Revolutionary High? Exposure to State Violence & Drug Use After

Revolutionary High? Exposure to State Violence & Drug Use after Revolution * Alexandra Domike Blackman † Sarah Kammourh ‡ Elizabeth R. Nugent June 17, 2021 Abstract Does exposure to state violence during revolution increase drug use? We leverage a unique panel study, the Population Council’s Survey of Young People in Egypt (SYPE), to test whether rates of drug use are higher among those who witnessed violence during the 2011 revolution. We nd that exposure to state violence signicantly increases drug use; respondents exposed to violence are twice as likely to use drugs than those who were not, an eect size similar to important predictors such as losing employment, experiencing depression, or becoming less religious. Results are robust to specications that control for respondents’ reported exposure to state violence prior to the revolution and drug use among family and friends, factors identied in medical research as key predictors of drug use. Our study sheds light on the downstream eects of state violence and its implications for public health outcomes and drug policy preferences under repressive regimes. *Assistant Professor, Department of Government, Cornell University. Contact: [email protected]. †Yale College, Class of 2022, Yale University. Contact: [email protected]. ‡Assistant Professor, Department of Political Science, Yale University. Contact: [email protected]. Introduction The use and abuse of drugs is a global epidemic but disproportionately aects developing coun- tries due to high rates of economic precarity and inequality, rapid urbanization, and overburdened medical systems (United Nations’ 2020 World Drug Report). Egypt is a developing country with particu- larly high levels of drug use and abuse. In 2018, the Egyptian Ministry of Social Solidarity reported that the drug abuse rate reached 10.4 percent, nearly double that year’s global average of 5.6 percent (United Nations Oce on Drugs and Crime 2018; Menawy 2018). The widespread use of tramadol, a synethetic opioid, and various cannabis products tops public health issues; addiction to these drugs accounts for the vast majority of admissions to addiction treatment centers and calls to national drug addiction hotlines (Egypt Independent 2020). While rates of drug use in Egypt have steadily risen since the 2000s, recent spikes have blamed on the 2011 revolutionary uprising and its chaotic aftermath. In 2012, the managing director of the addiction unit at Egypt’s Ministry of Health said, “there should be little doubt that drug abuse has risen signicantly since 25 January,” shorthand for the 2011 revolution (Viney 2012). Similarly, the director of Egypt’s Nation Fund for Drug Control and Addiction Treatment claimed the revolution created a 300% increase in drugs rehabilitation center admissions in 2013 (Reuters 2013). These claims are vague on exactly how the revolution increased drug use and abuse. In this paper, we seek to understand what, if any, relationship exists between revolution and drug use. We draw on existing medical understandings of drug use to focus on the eect of one specic aspect of revolution: exposure to state violence. During the revolution and its aftermath, the Egyptian state responded to protest mobilization and opposition in all forms with brute force. A July 2013 counterrevolution included a military coup, renewed deadly violence against protesters, and massive waves of arrests. Between the revolution and the counterrevolution, a large number of Egyptians were exposed to state violence, many for the rst time. We argue that increased exposure to state violence during revolution increases drug use as people self-medicate to cope with this traumatic experience. We leverage a unique panel study of young Egyptians to test whether exposure to violence during the revolution increased drug use. The Population Council’s Survey of YoungPeople in Egypt (SYPE) 1 interviewed 10,916 young adults in 2009 and again in 2013 and 2014. Both waves of the survey asked sev- eral questions about the respondent’s personal drug use and drug use by family and friends. The 2014 instrument also included a battery capturing the respondent’s experience of the 2011 revolution and asked whether they witnessed violence during that time. The panel structure of the data permits us to control for the individual and social factors that might increase an individual’s propensity to use drugs while iso- lating the eect of exposure to violence during the revolution. We nd that exposure to state violence during the 2011 revolution signicantly increased drug use; respondents exposed to violence are 1 to 2 percentage points more likely to subsequently report using drugs than those not exposed to violence. Substantively, the size of this eect is