Introduction - University of South Wales Research …€¦ · Web viewFighting like M-Cats and dogs: Users’ accounts of the links between mephedrone use and violenceDr Fiona Brookman

Fighting Like M-Cats and Dogs

Fighting like M-Cats and dogs: Users’ accounts of the links between mephedrone

use and violence

Dr Fiona BrookmanProfessor of CriminologyUniversity of South Wales

Pontypridd, CF37 1DLTel: 01443 482572

Email:[email protected]

Dr Trevor H. BennettEmeritus Professor of Criminology

University of South WalesPontypridd, CF37 1DL

Tel: 01443 482236Email:[email protected]

(Corresponding author)

Citation details: Brookman, F., and Bennett, T. (2017), ‘"Fighting like M-Cats and dogs: Users’ accounts of the links between mephedrone use and violence", The European Journal of Criminology, First Published January 3, 2017 online at: http://journals.sagepub.com/doi/full/10.1177/1477370816686121

Brookman and Bennett (2017). Please refer to DOI: 10.1177/1477370816686121 for published PDF.

http://dx.doi.org/10.1177/1477370816686121

http://journals.sagepub.com/doi/full/10.1177/1477370816686121


Abstract

There is a growing belief among medical practitioners and researchers

that mephedrone use and violence are in some way connected. However,

there has been little research conducted on either the association or the

causal connection between mephedrone use and violence. Drawing upon

in-depth, semi-structured interviews with 12 mephedrone users and open-

ended questions from a questionnaire survey of 67 mephedrone users,

the paper explores the relationship between mephedrone use and violent

behaviour as perceived by users. Our research adds to current knowledge

by presenting users’ accounts of the connection between mephedrone use

and violence, by suggesting ways of applying current discussions on

mechanisms-based causality in an empirical setting, and by building on

Goldstein’s (1985) tripartite framework through the development of

frequently occurring sub-categories.

Keywords

mephedrone, violence, aggression, drugs-violence nexus, accounts

Author biographies

Fiona Brookman is Professor of Criminology at the University of South

Wales. Using qualitative methods, she explores the characteristics and

causes of homicide and violence and the police investigation of homicide.


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She is currently undertaking ethnographic research on the role of forensic

science and technology in homicide investigations in Britain.

Trevor Bennett is Emeritus Professor of Criminology at the University of

South Wales. He has published widely in the area of offender behaviour,

crime prevention, policing, drugs, crime and the drugs-crime connection.

He is co-author of Understanding Drugs, Alcohol and Crime (2005), Drug-

Crime Connections (2007), and co-editor of the Handbook on Crime

(2010).


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Fighting like M-Cats and dogs: Users’ accounts of the links between mephedrone use and violence

Introduction

There is a growing belief among medical practitioners and researchers

that mephedrone use and violence are connected (Daly, 2012; Lusthof et

al., 2011; Sedefov and Gallegos, 2011; Van Hout and Bingham, 2012). The

evidence for this comes from a small number of case studies and

anecdotal reports of mephedrone users behaving aggressively or violently

following use of the drug (John et al., 2014; Lusthof et al., 2011; Wood and

Dargan, 2010). Apart from these studies, there has been little research

published on the relationship between mephedrone and violence.

Mephedrone is the common name for the synthetic cathinone 4-

methylmethcathinone which has similarities to the African shrub Khat

(Mackay et al., 2011; Sedefov and Gallegos, 2011). Common street names

for mephedrone include: ‘meow meow’, ‘plant feeder’, ‘bubbles’, ‘top cat’,

and ‘M-Cat’ (Measham et al., 2010; Sedefov and Gallegos, 2011; Winstock

et al., 2011). Mephedrone is usually sold as a white powder in capsules or

bags and is typically ‘snorted’ or taken orally. Oral use includes

swallowing capsules, tablets, or powder, as well as wrapping the

substance in cigarette paper (‘bombing’) prior to swallowing (Measham et

al., 2010). It can also be injected (Nutt, 2012). In March 2010, the UK

Advisory Council on the Misuse of Drugs (ACMD) recommended that


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mephedrone be classified as Class B controlled substance under the

Misuse of Drugs Act 1971 (Advisory Council on the Misuse of Drugs, 2010).

Mephedrone is one of the new psychoactive substances previously known

as ‘legal highs’. As a result, it does not have a long history of patterns and

trends. The main source of information on changes in mephedrone use is

the Crime Survey for England and Wales drug use module, which has

published data on mephedrone use since 2010/11 (Lader, 2015). In

2014/15, lifetime mephedrone use was reported by 2.2 per cent of 16-59

year olds and 5.3 per cent of 16-24 year olds, and last year use was

mentioned by 0.5 per cent of 16-59 year olds and 1.9 per cent of 16-24

year olds. Hence, mephedrone is used more frequently by young adults

than in the general population as a whole.

The aim of the paper is to examine the nature of the relationship between

mephedrone use and violent behaviour. Investigating any aspect of the

drugs-crime connection is fraught with difficulties as one of the central

concerns of the debate is the extent to which the links can be considered

causal. This raises the broader issue of what constitutes a causal

relationship and how a causal connection might compare with a

correlation or association. The problem of defining causality is currently

receiving considerable debate in the social sciences (Mahoney, 2001;

Friedrichs, 2016; Hedström and Ylikoski, 2010; Gerring, 2008; Hedström,

2008). In order to discuss the connection between mephedrone use and

violence, it might be helpful to address briefly some of these issues and

define the key terms.


