There has always been a strong relationship between substance use and working class communities. In the Victorian period working class people frequented the old gin halls and also took laudanum (a formula containing opium) to stave off the hunger pangs that were part and parcel of living in poverty. Working class substance use has always caused concerns for the establishment. It should not be forgotten that Bank Holidays were introduced during the industrial revolution to normalise the idea of regular working hours, as previously Mondays were widely seen as the day to recover from the weekend excesses.
The Victorian middle classes were horrified by this behaviour and the numbers of religious or university missions across the East End of London, and other inner city areas, bear testament to their desire to morally educate’ the working class.
Interestingly, middle class drug use seemed to cause less fears and a quick look at Queen Victoria’s pharmacy bills show how partial she was to cannabis tincture, cocaine and opium (for medical purposes only of course!). Also, the whole romantic movement of artists and writers were inspired by their use of many of the same substances. As ever, no surprise that there is one rule for the rich and another for the working class. Also we should remember that we live in a country that actually sent the gunboats into China to defend Britain’s right to sell opium.
Today, substance use remains as ingrained in working class culture as it was a century ago and, in many ways, as frowned upon by the middle classes. However, there is a marked difference between these two eras. Substance use has now been artificially divided into two groups: the legal and acceptable (alcohol, tobacco and caffeine) and the illegal and prohibited (cannabis, heroin, cocaine, ecstasy. et al). It is unclear what informed this process of division, as it is inconceivable that alcohol and tobacco would have been selected as the substances least likely to cause health problems. Some believe, that the US chose to endorse substances linked to the dominant communities while prohibiting those linked to black communities. Since the late 1970s, there has been a rapid increase in illicit drug use. 50% of young people report having tried illegal drugs by the age of 16 (mostly cannabis and ecstasy). Despite all attempts to halt this upward trend, some commentators think that drug use will become increasingly normalised as more and more people try illicit drugs while a percentage go on to become regular users. Patterns of drug use vary. The vast majority of people who use drugs do so without major problems, despite that lack of information, variable quality and the absence of positive role models. A small number of people do, however, get into problems. Some drugs are more likely to cause problems than others. However, there are examples of people using all types of drugs who stay in control most of the time while conversely there are examples of people getting into problems with most types of drugs. Equally while the stakes may be higher with some methods of taking drugs this is heavily affected by someone’s social setting, and injectors have largely changed their behaviour in light of advice on HIV/AIDS.
When looking at data on drug taking, one factor is absolutely clear. There is a strong relationship between problem drug use and class. This does not mean that more working class people use drugs. Drug use is spread relatively evenly across all social groups. So why the link with problem drug use and class? There are probably a number of factors:
*If you cannot afford your drugs you are more likely to end up involved in crime and facing health problems. Prohibition massively inflates the price of street drugs, which makes matters worse.
*Working provides a structure to your life, so using drugs and having nothing to do all day can be a risky combination.
*Drugs, particularly crack and heroin, provide insulation against the limited opportunities and poor housing for those who live in run down areas.
*Inner city areas provide a stable market for drug dealers with sufficient demand to offset the risks of supply (although recent evidence shows all drugs spreading into even more scarcely populated regions).
*In areas with high degrees of visible drug use, young people are forced to make a choice about whether to accept the offer to use.
*As drug dealing becomes established, and has a public profile, kids see a way out of poverty, which in turn leads to greater availability.
Working class areas get caught in a Catch 22 situation. The condition of an area contributes to the level of drug taking, while the impact of drug taking runs the area down further. The State has made a huge investment in combating drug taking. Ironically, the money thrown into the War on Drugs could easily have ensured a free, clean and unlimited supply of drugs to every user across the world and thus limited both personal risk and the widespread social consequences of drug taking. Despite this fact, there is surprising unanimity among Governments about drugs policy. The public position is that illicit drugs are dangerous and only the sad, mad and bad take them. These people, and their suppliers, should be hunted down and punished or at the very least forced into treatment.
Against this backdrop an alternative approach has been developed. The Harm Reduction movement came to prominence in the late 1980s with the advent of AIDS. In 1985, reports surfaced that 50% of injecting drug users in parts of Scotland were infected with HIV, the virus that can lead to Aids. If this pattern had been repeated across other parts of Scotland, England and Wales, the effects would have been devastating, leading to fears that injectors would provide a potent source of cross-over infection to the dominant population. These fears led the Thatcher Government to support a pragmatic harm reduction policy, which put public health above moral objections. This led to the development of needle exchange and the expansion of methadone maintenance prescribing (offering dependent drug users a stable dose of a heroin substitute).
