Chapter 1
Introduction
1.1
Drug Self-Administration Routes
For many people, heroin calls to mind images of debased and deteriorated individuals
jabbing themselves with needles. The paraphernalia of injecting --needles and syringes,
spoons and tourniquets-- have become powerful allegories for this psychoactive compound.
Considered from a global perspective, this association is, in fact, only valid for a
minority of heroin users. Heroin, and most other opiates, can be taken into the body in
more, although less efficient, ways. Simple oral ingestion (mixed with food or drink or
not), sniffing and smoking all produce similar states of intoxication. Injecting is only
one of the several routes of heroin self-administration, albeit the most efficient.
Globally, injecting heroin users are outnumbered by those who ingest this drug by method
of smoking or. more correctly, inhalation.
Injection has been the predominate route of heroin self-administration among heroin users in Western societies while heroin smoking has been the most common route in Eastern societies. However, there has been a process of continual 'crossover' with Western routes appearing in the East and Eastern routes appearing in the West. the Netherlands provide a relatively unique social situation, because since the introduction of heroin in 1972 both routes are prevalent. In the Rotterdam ethnographic study, on which this report is partly based, 23% of the contacted drug users inject and 77% smoke their drugs.(1) (2) (3) Several other recent Dutch studies found similar distributions.(4) (5) (6) Recently heroin smoking has also been reported in the United Kingdom.(7) (8) (9) The most common form of heroin smoking in the Netherlands is called 'chinezen' by users, which means chinesing and reveals its Eastern origins. In English speaking countries, this form of heroin smoking is called 'chasing the dragon' or shortly chasing.
1.2 Drug Self-Administration Routes
as Rituals
From an ethnographic perspective, routes of administration when observed in their
social context and meanings can be termed drug administration rituals. The route of
administration is related to the interaction between user preferences, economic variables,
such as price, purity and perceived availability, and socio-cultural variables, such as
pre-existing patterns and (sub)cultural norms. This interaction results in the
formalization of distinctive sequences and meanings associated with the consumption of a
drug. These stylized interaction forms have been referred to as drug administration
rituals. The concept of ritual has been a mainstay in the ethnographic literature on drug
use. Its application goes, however, far beyond this field of inquiry. The concept of
ritual has been fruitfully applied in a broad spectrum of sociological and anthropological
studies, for example investigating traditional tribal societies (10) (11) and modern tribes,(12) religion,(13) (14) everyday casual interaction,(15)
social relations,(16) the formation of cognitive
processes,(17) greeting behaviors,(18) (19) gender aspects in
advertising,(17) art, (20)
and watching television.(21) Rituals play an important
role in many facets of everyday human life. They fulfill various meanings and functions
dependent on the participants' beliefs and the situation at hand. Rituals can be strictly
formal or sacred --e.g. a church ceremony-- or informal and secular --e.g. greeting.(14) (15) They can be
performed by individuals --e.g. a prayer-- or in groups --e.g. a marriage. Individual or
solitary ritual influences the consciousness (and often performance) of the individual,
while social ritual impacts on the collective consciousness of the whole group.(13) Rituals can furthermore have both instrumental and
symbolic functions.(22) For an extensive review of the
scientific literature on the concept of ritual the reader is referred elsewhere.(23)
1.3 The Study:
Ritual as Main Theoretical Concept and Methodology
Ritual has been the main theoretical concept of the NWO-funded fundamental field study
into the drug taking behaviors of regular users of heroin and cocaine, which generated,
and partly entailed the research reported here. Its utilization has proven to be an
extremely productive apprwoach and has resulted in several important practical findings,
such as the description of a, formerly unknown, mode of HIV transmission among injecting
drug users (IDUs) (1) and information on the changing
patterns of cocaine smoking in this population. (3) It has
furthermore generated pioneering theoretical insights and hypotheses concerning the
instrumental and social functions of ritual drug taking patterns and the determinants of
controlled drug use. (24)
The principle methodology of the research has been 'street' ethnography. Intensive participant observation was conducted of drug users' self-administration of heroin and cocaine in their 'natural' setting --at dealing places, their homes, and public places in two neighborhoods of Rotterdam characterized by high concentrations of drug activity-, guided by an observational protocol. The protocol and more elaborate descriptions of the methodology have been published elsewhere.(12) The definition of ritual used in this study has been formulated by Michael Agar: "For an event to be a ritual event it must prescribe a sequence of psychomotor acts and this prescribed psychomotor sequence must be invested with a special meaning for the person performing that sequence, (25)
1.4
Nature and Contents of the Report
An important characteristic of this study has been its combination of the exploratory
nature of the ethnographic method and the generating and, when possible, testing of
hypotheses which emerged from the descriptions of the everyday behaviors of active drug
users. This report provides an example in case. The fieldwork established that chasers and
IDUs largely participate in quite separate networks, although both are segments of a
larger social network structure primarily connected through dealing addresses. It
furthermore suggested that, in contrast with the popular belief, chasing may well be a
stable and persistent pattern of heroin and/or cocaine administration, representing
different (sub)cultural pathways, values and other differences. As Agar has argued,
different ritual self-administration of the same drug may involve very different sequences
of psychomotor behavior and quite different meanings for the user.(25) Finally, the fieldwork suggested that over the years the
distribution of chasing and injecting has been and is gradually changing in favor of the
smoking ritual.
These ethnographic findings inspired the reconstruction of the introduction and spread of the chasing ritual in the Netherlands. A model based on diffusion theory (26) was developed, explaining this phenomenon in terms of a rather rare combination of factors, unique to the Dutch situation. The results of this social-historical exploration are reported in chapter three. To assess the validity of the explanatory model a, from the model derived, hypothesis was tested in a secondary analysis of two separate databases. The results of this secondary analysis are reported in chapter four. In order to facilitate appreciation of the distinguished characteristics of chasing, chapter two provides a basic description of this smoking technique.
1.5 References
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HIV transmission risks: The practice of "frontloading" in the Dutch injecting
drug user population. Journal of Psychoactive Drugs. 1991; 23: 1-10.
2. Grund J-PC, Kaplan CD, Adriaans NFP: Needle sharing in the
Netherlands: An ethnographic analysis. American Journal of Public Health 1991; 81:
1602-1607
3. Grund J-PC, Adriaans NFP, Kaplan CD: Changing cocaine smoking rituals
in the Dutch heroin addict population. British Jdurnal of addiction 1991; 86: 439-448.
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van: Preventing AIDS in drug addicts in Amsterdam. Lancet 1986;ii:1435.
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voor Sociale Geografie, Universiteit van Amsterdam, 1990.
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Legaal en illegaal drugsgebruik (in de regio). Amsterdam: SPCP Amsterdam, 1990.
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