Rethinking Heroin: Use, Addiction and Policy in 'Austerity Britain'

Rethinking Heroin Use, Addiction and Policy in ‘Austerity Britain’ A thesis submitted to the University of Manchester for the degree of Doctor of Philosophy in the Faculty of Humanities 2014 Stephen Wakeman School of Law Centre for Criminology and Criminal Justice Contents Abstract p. 4 Declaration p. 5 Copyright p. 6 About the Author p. 7 Acknowledgements p. 8 Prelude: The ‘Alternative Submission’ Format p. 10 Part One Introduction p. 13 Literature Review p. 26 Methodology p. 65 Part Two Article One p. 92 Fieldwork, Biography and Emotion: Doing Criminological Autoethnography Article Two p. 119 The Moral Economy of Heroin: Reconstituting the Social in ‘Austerity Britain’ Article Three p. 141 Prescribing Heroin for Addiction: Some Untapped Potentials and Unanswered Questions Article Four p. 163 ‘No One Wins. One Side Just Loses More Slowly’: The Wire and Drug Policy 2 Part Three Rethinking Heroin p. 190 Conclusions p. 216 References p. 223 Appendices: Appendix i: Participant Profiles p. 242 Appendix ii: Information Sheet for Prospective Participants p. 243 Total Word Count: 86,177 3 Abstract A thesis submitted to The University of Manchester By Stephen Wakeman For the degree of Doctor of Philosophy In 2014 Rethinking Heroin: Use, Addiction and Policy in ‘Austerity Britain’ This thesis is concerned with heroin. Its use, addiction to it, and the policy measures that have come to surround both in what is now commonly known as ‘austerity Britain’. It provides a set of interlinked arguments around these topics through the presentation of four journal articles and related theoretical engagement with data gleaned from an ethnographic exploration of heroin use in a deprived area of North-West England. Whilst the arguments here are diverse, they share one common thread; the need to rethink what we know about heroin at this particular point in time. To this end the thesis makes original contributions to criminological knowledge surrounding the ways in which drug addiction is researched; the socio- economic role(s) of heroin in marginalised communities; heroin assisted treatment techniques; and the ways in which drug policy problems, and some potential solutions to them, have been culturally (re)presented. Following this, the thesis then teases out some of the links between the above and in so doing, offers a unique and progressive theory of heroin addiction in the UK today alongside some tentative suggestions around the future directions of national drug policy. The potentials and limitations of the above, along with the areas revealed to be in need of future research, are discussed to close. 4 Declaration No portion of the work referred to in the thesis has been submitted in support of an application for another degree or qualification of this or any other university or other institute of learning. 5 Copyright Statement The author of this thesis (including any appendices and/or schedules to this thesis) owns certain copyright or related rights in it (the “Copyright”) and s/he has given The University of Manchester certain rights to use such Copyright, including for administrative purposes. Copies of this thesis, either in full or in extracts and whether in hard or electronic copy, may be made only in accordance with the Copyright, Designs and Patents Act 1988 (as amended) and regulations issued under it or, where appropriate, in accordance with licensing agreements which the University has from time to time. This page must form part of any such copies made. The ownership of certain Copyright, patents, designs, trade marks and other intellectual property (the “Intellectual Property”) and any reproductions of copyright works in the thesis, for example graphs and tables (“Reproductions”), which may be described in this thesis, may not be owned by the author and may be owned by third parties. Such Intellectual Property and Reproductions cannot and must not be made available for use without the prior written permission of the owner(s) of the relevant Intellectual Property and/or Reproductions. Further information on the conditions under which disclosure, publication and commercialisation of this thesis, the Copyright and any Intellectual Property and/or Reproductions described in it may take place is available in the University IP Policy (see http://documents.manchester.ac.uk/DocuInfo.aspx?DocID=487), in any relevant Thesis restriction declarations deposited in the University Library, The University Library’s regulations (see http://www.manchester.ac.uk/library/aboutus/regulations) and in The University’s policy on Presentation of Theses. 