3. Research design - methods
3.1 Empirical access
3.1.1 Sampling - accessibility
3.1.2 Interviewing instrument
3.2 Analytical access
3.2.1 Statistical operations
3.2.2 Manner of presenting results
3.3 Quality criteria

4. Results
4.1 The "fieldwork"
4.2 The sample
4.2.1 Age, sex, marital status, nationality
4.2.2 Education level - current job
4.2.3 Current housing conditions
4.3 The "drug career"
4.3.1 Current drug use patterns
4.4 Physical condition
4.4.1 Physical, psychical general condition
4.4.2 HIV status
4.4.3 Overdose experiences
4.5 "Everyday life"
4.5.1 Practice of covering cost of living and drugs needed
4.5.2 Acquisition of drugs
4.5.3 Significance of the scene
4.5.4 Current contact intensity "drug aid"
4.5.4.1 Intensity of using the safe injection room service offered
4.6 Partial evaluation "Safe injection room statistics"

6. Literature

1. Introduction

Before beginning this portrayal, we have to express our thanks to the following persons and institutions. First of all, we are very much obliged to those interviewees who have taken time to give us a partial insight into their every-day activities. Moreover, we would like to express our thanks to the interviewers - Vannessa Barth, Torsten Lay, Irene Meyer, Oliver Müller, Ilona Ostheimer, Jörg Steinmetz, Phillip Stielow. and Karsten Tögel. Without their committed field work, it would have been impossible to realise the research project within this tight time schedule. Last, but not least, we have to express our particular thanks to the institutions of the Frankfurt drug helping services - above all, to "AIDS - Hilfe Frankfurt" and Verein "Integrative Drogenhilfe" - for their willingness to cooperate.

2. Objectives

The aim of this study comprises a dual interest in acquiring knowledge on two questions that are closely connected:

We plan to conduct a survey of the current structure (composition) and living conditions of the open drug scene (regarding the colloquial term "open drug scene", see also 2.1) in the main station area. This survey is to focus on perpetuating in some way or other, studies that have been conducted in recent years in Frankfurt am Main, in the same empirical reference sector (VOGT 1992; OSTHEIMER/et. al. 1993; KEMMESIES 1995) to get an impression of the developing dynamics of open scene structures and first hints regarding possible developments in the open drug scene of the city. Inspired by this intention, the catalogue of questions coordinated with data of former interviews on the open drug scene deals with sundry constellations of issues relating to drug consumption and life-style such as mentioned in 3.1.2. In addition, the inquiry is also pertaining to the safe injection room service system within the drug-aid system of the City of Frankfurt, this aspect touching the second interest in obtaining know - how as aimed at by the present study.

The intention of disclosing a first survey of the utilisation intensity of the safe injection rooms by the target group may be translated into the following questions: To what extent does what consumer group make use of the safe injection room service offered? Indicators relating to the current "everyday observation" in the main station district are of specific interest in that respect. Observations according to which, notwithstanding the implementation of service offered near to the scene (mainly safe injection rooms offered), open scene structures and/or public drug consumption (with all potential negative implications - not only for the users of illegal drugs themselves, but also for the public) is continued to a considerable extent: Is there any possibility of a specific user group or partial segment of the open drug scene not being reached by the injection room service offered, and, if so, why not?
Based on drug use patterns practised, acquisition patterns as well as biographical standard data and current living conditions, we plan to give a first plastic picture of possible motives for using or not using this specific offer. When anticipating the "empirical access" (cf. 3.1), it already becomes obvious that any clarification nearing this complex of questions will require, above all, a consideration of and concentration on user perspectives as well as the visual range and experience of the target group the service offered focuses on. Only this way will it be possible to obtain information coping with specific target groups - and with current practice - and to optimise this partial offer within the scope of a well - differentiated drug-aid system.
As can be seen from the statements made so far, questions formulated are to be seen in a specific context relating, in particular, to safe injection rooms established in Frankfurt am Main. To formulate this aspect as a question: What about running safe injection rooms in practice - above all in the user perspective - ,and why does this service - bearing in mind public consumption that can be observed in many places (in particular, in the main station area) - apparently reach parts of the open drug scene to a rather limited extent only? To finally sum up this complex, it can be said that the study is aiming at (partial) explanations of the following contents and/or phenomena:

To concretise the research subject of this study, we shall refer, hereinafter, in the form of a general view, to terms like "open drug scene" and "safe injection room", inasmuch as these terms are particularly representing the empirical context of this study and/or the central subject of research.

