Collective rites

It is an indisputable fact that, at least for a decade, the use of especially exciting drugs, in particular cocaine, has progressively invaded the scene of the consumption of psychoactive substances, especially among the young, where the consumption of “old-fashioned” heroine or alcohol abuse, which is undergoing sharp growth, has taken on original connotations in comparison with traditional drinking with extremely diversified forms and types of consumption, and the kinds of persons involved. On the basis of the survey conducted on the population and published by the European Observatory last week, consumption is increasing both in terms of the total number of persons involved, and in terms of the ever expanding age range of consumers. It is an age of first consumption of cocaine that begins as early as the age of 14/15 and even earlier as far as cannabis is concerned, that may be prolonged well beyond young adulthood and that is found in ever growing numbers in mature adults of 50 or older. So we are speaking of approximately 3 million consumers of cocaine in Europe last year, of whom at least 800/900 thousand consider they have a “problematic” (i.e. addicted) consumption and only a tiny proportion, no more than 100,000, i.e. 3% of consumers, have sought treatment for drug dependence from public or private services and with a significant time gap (between 6 and 8 years) between initial experimentation and access to services. That means there is an enormous submerged world of problematic drug abusers and consumers about which we know little and still less devote our attention to. The age group in which consumption is highest is between the ages of 15 and 34 with a progressive lowering of the age threshold of first consumption in recent years. This could lead us to speak of a cocaine emergency and to describe apocalyptic scenarios of innumerable new cocaine addicts and multi-substance abusers. The data, however, need to be read with attention, albeit with the deep concern they merit. What the European Observatory tells us with its data is the common denominator that increasingly links determined lifestyles with determined patterns of consumption and abuse.The growth of the transgressive supply, apart from representing a consequence of a modification of attitudes (not only among youth) to the law/transgression dialectic, has rapidly contributed to increase demand, so much so that new “cultural” majorities have been aggregated to so-called transgressive forms of behaviour. If until a decade ago adolescents and youth with so-called transgressive forms of behaviour represented a minority, today those that have never consumed any illegal substance and/or abused those permitted by the law represent an increasingly small minority.The identification with the majority increasingly takes the form of the participation in the collective and ever more homogenizing rite in which the different gradations of drug consumption are expressed. The massive diffusion of especially cocaine consumption and abuse, as is confirmed by all the data of analyses of trends in consumption and the experiences of the various territories, is one of the most shocking data of a profound change that has invested the whole world of drugs in Europe, their consumers, systems of distribution, trafficking and consumption. A significant contribution to understanding these phenomena has been made by the results of a research project conducted in England among a thousand problematic consumers of alcohol and cocaine and their resistance to seek treatment for their condition: they declared their anxiety about the idea of a life devoid of the habits and pleasures connected with the consumption of drugs on which their very social identity had come to be based, because in their eyes life itself without such consumption might lose its meaning and might not be worth living at all; another source of anxiety was connected with their routine, their places of socialization, their agreeable activities and especially some of the personal relations on which they placed most trust, strongly interconnected with their habits of drug use, which they feared to lose.These considerations pose to us a different paradigm of approach to alcohol and cocaine consumption and abuse, namely, that of relating to these abuses by treating habitual consumption not primarily as a chronic disease or exclusively as a social or health-care danger to be combated. Today, in the majority of cases, when we encounter a consumer of cocaine, we find ourselves faced not so much with a situation of distress, but primarily with a situation of consumption in its multiple forms (which, among other things, is unlikely to involve the use of a single substance, from the single experimentation to repeated consumption or episodic abuses, often during the weekend, or real forms of psychological dependence). Drug addiction, rather, is a “collateral and undesired” effect of the assumption of the “doping” effect. We believe that consumption, abuse and dependence on “addictive” substances, where they really exist, require, and have done for some time, to be placed in a logic of possible and adequate responses to ever more complex and diverse demands. The data and the growing needs oblige us to re-think the system of intervention and the instruments so far used in all European countries.