Through the 1980s and 90s, the harm reduction approach has lived in an uncomfortable relationship with a public order model, albeit one which placed an increased focus on getting the dealer rather than the user. However, some within the harm reduction movement have started to fear that while Governments were willing to fund harm reduction in the HIV era, the support for progressive interventions is ebbing away as this health crisis subsides. To support this view one only has to look to the epidemic of Hepatitis C (HCV) among injecting drug users. The 60- 90% infection rates of HCV among injectors seem to have left most Governments unmoved. This has led one leading international drug user activist to comment, “there seems to be a direct correlation between our ability to secure funding and our likelihood to infect the dominant population”. Unlike HIV, HCV is very infectious ensuring very quick transmission between injectors, but HCV is not sexually transmitted thus limiting crossover transmission. Simply put, it seems that as long as epidemics of blood borne viruses can be contained among drug users then the Government seems unpersuaded of the need to fund public health campaigns. To demonstrate their total disregard for drug users, a recent consensus statement from European experts on HCV recommends the exclusion of active injectors from the only costly treatment (approximately 90% of the total HCV infected population arc injectors). This effectively protects State funded health services from the impact of their Government’s decision not to meet their obligation to respond to this new public health crisis.
The desire of Government’s to press on with the War on Drugs, despite the substantial weight of evidence against prohibition, has led some to question the underlying motivation to the War on Drugs. Drug users provide effective scapegoats who can be blamed for poor education, run down housing estates and an over-stretched NHS. Simultaneously, the War on Drugs justifies the need for the extension of CCTV schemes, more police and the removal of fundamental human rights such as the right to silence, the right to free assembly, and the right to privacy. Most importantly, anti-drug user propaganda brings division right to the heart of working class communities and, particularly with drug testing, into many work places. New Labour, New Scapegoats! Conveniently, the very poverty of many working class communities ensures the spread of drug taking while at the same time providing someone to blame for the poverty.
One cannot talk about drug use without considering the role of the US Government. From a US perspective, drugs have replaced the ‘red threat’ in the post-Cold War era. No longer is it the ‘reds under the beds’ but ‘junkies destroying our communities’. Interestingly the War on Drugs justifies US interference in man5’ of the same geographic regions as the Cold War. To many, the moral rage of the US Government is laughable given the recently published report into the Contra affair. The long-awaited declassified version of volume 2 of the report was released on 8 October 1988, just one hour after the House of Representatives voted to conduct an impeachment inquiry into President Clinton. This has purposely and effectively killed comment on this revealing document. The report, which has been in the hands of the Intelligence Committees of both houses since the spring, is a virtual confession by the CIA that it engaged in a conspiracy to hide drug trafficking and gun running throughout the battle against the Sandinista Government in Nicaragua. The report points an accusing finger at Oliver North, the National Security Council and, indirectly, at George Bush, who was then head of the CIA.
This confirms that the US has a pragmatic position all of their own. Rather than reducing harm, they want to maximise division. Either through direct intervention, or deliberate non-intervention, the US in particular, seems happy to allow the spread of problematic drug use within certain sections of the community. The close connection between the location of major crack use and the sites of the race riots of the 1980s, in both the US and Britain, is worthy of note. So it is clear that the US is happily having its cake and eating it. Drumming up, and benefiting from, anti-drugs propaganda while at the same time willing to play for political advantage with the impact of the drugs trade. Prohibition has clearly placed the drugs trade firmly in the hands of organised crime and driven out the more amateur enthusiasts such as Howard Marks. This was hardly difficult to predict as the US had already seen the devastating impact of their abandoned attempt to prohibit alcohol. Attempts at progressive policy change, such as the legal prescription of heroin to dependent users in Australia, is met with US threats of international sanctions. The US is not alone in this behaviour. Both Germany and France have put huge pressure on Holland to withdraw its progressive harm reduction approach and New Labour, with their American-style Drug Tsar, are increasingly beating the prohibitionist drum.
Even if readers of this article are untouched by the human rights case put by drug user activists, then the attempt of the drug users movement to reach out and form alliances with others affected by drug use is an interesting challenge. Drug use clearly has a major impact on working class communities, which cannot be avoided by those who are committed to championing working class agendas. It is clear that the State has got its act well together on drug use. There is an opportunity for us to stand back from the demonisation of plants, powders and pills and to address the social consequences of drugs policy and the desire by the State to maximise the potential of divide and rule from scapegoating drug users. Drug use is not an easy issue to manage and it promotes strong feelings among those it has touched. However, it is an issue that the Left ducks at its peril.In the next edition of RA, the second article in this series will consider the range of responses from the Left and put forward a progressive model of community organising around drug use in working class communities.
Reproduced from RA Vol 4, Issue 1, June/July 1999