2.2 "Safe injection room" - definition of terms, background

Until now, more detailed reports on experience gathered in connection with the safe injection room capacity offered in Frankfurt am Main (as well as across Germany) are not available. This deficit is intended to be eliminated by presenting this study focusing, above all, on conveying a first impression of user practice, i.e. use of this service by the open drug scene - that’s to say by the actual target group (cf. 2).

3. Research design - methods

As you can see from the dual interest in obtaining information that are subject of this study complex (cf. 2), different methodical - in particular, empirical - approaches are indispensable. We shall give you a condensed survey of methods applied in the following chapter, this partial chapter being concluded with a concrete discussion related to the research process, discussion of the potential range of the research results, presentation of these results being based on classic quality criteria (reliability, validity, and representativity).

3.1 Empirical access

"Empirical access" is the sampling method and the, inquiry methods applied. Let us consider, first of all, the methodical conception of sampling.

3.1.1 Sampling - accessibility

As the objective of this study not only consists in giving a current survey of the structure of the open drug scene, but also in looking into the question whether the group using the injection rooms might possibly be characterised by specific features, the consideration of accessibility required different approaches. In accordance with this specific interest in obtaining knowledge, interviewers had contacted potential interviewees directly in the open drug scene and in the main station quarter, but also in the three safe injection rooms of the City of Frankfurt am Main "Eastside" (Schielestr.), "Druckraum Moselstrasse" (Moselstrasse, main station area), and "La Strada" (Mainzer Landstr., main station area). The number of persons interviewed totalled 150, 100 of them having been directly contacted on the open drug scene ("Scene Inquiry") and 50 in the safe injection rooms ("injection room inquiry"):

A total of 106 attempts to establish contacts proved unsuccessful. 65% of the persons refusing to be interviewed substantiated this refusal by arguing "to be pressed for time", every third person (31%) stated a "lack of interest", and four persons (4%) apparently mistrusted the anonymity of the interview. The total success rate (number of interviewees / number of attempts to establish contact ratio) was 59% ("Scene inquiry": 57% / "injection room inquiry": 61%).
This percentage may be deemed comparatively high bearing in mind the sensitivity of data to be collected. Contrary to difficulties mentioned in research literature (for instance: BERGER/et al 1980, 19), initiating research contacts with the open drug scene proved rather unproblematic - although they required a great deal of energy. The 100 interviews, scheduled to be arranged with users of illegal drugs within the scope of the "scene inquiry" have been realised by a team of six interviewers between July 12 to 24, 1995, the 50 interviews scheduled to be arranged within the scope of the " injection room inquiry" have been realised by three interviewers between August 3 to 22, 1995. To ensure inclusion of the spectrum of potentially different types (of drug use) into the visual angle of research, interviewing activities have been evenly spread over the weekdays (47% of such interviews having been held on weekends - Friday to Sunday - and 53% on work days - Monday to Thursday) and were held at fixed times (42% of them having been conducted between 10 a.m. and 3 p.m. and 58% between 3 p.m. and 8.30 p.m.).
The remarkable willingness to give information (cf. 4.1) that could not be expected in view of the hectic conditions, helplessness, and monotony normally observed on the scene (in this respect, we would like to recall to people primarily refusing to give interviews for lack of time) has been made possible by the following sensitive interviewing procedure summarised as follows.
Potential interviewees have been assured of absolute anonymity. Any information likely to identify the respective person has not been recorded. In particular, the "one-off-nature" (BRANNEN 1988, 558) of the interview contact has been, among others, of decisive importance:
Persons interviewed did not have to fear any consequences at all resulting from research contacts, such contacts not having been connected with any therapeutic or judicial setting. The open information about the research interest has also been one of the decisive elements. The intention to describe the everyday scene and the practice of safe injection rooms as people concerned use to see it, appeared, in many cases, to be a factor motivating to show more willingness to answer the interrogators’ questions. Whenever people contacted showed a fundamental readiness to be interviewed, they were promised an expense allowance in the amount of DM 5, -, this aspect having been deliberately put at the end of contacting attempts to ensure a fundamental willingness to cooperate and to avoid any "monetarily motivated" interviews with all potentially related "validity problems". We can assess, but rather roughly, to what extent interviewers succeeded in taking random samples to depict an exemplary section of the Frankfurt open drug scene, when considering the vast darkness of problems particularly relating to this research sector. We shall reconsider these aspects in 3.3.

