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4.2 Pattern
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).
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.
Figure 4.3
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.
4.3 Location
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.
Figure 4.4
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.
Table 4.1
Most important location of use in the different periods, for opiate users (O) and non-opiate users (NO)
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