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Articles - Opiates, heroin & methadone
Written by Jean-Paul Grund   



'Coke is king', drugs researcher J.P. Grund tells Harmen Bockma, the jounalist. And that is why the plan of Rotterdam police to distribute heroin free to heavy users is doomed to failure. These days heroin is used to lessen the unpleasant effects of cocaine. 'A functional relationship has evolved between the two drugs. You can't change that by distributing one free. '

Distributing heroin on a small scale to drug addict is practically useless as a tool for fighting drug related problems. Cocaine has become the number one drug in the last few years for the majority of users. You cannot stop the demand for drug number one by distributing drug number two. Cocaine is the engine of the drugs scene.

J.P. Grund, who runs an agency for research into drug abuse, is disappointed at a resent proposal by the Rotterdam police to experiment with distributing heroin to a group of 'heavy addicts'. They feel the this is the only way to bring a halt to the nuisance the users cause Rotterdam police are stretched to the limit. 'We simply do not have the resources to use more police to deal with the nuisance caused by drug users,' according to the 1993 Annual Plan.

Almost one hundred per cent of the drug addicts in my study use heroin as well as cocaine,' says Grund. 'Coke is king.' Heroin has taken on a new role. It is now used to reduce the unpleasant effects of cocaine. A functional relationship has evolved between the two drugs. You can't change that by distributing one of them free.

There are other reasons for Grund's scepticism concerning the plan. 'The down and out users - the people who will probably never kick the heroin habit - are most easily identified as addicts. They are too conspicuous to be able to steal much. Their skills are also severely handicapped by their drug dependence. They just can't run very fast any more . '

Grund has nearly finished a 4-year PhD study of Rotterdam drug users which shows that the approximately 3000 users who make up the drugs scene are able to control their heroin use to a certain extent. But the same does not apply to cocaine and that is where most of the problems occur. Many completely lose control of their habit. As one user told him: 'Coke steals your brain right out of your skull.' Although cocaine is often regarded as a 'Yuppie drug', the study shows that it has become firmly established among heroin addicts.

Significantly cocaine is not snorted but injected like heroin, taken 'Chinese style' (the cocaine is placed on a piece of aluminium foil and heated and the fumes are then inhaled) or 'based' which means smoking it in a special pipe.

Medical dispensing of heroin or injectable drugs on a small scale is perhaps beneficial for a subgroup of users, for example those with serious stages of HIV disease, but will not have a significant impact on the heroin culture as a whole. It does not take away craving for cocaine, and it does not stimulate self-regulation, because control over the use level remains in the hands of an outside force - the doctor who writes the script. It has, furthermore, very little impact on the 'uncontrolled' black market. Instead of medical dispensing, criminal law must gradually be abandoned as the (dominant) instrument of drug policy. By abandoning criminal law the chain between producer and consumer can be regulated more efficiently by simpler enforceable regulation systems - leading to what one might term a 'controlled availability' of drugs. When these drugs become gradually more available, both the users and society at large can learn to cope better with their use.

'Heroin is a "downer",' says Grund. 'The more you use, the more sluggish you become. The opposite is true of cocaine. Because of the way it is introduced into the body it produces a "flash" - a short, very intense "high". It only lasts a very short time so some people repeat a dose after just twenty minutes, sometimes less. Therefore you need much more money.' Heroine is used to combat the terrible 'hangover' which follows cocaine use. It is often used simultaneously.

Mr Grund cites the example (an extreme case) of someone who used a great deal of cocaine every day. 'He followed the postman around every day. Whenever the postman delivered a packet of giro cheques, the man would go along and fish them out of the mail box later. He would get 4500 guilders for three packets from a fence and he used it all up in one day. ' The man has since kicked his habit.

By no means all drug users resort to crime to finance their habit says Grund. 'A study by the Ministry of Justice shows that of all the Amsterdam drug addicts who spend most of their time on the streets, only 22 per cent steal. The rest find other ways to get money.'

According to Grund, the increase since the mid1 980s in drug-related problems, especially around Central Station, has been caused by an increase in the use of cocaine and the slowing down of urban renewal schemes in Rotterdam. The fact that less is being done on urban renewal means that more people end up living on the streets. 'Urban renewal temporarily creates places where people can use drugs without being disturbed. I call them unofficially sanctioned user areas because as long as the users aren't causing any trouble they are left alone. Now more and more users are looking for their kicks on the street because there are fewer available buildings.'

Grund also maintains that addicts have not yet learned to use cocaine properly. 'Heroin has a whole system of rules which have evolved in the twenty years that it has been used. Within the group culture of heroin addicts there are all kinds of accepted standards which ensure that their behaviour does not get out of hand. Cocaine has not come that far yet. The process of learning to control cocaine use is often extremely dramatic for individual users.'

According to Grund there are three inter-related factors which determine whether an addict can control his habit. The first is the availability of the drug. If a drug is easily available like alcohol, there are generally applicable social rituals and rules which control its use.

'Because heroin is prohibited, users concentrate on finding safe places to administer it and channels for obtaining it. Learning the rituals and rules takes longer and is more difficult and that is the second factor. The third is how structured your lifestyle is. A dealer for example who uses himself has to control his habit sufficiently to maintain a certain structure in his life, otherwise he can't earn any money.'

According to Grund the best approach to drug use is by encouraging better cohesion between the three f:actors which strengthen the controlled use of drugs

'Legalising drugs is not feasible at the moment under the Dutch system of legislation and in the current political climate. But you could provide places where addicts could buy and use drugs in a less disruptive way.'

Grund visualises about 20 or 30 'closed clubs', which would be a sort of cross between an opium den and a coffee shop. 'If a dealer with authority were the boss, the problem on the streets would decline,' he predicts. 'The police would have to turn a blind eye to consumer transactions and use in the clubs and tackle whatever drugs related activities occur outside them.

In Grund's opinion Perron 0, a project for addicts set up by Reverend Visser, shows that a sanctuary can work well. 'But it also shows that it musn't be on too large a scale, otherwise things get out of hand.'

Harmen Bockma, Journalist, De Volkskrant

This article was previously printed in the Dutch newspaper

'De Volkskrant', used with kind permission


Our valuable member Jean-Paul Grund has been with us since Sunday, 19 December 2010.

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