3.1.2 Interviewing instrument

Questionnaires as used in connection with the partial inquiries ("scene inquiry": n = 100 - "injection room inquiry": n = 50) are identical, except for two. As far as the "injection room inquiry" is concerned, the question whether the person interviewed is currently undergoing a substitution therapy has been waived on account of the fact that interviewers had to expect to get untrue answers particularly to this question, since interviewees had been directly contacted in safe injection rooms subsequent to having made use of this offer and having assured (by a written declaration; on the judicial background cf. 2.2) that they were not currently undergoing a substitution therapy. This specific constellation, as regards the establishment of contacts, induced interviewers to waive this question in view of validity problems obviously resulting therefrom, a further deviation of the questionnaires concerning consumption of medicaments (Benzodiazepine, Barbiturates). Persons interviewed within the scope of the "injection room inquiry" were asked concrete questions relating to their consumption of medicaments, whereas drug users interviewed within the scope of the "scene inquiry" have been asked "unspecified" questions relating to the use of medicaments, questions put in connection with a whole complex of questions asked (in both partial inquiries), i.e. "What drug did you consider most important for you last week?" (This is a "ranking" question: all subjectively relevant drugs were to be named in a decreasing rank order), the intention of this deviation of interviewing being the determination to ascertain whether persons interviewed possibly refrain from reporting the use of medicaments or elect to report clearly less, whenever interviewers fail to ask concrete questions. In this context I would like to stress that such a reluctance might express a drug use pattern tabooed or considered as "un-cool" among heroin and/or cocaine consumers (patterns they don’ t like to concede in spite of the fact that it is -possibly - wide spread).

3.2.1 Calculating methods applied - statistical operations

In view of the abundance of available data - more than 180 individual figures have been collected for every person inquired (150) - such data, when codified, corresponds to a data record comprising more than 37,000 digits - a computerised analysis of data has turned out be inevitable. Statistical calculations have been made by applying the evaluation system SPSS/PC4 (version 4.0). The first descriptive-statistical access consisted in making a classifying tabular approach to screen material available based on the frequency and percentage distributions: How are the characteristics distributed within the over-all sample and the two partial samples ("scene inquiry" and "injection room inquiry"). In addition, characteristic values have been determined give an overview of specific features ascertained (primarily: arithmetic series). Whenever this comparative screening of characteristic values obtained from the "scene inquiry" and "injection room inquiry" produced any differences in specific features (for instance, age groups, frequency of consumption of different substances etc.), analyses have been carried out to find out whether the differences detected were of statistical significance or whether they were to be deemed merely incidental (test procedures given priority: T-Test, Chi-Square Test). Such comparative evaluations have also been made on the basis of data obtained from the "scene inquiry" within the scope of the Dutch - German comparative study (KEMMESIES 1995/more detailed information cf. Figure 1), because a referral to SPSS data evaluation was possible. Any comparative survey of partial samplings ("scene inquiry" and "injection room inquiry") were only carried out in cases of differences becoming visible. Whenever this survey relates exclusively to the total sample (n=150), this configuration indicates the absence of any significant differences between partial samplings, as far as respective specific features are concerned.
In addition, selective correlation calculations have been made to get useful hints regarding a (possible) correlation of different specific features. By the way, we would like to refer to problems relating to the interpretation of correlation coefficients. These are not to be interpreted as causal connections, when considering the probability of such coefficients being mere research artefacts hardly to be determined.

