INTRAVAL. Bureau voor sociaal-wetenschappelijk onderzoek en advies<
 
Between the Lines
Summary
Following indications that cocaine consumption has been increasing in recent years, the Rotterdam City Council commissioned Intraval, bureau for research and consultancy, to investigate the nature, spread and extent of cocaine use in the city. Studies based on the research proposal of Intraval have been conducted concurrently in Barcelona and Turin.
Research design
The method of data collection consists of a combination of snowball sampling and targeted sampling. In conjunction with the applied questionnaire, this has resulted in information being gathered on 1,161 individuals, comprising 110 respondents and 1,051 nominees (users about whom respondents provided information). During the interviews a two-part questionnaire was used. The first part, an item list, provided information for the analysis of the nature of cocaine use. With the help of the minimum-maximum comparison method, a typology of cocaine lifestyles has been constructed. The second part, questions with pre-coded answer categories, has been used to determine the spread and extent of cocaine use. The methods used include personal network analysis and two-level regression analysis. Two estimators have been developed to determine the extent of cocaine use.
Background characteristics of users
The use of cocaine occurs in all strata of the population. The social backgrounds of the users show wide variations. One third have had higher education and one fifth lower technical school. Users are found among the employed and unemployed, school pupils, students and housewives. There is also a great variation in the sectors in which users are employed: ranging from pub/cafe work, technical, artistic, cultural and professional occupations, to criminal circuits and the sex industry.
The average age of the respondents is 29 years. The youngest is 18 and the oldest 47. The research population is roughly 75% male and 25% female. Cocaine use in Rotterdam is spread across various age categories, with concentration in the 20 - 30 year old category. The age at which respondents first used cocaine varies from 13 to 37 years. The average age is just over 20. Consumption duration shows a wide spread, ranging from a couple of months to more than 30 years. The average period of consumption is nearly eight years. One third of the respondents is using, or has used, opiates in addition to cocaine. The consumption duration of these respondents is, on average, longer than that of non-opiate users. 39% of the respondents who have also used opiates declared that they had stopped opiates but were still taking cocaine. At the time of the interview, one third of the respondents declared that they were no longer taking cocaine.
The first drug for the majority of the respondents (87%) is cannabis, when alcohol is discounted. It appears that most respondents have had experience with drugs other than cocaine. These include cannabis, amphetamines, hallucinogens, tranquillizers and opiates. A relatively new drug which one third have experienced is XTC. Only 2% of the respondents have used only cocaine.
   
Consumption
Cocaine is being taken in many different ways. Sniffing is the most common method (50%), followed by injecting (15%), basing (5%), chasing the dragon (3%) and smoking (1%). A quarter (26%) of the respondents take cocaine in more than one way. Sniffing, in particular, is often combined with another method, usually basing or smoking. In the period of heaviest consumption, basing was the main method for 12% and injecting for 16%.
Frequency of consumption varied widely, ranging from daily to a few times a year. In the period of heaviest consumption cocaine was taken every day by half (54%) of the respondents. More than a quarter (28%) took cocaine at least once a week in this period, 13% two or three times a month, and 5% less than once a month. In general, opiate users consume larger amounts of cocaine and take it more frequently than non-opiate users. The differences among the non-opiate users are, however, greater. Respondents who base, inject or chase the dragon take cocaine more often and in larger amounts than sniffers. Frequency of use and amounts of cocaine taken vary widely among sniffers, however. In cases in which opiate and non-opiate users employ the same method, there is little difference in frequency but opiate users consume larger amounts of cocaine. Method of use, frequency and amount of use show a strong connection.
