Cover Page

Title Page


Thanks to Emma Longstaff at Polity Press for persuading me this was the book to write. I would also like to thank my colleagues at Glasgow Caledonian University for giving me space to write it, as well as my many collaborators and co-authors on relevant topics over the years, including: Simon Anderson, Niall Coggans, Phil Dalgarno, Norman Davidson, John B. Davies, Jim Dignan, Lawrie Elliott, Frances Finnigan, Alasdair Forsyth, Mary Gilhooly, Jean Hine, Simon Holdaway, Richard Jenkins, Furzana Kahn, Tara Lavelle, Louise Marsland, Pete Marsh, Keith Millar, John Minkes, Michael Morgan, Val Morrison, Ken Mullen, John Oliver, Stephanie Pearl, Peter Raynor, Marie Reid (also my spouse and support), Anna Stallard, Iain Smith, David Teeman, Paul Wiles and Paul Wilner. Particular thanks to Jason Ditton and David Shewan for reading and commenting on chapters of the book, as well as being stout-hearted collaborators, and to three anonymous referees. Finally thanks to my parents, Mary and George Hammersley, for the gifts of compassion and reason.

Glasgow and Cockburnspath, September 2007


Constructing the Problem of Drugs and Crime

This is the problem: drugs and crime are consistently related to one another in different studies. Even when different places and different forms of drugs and crime are studied, the conclusion is consistent. Some general surveys, for example, show that the same people who admit to doing drugs also commit crime, particularly in youth (e.g., Elliott, Huizinga and Ageton, 1985; Jessor and Jessor, 1977; Willis, 1971; Kandel, Simchafagan and Davies, 1986). Similarly, drug users admit more crime than non-users (Bean, 1971; Gordon, 1973), while criminals admit more drug use than non-criminals (Noble, 1970; Bass, Brown and Dupont, 1972; Lightfoot and Hodgins, 1988; Spunt et al., 1995; Lamb and Weinberger, 1998). There are studies that reveal that some people who are drug dependent commit high levels of crime (Inciardi, 1979; Jarvis and Parker, 1989) and use much of the proceeds to buy drugs (Rajkumar and French, 1997). This applies to those on heroin most commonly, but also to some cocaine users, particularly crack cocaine users, and to people dependent on other drugs or alcohol. Here I’m giving only a handful of illustrative examples, mostly from the USA and the UK, but studies around the world in places as different as Chile, Hong Kong, Australia, Russia and Thailand all find that drug use and crime are correlated.

However, despite what people may believe, the connections are in fact far too complicated to summarize as a straightforward ‘drugs–crime’ relationship (Bennett and Holloway, 2005a). This book looks in depth at the complex issues surrounding these phenomena. For example, drug-dependent people who are also known to commit crimes tend to be clustered in areas that are socio-economically deprived (Burr, 1987; Curtis, 1998; Ihlanfeldt, 2007) in the same way as people known to commit crimes without drug use. When people who are known to be drug dependent and commit crimes are treated for their drug problems, then both offending and drug use tend to improve (Inciardi, Martin and Butzin, 2004; Dijkgraaf et al., 2005; Ribeaud, 2004; Gossop et al., 2000), although this more often involves reductions in both than complete non-offending and complete abstinence. Indeed, there are problems of defining ‘non-offending’ and ‘abstinence’ which cloud the findings. Moreover, when heroin is in short supply then offending can reduce, rather than increasing in order for the users to be able to pay the resulting higher price (Donnelly, Weatherburn and Chilvers, 2004), and when habits shifted away from crack cocaine in New York, then violent crime fell (Bowling, 1999). However, reduced availability does not have uniform beneficial effects everywhere. For instance, it can lead to people switching to more problematic substances, as when expensive Scottish heroin in the 1980s led to the injecting of insoluble temazepam (Hammersley, Lavelle and Forsyth, 1990). Or, it can lead to further criminal professionalization of the black market. Moreover, some people argue that drugs–crime connections are largely a product of the illegality of drugs, which criminalizes supply, inflates prices and abdicates the sorts of controls over drugs that are exercised over alcohol, tobacco and medicines.

It is clear that crime would exist without drugs because other social forces create and stimulate demand for stolen goods and because the same psychological and social pressures form criminals and people with serious drug problems: drugs and crime exist in a ‘common causal nexus’ (Elliott, Huizinga and Ageton, 1985) where it is impossible to blame one for the other in any simple way.

