Between the Lines
Chapter 4 The main characteristics (part 1)
This chapter will examine some of the main characteristics of cocaine use in Rotterdam. The issues that will be looked at are: drug career, use pattern, location of use, use intensity, income, criminality and cocaine dealing, problems and contacts with drug assistance agencies. The last section will look more closely at the connection between three important explanatory variables: opiate use, gender and method of use. For the description reference has been made to the quantified data derived from the qualitative section of the interviews.
4.1 Drug career
The age at which each of the 110 respondents used cocaine for the first time differs enormously, varying from 13 to 37 years. The average starting age is about 20 years. This is two years younger than the average age for non-deviant cocaine users in Amsterdam (Cohen 1989). When it comes to the average starting age there is little difference between women and men and between opiate and non-opiate users. There is great divergence in the period of time that cocaine is taken. Some respondents had only used or been using the drug for a matter of months; one respondent had been taking cocaine for 30 years. The average duration is almost eight years. On the whole women take drugs for a longer period than men; for nine as opposed to seven years. The average use duration for opiate users is ten years and seven years for non-opiate users. That the respondents provided supplementary information on at most ten other users (nominees), including information on the length of their cocaine consumption, has been explained in chapter two. We therefore know how long 278 nominees have been users. Here too the diversity is great. One tenth (9%) of the nominees had been users for less than a year whilst almost half of them (46%) have been using cocaine for more than seven years.
Of the 110 respondents two thirds (66%) were still on cocaine at the time of the interview. The others had, for a diversity of reasons, stopped taking the drug. Some of them had not touched cocaine for over five years, others had come off it only a few months before the interview. Half (53%) of the opiate users had stopped taking cocaine at time of the interview and a quarter (26%) of the non-opiate users. This difference is largely to be explained by the fact that a relatively high proportion of opiate users were interviewed in the drugs free wing of a prison where cocaine use is forbidden. The non-opiate users who, at the time of being interviewed, no longer took cocaine had used it for a shorter time than those who were still taking it(1). No such correlation has been seen with opiate users(2).
In the previous chapter it was revealed that the majority of respondents have had experience with drugs other than cocaine. Figure 4.1 shows which drugs the respondents have been taken at one time or another and what kind of drugs they are currently using (if they have stopped, the last cocaine use period has been looked about). A differentiation is made between taking only cocaine, taking other drugs in addition to cocaine such as cannabis, amphetamines, hallucinogens and tranquillizers, and between taking opiates in addition to cocaine (and possibly other drugs as well). The current or most recent drug taking habit indicates a definite increase in the number of respondents who changed to the exclusive use of cocaine. Respondents who also used other drugs and respondents who also took opiates had switched to taking only cocaine. What is particularly striking is that 39% of the opiate users stopped taking opiates whilst still using cocaine(3).
Current/most recent drug use and life-time drug use
On the basis of the in-depth interviews with the 110 respondents the pattern of use over time has been drawn for each of the respondents. Both the frequency and the consumption level were taken into account. Once these patterns had been examined it was possible to distinguish seven basic patterns of use (see also appendix C):
1. Increasing: the consumption level gradually rises.
2. Decreasing: the consumption level gradually falls.
3. Same level: the level remains the same.
4. Discontinuous: periods of drugs use are interspersed with periods of abstinence.
5. Peak: a gradual rise in intake is followed by a gradual decrease.
6. Twin peaks: the consumption level varies and is characterized by different peak intake levels.
7. Peak-level: the consumption level gradually increases and then decreases to a fixed level.
The first six patterns correspond with those outlined by Cohen (1989) for cocaine users. In our study, however, a peak pattern variant has been added. With a number of the respondents it became apparent that, after reaching a peak consumption level, their intake level stabilized - for at least the same length of time - at a given lower level (see figure 4.2).
