Heroin and Crack – What’s on the Tin?

by Paul North


Cannabis has been getting a lot of air time across both radio and TV in the past few months. Various documentaries, panel debates and news stories have covered the issue and examined legalisation of the drug. While this great for the reform movement, and I certainly welcome fresh perspectives on the issue, sometimes all it takes is a few words to throw a spanner in the works and distract from the debate.

The recent BBC Newsbeat documentary ‘Cannabis – Time for Change?’ is a good example of this. Things were progressing nicely, various angles of the debate covered until a drugs worker from London called Louisa declared that she ‘would prefer you (her children) to take heroin than skunk’ and that ‘heroin and crack; it does what is says on the tin’, to which she then suggests that skunk – by which she means high THC, low CBD street cannabis, is more dangerous as it can lead you to be psychotic, while heroin and crack don’t.

If heroin and crack were sold in tins thy would certainly carry quite a health warning, and a pretty severe one at that. Something like ‘this product has a significant chance of ruining highly important aspects of your life’ would suffice.

Opiates deaths are at an all-time high, and we are on the verge of a fentanyl crisis taking place when treatment services are more vulnerable than ever before due to cuts to public health budgets. Crack remains a ferociously addictive drug, and has an evidenced track record of impacting on people’s lives physically, emotionally and socially. Telling anyone (young person or not) that heroin and crack are safer than any other drug because “it does what it says on the tin” is a deeply problematic message. The potential harms associated with both their chronic and acute use are significant and their instance of problematic use is higher than many other drugs.

Telling anyone that cannabis is more dangerous that heroin or crack creates confusion and takes us back to the dark ages in terms of drug education. The gold standard of drugs education is to provide open, honest and accurate information on drugs to create an informed debate.

We need to stop thinking about drugs in such a simplistic way. Understanding harm purely based on the risk of it causing psychosis is no a logical way of thinking. This same mistake is made by many who have been outraged by Louisa’s comments. Just because cannabis is a plant, is used medicinally round the world, and hasn’t directly killed anyone does also not make it safe.

All drug use carries a risk, and we need to educate society on the reality of street cannabis. This should be done by having open, honest and clear conversations with people about evidence, experience and the growing knowledge base we have on the subject.

The most responsible message we can give right now is that consuming street cannabis to help deal with problematic thoughts and feelings carries a risk. There is a growing evidence base that cannabis with high levels of THC and little CBD can for some people lead to a serious deterioration in their mental health. There is also a substantial number of young people using street cannabis problematically in treatment services and academic evidence highlighting how regular use impacts on education. The corollary to this, of course, is that many many people use street cannabis perfectly unproblematically every day.

We should however stop looking at this issue in such a black/white fashion. Mental health, just like physical health, is a spectrum. The debate should mirror this, and acknowledge that although a minority of those who use street cannabis find themselves admitted to hospital, more people than ever before are accessing treatment services for help. Frontline experience in both mental health and drug treatment services suggest street cannabis is playing a key part in this. It is far from the only factor, but it’s one that should be highlighted when discussing harms.

Personal experience should not be used in isolation to educate anyone on drugs. This is taking place on both sides of the debate. It may well be that in Louisa’s personal experience she has seen people in drug treatment who are experiencing more complex or severe problems with cannabis than heroin or crack. This does not make such an experience a fact fit for educational purposes, it is simply one experience. It should be complemented with evidence and research.

The same is true for those who proclaim cannabis is completely safe. Just because an individual who uses cannabis feels it causes them no problems, it does not mean for everyone the drug is safe. This is just an experience of one individual rather than truth. To claim a drug is safe simply because in someone’s experience they have found it to be fine is just as problematic as Louisa’s view.

Education on drugs should empower people to make their own choice about what is right for them. Street cannabis carries risks, and we should certainly continue to debate and explore their nature. To do that we need to recognise that personal experience is not ideal and highly individualised. So much so that if it is not complemented with research or a wider understanding of the issue, the message becomes one that is not fit for purposes of education or raising awareness.

Paul North is an Addiction and Treatment Advisor at Volteface. Tweets @Paul_North

You may also like

Leave a Comment

This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish. Accept

Privacy & Cookies Policy