Problems
Cocaine is not such a harmless drug as some people claim. The information obtained in the interviews indicates that more than half (55%) of the respondents admit to having problems connected with cocaine use. The problems mentioned range from a hangover the next day and being short of cash to a craving for the drug. A quarter of the respondents are experiencing serious problems due to cocaine use. They describe themselves as cocaine addicts or admit to suffer from both physical, psychological, social and economic difficulties. Respondents who are not addicts often have psychological problems. These range from guilt feelings the morning after to symptoms of paranoia. Social and economic problems come lower on the scale. Eleven percent of the non-opiate users have serious problems; they are the cocaine addicts.
There is a connection between frequency of use and problems. As far as less serious problems are concerned, the borderline is between weekly and monthly use. For addictions problems, it lies between weekly and daily use. This applies to both opiate and non-opiate users. In general, opiate users are more likely to have problems and more likely to be addicted to cocaine than non-opiate users. Almost all male basers and injectors have problems due to cocaine use. Contrary to expectations, the occurrence of (addiction) problems is normally not linked to duration of cocaine consumption. When non-opiate users encounter problems linked to cocaine consumption, a large number of them appear to stop taking it.
Two thirds of the respondents, who admit to having had problems with use, have (had) contact with (drug) assistance agencies. For people with addiction problems, this figure is 85%. The categories which do not have contact with (drug) assistance agencies are: women who are non-opiate users and men who sniff but do not take opiates. Few people in these categories have addiction problems. Opiate users who admit to problems with cocaine consumption obtain help within the context of the methadone programmes which have been set up for heroin users. Fifty percent of the respondents who are cocaine addicts but do not take opiates and who have contact with the assistance agencies, established this contact only in jail.
Criminality
Cocaine consumption does not necessarily go hand-in-hand with criminal behaviour. For a lot of respondents there is no relationship between cocaine and criminality. More than half of the respondents, however, were criminally active in the period of heaviest use. This lawbreaking is predominantly a question of property offenses, followed by activities within drug dealing. Only a handful of respondents (4%) admit that crimes of violence form the main criminal activity in the period of heaviest use. In these cases it is difficult to ascertain the extent to which these crimes may be attributed to cocaine, alcohol or speed, or to a combination of these substances. The majority of the offenses are related to obtaining money, directly or indirectly.
Excluding the period of heaviest consumption, half of the respondents obtain their income exclusively by legal means, a quarter in a semi-legal manner (prostitution or moonlighting) and a quarter in an illegal manner (by means of criminal activities). In the period of heaviest use this figure rises to 43%. Men are more likely than women to acquire illegal earnings. The same applies to opiate-users versus non-opiate users and basers and injectors versus sniffers.
One third of the respondents are (have been) involved in cocaine dealing, men more often than women. Non-opiate users are more likely to be selling only small amounts to close friends. Overall, respondents who are basing are more likely to be involved in dealing than respondents who take cocaine in another way. Two separate circuits relate to cocaine procurement: opiate users go to house dealers who are also selling opiates while non-opiate users make use of friends and house dealers who are not selling opiates. The only category making use of what is on offer in the entertainment circuit are sniffers. Women are more likely than men to obtain cocaine from close friends.
Consumption patterns
A number of patterns can be discerned in the frequency and the amount of cocaine taken. In this study the most commonly noted patterns are the one in which the consumption slowly increases (increase) and the one in which, after an increase, a decrease follows (peak). Other patterns that often occur are the pattern in which the level shows variation with several peaks (twin peaks) and the one with the same level all the time (same level). Respondents who are non-opiate users and who have stopped with cocaine, more often show an increase pattern, respondents who are not on opiates but continue to take cocaine are more likely to show a peak pattern.
The drug career of the respondents is divided into the initial period of use, the current/most recent period of use and the period of heaviest use. In 4% of cases this latter period coincides with the initial period and in 34% with the current/most recent period. In half the cases, the period of heaviest consumption is an interim period, while 12% remain at a constant level throughout the whole of their career.