3.2.2 Manner of presenting results

In accordance with this form of representation, asterisks are referring to the percentage of residual probability (about: ** - 5% level), in which the difference or correlation might be merely incidental: So, for instance, two asterisks, put in connection with a difference in average age indicate that the difference detected is likely to be incidental (residual probability of 5%), without being of any significant importance, as far as basic totality is involved. Or, in other words: There is a 95% likelihood of the difference found not being incidental, rather than reflecting a significant deviation - irrespective of its initial substantiation. Moreover, please note that all percentages mentioned are rounded values, unless they are relating to the respective partial samplings, inasmuch as they have been totally included in the calculation ("Scene inquiry": n= 100; "injection room inquiry":n=50).

The following discussion is not intended to be a fundamental, methodologically orientated discussion of classical quality criteria like validity, reliability and representativity - in this respect, we refer to the relevant specialised literature. What is more, people are invited to consider some central issues concerning the concrete research process, enabling them to assess the possible meaning and cognition horizon of results presented, at least basically.
First of all, let us consider the criterion of reliability. This criterion referring to the reliability of a measuring instrument is defined as the degree according to which repeated measurements taken with the inquiry procedures applied produce identical measured values. In view of the dynamics of the field of phenomena to be considered (open drug scene), any repetition of measurements producing identical results must be virtually excluded, this applying all the more as this research process is dealing with a "field inquiry" inevitably producing, in case of controls, deviating results. Finally, it would not be possible in case of any controls to disentangle potential influences and define, more precisely, the intensity of these influential effects, as regards possible deviations of results: What about the scene having been subject to intermediate changes (for instance: new [sub]cultural trends, modified control measures taken by prosecution authorities, different socio-medical situations [for instance, change of substitution practice] etc.)? Did the same interviewers arrange such interviews? What about simultaneous effects of the aforementioned influencing factors? Did these factors produce cumulative or contrary effects? The preceding statements are directed, in general, against any claim to reality asserted by the drug research sector and/or the sociological research sector in general: For, reliability, a classical quality criterion, is based on the assumption of a constancy of phenomena ignoring the historical character of social phenomena in an inadmissible manner, that’s to say in a manner disproportionate to the subject involved.
Validity touches the aspect of accuracy of an inquiry instrument: Do results of such inquiries really correspond to the results originally intended, that is to say, to values formerly intended to be measured? In concrete terms, as regards such inquiries, this validity criterion is giving rise to ask, above all, the question, whether "true" statements have been obtained, that is to say statements not deliberately falsified. A factor guaranteeing the impossibility of deliberate fraudulent misrepresentations having been the interviewers' familiarity with the phenomena dealt with, familiarity attributable to existing experience in research as well as to concrete instruction of interviewers in specific questions to be asked. A further element of central importance has been the observance of absolute anonymity of interviewees, not to forget the fact that the inquiry has not been associated with prosecution authorities, and the assurance of the exclusive scientific purpose of collecting these data. Sundry studies carried out in the United States of America , i.e. studies dealing. in particular, with the issue of validity in this specific research sector (to get a general idea, cf. WOLBER/et al 1990, 550 ff) prove a high degree of validity - above all, as regards to interviewees’ reports on drug consumption. ROUNSAVILLE/et al are affirming the absolute guarantee of a high degree of "validity" and/or "truth", "as long as the research questions are independent of legal or treatment decisions" (ROUNSAVILLE/ et al 1987, 227). Notwithstanding the fact that these prerequisites (anonymity, no social consequences of these interviews) have been unconditionally guaranteed, conditions obviously recognised by the interviewees themselves showing their willingness to answer questions asked (cf. 4.1), it is not entirely possible to exclude any possible effect "likely to distort the truth": Insufficient memory - sometimes, statements made (for instance, age of starting to consume specific drugs) are based on mere estimates. Nevertheless, in view of the large extent of these samplings, this effect may be deemed relatively insignificant, since we may proceed on the assumption that "estimating errors" are balanced to a very large extent.
Finally, let us broach the criterion of representativity, this criterion being of specific importance, as regards the meaningfulness of a study, when bearing in mind that the degree of representativity of a study is a decisive element to ascertain how far results obtained are representative of the population the research is focused on. When summarising the complexity of problems ("drug research - representativity") with due care to time available, we have to keep in mind that it is, more or less, impossible to guarantee representative samples. For, in view of the mysterious character of the research field, it is not possible to define who really belongs to this basic totality ("intensional definition") (KROMREY 1983, 137) and, in addition, it cannot be precisely proved "what sort of element characterises the components of said basic totality [intentional definition (This definition has been dealt with under 2.2 with concrete reference to the field of investigations)] (cf. 137). And, although it might be roughly possible to take representative random samples, representativity always appears to have a temporary character, when bearing in mind the historical character of social phenomena as already mentioned in connection with reliability criteria.
Representativity is fading due to the permanent change of the drug scene, this change being attributable to structural displacements resulting from changes of drug legislation, drug-aid structures, and (sub)cultural (fashion) trends as well as from corresponding drugs and consumption patterns. But, what does this mean in the light of the correlation of research issues discussed in this paper?
Consequently, the spot-check underlying the study does not meet - as is typical of drug research - the criterion of representativity. Nevertheless, it may be deemed an element of comparatively high exemplary quality to picture the Frankfurt open drug scene in the summer 1995; this view being supported by the fact that, in terms of quantity, the open drug scene in the main station quarter is estimated to comprise about 200 persons (reference period of the study), people staying, daily fluctuations excepted, more or less permanently in the main station district. On the other hand, said exemplary picturing quality of the mentioned spot-check is substantiated by the fact that interviewees have been recruited at relatively identical intervals weekdays and times of the day, so to cover - as already mentioned (3.1.1) - the widest possible spectrum of different types of drug consumption. Above all, we must not ignore that interviewees have been directly contacted in the interesting research field of the open drug scene (contrary to, "institutional" research approaches, for instance in therapy institutions or prisons), this practice ensuring, to a certain extent, that interviewees are deemed representatives of the environment ("drug scene") this scientific project intended to study.

