INTRAVAL. Bureau voor sociaal-wetenschappelijk onderzoek en advies<
Between the Lines
Chapter 1    Introduction
Cocaine is a topic which is much talked about recently. There is evidence that cocaine has been used increasingly in the Netherlands in the past ten years (Avico et al. 1988, Cohen 1989, Bieleman et al. 1990, Intraval 1990b, Korf et al. 1990). The research 'Harddrugs en criminaliteit in Rotterdam' (Hard drugs and crime in Rotterdam) came to the conclusion that there is an increase among young people in this city (Intraval 1989). The attention being paid to cocaine may be connected with the problem of poly-drug use among opiate addicts, the reports of the use of cocaine in nightlife and the idea that cocaine is the drug of the people with glamorous and successful careers.
As far as is known, the active constituent in cocaine was first extracted from the coca leaf in 1859, following which it was developed as a remedy for colds and influenza, and also as a local anaesthetic. In the Netherlands for example, the 'Nederlandsche Cocaïnefabriek' (Dutch Cocaine Factory) began producing remedies based on cocaine in 1870 (Korf and De Kort 1989). Doctors were among the first to become addicted to the cocaine which they prescribed. Freud also used the drug and experimented with it in his practice. Coca leaves come mainly from fields in Bolivia, Peru and Colombia. The Indian population apparently discovered the stimulating effect thousands of years B.C.. They chewed the leaf while working and as a remedy against fatigue, pain and appetite. Later, the Spanish conquerors in South America administered the drug to mine workers among others. Finally, the active constituent was used until the beginning of this century in the production of Coca-Cola in America. Today the coca leaf is illegally processed into cocaine primarily in Colombia, and from there brought onto the international market. The 'Medellin Cartel' is the most notorious criminal organisation there (Eddy 1989). The Colombian government receives financial and military support from the U.S. in its fight against the drug gangs. The American market is said to be becoming saturated in recent years, which is making the market in Western Europe more interesting for traders.
1.1    Demand and supply
According to Interpol data, Spain is the country in Europe where by far the greatest quantities of cocaine are intercepted. More recent data show that the difference with the Netherlands, the number two country, is getting smaller: the quantities discovered here are on the increase, while those in Spain are decreasing (Interpol 1990). It is assumed in any case that both countries have an important transit function for Europe. Concerning the use of the drug, Spanish data show that there has been an increase in recent years (Barcelona 1990). These so-called prevalence figures lie in the same order of magnitude as in the Netherlands. Italy, finally, is placed sixth on the Interpol list, after West Germany, France and Portugal.
According to Interpol the entire quantity of cocaine confiscated in Europe in 1978 (155 kg) was exactly enough to fill one suitcase. In 1988 it would have filled a container of a ship. Furthermore, that year was the first in which more cocaine was intercepted than heroin: 5.3 as compared with 2.2 tonnes. The quantity encountered increased considerably again in 1989 to 6.1 tonnes; in the Netherlands the increase was from more than 500 kg in 1988 to as much as 1,400 kg (1.4 tonnes) in 1989 (Interpol 1990). According to Lewis (1989) Western Europe's cocaine problem could derive at least as much from an increase in the degree of organisation of crime as from cocaine usage as such.
As far as further distribution is concerned there is on one hand an overlap with heroin dealership, both at private addresses and at street level (Kaplan, et al. 1985, Intraval 1989). A study by Grapendaal (1989), entitled 'Wit of bruin' (White or brown), recognises this (see Appendix A for the explanation of specific terms and expressions). On the other hand the current impression is that separate networks exist for cocaine: dealers for other circles keep the door closed to junkies. Furthermore, it is known that the demand for cocaine is more elastic than that for opiates. Individual consumption is not continuous but intermittent (Peele 1987, Lewis 1989). In a Dutch study by Cohen, almost nine out of ten respondents experienced periods of non-use of a month or longer, because of lack of money or simply because they did not feel like it (1989). In itself this discontinuity in use makes it more difficult to come to grips with (the extent of) the phenomenon.
As compared with the illegal and criminal supply of cocaine, there are two reasons to regard the demand side as a problem. First of all it is a drug in the sense that the substance influences consciousness. This influence may be strong. Excessive use can cause social and health problems. Incidentally, the exact nature of dependency on cocaine is the subject of discussion. Secondly, its illegal character means that the user must pay a high price for the drug. When this cannot be financed out of legal sources, people will turn to irregular, including illegal, sources. This leads to income generating crime. Furthermore the drug can fulfil functions in social settings where rule breaking behaviour occurs or is even the norm. Cocaine appears in various ways to be capable of producing an uninhibiting effect, and to lower the threshold both for criminal behaviour and the use of other drugs such as alcohol and heroin. Cocaine was found to be an entry-drug to heroin addiction, in Rotterdam by Intraval (1989) and in the United States by, amongst others, Petersen et al. (1983).