Many people looking at drugs–crime connections conclude that it is obvious that the same risk factors predispose people to both drug use and offending, and that drug dependence causes crime because users need money to buy drugs. Indeed, the consistency of links challenges strongly socially constructed explanations of drugs–crime relationships, as one would surely anticipate more variation across different cultures and social conditions. However, perhaps consistency is in the eye of the beholder. While the behaviour of drug-dependent offenders is reasonably similar everywhere it has been studied, links between drug use and offending at the population level are unpredictable (Martin et al., 2004). The sheer scale of drugs and crime problems is often held to be justification for action, yet their magnitude is partly a matter of assumption and definition. Furthermore, whatever the scale of the problems, even if drugs cause a lot of crime, it does not necessarily mean that eliminating drugs will reduce crime, or have only beneficial effects on society. Finally, it is not clear that drugs and crime problems can be tackled in isolation from wider social problems. Wars on drugs and crime are wars against ourselves, not against alien agents in our societies. Some of the difficulties with this received view can be illustrated by discussing an example.

The received view of the problem

In 2002, the then home secretary wrote:

If there is one single change which has affected the wellbeing of individuals, families and the wider community over the last 30 years, it is the substantial growth in the use of drugs, and the hard drugs that kill in particular. The misery this causes cannot be underestimated. It damages the health and life chances of individuals; it undermines family life, and turns law-abiding citizens into thieves, including from their own parents and wider family. The use of drugs contributes dramatically to the volume of crime as users take cash and possessions from others in a desperate attempt to raise the money to pay the dealers. In addition, otherwise decent people become dealers in pyramid selling, as they persuade friends, acquaintances and strangers to take on the habit, so that they themselves can fund their own addiction. (Blunkett, 2002, 3)

Like many statements about drugs and crime, the quote offers a series of clichés, misrepresentations and stereotypes as truth (Stevens, 2007; Orcutt and Turner, 1993). Let us look at six serious difficulties in turn.

First, it is questionable whether drug use has actually risen over the past thirty years, particularly if one counts tobacco and alcohol as drugs, which the British government does not. It is even questionable if hard drug use has risen that much, after its initial rise in the early 1980s. Over the 1990s, in the British Crime Survey annual prevalence for heroin use remained under 1 per cent, while cocaine use crept up to about 5 per cent. It is important to remember that ‘annual prevalence’ includes an unknown number of infrequent or one-off users and that this is supposed to be more likely for cocaine than for heroin. Whether cocaine use has increased or not, it certainly has not increased as much in the UK as had been predicted in the mid-1980s. Instead, cocaine use has spread more slowly and insidiously until some 5 per cent of Britons admit use.

In the 1940s over 70 per cent of the population smoked cigarettes. Nowadays smoking (of cannabis or tobacco) is under half as prevalent and other drugs are rarer still. With a different political mindset, this could be a great public health success, with the unfortunate sting that substance use has diversified in many countries among the young. Although alcohol intake may be increasing, particularly among women and younger people, it has not yet reached levels recorded some hundred years or more ago (Cabinet Office, 2003). Furthermore, the United Nations Office on Drugs and Crime (2006) estimated that world opium production has fallen by 80 per cent in the last 100 years. Just because it is widely accepted that drug use is increasing, it is not unquestionably so.

Second, mortality rates for heroin injection are indeed high (in the UK opiate overdoses are now the leading cause of mortality among people under thirty, surpassing alcohol overdoses and other forms of suicide (e.g., Roberts, Barker and Li, 1997; Johnson et al., 2005), but cocaine does not kill that often and cannabis does not kill at all, except as a contributor to accidents. Drugs policies are usually written against heroin and cocaine but enforced against cannabis (Runciman, 1999).

Third, the misery of drugs is only half the story. People usually take drugs for enjoyment and often continue to take them, or return to use, because, for them, the benefits outweigh the misery caused (Mullen and Hammersley, 2006). Looking only at misery inclines people to assume that drug users are crazy – otherwise why use? This leads to two serious fallacies: that drug users are not responsible for their actions and that they are fundamentally different from ‘normal’ people, who use only selected substances such as alcohol, in responsible(ish) ways. Drugs can indeed damage health. However, neither heroin nor cocaine themselves harm health as much as alcohol or tobacco, although the related lifestyle can be appalling, particularly if it involves drug injecting and poverty (see, for example, Neale, 2000).

Fourth, drugs rarely turn law-abiding citizens into thieves. Most drug users who steal to buy drugs had acquired the skills to steal before they used drugs (see Bennett and Holloway, 2005a, 111–26). Not surprisingly their families may be unaware of this, unless, as sometimes happens, they abetted it. If drug users have no criminal skills then they usually make incompetent thieves and are caught quickly. Imagine, could you raise £70 (throughout I assume €1= $1=£0.70) or more a day by stealing, starting tomorrow because you just happen to have become dependent for the first time?

A related difficulty, rarely considered, is that, while drug use has risen in the UK, so crime, other than certain types of violent crime, has fallen in the British Crime Survey. If drug use and crime had more stereotypically risen together, then politicians would not have hesitated to force the ‘obvious’ causal link. So, as drug use has risen while crime fell, drugs clearly prevent crime! There are reasonable explanations of this (temporarily) obvious fact.