In the initial and the current/last period of use, the most usual locations for taking cocaine are the entertainment circuit or the home circuit. In the period of heaviest use, the hard drug scene is also important. Opiate users are most likely to take cocaine in the hard drug scene while non-opiate users prefer the home circuit or the entertainment circuit. In the initial period, cocaine use of the latter mostly takes place in the home circuit, in the current/last period and the period of heaviest use the entertainment circuit is equally important.
Typology
Besides the already mentioned differences in methods of use, frequency, amount taken and so on, there are great differences in the function and meaning of cocaine. These differences have lead to a typology of eight types of users with different cocaine lifestyles. They are characterised by the specific combination of the central role played by cocaine in lifestyles and the significance of cocaine.
The Burgundian type
Cocaine plays a role of only minor significance in the lifestyle of this category. It is part of a predominantly luxurious style of living. Cocaine is seen as an exclusive social drug and its use is consciously limited in order to maintain this exclusive character. A crucial role is played by the circuit of close friends, both for obtaining the cocaine and for its consumption.
The experience type
For this type, cocaine is of a limited significance and is not a central feature of the lifestyle. Important for this category of user is that they want to obtain personal experience. Cocaine is considered one of the means of enriching this personal experience. In each phase of use, the positive and negative effects are weighed against each other. It may be described as a calculated use of cocaine.
The situational type
Cocaine has a role on the periphery within this lifestyle. It is considered a (social) party drug. An outstanding feature is the manner in which the use of cocaine is linked to special occasions such as Christmas and New Year's Eve. The level of consumption is, to a greater or lesser degree, consciously kept within certain limits.
The distinctive type
Cocaine plays a particular role in the lifestyle and is seen as a means of subcultural distinction. Consumption of cocaine is embedded in a subculture to which the user (temporarily) belongs. He is a member of a 'select' group of users. Many aspects of use (initiation, progress and, possibly, abstinence) are largely linked to the group.
The hedonist type
Sex and drugs and rock & roll are the motto for this category of user. The central feature of the lifestyle is unbridled enjoyment. Anything which can increase enjoyment in our modern society is made use of. Cocaine fits into this pattern ideally as a stimulant. Consumption ceases the moment that cocaine presents physical or financial problems thereby reducing the level of enjoyment.
The routine type
Consumption of cocaine plays a particular role in the lifestyle. Cocaine is not seen as luxury or exclusive item, but simply as one of the whole range of means of enjoyment which are on offer. It is a well-tried and more-or-less integrated feature of the life of this user. In other words, consumption of cocaine has become routine.
The poly-drug type
The main characteristic of this type is that cocaine has joined opiates as a central feature of the lifestyle. Poly-drug consumption is the pivot of the user's daily life. The user is found mostly in the subcultural setting of the hard drug scene. Compulsive consumption of cocaine is characterised by a broad range of problems (physical, financial and psychological). In addition, there are often indications of a (temporary) criminal lifestyle which may include contact with the police and lawcourts. Most members of this category have had considerable experience of different areas of the (drug) assistance agencies.
The cocainists
A central and dominating role is played by cocaine. The main characteristic of this type of user is a compulsive consumption of cocaine but without use of heroin, in contrast to the poly-drug type. Contact with the hard drug scene is non-existent or sketchy. A reason often cited for beginning with cocaine is that the user has difficulties. Compulsive consumption of cocaine becomes problematic over time. Often they are involved in the cocaine trade. In this context, there may be contact with the police and lawcourts.
Spread
Cocaine use in Rotterdam appears to be of an open nature within the user population. The respondents are able to name, on average, 13 other users among their acquaintances. These are people active in the entertainment circuit, the workplace, the home circuit, hobby/sports and the hard drug scene. There are indications of a moderate degree of contact between users from the various circuits. On the basis of the average number of users named by the respondents in the various circuits, it appears that two more-or-less distinct circuits are found in Rotterdam. These are the so-called entertainment + home circuit and the hard drug scene.