4. Results

Fig. 1: Project profile of studies referred to for the purpose of analytic reflections

4.1 The fieldwork

Interview times averaged nearly half an hour [mean: 27.6 (minutes), SD: 10.2/min:10 - max: 60], clearly exceeding the time initially scheduled for the questionnaire (interview times of 15 to 20 minutes). These particulars illustrate the interviewees’ high readiness to answer questions and to be interviewed. We perceive this as a clear indicator that the interviewers obviously succeeded in establishing an open and trustful interviewing situation encouraging interviewees to report. This is true all the more as interviews within the scope of the "scene inquiry" have been initiated exclusively in the form of direct scene contacts in public places. Nearly every third interview (71%) of this scene inquiry was arranged directly, that is to say publicly. The remaining 29 interviews have been arranged in drug-aid institutions and services in the vicinity of the scene. As far as initiation of contacts and arrangement of interviews for the "injection room inquiry" are concerned, these took place directly in the safe injection rooms (cf. 3.1.1).
Every fourth interview has been conducted in the presence of a third person, a procedure expressly approved of by interviewees and even, sometimes, expressly desired. Except for some particular cases, where friends of interviewees helped them to remember certain times, dates etc., these third persons present assumed a passive attitude. The manner in which interview contacts have been initiated clearly proved that the majority of partners interviewed had been under the influence of drugs. Interviewers have deemed two of three interviewees to be slightly to considerably influenced by recent drug consumption. Nevertheless, the physical and mental condition of interviewees never has given reason to break off talks, although two interviews were characterised by partial contradictions. But, in spite of being influenced by drugs, the vast majority of persons interviewed (70%) appeared to be concentrated on the subject. In summary, the atmosphere of the interviews may be characterised as very relaxed and communicative. All in all, conversations proved to be trustful and open. Interviewers obviously succeeded in establishing a confidential conversation atmosphere substantiated by the fact that only four persons addressed refused to be interviewed, their refusal apparently being attributable to a lack of confidence in the anonymity of the interview (cf. 3.1.1.).