Fifth, some dependent heroin or cocaine users do indeed steal a lot to buy drugs, and they can be responsible for a great number of crimes. Others do not. Trying to work out why is a central problem for this book. Another central problem is to decide how much crime is caused by drug use. This is too complicated to go into yet, but jumping to the simplest and most appealing answer, that drugs cause a lot of crime, is like taking the easy guess in an arithmetic test to save doing the hard calculations – it does not make the guess correct. This book will introduce you to both the statistical assumptions about the drugs–crime relationship and the conceptual assumptions underlying it. Both are equally important. This book is about drugs and crime, with the emphasis on drugs and a focus on crime only insofar as it is supposedly (or really) related to drugs.

Finally, Blunkett compares drug dealing to pyramid selling. Pyramid selling often involves selling a product, but more importantly selling franchises to sell the product. There are fewer people who will participate than you might think, and unless you are near the top of the pyramid this does not work; a town can support only so many sellers of domestic cleaning products or jewellery, or even of drugs.

However, there is a huge market for illegal drugs, which is one of the world’s largest industries (Castells, 1998, 166–205; RSA, 2007), rivalling the weapons trade. The drugs market is demand led, and dealers do not actively have to recruit new customers. Indeed some dealers retire because they are sick of being hassled by keen customers day and night. It is usually new users that turn each other on, often despite the dire warnings of more seasoned and more dependent users (Hunt and Chambers, 1976), which may include some local drug sellers.

Everyday thinking about drugs and crime

This deconstruction of Blunkett’s rhetoric illustrates how society tends to care about drugs and crime with inaccurate and exaggerated fear and concern, which is widely taken for fact. Another central question for this book is to understand why those fears and concerns exist and are so powerful that they are quite resistant to rebuttal by evidence, facts or reasoned arguments. When I tell laypeople what I study, they generally have strong beliefs about drugs and crime that they are happy to put to me as the correct answers. The following are some of the common prejudices I hear.

Society is too soft on drug users.
Drugs should all be made legal to get rid of the problem.
Heroin is extremely addictive.
Cocaine is extremely dangerous.
Drug dealers should be killed and then punished for a long time (to compound a number of prejudices).
Cannabis is completely harmless.
Cannabis is extremely dangerous because it leads to other drugs.
I know a person who had the terrible experience of being the victim of a crime done by a drug user; he or she was terrified, consequently drugs are evidently very bad.
Drug problems are all caused by … (insert the ethnic minority or other disliked social group of your choice).

Over twenty years, the candidates for blame I have heard include blacks, Chinese, Glaswegians (heard in Edinburgh; for non-Scots insert two local rival cities of your choice), Arabs, the IRA, the UDA (both in news items from Belfast at different times), the government, doctors, the United States government and the CIA. Perhaps inevitably al-Qaida were linked to drug trafficking as early as 2003 (, 2003), although such links are largely circumstantial (Transform, 2001). Indeed, anyone wishing to make large profits quickly and tax free with no questions asked, for any purpose, is likely to be tempted by drug dealing. For, if it is not the world’s largest industry, it is certainly the world’s largest industry that is completely untaxed and unregulated.



(Kenco disposable coffee cup, Great Western Rail, 2004)

Previous generations seemed to believe that people could drink hot coffee without advice. Nowadays, people allegedly want their coffee hot enough for enjoyment, but not so hot as to scald – a tricky if not impossible balance for caterers afraid of litigation. The management of potential risks has sometimes led to bags of peanuts labelled ‘Warning – may [sic] contain nuts’, swing parks without swings, all rectal examinations taking place in front of two health-care professionals (one of each gender so all patients are equally embarrassed) to avoid sexual harassment or allegations thereof, teachers doing drugs education required to refer any pupil mentioning their own drug use to the head teacher, all metal sharpish objects being banned from air travel, and parents being worried about taking pictures of their children nude. Risk management is usually well intentioned, but can have strange consequences.

There are a number of serious points (see Adams, 1995, and chapter 6). First, definitions of risks that are worth managing vary from place to place, so people do not agree. Second, the information needed to calculate what the risks of harm really are is always incomplete and is always difficult and often impossible to obtain, so people have to guess. Third, making things seem less risky can cause people to behave more dangerously. If coffee is routinely labelled ‘hot’ then the server doesn’t have to bother warning the customer if the cup seems unusually hot, and liability is passed to the customer; if the swing park has a padded floor, then children jump from higher up because landing might hurt less. Fourth, developed societies are increasingly centralizing risk, security and safety, moving away from a ‘modernist’ view that innovation, novelty and technology are generally good. Since Beck (1992) identified these trends, they have intensified. For example, around 80 per cent of UK citizens now favour spying on terrorist suspects and detaining them without trial (National Centre for Social Research, 2007).

