Phil Dalgarno

Reducing the risks of drug use: The case for set and setting

The central proposition of this article is that if people are thoughtful, well-prepared and aware of the means and best environments for using a particular drug, then the risks associated with the use of a particular drug – any drug – can be minimal. The types of drugs discussed in this context focus on those assumed to be the most ‘addictive’ – heroin and cocaine – to those less well-known but potentially more hazardous to use without prior knowledge and preparation – such as Yage and Fly Agaric. This proposition is discussed in the context of different definitions of relatively non-problematic patterns of drug use, specifically: controlled, recreational and unobtrusive. It is concluded that while the effect of taking a particular drug is a primary motivation to the user, the role of set and setting are of fundamental importance in ensuring that the effects of that drug are as intended for and expected by the user.

Patterns of Heroin use among a Non-Treatment Sample in Glasgow (Scotland)

Semi-struclured interviews were carried out with 74 participants in Glasgow who had used opiates at least twenty times in the previous two years, who had never been in addiction treatment, and who had never served a custodial sentence. Typically, participants were experienced users of a range of non-opiate and of different opiates, with most describing heroin as their “main opiate of use”. Participants tended to have first used opiates at a relatively late age (mean 22.3 years), and a significant minority of the sample are relatively new users of opiates, with some indication that opiate use may be increasing among users of “dance drugs”. Heroin was rated as the most enjoyable opiate to take, and self-ratings of Severity of Dependence for light and moderate heroin users was low by comparison to clinical samples. Participants reported relatively few major drug-related health and social problems. Levels of criminal activity were higher than those reported in the Scottish Crime Survey general population, but...

Subjective Effects of Salvia Divinorum

Abstract Salvia divinorum is a hallucinogenic plant native to Mexico, where the Mazatec Indians use it in divinatory rituals as a facilitator for contacting the spirits of the dead. A number of traditions surrounding the ritualistic use of Salvia are still observed. Generally the leaves are chewed for the visionary effects. Salvia has recently been embraced by Western drug cultures, where the traditional methods of ingestion are generall y eschewed for the more immediately effective technique of smoking the dried leaves. This article discusses the history and indigenous cultural uses of Salvia before outlining its rediscovery in the 1 960s and its subsequent introduction to the Western drug scenes (particularly Britain) since the mid 1990s. Qualitative data from 10 Salvia users were collected by means of email interviews. The participants were asked to provide as in-depth responses as possible. No time or space limit on answers was imposed. Their responses to each question are presented verbatim. The effects of Salvia appear to vary between users and seem sensitive to situational factors. Users who understand something of the ritualistic setting for traditional use would appear to have a fuller experience than those who do not.

Buying Ayahuasca and other entheogens online: A word of caution

Since the mid 1990s a number of publications have appeared in the UK and Europe and stimulated interest in a number of psychoactive plants native to South and Central America that had previously been relatively obscure outside of their places of origin. While information describing the effects of these together with extraction techniques was widely available, the plants themselves remained difficult to source until the proliferation of online “headshops” trading in legal alternatives to controlled drugs. The main aim of this study was to assess users’ own experience of accessibility of information available from online suppliers of these drugs. An online survey was carried out via relevant websites where the participants were users of such and such drugs. Measurements were done by semi-structured online interview. It was concluded that none of the online dealers provided any instruction regarding safety issues such as possible toxicity, methods of ingestion or possible interactions with other substances. Therefore, while the practice is legal, there remain larger ethical and moral questions to be addressed.

Long-Term Heavy Cannabis Use: Implications for Health Education.

There is growing evidence that cannabis can have negative effects on health. While the ongoing debate about the nature and duration of these effects recognizes mild cognitive impairment, the evidence for irreversibility of cognitive impairment and causal links with psychiatric illness is not conclusive. There is undoubtedly potential for impairment of respiratory functioning, but that will depend on lifetime load and in most cases is confounded with tobacco smoking. There is a lack of data that addresses the long-term cannabis users perspective. How do long-term cannabis users perceive the impact of their cannabis use on their own lives and what are the policy implications of their experience and perceptions of cannabis use? A recent study of long-term cannabis users explored a number of issues that have relevance for policy in relation to health education interventions. Quantitative data gathered from 405 long-term cannabis users provide insights into the impact of different levels of cannabis use over ten or more years on a range of issues: health; dependence; cannabis-related beliefs and attitudes; and preferred sources of cannabis-related information. Implications and the need for innovative approaches to cannabis-related health education are discussed.

Trauma in the childhood stories of people who have injected drugs

Abstract Aim: To document childhood trauma in the life stories of people who have injected drugs. Method: Fifty-five participants (38 m, 17 f) recruited via Scottish recovery networks, who had injected drugs in the previous five years, were interviewed by peer researchers using the Life Story method. Results: Remembered childhood trauma included persistent violence, repeated sexual abuse, neglect and traumatic bereavements. Many traumas were related to adult alcohol use. Few participants told of no trauma, some of severe trauma contributing to subsequent drug problems, some recounted stories including traumatic events, but not linked to later drug problems. A few told of initial severe behavioural problems leading to trauma for the child and to drug problems. Drug problems followed trauma by various routes, without straightforward cause and effect: direct use of drugs as avoidant coping; juvenile heavy recreational use that escalated; forming relationships in mid to late teens with criminals. For men, this involved enmeshment in drug dealing, crime and prison. Some women formed relationships with men who injected drugs, who often introduced them to drugs, and some of whom were violently abusive. Heroin injecting was an effective means of blotting out distressing thoughts and feelings. Although, childhood stories also contained positive memories, factors that might have promoted resilience were rarely mentioned. Conclusions: Severe childhood trauma was common and gravitated people towards problem drug use via various pathways. Participants had often normalised the problems and did not remember adult help. Parental alcohol use contributed to trauma. Addiction services need to be more trauma minded.

In the absence of hard data, Is soft data better than no data at all?

Abstract Where total anonymity and confidentiality were previously respected in drug research, a tendency towards the provision of “hard” data such as verifiable personal details seriously disadvantages researchers working with “hidden groups” who use drugs in a relatively problem free way. This particularly applies to those who use substances generally regarded as highly addictive and problematic, such as heroin. Funding for a follow-up to an earlier research project was sought; the original investigated non-problematic heroin users, whereas the chief aim of the follow-up was to examine “resilience” to the problems commonly associated with the use of heroin. An illustration of attempting to put the gathering of “hard” verifiable data into action is presented here along with the immediate consequences. Unsurprisingly, the response of potential participants to the idea of providing personal details was largely negative, as the perceived consequences of being “outed” as a heroin user were generally regarded as worse than any of the issues associated with the use of the drug itself. An irony of the situation is that this “resilience” may be due to participant refusal to compromise their anonymity. This raises some obvious ethical issues. A number of potential longer term consequences on substance use/misuse research are also discussed.