It is usual for exotic drugs to be surrounded by myths. In the case of cocaine these concern, amongst other things, its effects on both intellectual performance and sexual enjoyment. Freud, it is suggested, may possibly never have succeeded in formulating his psychoanalytical theory without cocaine (Zuidhof 1984). Earlier, in the second half of the 19th century, the drug was administered to (black) mine workers to increase their productivity. This, incidentally, gave birth to the story that blacks could not control their sexual urges while under the influence of cocaine, which supposedly led them to rape white women. In addition, they were thought to become immune to certain types of police bullets (Tieman 1981).
In recent decades cocaine was initially regarded as the caviar or champagne among drugs; its status was generally positive. As early as 1953 Wikler, an American, suggested that cocaine use went well with success-oriented behaviour and identity: in other words, with the American culture (Siegel 1984). Roughly a quarter-century later, this view became reality on a large scale, in the United States and later in the Netherlands. The increase in cocaine use in recent years might be due to the fact that it fits into the spirit of the times. The idea exists that the whole of society has become, in a word, more 'cocaine-ish'. The drug has attained an aura of really having made it, and having the capacity to achieve still more. This is in stark contrast to heroin, the escape route from reality, the symbol of the underprivileged youth (Van Ree and Esseveld 1985).
The recent trends in cocaine usage in the Netherlands reflect earlier developments in the United States. In many reports cocaine has been named as the number one illegal drug there over the past ten years. The National Institute on Drug Abuse estimated in 1986 that more than 20 million Americans (almost 10% of the total population) had used cocaine at least once, that 4-6 million used it regularly, and that between 200,000 and 1 million people would have to be classified as compulsive users (NIDA 1986). In 1982 as many as 19% of the age group between 18 and 25 years was estimated to have used cocaine at least once in the last year. The following figures are known for the city of New York (18 years and older; figures are from 1986): 13% had used cocaine at least once, 5% in the last month (Des Jarlais and Friedman 1989). The figures for the Netherlands are small by comparison. The SWOAD percentages from 1983 report that in the age range 15-24 years 3% had at least once used cocaine; in the larger cities 6%. In the same period, incidentally, a figure of 4% was found for the same age group in West Germany.
More recent figures present the following picture. The lifetime prevalence, that is someone having used the drug at least once, is in Amsterdam 5.8% among 15-39 year-olds (Sandwijk et al. 1988); in the less urban environment of Het Gooi it was only 2% (Korf et al. 1990). The last-year prevalence is 1.7%, and only 0.6% of the population of Amsterdam used cocaine in the month preceding the interview. More recent American figures estimate the lifetime prevalence at 11% and the prevalence of present use at 1% (NIDA 1990, Rouse 1991). According to Anthony (1992) a downward trend in the use of cocaine and other illegal drugs can be observed in the United States. This is caused by a decrease in the number of young people, while at the same time the number of older people is increasing. Nevertheless, the current prevalence figures in the Netherlands turn out much lower than in the United States. In terms of accuracy there are however some shortcomings attached to these estimations, due to the limited data they are based upon.
Finally, if we look exclusively at acknowledged addiction problems, it appears that in 1988 more than 900 clients were registered in Dutch CADs (consultation agencies for alcohol and drugs) in connection with addiction to cocaine as main drug (NVC 1990). According to the Rotterdam CAD about 90 people who only use cocaine came to seek help with cocaine dependency problems over the past two years. Some experts think that the number of long-term users who have problems with cocaine and therefore seek help from agencies such as the CAD will increase considerably. They therefore also expect that cocaine rather than heroin will present an increase in new and serious problems in the coming years. This expectation is based on developments in the United States and the fact that cocaine dependency problems come to light only after some time.
1.2    Research question
Compared to heroin, cocaine is a drug with many faces. Cocaine is used not only by so-called captive groups like opiate addicts, but also by other categories which are not so easily to trace. Furthermore, it is not clear if cocaine is addictive nor what connections exist with deviant and criminal behaviour. Specific cocaine studies are relatively new. In contrast to research among opiate addicts, there is no tried and proved method of study. Similarly, a broad basis of knowledge for comparison with the findings is also lacking. Not counting studies of opiate addicts the only exception (in the Netherlands) is the study of Cohen (1989). This research, however, was aimed only at non-deviant cocaine use in Amsterdam. In order to gain more insight into the phenomenon, the City Council of Rotterdam together with Barcelona, and later joined by Turin, decided to an extensive study into cocaine use in these three European cities. The studies have been conducted more or less simultaneously, and the researchers and supporting officials aligned their activities. An identical approach has been conducted in the three cities, based on the research design from Intraval (Intraval 1990a). The focal question in the (Rotterdam) study was:
What is the nature and extent of cocaine use in Rotterdam?
