Recreational Drug Use  Laura Gamble   Really Useful Knowledge

This paper is a brief summary of an ongoing piece of research which explores the mix of knowledge, folklore, tribal customs and boundaries which together shape the strategies used by young people to control their recreational drug use.

Young people may begin experimenting with a particular drug for its specific effects - or they may try several drugs and even mix them.  As well as the pleasurable effects for which they are taken, most drugs can produce unwanted effects and carry the risk of a range of problems.

In addition to the risks off increased tolerance and physical or psychological dependence, there can be unpleasant symptoms such as nausea, vomiting or tiredness; some types of drug use can cause depression and feelings of panic.

Broadly, there are four types of potential risks:

To mental health (for example, a drug can trigger mental health disorders which have never surfaced before)

To physical health (some drugs can be especially harmful to people with conditions such as heart disease, diabetes or epilepsy)

To psychological well-being (effects can range from mild anxiety to panic attacks and even paranoia)

Situational risks (driving, riding a motorbike or working with machinery can all be dangerous)

With any drug, legal or illegal, zero risk from potential harm can only be achieved by not taking it.  Most professionals working with young people have now adopted an approach which acknowledges that a proportion of young drug users will know about risks but will continue to use their chosen drug, or drugs.

So, what can we learn about this successful controlled recreational drug use?  How is this recreational relationship with drugs generated and how is it maintained?  What do we know about these young people who do not describe their drug use as problematic and who rarely approach drug services for help or advice.

In 1993/4, my colleague and I studied in-depth interviews conducted with 26 respondents, all recreational drug users with several years’ experience of a wide range of drugs.  The results of this study established some significant factors which enable young users to maintain control:

*           There are certain drugs which appear ‘protective’ of control, because of their particular effects, low prices and context of social use.  CANNABIS, EXSTASY, AMPHETAMINE and LSD are amongst these. By contrast the ‘antagonistic’ group of drugs (notably HEROIN, COCAINE and CRACK COCAINE)  are seen as those to be avoided, because of their ability to cause dependence, high cost and more isolated context of use.

*           Users seem able to learn strategies which avoid, or reduce, damage to their health.  They are cautious about where they buy drugs, control intake to avoid becoming dependent and understand adverse reactions and how to cope with them.

*           The Social group also acts in ways which monitor lapses in control and seems to have a role in moderating drug choices, methods of use and even behaviour.  Within these unwritten ‘rules’, support and reassurances are given to friends who need them.

All of these boundaries, combined with the fact that almost always this recreational drug use is funded from disposable income, enable controlled drug use to continue successfully.

In the second part of our research, we have attempted to identify the factors which distinguish successful controlled drug users from dependent drug users.  We developed a questionnaire to try to define the contrasts in lifestyle and behaviour between a group of recreational drug users, who had never sought hel from any drug services, and a parallel group of young clients of my service (DAIS) and my colleague’s agency (OPTIONS in Worthing).  The two groups were in the same age-band (under 30) and as far as possible there was an equal gender balance.  There were 68 respondents in each group.

The questionnaire attempted to identify a variety of issues relevant to maintaining control over drug use and reducing problematic outcomes.  These included: knowledge about drugs used; boundaries and taboos about particular drugs; methods of administration; attitudes towards caution and fear of consequences; and learning from mistakes or bad experiences.

Our work in part one of the research suggested that the ‘recreational’ group would typically be socially-integrated, fun-loving people, though relatively cautious and controlled; whilst the profile of the ‘treatment’ group would be more socially isolated, impulsive and uncontrolled.

In terms of lifestyle, we were attempting to measure the degree to which members of both groups take part in social activity, enjoy the company of other people, use drugs in a social context and choose to spend time on other recreational activities.

Other sections provided data on drug choices, initial drug use and spending on drugs (and alcohol); the influence of friends and the importance of the social group; the valued sources of knowledge about drugs and their effects, as well as ‘boundaries’ concerning drugs to be avoided; and the extent to which issues such as fear of negative consequences or learning from mistakes have a role in shaping behaviour.

What follows is a brief resume of the main findings of this second study.

*           The recreational group are more likely to be employed or students, more socially integrated and feel more in control of their lives than the treatment group.

Chi Square = 22.92        Significance = p<0.01

These figures lend weight to the idea that internal ‘lifestyle’ factors impose a protective effect on the control of drug use.

This is also supported by the data on spending:

INCOME SPENT ON DRUGS/ALCOHOL BY GROUP

From this it is clear that the treatment group spend significantly more of their ‘available’ income on drugs and alcohol than the recreational group.  A quarter of the treatment group reported spending all of their income on drugs.

*           The treatment group are far more likely to use opiate drugs, cocaine and benzodiazepines while alcohol, cannabis, amphetamine, LSD,and magic mustrooms were more likely to be used by the recreational group.

Which drugs have you used in the last three months including alcohol, (both groups)

*           Most people in both groups reported that worries about breaking the law did not affect their drug use - over three quarters of the combined groups agreed on this.

            This is an interesting finding because the responses from both groups were so similar.

However, the reports of drug-related problems reveal a quite different picture:

Numbers of respondents reporting drug related problems in differing life areas, by group

*           The treatment group revealed significantly higher levels of drug-related problems and they were six times more likely to feel that their drug use was ‘out of control’.

*           The influence of friends on patterns of drug use showed some interesting results, including the finding that friends of the treatment group were significantly more likely to worry about their drug use than those of the recreational group.  So, whilst problematic drug users may lead more chaotic lives, this challenges the idea that they exist in an uncaring community in which no-one is concerned about them.

*           Most drug users acquire knowledge about drugs either by finding information for themselves, or they learn by experience, first-hand or from friends.  The study findings showed that successful recreational users are more likely to find out about a particular drug before trying it  - whilst those in the treatment group are more likely to find out about it by  trying it.

The findings from this research offer potential new directions for health promotion/risk reduction campaigns, both in terms of content and style of delivery.  There would clearly be value in a focus on ranking drugs and behaviour in a ‘hierarchy of dangerousness’ and in making available accurate, reliable information.  If these messages could be delivered directly to the peer group, they would be in tune with the attitudes, beliefs and experiences already well understood by young people.

In acknowledging that all drugs are not the same, and that each carries specific risks, public health campaigns will need to avoid the accusation that we are condoning some forms of drug use.  We are all familiar with messages about ‘safe’ levels of alcohol use, which promote protective strategies whilst warning against antagonistic behaviours - are we ready to accept the same approach for recreational drug use?

REALLY USEFUL KNOWLEDGE is a research project which began in 1993.  The authors are Michael George, Director of Drug & Alcohol Services, Worthing Priority Healthcare Trust; and Laura Gamble, Acting Director of the Drug Advice and Information Service, Brighton, South Downs Health NHS Trust.