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The main distinction to make is when drugs and crime are causally

connected and when they are merely associated. In the case of the

former, there is tangible mechanism that links the two events and the

cause precedes the effect. In the case of the latter, there is no such link

and one might not always precede the other. There are at least two

conditions under which co-occurring events might be defined as an

association rather than a causal connection. The first is when the

concurrent events are correlated through a third factor that causes both

of them (Befani, 2011). This kind of relationship is sometimes referred to

as a ‘common cause’ or ‘spurious ‘connection (Friedrichs, 2016). The

second is when there is no clear mechanism or process linking the two

events (Hedström and Ylikoski, 2010).

The current debate in the social sciences has focused on the constituents

of a causal explanation rather than a causal connection. It is argued that a

causal connection can be defined as when one event influences another.

However, a causal explanation requires knowledge of the process by

which the influence occurs (Befani, 2011). One common feature of a

causal explanation is the idea of identifying a ‘mechanism’ that creates a

tangible link between cause and effect (Dalkin et al., 2015; Falleti and

Lynch, 2009; Gangl, 2010; Hedström, 2008; Pawson and Tilley, 1997).


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There are a large number of potential definitions of a ‘causal mechanism’.

Gerring (2008), for example, has noted nine different meanings of the

term ‘mechanism’ in the social sciences. He rejected eight of the nine on

the grounds that they were repetitive or contradictory and selected one

that he believed was consistent with contemporary usage, namely: ‘a

pathway or process by which an effect is produced’ (Gerring, 2008)

(p.162). In another study, the author found 24 different usages of the term

‘mechanism’, which he combined into three groups: an intervening

variable, a theory of the connection, and ‘an observed entity that–when

activated- generates an outcome of interest’ (Mahoney, 2001)(p.580).

Studies of the drugs-crime connection have also struggled with the

problem of how to define and identify a causal explanation. Some authors

have argued the need for complex models involving several factors

operating at different levels in order to provide acceptable explanatory

power (Seddon, 2000; Seddon, 2006). Others have stressed the need to

take into account the social context in which the events under study take

place (Pawson and Tilley, 1997). There have also been suggestions to take

into account the offender’s perspective in determining whether the

connection is causal (Bennett and Holloway, 2007). A study conducted in

Australia, for example, reported that 32 per cent of detainees in police

custody suites who had used illegal drugs in the previous month thought

that their drug use contributed to the offence for which they were

currently detained (Payne and Gaffney, 2012).


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In the current paper, we will draw on the discussions above to consider

whether there is a causal relationship between mephedrone use and

violence. This means that we will consider not only whether the events

occur together (thus establishing the first stage of a causal connection

that there must be an association), but also whether there exists a

plausible ‘mechanism’ that creates a tangible link between the potential

cause and effect. We will base our search for mechanisms on Goldstein’s

conceptual framework of three broad processes: ‘psychopharmacological’,

‘economic-compulsive’, and ‘systemic’ (Goldstein, 1985). We will argue

that, while Goldstein’s framework is a useful starting point, the three

elements proposed need further deconstruction to identify the lower-level

mechanisms at work. In our own study of mephedrone users in South

Wales, we look beneath the surface of the broad categories proposed by

Goldstein to determine the extent to which mephedrone use influences

violence.

Literature review

There are several limitations to the empirical research on the relationship

between drugs and violent crime that inhibit clear conclusions. Research

has tended to be ad hoc in terms of its location, sample selected, and the

drugs investigated (Brownstein, 2016). This means that there are gaps in

the knowledge about the drugs-violence connection. The lack of

consistency in research methods used also limits our ability to compare

factors of interest across studies, such as country of origin or area

location. The research also shares many of the problems associated with


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defining causality discussed earlier. The fact that drug use and violent

behaviour might be concurrent does not alone provide evidence of a

causal relationship (Stevens, 2007). Further, the drugs-violence nexus has

been investigated predominantly in relation to the links between alcohol

or stimulant drugs and violent crime. Much less is known about the role of

other drugs in the generation of violence, including the new psychoactive

substances.

The following review focuses on what is known about the association

between drug use and violence and what is known about the evidence on

linking mechanisms that might form the basis of a causal explanation. The

review is divided into four sub-headings: (1) research on the association

between mephedrone and violence; (2) research on mechanisms linking

mephedrone use and violence; (3) research on the association between

other stimulant drugs and violence; and (4) research on mechanisms

linking other stimulant drugs and violence.

Research on the connection between mephedrone and violence

Most of the current research on mephedrone and violence comes from

medical case studies and anecdotal examples found in official reports. The

Advisory Council on the Misuse of Drugs, for example, reported cases of

mephedrone users funding their use through robbery and burglary. They

also reported cases of violence associated with trading mephedrone on

the streets (Advisory Council on the Misuse of Drugs, 2010).


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The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)

gave examples of violence in Northern Ireland resulting from mephedrone

sellers being targeted by the paramilitary and violence in Guernsey

relating to street trading of mephedrone (Sedefov and Gallegos, 2011).

Research on users presenting to emergency departments frequently cite

aggression as a side effect of the drug. A study of 20 patients presenting

to Edinburgh and Falkirk health services for problems relating to

mephedrone use reported that aggression was the most common problem

(Mackay et al., 2011). There has also been some research based on

interviews with users. One study conducted in the Republic of Ireland

discussed an example of a mephedrone user who described an occasion

following mephedrone use when he nearly slit the throat of someone who

had challenged him and only refrained from doing so because the police

were nearby (Van Hout and Bingham, 2012). Overall, the existing research

on the association between mephedrone use and violence is sparse and

more research is needed before a connection can be more firmly

established.