4.2.1 Age, sex, marital status, nationality

Figure 2: Age groups (n = 150)

The average age ascertained (30.6 years) indicates, in comparison with former studies, that the average age of the "scene population" is seemingly rising. VOGT (1992) ascertained an average age of 27.7 years (SD: 6.1), OSTHEIMER/et al (1993) 28 years, and KEMMESIES (1995) 29.9 years (SD: 6), the tendency of increasing age are also being reflected in the fact that , as far as the VOGT study (1992) is involved the group of older persons (35 - 45 years) totalled 15% of all samplings, whereas the present inquiry shows that every fourth interviewee (25%) belongs to this age group. A rise in age of the scene population is indicated, also indirectly by criminal-statistical data (only referred to as indicative signs and only restrictedly comparable) relating to the drug related mortality rate registered in the City of Frankfurt am Main. Statistical material gathered by detective police authorities brings evidence of a continuous increase in the average age of drug deaths registered (from 28.7 years to 30.8 years for the years under report, that's to say 1988 through 1994 POLIZEIPRÄSIDIUM (police headquarters) Frankfurt am Main: 1190, 27; 1991, 39, 1992, 17; 1993,21; 1994, 176; 1995, 143). Obviously, the horror scenario regularly depicted by mass media of a drug scene, where we can meet consumers of increasingly lower age, is not substantiated by any facts, the majority of interviewees being considerably older than 25, only one of them had not yet completed his 21st year of life when being interviewed.
37 of all persons interviewed (137) had been women, this number representing a rate of 25 % ranging within the scope of correlative values shown by corresponding research projects. Women interviewed have been - according to tendency, although not significantly - younger than the group of male persons (about half a year)

Figure 3: Marital status (n=150)

The vast majority of drug users interviewed consisted of unmarried people. Please cf. VOGT (1992, 120) and KEMMESIES (1995, 134) for a nearly identical repartition.
90% of all people interviewed had been German citizens, the percentage of foreigners (10%) however not reflecting the real proportion of different nationalities on the Frankfurt open drug scene, since - due to language barriers - it has been hardly possible to establish interview contacts with foreign drug users.

In general, the education level of partners interviewed is to be deemed very low, values ascertained ranging between those shown by the VOGT study (1992) and the KEMMESIES study (1995): 13% of all persons interviewed did not have any completed school background (VOGT: 4%; KEMMESIES: 28%), and 78 interviewees (52%) so far failed to commence a vocational training or abandoned such a training (VOGT: 44%; KEMMESIES: 58%). Experience gathered by VOGT (1992, 15) stating that women have, in general, a better school education, was not reflected in the data material available. Although, it could be observed - in accordance with the VOGT study - that more male than female persons have completed a vocational training (women: 30% - men: 49%; chi-square: 4.1 * */DF:1).
Only every tenth person has a gainful employment (regular job), the absolutely predominant majority (79) of partners interviewed being jobless at present. The high unemployment rate also shown by VOGT (1992,16) and KEMMESIES (1995, 219) seems to be a feature typical of the open drug scene. To what extend and in what form deficits in income derived from regular jobs are reflected in specific forms of financing costs of living and drugs required will be dealt with in 4.4.1.

