Source: Dagens Nyheter, Stockholm, Sweden Copyright: DN 1999 Pubdate: Tues, 22 June 1999 Section: "DEBATT 990621" (OP-ED) Website: http://www.dn.se/ Author: Ted Goldberg Note: Translated By Lars Hedman, June 23, 1999, 'NINE OUT OF TEN CAN HANDLE TRYING DRUGS' Docent Ted Goldberg: We must abandon the myth that all who experiment with narcotics become addicts. In the past two decades Swedish drug policy has been geared to drive home the message that all non-medical use of narcotics constitutes abuse. In other words: All consumers are equal in this respect. Either reject all narcotics totally or you are an abuser. If a similar either/or attitude was transfered to alcohol it should mean that a glass of wine with dinner would make the drinker just as much an abuser as a down and out alcoholic. In reality the user patterns of both alcohol and narcotics can be considered as a "continuum", meaning that there is a line where a user can be at any several place between the two end points. In one end point place those for who drugs mean nothing ; and in the other those for which drugs are a very important part of life. In between we'll find people with any and all possible patterns of use. There are many different ways to classify the different locations along the continuum, but here I shall only touch on three: Those who abstain totally (at one end point), recreational users (most of the locations along the line) and problem users (the relative few individuals who's lives revolve around narcotics). In Sweden's attempts to present a united narco policy to the country's youth, we have foolishly pretended that "recreational" users do not exist or can only exist for a short period of time. The basis for this pretention it the theory (faulty) that sooner or later all users, regardless of their own will, will become addicts. In order to demonstrate why the theory that "all become addicts" is faulty, I will try to estimate the number of people who have become "problem users" and their numeric relation to those that have only tried drugs. I will base those estimates on available statistics but I must here caution that it is not possible to arrive at exact figures. All statistics within the drug enforcement area suffers from problems of exact collection and measurement and in addition comparison between different investigative data is sometime difficult. The investigations I will use are: 1. Narkomanvardskommitten (Narco Care Committee) approximately 10,000 heavy addicts country-wide in 1967. 2. UNO 1979 (the first of two country-wide investigations of major addiction) approximately 12,000 heavy addicts 1979. 3. UNO 1992 (UNDERSOKNING ON NARKOTIKAS OMFATTNING) (Investigation into Narcotics Penetration) the second country-wide investigation) approximately 17,000 heavy addicts 1992. 4. Since 1988 CAN (The Central Board for Alcohol and Drug Information) has every year assigned SIFO or TEMO (Government Public Opinion Researchers /translator's note) to investigate how many Swedish citizens have tried narcotics and illegal drugs. The results have been published both in the Public Heatlth Institute's and CAN's Annual reports "Drug Developments in Sweden". In the recently published "Rapport 99" the number of Swedes in the age groups 15 - 75 years of age who have tried drugs are given as slightly exceeding half a million. In the analysis below I will follow UNO and use the term "heavy mis-users" instead of "problematic consumers". According to UNO (and even, lately, CAN), heavy mis-users are "all persons with injection use together with all persons with daily or nearly daily use of other narcotics in any form (e.g. cannabis)". How many "recreational users" and how many "heavy mis-users" are there? The simplest estimation is in the 1992 statistics, the last year the county-wide assessment of the heavy mis-use was carried out. That year we recorded nearly 500,000 15 - 75 year olds having tried narcotics and approximately 17,000 "heavy mis-users". It can fairly safely be assumed that approximately 95 percent of those that have tried narcotics are not heavy users. To estimate how many that at one time have been heavy users and quit those must also be counted. Usual estimations abroad are that approximately 3 percent leave the cadres of heavy mis-users every year (due to deaths, rehabilitation, care, etc.) These figures are equally supported by UNO's findings and will be used here. Founded on available statistics I will divide my calculations into four time periods: 1. 