Research on the mechanisms linking mephedrone use and violence

Some insight into the association between mephedrone use and violence

can be found in research on the mechanisms that might link them. One of

the most common mechanisms mentioned is the tendency for

mephedrone users to become paranoid. One clinical study, for example,

described the case of a 40-year-old man with no past psychiatric history


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admitted to an inpatient psychiatry unit as a result of his recent paranoid

behaviour following use of mephedrone. His wife reported to the police

that he had recently purchased a gun with the plan to shoot

neighbourhood children who he believed were trespassers on his property

and wanted to kill him (John et al., 2014). Another study, based on in-

depth interviews with mephedrone users attending a harm reduction

service in the Republic of Ireland, reported that paranoia contributed to

elevated levels of aggression among users and participation in violent

criminal acts (Van Hout and Bingham, 2012).

The research has also drawn attention to the dissociative and psychotic

effects of the drug as possible linking mechanisms. One clinical study, for

example, described a case of a 36-year old man who had injured himself

severely by smashing windows in a rage of fury following mephedrone use

and later died (Lusthof et al., 2011). The authors concluded that the state

of rage was the result of the toxic effects of mephedrone leading to

aggression, hallucination, and psychosis.

Research on the connection between other stimulant drugs and violence

There is some research that has shown that cocaine use and violent

behaviour are statistically associated (Copeland and Sorensen, 2001;

Giannini et al., 1993; Kuhns and Clodfelter, 2009). Parker and Auerhahn

(1998), for example, noted that under some circumstances cocaine use

and violent behaviour were connected. Methods of delivering the most

intense and immediate effects, such as smoking the drug and taking the


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drug intravenously, were most closely associated with violent behaviour

following cocaine use. Violence also has been associated with

amphetamine use (Boles and Miotto, 2003; Miczek and Tidey, 1989; Nurco

et al., 1991). (Wright and Klee, 2001) interviewed 86 amphetamine users,

half of whom were seeking drug treatment and the other half were not in

treatment. Von Mayrhauser et al. (2002) investigated methamphetamine

users in Los Angeles and found that almost two-thirds of the participants

interviewed reported violent behaviour (time period not mentioned).

Research on the mechanisms linking other stimulant drugs and violence.

The classic work on mechanisms linking drug use and violence is

Goldstein (1985) tripartite conceptual framework that divided

explanations into three types: psychopharmacological’ ‘economic-

compulsive’, and ‘systemic’. The psycho-pharmacological model proposes

that some individual become aggressive and violent as a result of the

psychopharmacological properties of specific substances. The economic-

compulsive model suggests that some drug users engage in economically-

oriented violent crime, such as robbery and burglary, in order to support

drug use. The systemic model suggests that violence results from the

aggressive interaction inherent within drug markets and the process of

buying and selling drugs.


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Since this work, there have been several empirical studies that have

drawn upon, or expanded the approach. Much of this research has

focused on drug markets as generators of violence. Drug market

transactions sometimes involve punishment or deterrent violence in

response to infractions, such as failure to pay for drugs (Jacques et al.,

2014). Drug dealers typically carry large amounts of cash on them, as well

as supplies of drugs, which makes them an attractive targets for robbery

(Jacobs and Wright, 2006; Wright and Decker, 1997). Drug market

violence stems in part from retaliation of those victimised within the

market. Instead of calling the police, the victims take the law into their

own hands (Jacobs and Wright, 2006; Topalli and Fornango, 2002).

Research has also been conducted that has looked at the mechanisms

linking drug use and crime across a broad range of drugs and offences.

Bennett and Holloway (2009) examined the drugs-crime connection

across nine offence types and found that the most common mechanisms

across all offences combined were ‘economic’ (56 per cent of all

mechanisms identified), followed by ‘pharmacological’ (37 per cent) and

‘lifestyle’ (7 per cent). However, linking mechanisms varied by crime type.

The most common mechanisms associated with drug use and assault

were aggression and judgement impairment (both psychopharmacological

explanations) and the most common link between drug use and robbery

was economic, followed by judgement impairment.

Data and methods


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The current data derive from a larger study of mephedrone use in South

Wales1. The findings reported here were based on two main methods: (1)

a questionnaire survey of 67 mephedrone users, primarily aimed at

exploring patterns of use, but included questions on aggression and

violence, and (2) a semi-structured interview with 12 mephedrone users

to explore in-depth the links between mephedrone use and violence. The

main results of the paper are based on the semi-structured interview

which focuses on the details of the events at the time of mephedrone use.

The results of the questionnaire survey also have been included in the

paper as they contained

relevant descriptions of the experience of mephedrone use. The

interviews were conducted between May and September 2013 and the

survey data were collected between May 2013 and February 2014.

The questionnaire survey of mephedrone users

Mephedrone users who took part in the users’ survey were contacted

through 14 local agencies dealing with drug problems in South Wales,

including: criminal justice services, mental health day services and

charitable organisations providing support for users and their families. The

questionnaires were hand-delivered or e-mailed to the agencies involved.

Staff at the agencies were asked to distribute the questionnaires to clients

who were known by them to be mephedrone users. Further, the

researcher sometimes distributed questionnaires herself while attending

the agencies to undertake interviews. The achieved sample thus 1 The research covered the southern part of Wales from Llanelli and Swansea in the South West to Newport in the South East and Brynmawr and Ebbw Vale in the Northern part of southern Wales. It covered two police force areas (South Wales Police and Gwent Police). The larger project also involved interviews with ‘experts’ who worked with mephedrone users either in drug-treatment agencies or prisons.


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comprised a convenience sample of known mephedrone user who were

currently clients of the agencies involved and willing to take part.