The shortage of housing among drug users interviewed ("scene inquiry") seems to be extraordinarily vast. As already stated by VOGT (1992, page 13 ff) and KEMMESIES (1995, 136), 46% of all partners interviewed being homeless at present. The fact that emergency sleeping places offered by drug-aid services and institutions apparently reflect the real emergency of many drug users is substantiated by about 59% of all homeless people making current use of overnight accommodation facilities offered by drug-aid services and institutions.
As far as the groups of persons living out of Frankfurt is concerned, housing conditions appear to be comparatively favourable: In this case the portion of homeless people approximated about 20%, whilst amounting to 51% for "native inhabitants of Frankfurt" (chi-square: 48.16 ***/DF:1) The group of interviewees living out of Frankfurt (in Greater Frankfurt) comprises 25 persons, representing 17% of the sample inquiry in toto. 23 interviewees stated to have a current residence in Greater Frankfurt (RMV commuter - belt), 102 persons interviewed having stated to live directly in Frankfurt am Main. The question whether being registered with the Frankfurt police has been answered in the affirmative by 63%, every third person (37%) being, at present unregistered, that's to say neither with a police authority out of Frankfurt nor elsewhere. The share of persons registered in Frankfurt am Main is clearly exceeding the percentage given by the VOGT study (1992, 12, showing a corresponding percentage of 40%). This discrepancy possibly evidences effects of measures motivated by the policy of law and order pursued in Frankfurt am Main, as regards non - local drug consumers. The fact that the Frankfurt drug scene is continuing to attract drug users from neighbouring regions - obviously attributable to the rather attractive drug market (price level, supply) - is substantiated by the number of non-local drug users appearing on the scene "for small visits": They usually come to the Frankfurt drug scene, on an average, four times weekly (mean:3.6, SD: 2.5). Failing any systematic inquiry, these trips might be motivated by the following main reasons: 1) Enormous attractiveness of the drug market, 2) Frankfurt scene deemed "an informal job market" ("dealing activities"), 3) anonymity on the scene of a large city (uncomplicated drug-related activities like purchase, consumption, etc., activities entailing a rather limited risk of being discovered).

4.3 The "drug career"

This chapter is to give a summarised survey of typical drug careers - based on drug sequences. For this purpose, we should like to present, first of all, a survey showing the average age of starting a drug career; life time prevalence (percentage of persons that have ever tried this substance) and the portions attributable to experimental users [relating to the substance consumed (percentage of persons that stopped the use of this substance after an experiment of consumption)]

Figure 7. Sequence of drugs (n=150)

The average age of starting consumption of the different substances ranges within the span of respective data of pertinent research reports (for instance: PROJEKTGRUPPE RAUSCHMITTELFRAGEN 1991, 83; KREUZER/et al 1991, 129). There are no significant deviations. Such deviations ranging within a tolerance level of (maximally; + / - ) 12 months. Equally, a direct systematic comparison (t - test) with the respective average age as ascertained in the study of KEMMESIES (1995, 200) resulted in no significant differences. So, the average age of starting the consumption of "hard drugs" as ascertained in the present study (17 years) is nearly identical with the respective value as ascertained in the KEMMESIES study (17.4 years; ibid. 201). A similar correspondence has been established, as regards previous experience careers (consumption of hard drugs) [13.6 years - 12.5 years (ibid. 206)]. Considering these data, it is neither surprising that the KEMMESIES study (1995) has included a similarly high share of drug users who had been consuming (more or less continuously) hard drugs for already more than 10 years [62% - 58% (ibid. 206)] [the gradually higher figures concerning the length of the drug carreer can be seen as another indication for the thesis that there is an increase in age among the users on the open drug scene]