In this cultural context, drugs and crime are useful for policy makers because disliking drugs and crime might unify us and divert attention from more problematic and complex changes that have occurred over the past thirty years. These include a widening of the poverty gap between richest and poorest, with resultant health and other inequalities both globally (, 2007) and within affluent countries (Luxembourg Income Study, 2000). However, it is relevant and perhaps not coincidental that New Labour policies have reduced child poverty in the UK across the same period as crime has broadly fallen (Hills and Stewart, 2005). Another problematic change has been the debasement of the educational system, partly through under-funding. For example, in England and Wales A-levels are easier than they were (The Economist, 11 August 2005). In 1993, 49 per cent of degrees in England were upper seconds or firsts. By 2004 this figure had risen to 58 per cent (Department for Education and Skills, 2005), suggesting lowered standards, as the numbers attending university also rose over that time – so presumably the mean ability fell. Yet another change is the erosion of secure career-type employment for most people, which has been replaced by jobs that are temporary and often part-time, requiring both adults in a family to work to make ends meet securely and thus making it difficult for people to be full-time parents (Ermisch and Francesconi, 2001).

An additional headache for national policy makers is that the power of nation states is diminishing in the world against the rise of global capitalist organizations, among which it is sensible to include organized crime and drug trafficking (Castells, 1998). Actually, it may be old fashioned to talk of ‘drug trafficking’, because increasingly trafficking in illegal cargo has become a global industry that will transport anything from a stolen kidney to shiploads of hazardous waste, to fake designer goods for street markets (Naim, 2005). The many skills required for trafficking may have been honed supplying drugs, but they can be used to conceal and ship anything. Crime is a more perennial problem, but it too is influenced by major social inequalities (Chamlin and Cochrane, 2005; Baron, 2006). It is unclear whether politicians can do anything about the changes over the past thirty years and whether the public want them to. Drugs and crime concerns are diversionary activities that unify us against these ‘incontrovertible’ dangers, rather than leaving us to worry too much about where our society is taking us in terms of inequality, exploitation, fearfulness and ignorant consumerism. This perhaps applies even more so to policy makers, who may be loath to concede impotency and difficulty foreseeing the global future.

Pragmatic realism

The idea that drug abuse and crime are socially constructed phenomena is threatening or incomprehensible to many people. Both clearly exist and are clearly related. I do not accept that the universe is constructed entirely from discourse, but I do accept the much weaker but more reasonable suggestion that all our thinking about and understanding of the universe is constructed from discourse of one sort or another. That is, the real world surely exists independently of our attempts to understand it, and there is a convincing philosophical argument to this effect (Husserl, 1977), but there are no guaranteed methods for finding out ‘the facts’ or ‘the truth’ of the real world. This approach to research can be called ‘weak social constructionism’ or ‘realism’ (Harré, 1970; Bhaskar, 1997), but to confuse things other philosophical positions are also called ‘realism’. The Bhaskar and Harré form I will call ‘pragmatic realism’: I do not want to abandon the idea of a real world independent of our discourse, because then there would be no point researching it, but I do want to abandon the idea that scientific or other research methods of any kind guarantee truthful knowledge of the real world.

The topics of drugs and crime are weakly socially constructed throughout and aspects of our understanding are strongly socially constructed; some drugs and crime ‘problems’ may not exist at all – the anticipated crack cocaine epidemic in the UK in the 1990s being one example.

There is considerable resistance by policy makers and the media to acknowledging any form of social constructionism, because ‘spin’ – managing discourse about events – is a main tool of their trades. Therefore it is often very difficult to show which concerns and problems are entirely illusory without being attacked for it. More widely, the management of information is a potent form of social power (Douglas and Wildavsky, 1983) – perhaps the only fundamental form of power in addition to raw violence (Galbraith, 1985). Scientists, health-care professionals and criminal justice professionals also wield information as power, so are also resistant to social constructionism. Of course, appreciating that social constructionism is accurate is itself power, but of a rather lame variety, as it leads to uncertainty about what to do, which in turn often causes social constructionists to be passed over in favour of those willing to present themselves as more certain. People readily confuse a person’s confidence with their knowledge, hence their power. Some people who understand social constructionism very well choose a positivistic presentation of knowledge. The most extreme form of social constructionism, which is often called postmodernism, poses a threat to science because it proposes that all accounts/discourses/texts compete equally. This may be an account of how contemporary societies tend to work, but it should not diminish the power of expertise, including science. For example, the discourse of some newspaper leader writers is unlikely to rehabilitate anyone from offending or substance dependence, whereas psychological and psychoanalytic discourse can. Architects are not generally encouraged to abandon engineering principles for postmodern playfulness.

Many practising scientists find social constructionism offensive to their belief that truth can be found in a consensus among experts that can be replicated in research and ‘works’ in operating the world. Weak social constructionism does not undermine this idea of truth, but it makes it extraordinarily difficult to achieve, potentially fallible and very vulnerable to human conceits among scientists, such as that their particular methods are superior. Scientists’ grandest conceit is that they are somehow above vanity, power and avarice, or that somehow their superb research methods cancel out such petty human vices and prevent bias from creeping into their thinking and writing. Common sense (and the literature on scientific fraud) suggests that bias is most likely when intricate and expensive research technology is involved, raising the stakes considerably. Social scientists are quick to spot vanity in policy makers, but often slower to recognize this weakness in themselves.

