Book Reviews
Living With Drugs
Michael Gossop
ISBN: 978-0-754649-19-9 2007 246 pages Ashgate
Alison Ritter
This sixth edition of Michael Gossop's Living with Drugs, is a very worthwhile and enjoyable read. The first edition was published in 1984, and since that time the book has maintained its relevance through regular updating. The author is a prominent and active international figure in the drug and alcohol field, with extensive experience in drug treatment in the UK, as well as in epidemiology and international drug policy. Over the last 30 years Professor Gossop has witnessed the changing nature of drug use and societal responses to drugs. He has brought that experience to this new edition of his book, providing an overview of types of drugs, drug-taking behaviour, problems associated with drug use and societal responses to drug use. Throughout the book, Gossop emphasises the normality of drug use in our society. The book provides a significant amount of historical information about drugs and their effects, as well as providing the most up-to-date information.
The book is not a text book, and is not a scientific treatise on the nature of drugs in our society. It is likely to appeal to a wide audience as a result and is suitable for general readership. At the same time researchers, practitioners and policy makers are likely to find points of interest, even though the subject matter is treated in a convivial, non-academic way. Gossop takes a sociological perspective, rather than a medical or psychological perspective and hence is well-suited to readers of Health Sociology Review.
The text is not referenced, and this will not suit the more research-oriented reader. For example Gossop describes work on the differences between introverts and extroverts in relation to the experience of drug effects. No references for this research are provided. It is refreshing not to have to trawl through the contrasting scientific literature, but it requires the reader to have faith in the author. In the case of this book, such faith is not misplaced. Gossop also clearly identifies where his own views may contrast with other specialists (such as in the sections on the legal status of drugs). This helpfully signposts the difference between opinion and science.
Gossop provides unusual examples and anecdotes, as he takes the reader through psychological, medical, historical and sociological aspects of drug use. For example the early chapters concentrate on theories of drug use but the usual language of theories is nowhere in sight. The famous and perhaps tired ‘drug, set and setting' from Zinberg is not mention in the book, yet Gossop clearly articulates the important triangulation of the chemical features of a substance, the psychological motives and state of the user, and the environment surrounding use. The complex interaction between these three aspects of drug taking is required in order to understand drug effects.
Chapter 1, ‘The Chemistry of Everyday Life', reminds us that not taking drugs is abnormal. The interpretations of drugs as good or bad and harmless or harmful depend upon the prevailing culture of the time. Later, Gossop gives the example of a white powder that millions of people take many times a day, is associated with harmful effects and when unavailable users experience unpleasant side-effects: the powder is sugar! Chapter 2 outlines drug effects and Chapter 3 discusses the social context of drug use.
Chapters 4 to 8 present the main drug types: prescribed drugs, alcohol, tobacco, cannabis, and hallucinogens respectively. The ‘archetypal drugs of abuse' - heroin, cocaine, amphetamines and benzodiazepines - are then covered in Chapter 9. One chapter is devoted to the control of drugs (Chapter 10) which opens with John Stuart Mill, On Liberty, indicative of the type of literature which Gossop draws on throughout this book.
Chapter 11 then fleshes out a number of ‘Junkie Myths', of most interest to sociologists. He identifies a number of salient myths such the drug pusher and the dope fiend. Likewise the popular image of heroin withdrawal is one of an horrendous and sickening experience that may be life threatening. In reality, heroin withdrawal is akin to a mild case of influenza. With these types of examples, Gossop highlights the dissonance between media and cultural portrayals of drug use and drug users, and the actual reality.
Gossop makes clear throughout that there are no simple answers in relation to drugs. Unintended consequences are a feature of many drug policy options. For example, in the chapter on tobacco, Gossop summarises the complexities associated with one policy: taxation. Taxation on cigarettes is regarded as a highly effective way to control consumption: the higher the price, the lower the consumption. There is good evidence to support price elasticity of demand for drugs, including tobacco. However, as Gossop points out, there are negative unintended consequences of a taxation policy on cigarettes. This includes reliance by governments on tobacco revenue resulting in the tobacco companies having significant political lobbying power. Gossop also notes that in developing countries, the reliance on tobacco taxation revenue is great (for example 41% of all central tax revenue in Haiti in 1983 was from cigarettes). Growing demand for cigarettes across the developing world when countries are seeking greater revenue sources is of concern. Another unintended negative effect of taxation strategies is the development of a black market. ‘About a third of all cigarettes on international sale...come from the black market' (2007:82). Bootleg trade between states and countries is also a significant problem. Throughout the book Gossop gives examples such as these of the complex interplay between positive and negative effects of drug policies.
Gossop is an advocate for policies that reduce legal sanctions against drug users. He notes with concern the growing numbers of prisoners in both the UK and US and the high proportion of drug-related problems within the prisoner population. Given that ‘drug taking is here to stay' (2007:xii) Gossop argues for humane and pragmatic approaches that will reduce drug related harm. The book is written in an easily accessible style, with liberal use of both irony and humour. It is suitable for a general readership. I highly recommend it.
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