The main question can be divided into three subjects:
1. The nature of cocaine use.
2. The extent and distribution of cocaine use.
3. Prevention and intervention possibilities.
Re 1. The nature of cocaine use
In studying the nature of cocaine use, attention has to be paid to the following aspects.
a. User/drug relationship
One of the aspects is the attraction of cocaine, probably due to its status and (alleged) qualities as a harmless but stimulant glamour drug, which fits in well with the achievement mentality of our society. Other important aspects are the (social) circumstances of the individual user, at the time of first use and over time. Furthermore, the situations in which cocaine is used have to be studied. It is possible that this factor will to some extent determine the substances with which cocaine is combined, as well as the method and frequency of use. These aspects may have an influence on the user/drug relationship and also on the level of addiction. An important question is the relationship between problematic and non-problematic use.
b. Social categories of users
Cocaine occurs in circles far removed from the familiar heroin addict groups. This often means, in practice, less 'tangible groups' (non-captive groups), also called hidden populations. Cocaine is often associated with fast and big spending, and with rapid and copious consumption. Furthermore, it is commonly associated with social night life, such as discotheques, trendy bars, and house parties. A real difference with heroin relates to the identity of the user. The use of heroin implies a certain lifestyle. With cocaine on the other hand, people use it as a sideline: they use it, but their life is centred on other things.
c. Connections with deviant and criminal behaviour
The connections with deviant and criminal behaviour may be listed as: drug trafficking, acquisition crimes, violent offenses; combined effects of poly-drug use (including alcohol), group vandalism and visual nuisance. The question of the type of social nuisance involved is a matter of discussion. At the level of the user a distinction can be made between criminal activity surrounding small-scale dealing, income generating crime, and other crime-reinforcing effects of cocaine.
Re 2. The extent and distribution of cocaine use
Cocaine use often occurs in so-called hidden populations. Knowledge is lacking, users mostly cannot be identified, and users rarely come into contact with police or care centres. This makes estimating the extent of cocaine use a difficult matter. In our study we have tried to develop new methods to estimate the extent of cocaine use, e.g. a combination of snowball sampling and network analysis. In addition, the network analysis can also provide insight into the distribution and dispersion of cocaine use in Rotterdam.
Re 3. Prevention and intervention possibilities
The analyses of the research data may reveal that cocaine use results in problems for (groups of) users and/or society. If this proves to be so, a policy of prevention and intervention will need to be developed. The research material may provide various leads for this. In consultation with agencies which deal with cocaine users, it will be determined which measures are effective and achievable. One could think of such areas as: the availability of cocaine; information on the negative aspects; shattering the myths surrounding the drug; and intervention in individual cocaine use careers (in particular at 'strategic moments').
In order to answer the main research question extensive interviews were held with cocaine users. Subjects included: the drug career, the functions and effects of cocaine, the social background and the present lifestyle. The description of the nature of cocaine use in Rotterdam is based on these topics, particulary the construction of a typology of cocaine lifestyles. In addition some characteristics of users are presented. Furthermore, the respondents were asked to give information about other users (nominees). This information is used for the description of the distribution and dispersion, and to estimate the extent of cocaine use in Rotterdam. In chapter two there is a detailed explanation of the way the different research methods are applied.
1.3    Contents of book
This book has the following order. In chapter two the research design and methodology is explained. Chapter three gives an initial impression of cocaine use in Rotterdam, related to certain findings in the literature on drug use and addiction. Among other things, attention is given to the opportunity structure, routes of ingestion, effects, addiction, connections with deviant and criminal behaviour, and the myths surrounding cocaine. Chapter four describes the main characteristics of cocaine use in relation to age, gender, use of other drugs, methods of use and so on. These relate to the drug career, pattern of use, income, criminal behaviour and cocaine traffic, problems and contacts with (drug) assistance agencies. Chapter five deals with the core of this study, namely the typology of cocaine lifestyles. The different types of cocaine users are identified and described. Chapter six gives an impression of the distribution, dispersion and extent of the cocaine use in Rotterdam. Chapter seven contains the conclusions and the discussion. In this chapter both policy recommendations and methodological questions will be dealt with. The book concludes with a summing up of the most important findings.
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Table of Contents
Chapter 1    Introduction
Chapter 2    Methodology
Chapter 3    General impressions
Chapter 4    The main characteristics
Chapter 5    Typology
Chapter 6    Spread, dispersion and extent
Chapter 7    Conclusions and discussion
Appendix A    Glossary
Appendix B    Occupation classification
Appendix C    Patterns of use
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