The questionnaire contained both closed and open-ended questions. The

closed questions covered mainly issues unrelated to the current paper,

such as onset, extent and patterns of use, methods of ingestion and

supply questions. The open-ended questions asked respondents whether

they had felt aggressive or acted violently following use of mephedrone. If

yes, they were asked: ‘Please describe the occasion when you acted

aggressively or violently; who (or what) did you threaten, hurt or damage;

what were the triggers; what was the outcome’? The aim of the open-

ended questions was to obtain a brief narrative on how the events

between use of mephedrone and violent acts unfolded. On some

occasions, drug-workers or the researcher assisted clients in the

completion of questionnaires by, for example, recording their words

verbatim onto the questionnaire on their behalf.

Almost three quarters of those who completed the questionnaire were

male, the remaining 27 per cent were female. Almost half (48%) of the

sample were aged between 18 and 29, a further 40 per cent were aged

over 30 years, and 12 per cent were aged under 18. Approximately half of

the users in this sample (47%) used mephedrone on a daily basis, 19 per

cent used mephedrone once a week, 15 per cent every other day, and 13

percent once a month). A small number of users consumed the drug every

other week (6%).


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The semi-structured interview with mephedrone users

Semi-structured, in-depth interviews were conducted with 12 mephedrone

users. The users were all contacted through the agencies mentioned

above, namely: criminal justice services, mental health day services and

charitable organisations dealing with drug problems. Mephedrone users

currently under the remit of the agency were asked by agency staff if they

would be willing to talk to a researcher about their experiences of using

mephedrone. As was the case with the survey, the selected respondents

comprised a convenience sample of mephedrone users currently available

at the selected agencies. Interviews were conducted in a suitable location

on the premises of the agency involved. On average, the interviews

lasted 40 minutes.

The interview schedule comprised 20 topic areas covering background,

drug use, and occasions when the respondent became aggressive or

violent following mephedrone use. All respondents were asked if they had

ever caused harm to themselves or others while using mephedrone. Those

that had, were read a prompt: ‘Thinking back to a time when using

mephedrone you became aggressive or violent, could you talk me through

what happened‘. The exact phrasing of the question varied slightly

depending on the situation, but always requested that the respondent

provided a narrative of a particular event when mephedrone was used

and violence occurred. They were also asked: ‘Do you think that you

would have acted violently on this occasion if you had not taken


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mephedrone?’ The interviews were audio recorded and subsequently

transcribed verbatim.

Analysis

The open-ended and interview responses were analysed in the same way.

The transcripts of the interviews or typed copies of the questionnaire

responses were entered into a qualitative software package (NVivo 10)

and analysed thematically. This involved establishing common nodes

relating to the effects of the drug (e.g. ‘anger’), the nature of the violence

(e.g. ‘violence’), as well as potential linking mechanisms connecting the

two (e.g. ‘paranoia’). The choice of nodes was partly our choice based on

our understanding of the literature and choices that emerged from

reading the transcripts. The overall aim of the analysis was to identify

potential mechanisms that might link mephedrone use with violence.

The sample

Table 1 provides an overview of the mephedrone users who were

interviewed. As shown, two-thirds (N=8) of those interviewed were male

and one-third (N=4) were female. Interviewees were aged between 20

and 39, with an average age of 28. The extent of their exposure to

mephedrone was varied with over 40 per cent (N=5) of the sample using

the drug daily and 40 per cent (N=5) of the sample using mephedrone


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only at weekends. One respondent consumed mephedrone every other

day and one respondent had only used the drug twice.

***Table 1 about here ***

Ethical issues

All participants approached to take part in the study were provided with

detailed information about the purposes of the research, including how

the information that they provided would be stored and how the research

findings would be disseminated. All of the users who took part in

interviews were initially approached by a member of staff who explained

the nature of the research. This information was repeated by the

researcher at the beginning of the interview. The voluntary nature of the

participation was carefully explained to all participants, as well as the fact

that they could withdraw from the interview at any stage.

Assurances of anonymity and confidentiality were provided at the outset

and explained carefully again at the time of the interview. All interviewees

were assured that they would not be named in any publications arising

from the research. The users were asked to select a pseudonym and were

told that these self-assigned names would be used in any publications.

Those surveyed by questionnaire were allocated a questionnaire number.

Avoiding harm to participants required being cognisant of any emotional

distress that might arise from taking part in the research and taking


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appropriate remedial action when this did occur. We were also careful to

ensure that neither the respondent nor the interviewer came to any harm

as a result of participating in the research. The interviews all took place in

safe areas in the agencies involved. The interviewees were told that they

could stop the interview at any time should they feel uncomfortable or

stressed.

In most cases, the interviews ran smoothly. However, during one of the

interviews with a mephedrone user (that took place in a prison) the male

interviewee began to perspire heavily and appeared uncomfortable as he

talked in detail about the effects of mephedrone. He was provided with a

glass of water and asked if he would like to have a break or stop the

interview altogether. He explained that just thinking about mephedrone

made him crave for the drug. After a short break, he indicated that he

was happy to continue. However, he soon appeared uncomfortable again

and so the interview was terminated. The interviewee was referred to his

drug worker for support.

Limitations

The method of selecting the samples (i.e. users from a particular

geographical and social community, drawn from agencies, including

criminal justice agencies, working with drug-users) means that the

respondents were not necessarily typical mephedrone users. Instead they

are likely to include more problematic users in terms of their level of

involvement in drugs use and other forms of problem behaviour, including


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criminal behaviour. While the sample cannot be viewed as representative

of all mephedrone users, it provides an insight into the nature of the links

between mephedrone use and violence within a sample of users currently

attending drug or criminal justice agencies.

