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Drug use and social exclusion: the implications for policy

Dr Aileen O’Gorman

School of Applied Social Sciences

University College Dublinaileen.ogorman@ucd,ie

Scottish Drugs Forum Drug problems and poverty– the poor relations?22 June 2006

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Key issue

Drug use is a widespread social

phenomenon. Yet, ‘problem drug

use’ is concentrated in socially and

spatially excluded neighbourhoods.

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Key questions

• What is a drug problem?

• Why ‘social exclusion’?

• How are socially excluded neighbourhoods created?

• What is the ‘lived experience’ of a socially excluded neighbourhood?

• What is the relationship between living in a socially excluded environment and developing a drug problem?

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Risk environments for problem drug use (1)

• Educational disadvantagePrimary level (34% - 51%)

Early school leaver (36% - 72%) 3rd level education ( 2% - 20%)

• Unemployment ‘joblessness’ (54% - 76%)

long-term (51% - 73%)

• Imbalanced social class composition Professionals (0.4% - 4%)

‘Unclassified’ (13% - 45%)

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Risk environments for problem drug use (2)

• High population density Total population (5,500 – 32,000) 15-29 age group (25% - 40%)

• Population instability (-11% - + 22%)

Cumulative & interconnected variables

Dynamic of social exclusion in a risk environment

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The ‘meaning’ of drug (heroin) use

• Part palliative, part ‘buzz’

• Gives structure and routine to their day

• Gives status, identity, respect

you've nothing to do, you're bored silly, you haven't even got your pride, you don't know who you are when you've no work. At least if you're an addict it's something, ‘I'm a junkie’ do you know what I mean. You don't have worries when you're on it you know, you're just - you're happy. You don't know whether you're happy ‘cos you're sitting there watching Coronation Street or ‘cos you're stoned out of your head. And that's, that's the truth you know It just takes the worry away.

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Joblessness

Alternatives & Opportunities

Education Poverty

Informal Economy

Prison

Social Networks

Life Structure

Social Isolation

DrugCareers

Policy & Political Context

RISK ENVIRONMENTO’Gorman (2005)

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Interpreting the evidence

Could have been interpreted as a culture of poverty, an underclass …. Instead found:

the ‘means’ may be different (constrained by lack of ‘legitimate’ opportunities) the desired ‘ends’ similar

Lethal combination of social exclusion and cultural inclusion - a surfeit of American values [of consumption] (cf. J. Young)

Compensating for exclusion by (over) identifying with the trappings of mainstream culture (cf. C. Nightingale)

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Policy Implications?

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The Policy Cycle Alcock et al. (2004:3)

Policy Proposals

Implementation

Evaluation of policy & effects

Identification of social need

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Analysing the policy discourse

• Dominance of neo-liberal, ‘new right’, ideology – the culture of poverty thesis; welfare dependency; different values from mainstream - the underclass analysis

• Stress on personal failings, family dysfunctions etc. (rather than a failing of the economic and political system)

• Communities of poor people treated as social problems (rather than a product of inequalities)

• Focus on crime and anti-social behaviour; drugs presented as the threat (rather than being symptomatic of other issues)

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Implications for policy• Focus of drugs policy shifts from public health and

harm reduction policies to law enforcement & supply control

• Criminalisation of social policy - social control rather than social care becomes the dominant policy concern

• Drug users subjected to control and surveillance through the drug treatment system, the criminal justice system, and the welfare system

• Moralisation of drugs and social policy – only those willing to be reformed and rehabilitated will be included and assisted. Others will be punished (benefits cut; ASBOs; prison; homeless).

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Policy Response based on evidence • Solutions to drug problems cannot be found in

drug policies alone

• The failure to take broader social, cultural, political and economic context into account in explaining why people living in poor and excluded neighbourhoods develop drug problems means that drug policies are continually compromised

• A focus on ‘reforming’ and/or ‘rehabilitating’ the individual and/or the community is not enough

• Need to focus on structural change and ‘drug proofing’, other public and social policies, such as:– Housing policies (design, management, allocation)– Urban planning and regeneration programmes– Economic/Employment policies– Education policies

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Policy responses?

MEDIUM TERM

• Social care rather than social control

• Interconnected services for interconnected needs

• Treatment – drug user as a patient rather than deviant

• Community development approach to drugs work

LONG TERM

• Tackle inequalities

• Universal policies and services

• Education - equality

• Housing – design, management and allocation policies

• Wealth distribution

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ReferencesAdvisory Council on the Misuse of Drugs (ACMD). (1998). Drug misuse and the environment. London: HMSO.

Currie, E. (1993). Reckoning: Drugs, the cities, and the American future. New York: Hill and Wang.

Lewis, O. (1968). ‘Culture of poverty’ in D. P. Moynihan (ed.) On understanding poverty: Perspectives from the social sciences. New York: Basic Books.

Lloyd, C. (1998). ‘Risk factors for problem drug use: identifying vulnerable groups’, Drugs: Education Prevention and Policy, 5, (3), p217-232.

MacGregor, S. (2003). ‘Social exclusion’, in N. Ellison & C. Pierson (eds,) Developments in British social policy. (2nd ed.) Basingstoke: Palgrave MacMillan, p57-74.

MacGregor, S. (1996). Drugs policy, community and the city. Occasional paper, School of Sociology and Social Policy, Middlesex University.

Murray, C. (1990). The emerging British underclass. London: Institute of Economic Affairs.

Nightingale, C. (1993). On the edge. New York: Basic Books.

O’Gorman, A. (2005). Drug Use and Social Exclusion: the development of heroin careers in risk environments PhD Thesis. Middlesex University

O’Gorman, A. (2000). ‘Researching the social exclusion - problematic drug use nexus’ in J. Fountain (ed.) Understanding and responding to drug use: The role of qualitative research. European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) Monograph. Luxembourg: EC Official Publications, p137-142.

O’Gorman, A. (1998). ‘Illicit drug use in Ireland: An overview of the problem and the policies’, International Journal of Drug Issues, 28, 1, p.155-166.

Pearson, G. & Gilman, M. (1994). ‘Local and regional variations in drug misuse: The British heroin epidemic of the 1980s’ in J. Strang & M. Gossop (eds.) Herion addiction and drug policy: The British system, Oxford: OUP p102-120.

Rhodes, T. (2002). ‘The ‘risk environment’: a framework for understanding and reducing drug related harm’, International Journal of Drug Policy, 13 p85-94.

Young, J. (1999). The exclusive society: Social exclusion, crime and difference in late modernity. London: Sage.