akin to the eect of losing employment, experiencing depression, or becoming less religious, major life events that are found to increase drug use in medical studies. Our results are robust to specications that control for respondents’ reported exposure to state violence prior to the revolution and drug use among friends and family. The paper proceeds as follows. First, we conceptualize revolution and counterrevolution as an experience that exposes the average citizen to state violence, often for the rst time. Second, we provide a brief overview of the 2011 revolution and the history of drug use in Egypt. We then turn to our research design, data, and results. Next, we discuss the implications of our results for public health outcomes and drug policy preferences in repressive political contexts, as well as how these downstream eects may create two unexpected avenues through which state violence can destabilize repressive regimes. In exploring drug policy preferences, we present an original online survey conducted in Egypt in March 2020, in which we nd that respondents who have used drugs or know others who do are more likely to support the depenalization of drug use in Egypt. We conclude by outlining future research. Revolution and State Violence A political revolution is “any and all instances in which a state or political regime is overthrown and thereby transformed by a popular movement in an irregular, extra-constitutional, and/orviolent fash- ion” and necessitates “the mobilization of large numbers of people against the existing state” (Goodwin 2 2001, 11).1 Existing studies of revolutionary success tend to cluster into two groups. Procedural analyses focus on the processes of revolutions – the events, decisions, grievances, and mobilization that create a revolutionary situation (Gurr 1970; Kuran 1991; Tarrow 2011). In contrast, structural analyses pay attention to a revolution’s social, economic, and institutional predecessors, such as the balance of power and the level and nature of socioeconomic development, to explain its outcome (Dix 1984). Scholars have struggled to stipulate a singular measurement of political revolutionary success (Bosi and Uba 2009), simultaneously pointing to a host of policy changes, the replacement of leadership, and shifts in the democratic nature of government. It is much clearer when a revolutionary situation is defeated, its gains reversed and the ancien regime restored or resurrected (Clarke 2021).2 These denitions focus on revolution at the institutional level. Instead, we conceptualize revolution and its aftermath as an experience, with an eye towards how the average citizen might encounter these dramatic events. For participants, a revolution is a whirlwind of emotions. Initially, a revolution is a joyful, even euphoric moment of deep connection with other protesters and innite possibility (Arm- brust 2019). Its defeat, then, creates feelings of hopelessness and inecacy, and increases distrust in others for those invested in its success (Nugent and Homan 2021). However, for the average citizen, a revolution and its defeat are experiences characterized by chaos and increased exposure to state violence. Revolutions are often initiated through nonviolent protests but rarely remain free of violence. Regimes defend themselves by exploiting their monopoly (or at least disproportional ownership) of state violence to repress their challengers. This tends to create interactive escalation, wherein protesters mobilize, states repress protesters in an attempt to demobilize them, and subsequent protests grow by mobilizing both the original targets as well as drawing in additional supporters, in turn increasing the level of force re- quired to tame the masses (Lichbach 1987; Davenport 2007). We hypothesize that it is through exposure to state violence that revolution increases drug use. 1 See also Brinton (1938) and Gross (1958). Mass mobilization stands in contrast to top-down political changes, such as coups d’etat or pacted transitions. 2 How and why the Arab Spring uprisings did not achieve lasting change is beyond the scope of this paper but has been discussed in detail elsewhere (Brownlee, Masoud, and Reynolds 2015; Nugent 2020; Abadeer et al. 2021). 3 Medical and psychological studies nd that exposure to violence correlates with an increase in drug use (Sullivan, Kung, and Farrell 2004; Lofving-Gupta¨ et al. 2018). Violence is broadly dened, encompass- ing violence experienced at school, in the neighborhood, or in the workplace; domestic and parental violence; and mass shootings (North, Smith, and Spitznagel 1997; Sullivan, Kung, and Farrell 2004; Menard, Covey, and Franzese 2015; Lofving-Gupta¨ et al. 2018). In line with these ndings, we expect that individu- als exposed

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