In the long haul, objectivity may be achievable to an extent in the natural sciences – with much scope for vanity, power, avarice and debate along the way – which do not study things that themselves have ideas and opinions. But in the social sciences, scientists’ theories can be understood by people – the very people being researched – and they can consequently alter the ways in which they behave or how they talk and think about what they do. Drug-dependent criminals come to talk of themselves in the language of health- and social-care professionals (Davies, 1997). Social constructionism cannot be ignored for very long without doing extremely poor social science or science relevant to people. Few theorists with social constructionist or postmodern positions apply this criticism soundly to their own ideas. The fallibility of research evidence does not mean it can be replaced with somewhat informed opinion.

Social constructionism has caused something of a split among social scientists. In psychology this has been characterized by the distinction between ‘social social psychology’ and ‘experimental social psychology’ (Sapsford et al., 1998). Social social psychologists embrace social constructionism and are wary of naïvely ‘scientific’ research on social behaviour. Experimental social psychologists reject social constructionism and believe that objective scientific methods will prevail. There is an equivalent, if less overt, split in criminology. Policy and government-funded research tend to favour the scientific, experimental, quantitative researchers over the critical social constructionists, to the point that, in the USA, qualitative sociological research often occurs in places with names such as the National Development and Research Institute and the Institute for Scientific Analysis to veil their nature. As a pragmatic realist, I accept that both approaches can be useful, but that neither are guaranteed to be true, correct, or even sensible. Progress in drugs and crime research would benefit from improvements of many types, including better use of existing methodologies, better understandings of socially constructed biases in our thinking and research, and the development of new methods.

Another aspect of pragmatic realism is the tolerance of a world that contains a multitude of diverse real things and caution about trying to reduce one level of reality to another. In criminology and mental health research there is often an excess of enthusiasm to reduce human activity to biological explanations such as genetics or neurological differences. Drugs and crime are classes of phenomena where the social and cognitive levels of explanation are important in their own right (see Morton, 2004).

It is also important to appreciate that science is a fallible human and social activity. All too often science, and social science, is presented as resulting in some form of accurate truth. Instead, pragmatic realism suggests that it is important to be wary of the following:

1 grand, single-theory explanations of complex human activities, such as drug use or offending. One should be cautious of assuming that any substance has inevitable effects on human behaviour (Davies, 1992; Shewan et al., 1998) or that any one factor ‘causes’ offending (Armstrong, 2004).
2 reductionist theories that seek to explain complex social activities in terms of individual neuropsychology, without considering the setting and social meaning of the activity. Substance use is a social activity as well as a pharmacological one and can sometimes occur purely for social reasons, without sufficient consumption of an active drug for specific pharmacological effects to be relevant. Examples include injecting heroin too dilute to be active (Johnson et al., 1985) and placebo effects (Stewart-Williams and Podd, 2004). That anything that affects behaviour must have neuropsychological effects is a tautology, not a causal explanation.
3 empiricism, which assumes that with sufficient methodological sophistication the data or the facts can be gathered accurately, without bias, including the conceptual bias inherent in the ways that the problems are labelled. For drugs, this is exemplified by documentation of the ‘risks’ of drug use, as if drug use, the associated risk factors and the consequences could all be measured without problem. All three are often dependent upon self-report data and, even when other harder sources of data are available, these too may be prone to sampling and measurement bias. For example, some people tend to deny or downplay all deviant activities and in surveys will tend to seem neither to use drugs nor to offend.

The biological metaphor

The triple mistakes of grand theory, reductionism and empiricism are common in drugs and crime research. Most research into substance use and dependence is biomedical science. Hammersley and Reid (2002) estimated that 85 per cent of journal articles on key illicit drugs are biomedical in orientation (including animal studies), rather than being concerned at all with the clinical, psychological or social correlates of use. Biological science offers an impressive combination of theory, including the ability to explain how one thing causes another, classification and detailed empirical observation. Sadly, biomedical research has as yet delivered little of use in tackling drug problems. Psychopharmacology has made mistakes historically, such as believing that methadone was a non-addictive substitute for heroin, and has not yet delivered well-targeted theoretically based chemical interventions against drug misuse, although these are repeatedly promised. Over the same five decades there have been considerable advances in the understanding and treatment of substance problems, based upon clinical and non-clinical research on drug users, reviewed in chapter 8. Among these are the widening acceptance of controlled substance use as a possibility, the use of brief interventions, of motivational interviewing and other cognitive behavioural interventions, and harm reduction as a viable approach. Techniques work at rates comparable to the treatment of other mental health problems and have been achieved with relatively modest funding and little or no reference to neuropsychopharmacology.