Results

In order to establish whether there is a causal connection between

mephedrone use and violence, it is necessary to establish both an

association (when there is one there is often the other) and a clear causal

pathway or process linking the two. We begin by examining whether there

is an association between mephedrone use and violence and move on to

consider whether there are any plausible mechanisms that might provide

a causal link between the two.

The association

Just under half of the questionnaire survey respondents reported feeling

aggressive after using mephedrone (44%) and a similar proportion said

that they had acted violently (42%). In contrast, three-quarters of the

interview respondents said that they felt aggressive after using

mephedrone (75%) and the same proportion (75%) said that they had

acted violently. To check whether these apparent differences were

meaningful or a result of sampling variations, we conducted a significance

test. This indicated that the differences in the proportions across the two

surveys were not statistically significant (aggression: p=0.065; and

violence: p=0.057; Fisher’s Exact Test).


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We also examined whether there were any important differences in the

composition of the two samples. This showed that there were no

significant differences in terms of gender (p=0.731), age (p=0.543) or

regularity of mephedrone use (p=0.539). Hence, on these criteria, the

analysis indicates that the two groups could have been drawn from the

same population (which in terms of location and agencies, they were).

The results show that a notable proportion of mephedrone users in both

samples reported that they felt angry or were violent after consuming

mephedrone. However, they also show that some users reported an

association while others did not. This raises the question of whether there

were any differences between mephedrone users who became aggressive

or violent and other users. Users who reported feeling aggressive or

violent were compared with other users in terms of gender, age, and

frequency of use of mephedrone. We found no significant difference in any

of the comparisons: gender (aggression p=.835; violence p=.658), age

(aggression p=.723; violence p=.891), or use rate (aggression p=.067;

violence p=.329) (Chi-square test with continuity correction). Hence, the

differences between mephedrone users who became aggressive and

violent and those who did not cannot be explained by these individual

characteristics.

Overall, the findings show that there is an association between

mephedrone use and violence among a substantial proportion of users


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who took part in this study. However, there are some users that do not

report an association. In the following, we will focus on those users who

reported an association and consider the extent to which the association

could be considered causal.

Several respondents in both the questionnaire and interview samples

gave examples of the events that took place on those occasions when

they consumed mephedrone and acted violently or aggressively. Details

of some of the comments from the interview sample are shown in Table 1.

Users in both the interview survey and the questionnaire survey who

described feeling angry often made a connection between their anger and

mephedrone use.

I basically grabbed him and threw him against the wall

screaming and shouting and got my money back, so to speak. So

I was aggressive on Meow. (Mark)

Arguing with boyfriend, leading to violence. Boyfriend gets too

violent using mephedrone, so doesn’t use it any more.

(Questionnaire 46)

Mephedrone was most frequently described as being associated with

anger during the period of ‘coming down’ from the effects of the drug.


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On the comedown, it would make me lose control, because I

wouldn’t know what was going on. I couldn’t breathe.

(Questionnaire 44)

It’s more about the coming down bit you do then. Like I say I’ve

come down so then I... that’s when I get aggressive. ... It’s when

I’m coming down you see, I’m really snappy with everyone,

really nasty. (Clare)

Smashed up a TV and laptop on a comedown. (Questionnaire 51)

One user thought that aggression was most likely to occur during the

transition from the high to the low.

It’s not when you’re at the high-high, it’s not when you’re low,

it’s when you’re just alert. It’s like when you go right up and you

just want to dance and all that, but then as it starting to wear off,

you’re like, is he talking about me? (Charlie)

Linking mechanisms

Several of the narratives given of violent events included comments about

intermediary mechanisms. All of the mechanisms mentioned by the users


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could be allocated to Goldstein’s tripartite categorisation:

psychopharmacological, economic-compulsive, and systemic. In each

case, we identified subcategories of mechanisms which operated in

slightly different ways.

Psychopharmacological. Psychopharmacological mechanisms linking

mephedrone use and violence relate to the influence of the drug on the

person’s psychological or physiological state. In the current study, we

identified three different kinds: paranoia, sleep deprivation, and

hallucinations.

Paranoia describes a state in which the person feels under threat of harm

from others.

Six of the 12 users interviewed and six of the nine users who reported

violent behaviour mentioned that one of the effects of mephedrone was

paranoia. This sometimes took the form of believing that people were

talking about them behind their back.

When I first sat there, it was the best feeling in the world, but

three years now, when I used to take it, just before I come in, I

never used to get that feeling. I used to only get it for ten

minutes and then I'd get really paranoid, think people are talking

about me, and then switch from the nicest person to, ‘are you

talking about me’ and stuff like that. It just used to make me

aggressive sometimes. Really paranoid. (Charlie)


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On other occasions, it made them feel that people were out to harm or

even kill them.

When I was paranoid really, and you think people are doing stuff,

or think people are trying to kill, you then obviously you do, as

you can imagine, you do get a bit aggressive and a bit violent

then yourself. (Charlie)

In some cases, the response to paranoia was quite extreme. One of the

participants who believed that he was under threat of attack said that he

always carried a weapon for protection.

...as my paranoia increased, the weapon increased in the

damage it could do I suppose. Instead of having a bat it moved

onto just a hunk of metal, sharpened, that when I was on

mephedrone I’d sharpen continuously, looking out the window

waiting for people, thinking continuously something’s going to

happen, something’s going to happen, something’s going to

happen. (Smithy)

Sleep deprivation resulted from the stimulant effect of mephedrone which

enabled users to continue to stay awake for several days at a time. Ten of


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the 12 users interviewed mentioned that they had gone without sleep for

extended periods of time following use of mephedrone.