Another indication of the open nature of cocaine consumption within the user group is the fact that the majority (65%) of the 1,239 named contacts are not acquaintances directly linked to cocaine. Nevertheless, there is the mutual awareness among these people that they use cocaine. In the hard drug scene cocaine plays a more important role in the contacts between people than in the entertainment + home circuit.
Relationships of respondents in the older age categories are less likely to be linked to cocaine than those of respondents in the younger age categories. Cocaine is a very important feature of relationships within the hard drug scene. Cocaine plays a more significant role in relationships in which the respondent nominates other users who have been taking cocaine for a relatively long period than in relationships in which the use is relatively short. In cases in which the respondents are university or polytechnic graduates who nominate other users at work, it appears that cocaine has little significance in these relationships. Finally, gender appears to play a role in cocaine relationships. In relationships in which the respondents are men and the nominees women, the role of cocaine appears to have little significance in these relationships.
The application of the size estimators developed within the framework of this study gives an estimation of approximately 12,000 cocaine users in Rotterdam. This is about 2% of the total population in Rotterdam. These users have taken cocaine at least 25 times and/or five times within the last six months.
Conclusions
Cocaine is not by definition an addictive drug. It is a far less straightforward drug than heroin, for example. In the question of cocaine there appear to be two different drugs, to be distinguished according to the way in which they are used. Sniffing can apparently be pursued without too many negative, social or personal, consequences. Basing, chasing the dragon and injecting are a more risky methods. They usually lead (in a short time) to compulsive consumption and the problems associated with this. Basing in particular occurs also among non-opiate users. It appears, moreover, that cocaine is not such a harmless drug as some people claim. We may expect that an increasing number of cocaine users, both poly-drug users and those who are exclusively on cocaine, will seek help from the (drug) assistance agencies. Seeing the effect of cocaine, it is advisable to consider new treatment methods which are of a more therapeutic nature, perhaps in conjunction with pharmalogical supplements in the form of antidepressants. Furthermore, the provisions for the more socially integrated user must be clearly distinguished from those for the poly-drug addict.
To date, there have not been many cases of criminal behaviour due to cocaine use. In the cases that have been noted, it is not always clear whether the criminal offence was due to cocaine, alcohol, or speed or a combination of these substances. There is the possibility that if basing increases there will be a corresponding rise in public nuisance, an increase in acquisition crime and more crimes of violence. In addition, there is the danger of crack. This variation of cocaine has a strongly compulsive effect. Its use and dealing in the United States and Great Britain have already resulted in major personal and social problems. It is therefore vitally important that measures are taken to prevent this variation (just as basing) from getting a firm foothold in the Netherlands.
Snowball sampling and a combination of qualitative and quantitative research methods appear to be a very effective approach in research among drug users. It produces results which are relevant for both scientists and policy makers. It is important, in such studies, that the initial sample is as random as possible. This is possible by obtaining respondents through so-called circuits, settings or social milieus. It is possible to estimate the size of populations of drug users on the basis of 'one-wave' snowball samples as long as the initial sample is large enough in relation to the estimated populations and the people in the initial sample are approached as independently as possible. Qualitative analysis in which the use of drugs is placed within the concept of lifestyles provides an excellent basis for research into a phenomenon as diffuse as cocaine use.
Snowball sampling and a combination of qualitative and quantitative research methods appear to be a very effective approach in research among drug users. It produces results which are relevant for both scientists and policy makers. It is important, in such studies, that the initial sample is as random as possible. This is possible by obtaining respondents through so-called circuits, settings or social milieus. It is possible to estimate the size of populations of drug users on the basis of 'one-wave' snowball samples as long as the initial sample is large enough in relation to the estimated populations and the people in the initial sample are approached as independently as possible. Qualitative analysis in which the use of drugs is placed within the concept of lifestyles provides an excellent basis for research into a phenomenon as diffuse as cocaine use.
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Table of Contents
Preface
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
Summary
Literature
Appendix A    Glossary
Appendix B    Occupation classification
Appendix C    Patterns of use
 
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