a sedative, as a stimulant and as an intoxicant to produce drunkenness and delirium. Alcohol became the European drug and it is still the dominant drug in European and Western culture.

The voyages of exploration that opened up the Americas revealed a wide range of psychoactive drugs hitherto quite unknown in the Old World. The first voyage of Christopher Columbus discovered people on Hispaniola and Cuba who smoked cigars, and in Central and South America there was an abundance of psychoactive substances. The explorers brought these home with them. Strangely enough, the one drug that seems to have been largely unknown to the Native American peoples was alcohol. In return for showing such drugs as tobacco, peyote and cocaine to the European explorers, they were introduced to alcohol.

The general reluctance to use psychoactive drugs (and particularly drugs with hallucinogenic properties) that was built into European society at this time cannot be entirely explained in terms of the absence of the drugs themselves. Mescaline, peyote and cocaine may have been unknown in the Old World, but other drugs were available. Hallucinogenic mushrooms grow widely throughout northern Europe and there are various common substances which can be used to induce altered states of consciousness. Cannabis had been introduced into Europe with the Muslim occupation of Spain more than a thousand years ago, and although there was little interest in it as a psychoactive drug, it was being regularly cultivated for hemp fibre by the 17th century. So drugs were available, had there been a sufficient desire to use them.

This tendency to resist using drugs other than alcohol may have owed much to the dominant cultural influence of the Christian Church. Despite a distinctly secular attitude towards certain pleasures of the flesh, the use of drugs (other than alcohol) to modify states of consciousness has been consistently reviled by the Church. This may have been because of their links with other, more 'primitive', religions. Alternatively, it may have been because dramatically altered states of consciousness were thought of in terms of possession - usually possession by devils. Consequently, knowledge about the uses of drugs remained in the hands of various closed groups: apothecaries, alchemists, physicians and a few individuals who involved themselves with such esoteric practices as witchcraft.

Although many of the things that seem to have round their way into the witches cauldron were probably there for their psychological significance, others contained powerful drugs. Bufotenine, for instance, is a highly toxic drug secreted by the toad. It is related to psilocybin (a drug which is found in certain hallucinogenic mushrooms) and to LSD. It is also related to an extremely important brain chemical called serotonin from which it was first isolated. However, the toxic effects of bufotenine were known for centuries before its chemical discovery.

In 1670, the Professor of Medicine at Leipzig noted that Toads aroused to the point of fury are venomous', and the following suggestion is contained in a medieval recipe for poisoners: 'Place a toad in a sack with a little salt and shake well. Use the salt for giving to men.' This procedure could be guaranteed to provoke fury in even the most placid of toads, and was apparently useful for slow and chronic poisonings.

Nor was the life of the South American toad made any happier by the existence of an ancient Maya drink of heated mead into which a live toad was dropped at the last minute. Again, this was not done out of a desire to invent the cocktail olive but for the hallucinogenic drug in the toad's skin. A bizarre modern counterpart has been reported in connection with the South American cane toad (now also available in Australia). In the US, a University of Florida student described the process of toadlicking: 'Picking them up is easy because they have dry skin, and that's usually enough to get them mad so they slime. Then all you've got to do is lick the head a couple of times and you're on the way' (reported in The Guardian, 11 July 1990). The high is described as being similar to that of LSD.

Plants containing henbane and belladonna have also been used in the manufacture of salves and potions for witchcraft. Henbane contains scopolamine, and has been known for thousands of years to produce hallucinations and delirium. In the 13th century Bishop Albertus Magnus described how henbane was used to conjure up demons; under its influence people routinely described and believed in their visions of hell. Similarly, the thornapple, or devil's apple, which contains atropine, was said to be a major ingredient in the witches' Sabbath. Under the influence of these and other drugs, the witches flew through the night on their medieval trips. The ignorant and the superstitious mistook the hallucinations for reality, and it suited the Church to discourage the use of psychoactive drugs through their supposed link with the devil.

Of the naturally occurring drugs, those that have had most influence upon our thinking about drugs have been opium and its derivati...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• Preface to the Sixth Edition
• Author's Apologia
• Acknowledgements
• Chapter 1 The Chemistry of Everyday Life
• Chapter 2 The Effects of Drugs
• Chapter 3 The Social Context
• Chapter 4 Chemical Comforts
• Chapter 5 Alcohol
• Chapter 6 Tobacco
• Chapter 7 Cannabis
• Chapter 8 The Hallucinogens
• Chapter 9 Archetypal Drugs of Abuse
• Chapter 10 The Control of Drugs
• Chapter 11 Junkie Myths
• Chapter 12 Doors in the Wall
• Selected Bibliography
• Index