Yeah, I spent… when I came up I did a three-day bender and I

hadn’t done that in a long time. Even with the other drugs I’d

been using I’d do a one or two-day bender then I’d go to sleep.

But, yeah, on my first session, yeah, I did a three-day bender

and then I regularly did that over the period of time I used it for

after that. (Smithy)

One user mentioned that sleep deprivation was linked to anxiety and

irritability.

It’s physically damaging, it just makes you anxious, it makes you

snappy. … When you want to go to sleep obviously you’ve still

got it in your system, so you can’t go to sleep, so obviously that

makes ... Yeah, it’s not good. (Abby)

Another user described the cumulative effect of sleep deprivation with

other effects of the drug.

Emotionally, for me, it sometimes can make you angry. It just

emphasises the mood that you are already in. But it’s just what

it does to you after, and the sleep deprivation can kick in as well

then. That’s when the paranoia starts. (Mac)


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Hallucinations were also linked to mephedrone use and violence. These

were not necessarily related to feeling angry or violent, but on some

occasions they were perceived as threatening.

Like when we was in the window and I could see jellyfish in the

window, even though you know for a fact the jellyfish aren’t

there, but you... like you even know people aren’t there and

you’re still looking for hours. (Clare)

On other occasions the hallucinations were described as more

threatening.

I thought there was a vampire in the spare bedroom and people

outside who wanted to kill everyone. You really didn’t think in

your mind you was stoned. (Clare)

They also included references to auditory hallucinations.

When I was taking it, I thought I was hearing voices, and I went

straight to my doctor and I said, “Look, I’m hearing voices,” and

he said, “Are you taking drugs?” And obviously I had to say,

‘Yes’. (Jack)


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There was one example when the user described how hallucinations

resulted in an attempted act of violence. In the example mentioned

below, Morgan was arrested running around wielding two long knives. He

explained that he did not aim to harm any particular person. Instead, he

was chasing imaginary people which he referred to as ‘ghosts’.

I grabbed the two knives then basically ran around ... chasing

ghosts. ...Yeah (I was) hallucinating, or you think and see things

that are not real, so as I say, chasing a ghost because you are

not chasing anything really, just chasing yourself. (Morgan)

Economic-compulsive. Economic-compulsive links between mephedrone

use and violence refer to the need to fund drug misuse through

illegitimate means. This can occur when the user has negligible legal

income or when the costs of the drug exceed the legal funds available.

These effects comprised two subcategories: economic necessity and

desperate need.

Economic necessity might lead to the commission of potentially violent

property crimes, such as robbery or burglary, as a result of the pressures

to obtain funds for drug use.

Some users reported spending over £100 a day on mephedrone. They

explained that part of the shortfall in legal income was funded through


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criminal activities. One of the offences described as being committed after

mephedrone use was residential burglary.

I’d never done burglaries and that in my life, and when you’re on

it, it’s just like you start doing different crimes that you’ve

never… I have never thought about entering somebody else’s

house at night to rob them, but when I’m on that you just don’t

care. (Jack)

One user cited that the worst thing that she had ever done was stealing

from her mother.

I stole all my mother's jewellery - £8,000 worth. [I] spent all my

ESA money, my DLA, every penny I had. I didn't pay my bills. I

wired my electric up. (Lou)

Desperate need was less to do with obtaining regular funds to maintain

their drug use, but more an urgency to obtain the drug at any cost to

avoid coming down. One user reported how the urgent need to obtain the

drug could lead to violence.

And you try and do anything to get money to just sit there and

have a buzz like. Because when you’re coming down you’re in

so much of a mood you just feel like going out killing somebody,


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not thinking twice about it and then just getting the money off

them, and just go out and get right off your nut again. (Jack)

Systemic. Users sometimes mentioned that violence associated with

mephedrone was the result of inherent conflicts between buyers and

sellers. Most of the users said that they had bought mephedrone from

drug dealers. This comprised two subcategories: debt repayment and

deterrence.

Debt repayment was often identified as part of the problem of ‘laying’ or

supplying mephedrone on credit to be paid back, with interest, at a later

date. This meant that mephedrone users were often indebted to their

drug dealer, which created the potential for conflicts when agreed

repayments were not forthcoming.

Well if people will get credit, so they will have drugs without

paying for them, so they’ll have them upfront, and then if they

use the drugs and don’t sell them or don’t sell enough of them to

pay for the original, it’s going to create problems isn't it? (Dave)

There were several examples of violence resulting from users owing

dealers money.

I’ve seen people having knee caps busted and shit like that

because they owe the dealers, but it isn’t the dealer that will go

for them. The dealer will go and get other boys to go and do the


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dirty work, and then the dealer will just give them a couple of

quid for doing it. (Jack)

Deterrence was employed by drug dealers to deter future non-payment

and to generate a reputation that they were people not to be messed

with. One user who was also a dealer explained that he took mephedrone

purposely to make him more aggressive and to facilitate violence.

I definitely felt aggressive and violent to other people and I’ve

used M-Cat specifically to make me aggressive and violent to

people because I used to deal. (Smithy).

Discussion

The association

The first essential characteristic of a causal connection between

mephedrone use and violence is that there is an association between the

two. In other words, when there is one there is frequently the other. The

research found that about half of the questionnaire sample and three-

quarters of the interview sample reported feeling aggressive or violent

after using mephedrone. While this provides initial support for an

association, it raises the question that not all mephedrone users

experienced aggression or violence following its use. This suggests that

the association between mephedrone use and violence is not inevitable,

but variable and most likely mediated by other emotional, psychological


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and situational factors. Recent research suggests, for example, that

violence is constructed in the moment by affective states (see, for

example, Brookman, 2015). Hence, even under conditions of drug

intoxication or withdrawal, which would tend to be associated with high

levels of emotion, impaired rationality and lack of control, violence

sometimes does not occur.