The brain is increasingly attractive to researchers and policy makers alike. Perhaps the photogenic nature of brain scans appeals to a society whose culture is increasingly visual rather than being concerned with complex verbal constructs. Crime cannot be entirely about the brain, but criminology is often attracted to a type of thinking about social problems that mimics biological thinking without appreciating that social problems and biochemistry are different – as are human and animal behaviour.

Criminology’s roots were in sociology and psychology, but it quite rapidly separated from these themselves immature disciplines. Relevant psychology theory has continued to develop and relevant sub-disciplines include forensic psychology and applied cognitive psychology, which studies issues such as eyewitness testimony and face recognition. As criminology developed into a discipline taught widely at universities, relevant sociology theory began to decline. Up to the 1960s there was considerable interest in deviance, which grounded early criminology, but by the 1970s Foucault described criminology as ‘entirely utilitarian’ (Foucault, 1980, 47) and observed that its mode of operation was to suggest that the practical problems were so pressing that there was no time, perhaps no need, to develop relevant social theory. Rather, criminology is driven by repetitive policy and practice problems. One foreword puts it like this:

Another development in criminology … has been the gradual secession of criminology from the field of sociology. The reasons for this rift are complex, but they include … the eagerness of many universities to exploit the explosive demand among students for courses and degrees that have the word ‘crime’ in them. Many universities have created entirely new programs, departments and degrees around the topic for reasons that make little intellectual sense and that inspire little confidence in the integrity of administrators … if criminologists fail to expose their students to the core disciplines of the social sciences, the long-term consequences could be catastrophic. (Warr, 2002, xii)

‘Catastrophic’ is perhaps overestimating the powers of social researchers and policy makers and underestimating the difficulties of a discipline even recognizing its foundation assumptions. However, thinking about complex social phenomena as if they were well-defined biological ones is a serious mistake.

At this point it is necessary to mention the ‘disease model’ of addiction, given that it remains influential on policy and treatment, particularly in the USA. According to the model, addiction is a disease caused by changes in the brain, perhaps more likely in some brains than others. More detail will be given in chapter 8; suffice it to say for now that the ‘model’ is really more of a metaphor, and ‘disease’ as used in the model is really just the claim that biology is paramount in addiction. Thinking about substance use may be refreshed by describing, then challenging, this more general and endemic ‘biological metaphor’ for substance use, which can be summarized as follows:

Because substances have demonstrable effects on biological systems, it is tempting to believe that use of a substance and its consequences are robust phenomena that meet scientific data quality criteria, operate consistently across people and can be explained by causal reductionist models.

This metaphor is too limited to encompass substance-use behaviour and fails to consider the impact of individual differences or the contexts where use occurs (the ‘set’ and ‘setting’, Zinberg, 1984; see chapter 2). Biological effects of substances are often necessary for substance use (although use of non-active substances, or debatably active substances such as herbal remedies, is widespread) but they are not sufficient.

The model is a ‘metaphor’ because, in both academic and non-academic discourse about substance use and substance problems, biology is applied only loosely. The most obvious example of this is the very use of the term ‘drugs’, as if this applied to some natural biological category that resulted in harm.

Although the biological metaphor fits drugs badly, it is widely used as if literal. Furthermore, there are signs that the biological metaphor is being reapplied to criminology as well, to suggest that a person’s drugs and crime problems are diagnosable conditions of that individual with a predictable development and prognosis. Allegedly, drugs and crime problems are not complex and unpredictable problems with substantial social, systemic and cultural contributions, as well as major influence from the immediate social and physical environment, but rather personal problems that can be prevented by appropriate child rearing, diagnosed unambigously and treated with medical and psychological interventions.


Drugs and crime are linked, but the size, seriousness and causes of this link cannot be taken for granted. Interpretations of the linkage are socially constructed, as are society’s concerns about drugs and crime rather than about other problems. These interpretations influence the very nature of the problems. The biological metaphor that locates ‘problems’ in the constitution and experiences of the person is too simple. A pragmatic realist approach will be used in this book, which considers all relevant types of facts and attempts to understand both drugs and crime themselves and society’s often fearful and negative amplifications of those problems.

Discussion points

Further reading

Davies, J. B. (1992). The myth of addiction. Reading, MA: Harwood Academic.

Zinberg, N. E. (1984). Drug, set and setting: the basis for controlled intoxicant use. New Haven, CT: Yale University Press.

RSA (2007). Drugs – facing facts: the report of the RSA commission on illegal drugs, communities and public policy. London: Royal Society for the Encouragement of Arts, Manufactures and Commerce.

Runciman, R. (ed.) (1999). Drugs and the law: report of the independent inquiry into the Misuse of Drugs Act 1971. London: Police Foundation; [accessed 31 May 2007].


