VFCC More drugs Information

Why some young people take drugs?

Enjoyment

Despite all the concerns about illicit drug use and the attendant lifestyle by young people, it is probably still the case that the lives of most young people are centred on school, home and employment and that most drug use is restricted to the use of tobacco and alcohol. They may adopt the demeanour, fashion and slang of a particular subculture including the occasional or experimental use of illegal drugs without necessarily adopting the lifestyle.
Even so, the evidence of drug use within youth culture suggests that the experience of substances is often pleasurable rather than negative and damaging. So probably the main reason why young people take drugs is that they enjoy them.

Environment

Many young people live in communities which suffer from multiple deprivation, with high unemployment, low quality housing and where the surrounding infra-structure of local services is fractured and poorly resourced. In such communities drug supply and use often thrive as an alternative economy often controlled by powerful criminal groups. As well as any use that might be associated with the stress and boredom of living in such communities, young people with poor job prospects recognise the financial advantages and the status achievable through the business of small scale supply of drugs.

However, drug use is certainly not restricted to areas of urban deprivation. As the press stories of expulsions from private schools and drug use in rural areas show, illicit drug use is an aspect of our society from top to bottom and in all regions.

Curiosity

Most young people are naturally curious and want to experiment with different experiences. For some, drugs are a good conversation point, they are interesting to talk about and fascinate everyone.

The defence mechanism

Some young people will use drugs specifically to ease the trauma and pain of unsatisfactory relationships and the physical and emotional abuse arising from unhappy home lives. Such young people will often come to the attention of the school. If these problems can be addressed, then if drugs are involved they can become less of a problem.

Natural rebellion

Whether or not part of any particular subset of youth culture, young people like to be exclusive, own something that is personal to themselves and consciously or unconsciously drug use may act as a means of defiance to provoke adults into a reaction.

Promotion and availability

There is considerable pressure to use legal substances. Alcohol and pain-relieving drugs are regularly advertised on television. The advertising of tobacco products is now banned on television, but recent research from Strathclyde University published by the Cancer Research Campaign concluded that cigarette advertising does encourage young people to start smoking and reinforces the habit among existing smokers.

Despite legislation, children and teenagers have no problems obtaining alcohol and tobacco from any number of retail outlets. Breweries refurbish pubs with young people in mind, bringing in music, games, more sophisticated decor and so on while the general acceptance of these drugs is maintained through sports sponsorship, promotions and other marketing strategies.Obviously, the illicit market is more discreet, but those determined to experiment appear to have little trouble obtaining drugs.

Cost

Value for money is often a factor as to which drug to use. Cannabis sufficient for a few joints would cost about £5, while an LSD trip would be around £2.50. In terms of how long the effects last, this compares very favourably with an average price for a pint of lager of around £1.80. By the same token, ecstasy of highly variable quality is still selling for up to £15 a tablet and many drug users have been voting with their wallet and turning to cheaper drugs such as LSD and amphetamine

What are the signs and symptoms of drug use?

Some pamphlets and books have lists of signs and symptoms of drug use. They often include changes in school and work attendance, mood swings, changes in appearance, excessive tiredness, lack of appetite etc. The problem is that many of these things may be caused by things other than drug use and are relatively normal behaviours. Unless you happen to be with someone while they are intoxicated or high on drugs you may not see any clear signs and symptoms. Even behaviour that seems like intoxification could be due to other things such as mental health problems or shock.

A danger with following lists of signs and symptoms is that you will jump to the wrong conclusion. If you feel that there is something wrong with a person or that they are acting strangely talk to them about what is going on in their life. Trying to spot signs and symptoms of drug use is no substitute for good communication.

What are the most commonly used drugs?

The most commonly used mood altering drug used in the UK is caffeine – contained in tea, coffee, many soft drinks and colas, some confectionery, included in many medicines and available in over-the-counter stimulant preparations such as Pro Plus

Apart from medicines in general the next most commonly used drug is alcohol, followed by the nicotine in cigarettes and other tobacco based products.

When it comes to illegal and other socially unacceptable drugs the menu, from the one most people have ever tried down to the one least people have tried, goes like this:

Cannabis

Amphetamine

Nitrites/ poppers

LSD

Magic mushrooms

Ecstasy

Solvents (aerosols, gases and glues)

Cocaine

Minor tranquillisers (not prescribed)

Heroin and crack cocaine

The recent British Crime Survey found that while 40 per cent of 16-19 year olds and nearly 20 per cent of 30-59 year olds claimed to have used cannabis at least once only 1 per cent of either age group claimed to have ever taken heroin or crack cocaine.

Are all drugs addictive?