Linking mechanisms

Mephedrone users frequently stated that mephedrone was associated

with violence because it made them angry, most notably during the

‘coming down’ period. They also suggested several possible linking

mechanisms, most of which could be allocated to one or more of

Goldstein’s three categories linking drug use and violence:

psychopharmacological, economic-compulsive, or systemic.

At the psychopharmacological level, paranoia, hallucinations, and sleep

deprivation were clearly highlighted. Half the users said that they had

experienced paranoia following mephedrone use, including the feeling

that people were talking about them or planning to harm them.

Hallucinations were described as precipitating violence when they felt that

the subject of the hallucination (imaginary people or in one case

vampires) were a threat to them. Sleep deprivation was noted as

associated with violence when it resulted in feelings of anxiety or

irritability.


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In relation to economic factors, users referred to economic necessity and

a desperate need to obtain mephedrone. Regular users often spent

hundreds of pounds a week to sustain their habits. Many were unable to

fund their use through regular employment and turned instead out of

economic necessity to potentially violent crimes, such as robbery and

burglary. Others committed violent offences simply out of desperate need

to obtain mephedrone as quickly as possible.

Users also mentioned the systemic pressures of operating within drug

market that generated a potential source of violence. Most of the users

bought mephedrone from drug dealers and most obtained them on credit

with the view of paying back later. This sometimes resulted in violence

relating to debt repayment. Others mentioned the role of deterrence

violence to obtain respect and to deter future non-payment.

Our research has shown that mephedrone users mentioned several

mechanisms by which mephedrone use might be linked to violence.

However, we have not established yet whether the mechanisms described

were part of a causal process or simply associated with use of

mephedrone. In order to claim that mechanisms were causal or non-

causal, it would be necessary to compare them against agreed criteria on

what constitutes a causal mechanism.

The current debate in the social sciences described earlier has not yet

resolved the problem of defining and measuring causality. However, it has


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made some useful progress. It is agreed that the mere existence of a

potential mechanism is not sufficient to declare a causal role in linking

potential cause with an effect. Instead, it is necessary to demonstrate a

causal pathway and in so doing take into account moderating and

mediating factors that might influence the relationship (Mahoney, 2001;

Friedrichs, 2016; Hedström and Ylikoski, 2010). The literature has also

stressed the need to take into account the social and situational context

of the mechanism (Falleti and Lynch, 2009; Pawson and Tilley, 1997).

The current research has not produced sufficiently detailed information to

match the mechanisms identified against all of these objective criteria of

causality mentioned above. While the users were encouraged to provide

narratives of events as they unfolded, in most cases there was insufficient

information given to identify a continuous causal pathway between

mephedrone use and violence. However, the users’ accounts of the nature

of the connection often covered the elements of a causal process.

First, users often made a causal link between mephedrone use and

violence. Clare reported, for example, that mephedrone ‘changes you

completely’, thus linking behavioural change with mephedrone. Mark

suggested that he ‘was aggressive on Meow‘, suggesting that

mephedrone use influenced the aggression. Others mentioned the effect

of ‘coming down’ from mephedrone on their behaviour: ‘Smashed up a TV

and laptop on a comedown’ (Questionnaire 51).


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Second, users sometimes described mediating factors. Mac referred to the

interaction between two potential mechanisms: ‘it’s just what it does to

you after ... the sleep deprivation can kick in as well then ... (t)hat’s when

the paranoia starts’. One respondent explained that his drug dealing

provided the link between mephedrone use and violence. His aggressive

demeanour resulting from mephedrone use generated respect and

compliance from his clients (see earlier quotation by Smithy).

Third, users sometimes mentioned or inferred the context in which

mephedrone was consumed or where the violence took place. Lou, for

example, mentioned that she stole £8,000 worth of jewellery from her

mother to pay for mephedrone use, thus locating the connection within a

family setting. Charlie mentioned that when using mephedrone in a dance

venue, she might sometimes become aggressive with other clubbers.

Hence, the setting provided the opportunity for potential violence.

While the statements made by mephedrone users are suggestive of a

causal connection between mephedrone use and violence, there are

several other factors that need to be considered. We have not taken into

account all possible rival hypotheses. We cannot tell whether the

identified mechanisms created the causal pathway or some other,

contemporaneous mechanism. There are many potential rival causal

pathways. It is possible that users were involved in multiple drug use and

the observed connections were a result, not of mephedrone use, but

another drug in the drug user’s repertoire. It should be reiterated,


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however, that we are basing our analysis of users accounts and in all

cases when a potential mechanism was mentioned the user stated that

mephedrone was responsible for the effect. It is also possible that

dispositional factors played a role in shaping the user’s response to the

effects of mephedrone. For some users, violence might not have been an

unfamiliar response to feelings of aggression or perceived threats.

Implications

Some of the findings of the current research are reflected in the results of

other studies on the relationship between violence and use of stimulants.

It was mentioned in the literature review that cocaine use was often

associated with violent behaviour, especially among those who injected

the drug (Parker and Auerhahn, 1998). Other studies have shown that

about half of amphetamine users had committed violent crime and half of

these attributed their violence to amphetamine use (Wright and Klee,

2001). Von Mayrhauser et al. (2002) found that two-thirds of

methamphetamine users interviewed studied reported violent behaviour.

