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I
n its various guises, no drug has widely been considered so enticing as
cocaine. Such beliefs played a part in lurid fears that cocaine would
undermine the World War I war effort – for the Times, a drug even
‘more deadly than bullets’. However, modern-day concern over cocaine
in Britain can be traced back to 20 April 1989, when Robert Stutman,
head of the Drug Enforcement Administration (DEA) in New York,
addressed Britain’s chief police officers.
His subject was the new smokable form, manufactured as small ‘rocks’ called
‘crack’. While snorted cocaine powder had a reputation as the drug for the
champagne set and business high-flyers, crack lent itself to mass distribution in
small quantities to the ‘persistent poor’ of US cities. Rapid onset created what, for
some, was an appealing ‘rush’ – otherwise available only at greater expense
and/or by injecting.
A powerful speaker credited by himself with bringing crack to national
attention in the USA and ‘single-handedly changing the policy of the United States
DEA’, Stutman set about waking Britain up to the threat. His story of an ‘explosion’
of crack use and related violence in New York ignited worries that crack could turn
Toxteth, Handsworth and Deptford into US-style drug ghettos.
Most startling was the revelation that ‘a study that will be released in the next
two to three weeks will probably say that of all of those people who tried crack
three or more times, 75 per cent will become physically addicted at the end of the
third time... We now know that crack is... certainly the most addicting drug
available in Europe. Heroin is not even in the same ballpark.’ Without immediate
action, Britain would, he warned, undergo the US experience within two years.
He was not alone. Addressing UK police chiefs in September 1989, Dr Tuckson,
commissioner of public health in Washington, challenged notions that milder
Britain would not react to crack in the same way as some of the USA’s poor black
neighbourhoods: ‘There is nothing particularly unique about the water... in your
country that would prevent the neurotransmitters and the pleasure centres of the
brains of your citizens [being] overwhelmingly affected by the instantaneous and
powerful euphoria that this drug presents. All you have to do is do it once and I
guarantee you any, almost any, human being would want to do it again.’
Later in 1989 Bob Stutman was paired at a conference on crack with Dr Mark
Gold, founder of the USA’s 1-800 Cocaine helpline. While Stutman told the London
audience his tales from the street, Dr Gold offered scientific evidence of crack’s
addictiveness and violence-inducing properties.
They had been invited by the City of London Corporation, whose delegation
had been ‘deeply shocked’ by a visit to New York. The conference ended with a
resounding attack from the City’s Lord Mayor on the ‘doubting Thomases’ in
Britain who were the ‘biggest problem’ because they did not believe the clear
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evidence about crack, such as that three hits can ‘effectively kill the brain’.
The same year, ‘Three Hits Can Get You Hooked’ was the Sun’s headlined
version of Stutman’s ‘terrifying statistics’. In the Times the as yet unseen study he’d
trailed had become a ‘survey’ which ‘showed’ these disturbing facts, later
attributed to the Home Office itself.
The Independent revealed that senior British police officers had ‘attempted to
trace the studies and the figures he quoted and found they don’t exist’. Still, in
1989 an emergency report from the Commons Home Affairs Committee
highlighted these same ‘facts’. The following year a BBC investigation found
Stutman’s address ‘littered with misinformation’. The claim that 73 per cent of
child-battering deaths in New York in 1988 were perpetrated by crack-using
parents was based on just two deaths, one involving chronic alcoholism, and
Stutman remained unable to produce the ‘three hits and you’re addicted’ study.
If study and ‘facts’ were illusory, so too was the forecast explosion of crack use
and violence. It was not that crack never became a problem – it did, and in some
localities, a big one – but Britain’s problems never rivalled the US experience. If it
emerged at all, the supposed hooking power of the drug came from a
constellation of circumstances, not deterministically from merely trying it a few
times – and circumstances were different in the UK.
Rather than an explosive epidemic, crack crept up to become a feature of the
UK drug scene and of the treatment caseload. In line with population trends, that
caseload has been declining since around 2008. Instead of being hard to stop
using, crack as well as cocaine, turned out to be hard to continue to use. And
rather than ‘not even in the same ballpark’, heroin seems harder to leave behind.
As the patient’s primary drug, across the UK since 2010 cocaine/crack has
accounted for about one in eight entering treatment for drug problems, down from
about one in seven in 2008/09. In contrast, in the early 2000s opiates accounted for
well over half, falling by 2015 to 21 per cent as cannabis took prime position. Total
treatment entrants have fallen, meaning that cocaine/crack treatment entrants too
have fallen from about 20,200 in 2008/09 to about 12,500 in 20 15.
Where in the early 2000s crack was the main variant, by 2015 it was the primary
drug for just 3 per cent of treatment entrants compared to 9 per cent for cocaine
powder. Among patients starting treatment for the very first time, crack as a
primary drug is even less apparent, accounting in 2015 for just over 2 per cent –
only about 720 patients across the UK. Cocaine powder is more prominent,
accounting for 14 per cent. Though uncommon as the main substance for patients
entering treatment, crack is more common as a secondary drug, especially in
England, where in 2015 its use was reported by 43 per cent of primary opiate users.
As well as the peak for treatment numbers, at 3 per cent, 2008/09 was the
peak in the proportion of 16 to 59-year-olds in England and Wales who, when
surveyed, said they had used cocaine in the past year. In 2015/16, all but 0.2 per
cent of the 2.4 per cent had done so in the form of cocaine powder. Across the UK,
most past-year users had taken it just a few times – well short of dependence.
Studies of problem drug use in England have instead estimated crack use by
triangulating from treatment and criminal justice statistics, confirming that
problem crack use is rare – in 2011/12 involving 166,640 adults, about one in 200
of the population. Most were using crack alongside opiates like heroin; about
38,000 were using crack without also using opiates. Crack’s peak in these
estimates came in 2005/06, since when numbers have fallen by 16 per cent.
As for the ‘not in the same ball park’ claim about the comparative
addictiveness of crack and heroin, that seems partly true, but in the opposite
direction. In the latest English national drug treatment study, three to five months
after starting treatment 44 per cent of followed-up heroin users had stopped
using, and after a year, 49 per cent. Corresponding figures for crack were 53 per
cent and 61 per cent, and for cocaine powder, 75 per cent and 68 per cent.
Confirmation comes from treatment completion and non-return figures,
considered indicative of successful treatment. In England, 44 per cent of primarily
crack-dependent patients entering treatment between 2005/06 and 2013/14 were
recorded as not having returned after completing treatment and leaving free of
dependence. For cocaine powder, the proportion was 55 per cent – both much
higher than the 27 per cent for opiates.
The champagne of drugs may be a bubbly treat, and crack a marketing
revolution, but neither can match more mundane intoxicants for staying power
and mass appeal.
Mike Ashton is editor and Natalie Davies is assistant editor of Drug and Alcohol
Findings, findings.org.uk
This article is based on the ‘hot topic’, ‘The ‘explosion’ that never happened; crack
and cocaine use in Britain’ at http://tinyurl.com/yb6djeam. See for further details
and links to source documents.
September 2017 | drinkanddrugsnews | 13