6 About the Author Stephen Wakeman is a sociologist interested in drugs. He has a BSc in Criminology and Counselling Skills, an MA in Crime and Justice, and an MRes in Criminology and Socio-Legal Studies. Before entering Higher Education in 2006 he was training to be a counsellor and working in drug rehabilitation centres, homeless hostels, mental health drop-in centres, and at a ‘problem’ youth project. At a number of these institutions he is also an ex-service user. He has taught criminology and sociology at the Universities of Manchester and Chester, and has recently taken up a post as lecturer in criminology at Liverpool John Moores University. His research interests span the sociology of intoxication, but are primarily focused upon heroin and crack cocaine, cultural representations of drugs and drug policy, and drug-using identities/subjectivities. His first book, Corporeality: The Body and Society (co-edited with Cassandra Ogden), was published by Chester University Press in 2013 and he has recently published articles in The British Journal of Criminology and Theoretical Criminology. He tweets as @Steve_Wakeman and keeps a Boston terrier named Lennon that sometimes bites him. 7 Acknowledgements I would like to thank my supervisors Toby Seddon and Judith Aldridge for all their help, support and guidance over the course of the last three years. Their impact upon me as a scholar has been immeasurable and will last for many years to come. I would also like to thank everyone in the Centre for Criminology and Criminal Justice at the University of Manchester for making my time there so enjoyable, especially Dave Gadd and Jo Deakin who were always so supportive of me and my ideas. Finally my biggest debts of gratitude are to my dog Lennon for reminding me that play is important, and to my wife Lisa for making everything matter. 8 I’m on my time with everyone, I have very bad posture Kurt Cobain 9 Prelude: The ‘Alternative Submission’ PhD This PhD thesis follows the ‘alternative submission’ format in that some of its content – indeed, the majority of its content – is submitted in a form suitable for publication in academic journals. The rationale for this was simple, the research questions lent themselves to this format in that they were concerned with two distinct yet similar and interrelated areas: the nature of heroin use in ‘austerity Britain’ and the potentials to be found in alternative drug policy interventions. As such it was agreed upon early in the first year of study that the alternative format would be used. This short prelude will give the reader an overview of the structure of the thesis in terms of its presentation in this format. A traditional introduction covering the content and problematic(s) of the PhD follows below. The thesis is broken down into three main components: Parts One, Two, and Three. Part One contains all the material the University of Manchester’s guidelines stipulate as requirements of any PhD. It contains an introduction which contextualises the research and provides its rationale, a review of the previous literature in this field, and a methodology chapter. Following this, Part Two is a results section containing four ‘chapters’ presented in the form of stand-alone journal articles. Three of these articles have been submitted to peer-reviewed journals, with two having been published at this time. A cover page provides some basic information for each article including the journal it has been (or will be) submitted to, along with its full bibliographic details if already published. As per the guidelines, each article has its own pagination and reference list; the sources cited in these articles are not listed again in the main reference list at the end of the thesis. Other than this no further details are presented around these articles, each is included exactly as it was last submitted to/published by the journal indicated. In the latter sections of the thesis Articles One and Four are cited as Wakeman ‘2014a’ and ‘2014b’ respectively due their published status, the remaining two are cited as ‘Article Two’ and ‘Article Three’. Finally, Part Three then presents a substantial chapter drawing the articles together followed by a conclusions chapter. It is in the former of these that the most significant claims of this work are made. In essence, this chapter is the analytical core of the thesis where the contentions of 10 the articles are incorporated into a coherent body of arguments surrounding heroin use and drug policy today. In closing however there is one potential drawback to using the alternative format that must be noted here – it does regrettably cause some repetition across the thesis as a whole. As journal articles require their own literature reviews and methods sections, the reader will find short sections of Chapter Two reproduced in the literature reviews of Articles Three and Four. Moreover, Articles One, Two and Three have virtually identical methodology sections that are in turn derived directly from Chapter Three. This is both recognised and permitted by the University’s guidelines as a feature of the alternative format, but I have endeavoured to keep it to a minimum throughout – repetition/reproduction never totals more than a few introductory paragraphs in the early parts of the articles.

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