It depends on what we mean by addiction – see what do we mean by addiction? People can become psychologically dependent on any drug – or anything else for that matter. This means that the person using drugs feels they cannot cope or face the world unless they are under the influence of drugs. This form of dependency has more to do with the people using the drug rather than about the particular drug they are taking.

In contrast people can only become physically dependent on certain drugs. Physical dependency results from the repeated, heavy use of drugs like heroin, tranquillisers and alcohol. Heavy and continual use of these drugs can change the body chemistry so that if someone does not get a repeat dose they suffer physical withdrawal symptoms - the shakes, flu like effects. They have to keep taking the drug just to stop themselves from feeling ill.

Continual use of drugs like cannabis, ecstasy and LSD does not result in physical dependency, even though people may become psychologically dependent. With other drugs – and particularly stimulant drugs such as cocaine, crack, amphetamine and the nicotine in cigarettes – there is debate over the extent that physical dependence can occur.

What do we mean by addiction?

Addiction means that a large part of a person's life is devoted to buying and taking drugs. It usually applies to regular, heavy users of drugs such as heroin or cocaine but it could also involve other drugs or alcohol – hence the term alcoholic. The term addiction and addict, however, conjure up all sorts of negative images of people and dehumanise those it is applied to. Some people even believe that addiction is a disease and that once people are addicts they will always be addicts, even though there is no real evidence to support this view. People can and do change throughout their life.

Saying somebody is drug dependent is better than calling them an addict - or worse -a junkie. Dependency is a strong compulsion to keep taking drugs.

Physical dependency

Physical dependency results from the repeated, heavy use of drugs like heroin, tranquillisers and alcohol. Heavy and continual use of these drugs can change the body chemistry so that if someone does not get a repeat dose they suffer physical withdrawal symptoms - the shakes, flu like effects. They have to keep taking the drug just to stop themselves from feeling ill.

Psychological dependency

Psychological dependency is more common and can happen with any drug. In this case people get into the drug experience as a way of coping with the world or as a way of feeling OK. They feel they could not cope without drugs even though they may not be physically dependent.

You can become psychologically dependent on just about anything - chocolate, gambling, playing computer games, sex, working out or even another person. If any activity becomes more important to you than everything else - school or college work, job, family or friends – things may need to change.

Dependency will often include both physical and psychological factors. While the physical aspect will only be present with certain drugs, a psychological aspect will occur with any form of dependence. With certain drugs – and particularly stimulant drugs such as cocaine, crack, amphetamine and the nicotine in cigarettes – there is debate over the extent that physical dependence occurs.

How many people are addicted to drugs?

Addiction or problematic use is a difficult concept to measure. Those with drug-related problems tend to be difficult to find, and addiction is difficult to measure. Experts consistently fail to agree on what constitutes an addict, problematic use or problematic user. Estimates as to how many people are experiencing drug problems have to be drawn from different sources, using different ways of measuring.

Regional Drug Misuse Database
The main source for a measure of problematic drug users are the Regional Drug Misuse Databases (RDMDs). They count not the number of people addicted to a drug, but those newly seeking help for their drug use or associated problems (and subsequently have their information sent to the database). The data is not submitted by all agencies and gives only the number of new, not ongoing, treatments within a six-month period.

The RDMD data is useful because it is large scale, covering England, Wales and Scotland and carried out twice every year. An RDMD is planned for Northern Ireland.
While the data on new notifications helps track how many people are newly seeking help for their drug use, it does not indicate how many people are addicted or having problems with drugs in total. To find this we have to find out firstly how many people are in treatment as a whole and then how many people are having drug-related problems but not seeking help.

Estimating the number of addicts in treatment

To start off we firstly estimate the number of 'not new' or ongoing treatments for drug-related problems. Research suggests that only two-thirds of help seekers are newly receiving treatment at any one time. To find out therefore the total number of people receiving treatment we multiply the number of new treatments by 1.5.

For the six month period ending September 2000, 39,658 people were notified as newly seeking help for their drug use to the England, Wales and Scotland RDMDs. Using the factor of 1.5, it can be predicted that 59,487 people were in treatment during that period, see Table 1 below.

Table 1 Number of people starting and continuing treatment in Great Britain, October 1999 to September 2000

Period	RDMD new notifications	Total treated (x1.5)
April 2000 to September 2000	39,658	59,487
October 1999 to March 2000	39,055	58,582

Estimating the number of addicts in and not in treatment

Table 1 only provides an estimate of the number of addicts in treatment rather than the total experiencing problems but not receiving treatment. Although it is almost impossible to count the number of people experiencing problems at any one time, there are ways of guessing.

