From: bagg@ellis.uchicago.edu (matthew john baggott)
Subject: Re: A question. . .
Reply-To: bagg@midway.uchicago.edu
Organization: University of Chicago
Date: Mon, 4 Jan 1993 19:22:41 GMT

In article <1huvhvINN5eu@usenet.INS.CWRU.Edu> cd741@cleveland.Freenet.Edu (Paul Andarti) writes:
>
>In a previous article, bagg@ellis.uchicago.edu (matthew john baggott) says:
>
>>Just to keep things in perspective, I'd like to point out that many (most?)
>>of the people smoking crack and injecting heroin don't have ATM cards and
>>probably don't have convenience stores open 24 hours in their neighborhoods.

>Oh sigh...sounds like more WoD propaganda.  Let me guess, you think
>all crack users live in the inner city etc.....  Let me suggest that
>you ask your local suburban teenager what *he* does with a box
>of Choreboy....

No. You may not guess what I think.  In the passage you quote, I explicitly
say "many (most?)" users.  If I thought _all_ users fit the media stereotype,
I would have said so. 

(insert Jackson 5 sample and sing "Who's down with W.O.D?  Yeah, you know 
me!")

I'll see what hard numbers I can come up with about the socio-
economic conditions of heroin and crack users.  I have a lot of NIDA
statistics, but they seem to gloss over this issue and just talk in
terms of sex, age, and race.  However, I recently saw a reference to
an article which addresses this exact topic, so I'll try to dig it up.  

This issue will partially come down to how we define "users" (use in 
last year vs. last month vs. last week vs. last day). 

I expect a correlation between severity of problems associated heroin 
use and low socio-economic standing.  Furthermore, I am
sure that sociologists and drug policy experts agree that regular
heroin users, 90% of whom inject, are overwhelmingly concentrated in
metropolitan areas and are relatively poor and undereducated.  A few
years ago, for example, NIDA announced that 22% of IV drug users were
homeless.  Although I would take that statistic with a grain of salt
until I see it in a peer-reviewed journal, it is a suggestive figure.
With respect to heroin-injecting people, the question is, how
many "chippers" (to use Trebach's term) are there whom we can reasonably
consider "regular users."  

For crack, you're certainly right that substantial numbers of
users do not fit the media stereotype of black, inner city gang members
and prostitutes.  I wouldn't try to argue otherwise.  Again, though,
the problems are worse and addictions more likely in the inner city.

Numbers will follow, I hope.

I am disappointed that you failed to quote the entire paragraph, thereby
obscuring the point I was trying to make.  My point was that we cannot
usefully explain drug use (or even drug addiction) by hypothesizing some
kind of pathology in the individual.  In particular, we cannot usefully
hypothesize that users and abusers of the "hardest drugs" (such as crack
and heroin) are too obsessed with instant gratification.  This specific claim
is most obviously ridiculous when we consider how much work and effort it
is to keep enough crack or heroin around.  Daily users are daily buyers
so they have to go through elaborate money-raising and drug-finding
activities on a daily basis.  

>>people turn to injecting because it requires less drug.  The rush of an
>                                     ^^^^^^^^^^^^^^^^^^
>I think you'll find that this is not true, either.
>
>>injection is certainly reinforcing, but it cannot explain why someone would 
>>initiate injection (given the increased risks which accompany injecting).  
>
>Maybe for the same reason they'd do anything that might be harmful....

My comment should be read as a statement about the economics of drug use,
not about the psychology of the individual.  I've repeatedly argued that
individualistic analysis of drug use is not particularly predictive nor
explanatory and this reading is in keeping with my bias.

It is generally accepted that the prevalence of injection among heroin users
is due to the economics.  Read any book on drug policy.
Basically, smoking (or inhaling the fumes of) crack and heroin wastes
substantial amounts of the drug.  IV administration, on the other
hand, wastes none of the drug.  Unfortunately, chronic IV administration is
damaging, particularly when done with unclean needles and adulterated
drug.  Why inject?  Individuals, of course, inject because their drug-using
peers inject.  But why does the practice of injecting persist?  Because
you get more bang for your buck when you inject.  This could be due to
either a better rush (measured by changes in plasma levels of the drug
and onset of subjective effects) or a larger dose (bioavailability).  I 
have asserted it is the latter and published data on bioavailability, plasma 
peaks, and onset of subjective effects all back me up.  There isn't enough 
improvement in the rush when one switches from smoking to injection to explain
the overwhelmining popularity of injection wrt heroin.  Therefore, bioavail-
ability becomes our preferred theory.  [Cocaine is slightly different since
the freebase form, which is the one smoked, crosses the blood-brain
barrier faster and dissapates faster than other forms.  So smoking
crack may be more reinforcing than injecting cocaine.] 

I'll post my references and numbers to back up this part of my argument when
I post what I can find on the breakdown of the cocaine and heroin user
populations.


>>   --M@
>P.