1960 - 67 According to Head of Medical Services, Dr.Jan Ramstrom, estimates of Swedish heavy mis-users in the beginning of 1960's were approximately 2,000. Narkomanvardskommitten (Narco Care Committee) estimated the same group at 10,000 in 1967. This should mean that there were approximately 1,700 "new recruites" to replace the 3 percent who annually have left the population during the 1960 - 67 as well as an additional 8,000 thus increasing the number from 2,000 to 10,000. It follows that the total number of "new recruits" for the heavy mis-users group to 1967 can be estimated at 2,000 (1960) + 1,700 + 8,000 11,700. Of these 11,700 only 10,000 remain since 1,700 are no longer registered as addicted. This is because they may have died, left the country, ended up in jail, received proper care or quit by own will power. In continuation of this reasoning I will use the rounded-off figure of 12,000 new recruits. 2. 1968 - 79 UNO estimated the number of heavy mis-users to 12,000 in 1979. Using the same methods as above to calulate the population of heavy mis-users, new recruits numbered approximately 5,000 replacing those leaving the population and, thus, increasing the total number from 10,000 to 12,000. 3. 1980 - 92 UNO found approximately 17,000 heavy mis-users in the country. Again using the same method of calulation the new recruits numbered approximately 10,000 in thirteen years or about 770/year. 4. 1993 - 98 Assuming that we had 5 percent higher recruiting level in 1992 - - 98 than 1979 - 92 we can calculate the number of new recruits in the category heavy mis-users at a little more than 800/year or approximately 5,000 for the six year period. Adding the estimates for the four periods we now arrive at a total of 12,000 + 5,000 + 10,000 + 5,000 32,000 as the number of individuals that at some time since 1960 have been in the category of heavy mis-user of drugs. I will now attempt to estimate the total number of individuals that in 1998 had tried narcotics. According to "Rapport 99" that should be approximately one half million. This figure is too inexact to be used here so I will use CAN's estimate of 500,000 in 1992 and compute how many have been added, using the annual investigations among students in class 9 of the Public Schoolsystem. According to these inquiries the following percent have used narcotics: 1993: 5 percent; 1994: 4,5 percent; 1995: 5,5 percent; 1996: 7,5 percent; 1997: 7,5 percent and 1998: 7,5 percent. Using the number of 100,000 students for each annual group, the total number of students trying narcotics in the period is 37,500, a number wich I have rounded off to 37,000. Adding the changes visible in military conscription investigations and that even older persons may test narcotics, the number increases. I have elected to stay at 537,000. The loss to the population pool of 15 - 75 year olds consists of those demised as well as of those reaching 76 years of age. Estimating the number of death due to narcotics at 750 annually and also estimating that among the additional dead an additional 750 that have tried narcotics, we can decrease the number by 1,500 annually. It can be safely assumed that few of today's 76 year olds have tried narcotics but it will reduce the number of those having tried by an additional 500 persons per year, bringing the total to 2,000 annually. For the six year period 1993 - 1998 we can therefore estimate the reduction to 12,000 individuals. This will bring the total number of individuals who have tried narcotics to 525,000 - a number which is in line with the estimation in "Rapport 99". If 525,000 individuals in Sweden have tried narcotic drugs up till 1998 and, further, if 32,000 of these have become heavy mis-users at some point in their lives, we must conclude that approximately 94 percent of those that have tried narcotic drugs never become heavy mis-users. Naturally, these figures can be questioned but even if the error would be as high as 50 percent it still shows that more than 90 percent of those that have experimented with drugs never graduated to heavy use. Those so called "recreational consumers" have other goals with their drug use than the problem users primarily because these groups are considerably different in life experiences. This explains why the transistion between the two groups are relatively few in numbers. Many Swedish teenagers have likely some time come in contact with recreational users. These young people have difficulty to relate their experiences to the stereotype drug addicts generally portraid. Most teens today have access to the Internet, many travel/study abroad and it's not difficult for this majority to arrive at other information than that which is officially provided in Sweden. If we adults want a reasonable chance to influence our young people and teens in these drug questions we must stop trying to frighten them into abstinence and have a meaningful dialog, taking serious consideration to their experiences and appealing to the adult in these children and teens. TED GOLDBERG Dagens Nyheter "Debate" June 22, 1999 - --- MAP posted-by: Richard Lake