Capture-recapture

A number of local studies have used what is called the capture-recapture method. Originally used to estimate population sizes, such as the number of fish in a pool, this method simply calculates the number of recaptured or missed fish every time the net is cast. This ratio is then applied to the whole population. In essence, two consecutive samples of the same population are taken. The first sample tags and releases all that are captured. The second then reveals the number of fish recaptured and those that are not (by way of the tags). This ratio of tagged to untagged can then be applied to the rest of the population. Therefore, if, on the second catch, five out of 100 fish are tagged, then we can estimate that every time we cast the net, we catch only 5 per cent of the total fish population (1 in 20 fish are caught every time we fish). From this we can estimate that in that pool, there are roughly 2000 fish.

Using this method, several studies have estimated the number of problematic drug users in their area. In 1984, Hartnoll collected data on the number of opiate users in North London who had attended a drug clinic and those admitted to hospital for infectious diseases. Comparing the sources, they found that a fifth of the hospital sample had also attended the drug clinic. The researchers used this ratio to estimate that the total number of opiate users was five times the number who attended the drug clinic.

It is difficult to know whether a multiplier of five is valid today and for all drugs. Whatever the figure, the number of drug users in treatment greatly underestimates the number of people dependent on one substance or another. Using the late 2000 RDMD figures (see Table 1 above), we can estimate the total number of addicts in Great Britain during that period by applying this multiplier of five.

Using this formula, we can predict that for the six months ending September 2000, there were roughly 297,435 (59,487 x 5) people experiencing drug-related problems.

This figure represents the number of people counted as addicted across a six-month period and not at any one point in time. This figure will be much less, due to many people stopping or starting after or before any point in time.

Factors affecting these estimates are availability and accessibility of treatment services, and people's willingness to seek treatment. With increased effort being made to encourage the uptake of services, the ratio of people seeking and not-seeking treatment is expected to fall to around three or less

How many people die from using drugs?

The straight answer is that we do not know exactly how many drug-related deaths there are in the UK. This is because:

There is not one organisation that collects information about drug-related deaths, for all of the UK.

There is no one definition of what we mean by drug-related deaths. For example, it could include:

people who are dependent on drugs and overdose

suicides by overdose of people who have no previous history of using drug

accidental poisoning or overdose

ecstasy related deaths where people have died from overheating through dancing non-stop in hot clubs rather than from the direct effect of the drugs

deaths associated with cigarette smoking

deaths from accidents where people are drunk or under the influence of drugs

murders and manslaughters where people are drunk or under the influence of drugs

deaths from driving while drunk or intoxicated

deaths from AIDS among injecting drug users.

deaths which had nothing to do with the presence of a drug in the body

Cause of death is recorded on death certificates but doctors may not mention drugs, even where drugs might be involved.

Despite these difficulties there are estimates of the possible number of deaths associated with different drugs.

It is estimated that each year in the U.K. over 110,000 people die from tobacco-related diseases, particularly from cancer, respiratory diseases and heart disease.

Estimates of annual alcohol-related deaths vary from 28,000 to 40,000. This includes deaths from cirrhosis of the liver and other health problems from long-term drinking, deliberate and accidental overdose, traffic deaths, fatal accidents while drunk etc.

A national register of solvent-related deaths reached a high of 152 deaths in 1990 but this fell to below 80 deaths a year since 1993.

Deaths associated with different illegal drugs are also difficult to judge accurately. One exception is ecstasy with over 80 ecstasy-related deaths being reported from 1987 to the present day.

Figures for drug related deaths in England and Wales are collated by the Office for National Statistics. The figure for 1993 was about 900 deaths rising to just over 1,700 in 1997. (In recent years an additional 140-175 drug-related deaths have been reported each year in Scotland). These figures include accidental and deliberate overdose with medicines (excluding paracetamol which is related to roughly 1000 deaths a year. Most of which suicide).

Between 1995 and 1999 there were over 8,600 deaths in England and Wales*. These included:

Drug Type	Number of related deaths
Methadone	1,760
Heroin & Morphine	2,667
Tamazepam Tranquillisers	532
Amphetamines (including ecstasy)	291
Cocaine	227
Ecstasy	78

There were 1,397 drug-related deaths in Scotland for the same period.

With many of these deaths people had also been using other drugs and indeed may not have died if they had not been taking more than one drug. Fift threedeaths were associated with cannabis use but in nearly all cases the users had also been using other drugs. Three deaths were associated with LSD.

Deaths from AIDS among injecting drug users who have contracted HIV by sharing injecting equipment are also difficult to judge exactly. However, by March 1999 in the UK almost 3,500 drug injectors had tested positive for HIV and over 1,000 had been diagnosed with full-blown AIDS.

* 2000 data for England and Wales, using IDC 10 and not double counting, is available from the National Programme on Substance Abuse Deaths (np-SAD). The data found the following: cocaine 57, amphetamine 19, ecstasy 27, opiates 486, alcohol 353, GHB 2.