Patterns of use
The two commonest patterns of use are the increasing (34%) and the peak (28%) pattern. Then comes the twin peaks pattern (12%) and the same level pattern (12%). As far as the discontinuous pattern is concerned, it should be noted that many of the respondents passed through one or more phases of total abstention from cocaine (Kaplan et al, 1992). It is only when the drug taking pattern is characterized by repeated periods of using and not using cocaine that it has been qualified as discontinuous. Compared with the Amsterdam sample, the increasing pattern is more common (34% versus 3%), the twin peaks pattern is less usual (12% versus 33%). This last phenomenon is remarkable because the opiate users in the Rotterdam study more often displayed a twin peaks pattern than the non-opiate users (25% as against 5%).
A problem when trying to identify the different patterns of use is the fact that the use duration amongst members of the respondent group varies tremendously. The question is wether every defined pattern can be seen as an independent pattern or do some of them merely constitute a phase of an other pattern? For instance, is what is taken to be an increasing trend perhaps the first phase of a peaking pattern, or is what is interpreted as a peak pattern nothing other than the first phase of a twin peaks pattern? If this were the case the increasing pattern would only be apparent amongst respondents who use cocaine for a short period and the peak pattern would be seen only with longer term users. The percentages shown in figure 4.3 do indeed confirm that there is a link between the pattern of use and the duration of use. The decreasing pattern, the discontinuous pattern and the tendency towards a series of peaks all become more apparent as people use cocaine for a longer period of time. The increasing, same level, peak, and peak level patterns are evident among users who have been taking the drug for a long period and users who have been taking it for a short period. In other words these patterns are apparent regardless of the drug taking duration. It was only among non-opiate users that there was a definite correlation between use pattern and wether people had stopped taking cocaine. The non-opiate users who had stopped more often displayed an increasing pattern (63% versus 20%) and less often a peak pattern (5% versus 22%) than those who still use cocaine.
Patterns of use and length of use (in years)
In the analysis, a distinction was made between the initial period of use, the present or most recent period of use, and the period of heaviest use. The initial period of use is defined as the period in which the respondent first occasionally took the drug. The heaviest drug taking period is that in which the respondent took cocaine most frequently and/or consumed his greatest quantities. Hence the situation that, for a number of respondents the period of heaviest use coincides with the initial period of use, or with the period of current/last use. For another group of respondents their heaviest drug taking phase constitutes an interim stage. It should be realized that the length of the periods varied from individual to individual. It is possible that the heavy use period may last for merely a week for one person whilst for another it continues for months, a year or even a number of years. When we examine the different patterns of use we discover that for 4% of all the respondents the heaviest period coincided with their initial drug taking period and that for 34% it was in the current or most recent period. For half (50%) of the respondents the period of heaviest use constituted an intermediate period(4). For 12% there is no such thing as the heaviest period: throughout their drug taking career they keep to the same frequencies and dosage.
In chapter two we have already described that the locations in which cocaine is taken are classified as: the entertainment circuit, the workplace, the home circuit, hobby/sports and the hard drug scene. Figure 4.4 shows the most important location of use for the distinguished periods of use.
Most important location of use for the different periods
In the early stages the home circuit is the location where cocaine is most often taken (47%), the entertainment circuit is the next most common location (27%). The picture remains the same during the later stage. However, when consumption is at its heaviest the hard drug scene also come to the fore. The respondents reported that the hobby/sports circuit and the workplace constituted less important cocaine taking locations. Half of all the respondents stuck to the same location during all three phases of use: 22% to the home circuit, 15% the hard drug scene, 12% the entertainment circuit and 1% the work environment. It is often the case that the entertainment circuit and the home circuit form interchangeable locations. Cocaine was often taken socially at home, at parties or while out with friends. At one point the emphasis might be more on the home situation and at another stage it might switch to the entertainment circuit. If the home circuit and the entertainment circuit are put together it would appear that three quarters (74%) of the respondents have stuck to these locations for the whole of their drug career.
For the opiate users the hard drug scene is the most important environment for cocaine taking. For the non-opiate users the home circuit and the entertainment circuit form the main locations. At first the drug tends to be taken chiefly at home. In the period of current/last use and in the period of heaviest use the entertainment circuit becomes more significant. In these periods both locations are equally important to the non-opiate users (see table 4.1). Chapter six will deal in more detail with the most important cocaine using locations for respondents and nominees.
Most important location of use in the different periods, for opiate users (O) and non-opiate users (NO)
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