What Are Drugs?

Even more than crime, drugs form a topic where all sources of information are biased. Official sources tend to take a pessimistic view, emphasizing problems and addiction, and hypothesizing that biological factors are primary. For example, the National Institute on Drug Abuse (2006) defined addiction as follows:

Drug addiction is a complex brain disease. It is characterized by drug craving, seeking, and use that can persist even in the face of extremely negative consequences. Drug-seeking may become compulsive in large part as a result of the effects of prolonged drug use on brain functioning and, thus, on behavior. For many people, relapses are possible even after long periods of abstinence.

Many writers in the academic literature are dubious about the usefulness of the disease model of addiction (see further reading), and at minimum not only the drug but also the mindset of the user and the setting of use are important (Zinberg, 1984).


The collective noun ‘drugs’ is often used as if it referred to something clear and concrete. It doesn’t. Imprecise thinking about ‘drugs’ is hardly extraordinary in everyday life, but it is surprising in supposedly educated and informed writing about drug problems. In everyday life ‘drugs’ has two meanings. The most relevant one roughly means ‘substances that have some sort of psychological effect that make people want to take them and are illegal to take in this way’. But many experts would include alcohol and tobacco at least with other drugs, although they are legal to take in many countries, at least by adults under defined conditions. Others see the legal status of substances as irrelevant to scientific definitions and prefer to classify all substances that have some sort of psychological effect that make people want to take them as ‘drugs’, whether they are illegal or not. This should incorporate many ‘drugs’ not in widespread use (see Dalgarno and Shewan, 2005) and probably many natural and synthetic pharmaceuticals that have not yet been used as ‘drugs’. For such reasons some people prefer to refer to ‘chemicals’, as in ‘chemical dependence’, or ‘substances’ instead of drugs. Both these terms seem to me unable to capture the special issues of ‘drugs’. ‘Chemicals’ is problematic for the consumption of plants and other materials where we are unsure about the biochemistry. It is also problematic because it is feasible that some ‘chemical dependencies’ involve only placebo effects, sugar being one example (Reid and Hammersley, 1999), so many chemicals are not ‘drugs’ and some ‘drugs’ are not chemicals (even if they are made of chemicals like everything else). ‘Substances’ is really too wide and potentially includes any food, drink, cosmetic or other substance ingested which might directly or indirectly have psychological effects. If face cream makes users feel happy, is this a ‘mood-altering substance’? Does it matter if it really penetrates the skin or not? A final reason for sticking with ‘drugs’ is that the legal status of substances can have major effects on use. If heroin were legal, inexpensive and freely available without prescription, then different people would use it, in different ways, and different problems would result. It might not be considered a ‘drug’. Alcohol use in Saudi Arabia is not the same behaviour as alcohol use in the UK. At the time of writing, in most of Europe, North America, Australia and New Zealand, tobacco is moving towards being a ‘drug’, having not been classified as such for some eighty years, while cannabis is gravitating in the other direction, towards not being a drug, like alcohol. It is becoming good practice to ask about cannabis separately in surveys and interviews, as young people in the UK (and reportedly in the USA) who use cannabis sometimes believe that they do not take drugs, only ‘blow’.

Unless otherwise specified, when this book mentions ‘drugs’, then it means drugs, alcohol and tobacco, as well as other chemicals or substances that are used sometimes for their psychological effects, but generally not things too far removed from ‘drugs’, such as face cream.

The second, more neutral meaning of ‘drug’ is merely some kind of medicine or possible medicine. This meaning is useful here to remind us that ‘drugs’ have generally been of benefit to humankind. If we could not drug pain, then not only would millions of people suffer from chronic pain but surgery would also be impossible and terminal illnesses such as cancer unendurable. If ‘mood-altering drugs’ did not exist, then more millions would have no relief from the miseries of depression and other psychological problems. It is difficult to get the right statistics, but there seem to be something like 12 million operations in the UK National Health Service every year, of which a large, but unknown, proportion will receive an opiate such as morphine or codeine for pain relief. This compares to an estimated 200,000 to 300,000 people who are problem heroin users. In other words, at minimum there are something like fifty times more medical opiate users than there are problem users, not even counting the many millions of chronic pain sufferers prescribed opiates, or buying weaker forms over the counter. ‘Drugs’ in its more sinister meaning can be a side effect of medicine. Cocaine, cannabis and amphetamines have all been popular medicines in their time.

People who make sweeping generalizations about ‘medicines’ are not generally taken seriously. The advantages and disadvantages of medicines are clearly dependent upon the specific substance being offered as medicine, the dose, what it is supposed to treat, its side effects, and so on. The same applies to drugs. Two oral paracetamol and codeine tablets for pain relief are not the same as injecting dihydrocodeine (DF-118s) as a heroin substitute. Or, take two very contrasting scenarios of use: that by a fifteen-year-old homeless person who has run away from care and that by someone who is terminally ill and in chronic pain. Ignoring issues of legality, people are likely to be concerned about drug use by the homeless child, whether it is of heroin, cannabis or alcohol, and less concerned about use by the terminally ill person.

