Patterns of new drug emergence: A comment in light of ‘krokodil’

Abstract

Philip Jenkins, in his estimable book “Synthetic Panics: the symbolic politics of designer drugs”, writes about the cycles of emergence and subsidence, as if in waves, of new or modified formulations of psychoactive substances. Almost invariably, these drugs emerge from obscurity in a few localities, are produced and used by an unknown but probably small number of experimenters, and then “exposed” by an intrepid reporter or two following up on information from a police or medical contact. Thereafter, the use expands and then most often quickly peaks. The rate at which the pattern unfolds seems to depend upon the ease of synthesis or acquisition, the market potential, and the appearance of relative benefit or adverse effects of its use. Faced with an emergence of a new drug, anti-drug authorities seize on a combination of strategies to reduce it expanding, using an almost standard characterization of the drug as the newest, greatest menace, likely to do more damage than the previous worst-ever drug it is seen to be displacing. The strategies include a mix of criminalization, control of the reactants in the synthesis or the possibilities for drug diversion or prescribing, demonization of the drug’s effects, and dehumanization of its users. Almost invariably, the drug is described as “the most dangerous drug yet”, worse than the previous most dangerous drug yet. And if the drug is being used by marginalized populations, the strategies take their harshest form. Reinerman and Levine demonstrate this point clearly in comparing free-base cocaine used by the rich and its commercialized form, crack, used by the urban poor and minorities (Reinerman & Levine, 2004). In the former case, drug treatment expanded; in the latter, criminal penalties were escalated, creating “…the most massive wave of imprisonment in the history of the United States” (Bureau of Justice Statistics, 1995; Reinerman & Levine, 2004). But the macro-level use patterns of drugs as they emerge and their use spreads often have a life of their own, defying efforts for control or receding to become historical footnotes without any assist from the authorities. A paradigmatic example of this approach to curtail and the counterintuitive effects of such efforts can be seen in the U.S. responses to reports of increasing methamphetamine use in the American heartland during the past decade. A parallel example can be seen in looking at the response to the emergence of krokodil use in the countries of the former Soviet Union. Comparison of these two patterns of drug emergence and spread reveals some interesting similarities and differences.