These similarities are important because they suggest that at least one of

the new psychoactive substances (previously referred to as ‘legal highs’)

appears to have similar behavioural consequences with respect to

violence as some ‘traditional’ illegal stimulants.


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The research findings are also of interest because they extend previous

research on the mechanisms linking drug use and violence, which to date

have focused on the role of psychopharmacological factors. Bennett and

Holloway (2009), for example, found that the most common mechanism

linking drug use and assault was aggression and judgement impairment.

The current research suggests that social and situational factors have the

potential to mediate feelings of aggression and potential acts of violence.

.

Conclusion

One option for future research is to develop Goldstein’s theoretical

framework. Goldstein’s relatively simple framework has stood the test of

time and the parsimony of the three mechanisms has been one of its

strengths. Nevertheless, there are still opportunities to build on his

framework. One way of extending the framework would be to catalogue

sub-categories of mechanisms falling within each of the main elements of

the tripartite system. It is likely that the contents of the categories will

vary depending on the drugs used and the offences committed. It is also

possible that there will be systematic differences in the content of the

three categories in terms of other factors, such as demographics and the

countries of origin. Our research contributes to this endeavour by

identifying subtypes of mechanisms within each of the three groups as

they applied to mephedrone users.


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There might also be opportunities for elaborating the role of social and

cultural factors that provide the context for the drug-violence association.

Goldstein, for example, mentioned the potential role of social context in

contributing to the connection, which he refers to as a potential

‘etiological factor’ (Goldstein, 1985). However, with the exception of the

role played by social factors in the systemic model, the contribution of

context in the other dimensions was not developed. This is surprising

considering that social context is likely to play an important role in

shaping the underlying processes. The motivation to offend, for example,

might be precipitated initially by the physiological effects of the drug, but

the nature of the offence, the choice of target and the severity of the

violence, are likely to be influenced by the context in which they take

place (Brookman et al., 2011; Collins, 2008). Some of our offenders

attacked or robbed family members in the location of their own home,

while others enacted violence in the cultural context of the night-time

economy.

Our research adds to current knowledge in several ways. It builds on

Goldstein’s (1985) tripartite framework through the development of

frequently occurring sub-categories. In doing so, it draws attention to the

role of social, situational and cultural factors as potential mediators linking

aggression and violence. The research also identifies a similarity in the

links between ‘traditional’ stimulant drugs and crime and the connection

between one of the new psychoactive substances and violence. Finally, it


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suggests ways of applying current discussions on mechanisms-based

causality in an empirical setting.


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Funding

This work was supported by funding from the Welsh Government and

South Wales Police.

Acknowledgements

We offer our sincere gratitude to all of the people who gave up their time

to speak to us about their experiences of using mephedrone. The

research would not have been possible without their co-operation and

openness. Thanks are also due to those clients who completed

questionnaires. We would also like to acknowledge the contribution of the

practitioners who helped to make the research possible and everyone at

the various agencies who provided information and data.


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Table 1: Description of the users interviewed and the nature of aggression and violence associated with mephedrone use.Pseudonym Gender Age Regularity of

Mephedrone useStated link to aggression

Description of aggression associated with M-Cat

Stated link to violence

Description of violence associated with M-Cat

Abby Female 26 Every weekend No Not aggressive No Not violentCharlie Male 20 Every other day Yes “I'd ... think people are talking

about me, and then switch from the nicest person to, ‘are you talking about me’ and stuff like that.”

Yes He punched a boy he saw talking to his girlfriend and hit the boy’s head against the kerb.

Dave Male 33 Daily Yes “...yes, do get aggressive on it. It's like when you get irritated or something you can't control, you lose your head.”

Yes He started a fight with a drug dealer who had cut mephedrone he had bought with another substance.

Steve Male 34 Weekends No Not aggressive No Not violentMark Male 26 Daily Yes “I was aggressive on Meow.” Yes He grabbed his cousin by the throat

and pinned him against the wall.

Georgina Female 31 Only twice No Not aggressive No Not violentMorgan Male 20 Daily Yes “Emotionally, for me, it

sometimes can make you angry; it just emphasises the mood that you are already in.”

Yes He threatened his best friend with a metal bar for no apparent reason.He ran amok chasing people with two knives in his hands.

Smithy Male 31 Daily Yes “I definitely felt aggressive and violent to other people and I’ve used M-Cat

Yes He punched a drug dealer in the face for offering him an unfavourable deal.He set fire to someone’s house who he said owed him money.He jammed his finger into someone’s eye who had complained about drugs that he had bought from him.

Clare Female 23 Weekends Yes “Is when I’m coming down you see, I’m really snappy with everyone, really nasty.”

Yes She smashed her house.She kicked her mother.

Ryan Male 34 Weekends Yes “And when I get nasty, I mean Yes He attempted to cut off the hands of


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really nasty. ... but I was getting so nasty on it.”

a boy who he said had stolen from him with a meat cleaver.

He attempted to cut off the head of a boy with hedge shears for attempting to steal his girlfriend.

Lou Female 39 Weekends Yes “I am a bit fiery, very fiery, yeah, very spoilt, so my way or the highway like. But it takes you to another dimension.”

Yes She had several fights with her partner after taking M-Cat.

Jack Male 22 Daily Yes “...you can just feel the rage just coming and you just want to kick somebody’s head in.”

Yes He punched a boy under the influence of M-Cat for no apparent reason.He beat up his step father for asking him to move off the settee.


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Documents

Introduction - University of South Wales Research …€¦ · Web viewFighting like M-Cats and dogs: Users’ accounts of the links between mephedrone use and violenceDr Fiona Brookman