Some people find it laudable to avoid drugs entirely, including caffeine drinks such as tea, coffee and colas. If one widens ‘drugs’ slightly more, then this becomes problematic. Should one avoid also medicines that help manage mood, like antidepressants? If you should, how badly depressed or unwell should a person be before it is acceptable to take mood-altering drugs? Should one avoid painkillers (analgesics) such as paracetamol, ibuprofen or aspirin? Again, how much pain makes their use acceptable and when does pain permit the use of opiates? The side effects of chronic aspirin use can be very serious – gastric bleeding can be life-threatening. Fear of getting patients addicted can lead to under-dosing patients with opiates, even when they are in serious pain or terminally ill, despite the finding that very few people prescribed morphine for acute serious physical pain become opiate addicts once the pain is over (Nicholson, 2003; Bressler, Geraci and Schatz, 1991).

What about using a drug that can alter mood or relieve pain, but employing it for other purposes, such as taking aspirin to thin blood and reduce the risk of heart attack? Is morality dose-dependent, or contingent on not enjoying the effects of a drug? What about the people who take over-the-counter analgesics daily, perhaps despite not being in pain or having other medical needs for them (Dowling, Storr and Chilcoat, 2006)? Purportedly they do so because they feel better. How much ‘better’ does one have to feel before a medicine is potentially addictive? What about medical marijuana use? As of 2006, eleven US states had passed laws permitting this (see Californian law includes ‘any other illness for which marijuana provides relief ’ (California Proposition 215, 1996, Section 1), and most of the eleven states license its use for chronic pain. Does using cannabis to relieve pain (or other conditions) involve not enjoying it? Can medicine be fun? A complete avoidance of medicines seems irrational in the modern world. Avoiding intoxicants is more feasible, but there is a wide grey area.

People who have recovered from a chemical addiction with Narcotics Anonymous, Alcoholics Anonymous, Cocaine Anonymous or Marijuana Users Anonymous differ in their choice of ‘abstinence’. Some avoid intoxicants entirely, some avoid the substances they had problems with, but continue using others. ‘Avoiding’ intoxicants includes avoiding tea, coffee and tobacco for some, but not for others. Some recovered heroin users avoid alcohol and marijuana. Others do not consider moderate use of these drugs to be a problem for them. Some people stop drinking by turning to marijuana. Some AA members continue to use prescribed mood-managing medication, such as Prozac, while others regard this as perpetuating chemical dependency. There are also now substances that can block all or part of the neuropsychological effects of specific drugs, such as naltrexone for heroin. Should taking these be regarded as a form of chemical dependency or not?

If people with personal expertise and experience in drug abuse disagree about what constitutes unacceptable use, then perhaps drugs and patterns of their use need to be judged on an individual basis. This is highly inconvenient for law making because it is much easier to regulate a chemical by banning or controlling it than by permitting its use under some conditions but not others.

It is also unrealistic to try and draw a watertight distinction between drugs and medicines. Take the following case history, of the Hollywood film producer Don Simpson:

As autopsy reports and pharmaceutical records would later reveal, Simpson … the summer before his death, was on a regimen that included multiple daily injections of Toradol, for pain; Librium, to control his mood swings; Ativan, every six hours, for agitation; Valium, every six hours, for anxiety; Depakote, every six hours, to counter ‘acute mania’; Thorazine, every four hours, for anxiety; Cogentin, for agitation; Vistaril, every six hours, for anxiety; and Lorazepam, every six hours, also for anxiety. He was also taking, in pill and tablet form, additional doses of Valium, plus the pain relievers Vicodin, Diphenoxylate, Diphenhydramine and Colanadine; plus the medications Lithium Carbonate, Nystatin, Narcan, Haloperidol, Promethazine, Benztropine, Unisom, Atarax, Compazine, Xanax, Desyrel, Tigan and Phenobarbital. (Simpson’s pharmaceutical records for July 1995 show billings of $12,902 – from one pharmacy, through one psychiatrist, at a time when Simpson was using at least eight pharmacies and several doctors, receiving medications using the aliases Dan Gordon, Dan Wilson, Don Wilson and Dawn Wilson, in addition to his own name. A law enforcement source who investigated Simpson’s pharmaceutical records estimated his monthly prescription medication expenses at more than $60,000. One ten-day period in August 1995 shows Simpson’s pharmacy expenses at $38,600.) Police and coroners’ documents also show that Simpson was experimenting with prescription doses of Morphine, Seconal and Gamma Hydroxybutyrate, or GHB. These medications were being ingested, autopsy reports would show, in addition to large quantities of alcohol and cocaine … More ominously, Simpson was using heroin. (Fleming, 1998, 8–9)