Looking more closely at the preceding figure, we could observe some peculiarities. Experience gathered in connection with the consumption of legal drugs like nicotine and alcohol as well as illegal drugs like cannabis, heroin, and cocaine is, obviously, an element of the "collective experience" of people consuming in the open drug scene. Interviewees are confessing, nearly without exception, relevant experience in consumption, their experience exceeding, by far, a mere experimental use.
9 out of 10 interviewees (88%) also mention consumption of medicaments exceeding a merely experimental stage. The people had been interviewed in the course of interviews in injection rooms. A high life time prevalence - although considerably lower in comparison with the substances already mentioned - can also be stated, as regards drugs like LSD, Speed, and crude opium (and/or pharmaceutical opiates). Nevertheless, every fifth (in case of crude opium: every fourth) person abandoned consumption of these substances following a phase of experiments. Observation of a considerably lower life time prevalence and a considerably larger group of experimental users suggests the presumption that these drugs are of minor importance within the open drug scene or have lost some importance - due to changing consumption, (fashion) trends and developments in the market. In this connection, three (hypothetically formulated) declarations relating to the specific substance are suggesting themselves, however, they need to be subject to a more differentiated analysis characterised by the inclusion of previous studies: Consumption of LSD has lost its sub-cultural correlation as formerly embedded in the "hippie" movement. In addition, consumption of LSD is hardly compatible with daily life in the scene and a rhythm of life (frequently dictated by physical addiction), this incompatibility being attributable to the hallucinogenic spectrum and the long-time effects of LSD. In the late sixties/early seventies, opiates ("pharmacy junk") met with ever increasing acceptance, a reorientation of international markets beginning in the early seventies and in the middle seventies resulting in replacing this substance more and more by heroin (regarding sub-cultural development trends as addressed in this connection, cf., for instance, SCHEERER 1989, 285 ff).
Therefore, it is not surprising in this context of declaration that the group of interviewees experienced in the consumption of crude opium and LSD is considerably older than groups of persons who, up to this point, never consumed these substances or abandoned consumption following a merely experimental use [crude opium: 32.4 (SD: 5.3) as against 28.9 (SD: 5.5) years; t: 3.9.1 ****/LSD: 31.5 (SD: 5.6) as against 29.2 (SD: 5.4) years; t: 2.38 **].
It also seems that speed (amphetamine, methamphetamine) - a stimulating drug which has been very popular in the open drug scene of the seventies - has also lost a great deal of its former popularity. Apparently, speed has been superseded by cocaine, a natural stimulating drug, this replacement being attributable to an extension of the cocaine market on the basis of a price level (relatively low in comparison with previous years) and to rather competitive packaging units (sold in very small quantities at prices of DM 20,-- onward). But, above all, the loss of importance of LSD, crude opium, and speed as indicated in this case is reflected in current consumption patterns of partners interviewed. Only exceptionally, reports are dealing with current use of these substances (cf. 4.3.1).
As far as newer drugs like Ecstasy (XTC) and crack are concerned, the picture is rather irregular. Like already practised on the occasion of the scene inquiry carried out in Frankfurt am Main in 1993 within the scope of a comparative study "Netherlands - Germany" (KEMMESIES 1995, page 185 ff), every third person concedes having tried Ecstasy at least once. Apparently, there has not been any extension of the group of people experienced in consuming Ecstasy within the open drug scene - although we must concede that this observation is founded on a comparatively limited empirical basis. Most obviously, Ecstasy is not well accepted in open scenes, this development being implicitly substantiated by the fact that a large segment (43%) of the "experimenting group" uses to abandon consumption of Ecstasy following first experimental tasting, and by the fact that, in practice, Ecstasy appears not to play any role regarding current consuming habits of the drug users interviewed (cf. 4.3.l.). Possibly, the rather marginal importance of Ecstasy in the (heroin) scene can be explained by some form of sub-cultural incompatibility: Ecstasy is closely associated with specific sub-cultural references and "styling processes" (Techno-, Rave-scene) having undergone intensification to form a (sub)cultural environment characterised by a very high degree of independence, an environment obviously having very few points of contacts with the open drug scene. In contrast to that, consumption of crack seems to gain increasing importance in the open drug scene (in the slip-stream of cocaine gaining in importance, so to say). While, a total of 16% of drug users interviewed in a sampling interview held in the scene in 1993 (KEMMESIES 1995) stated to have consumed crack already once, the corresponding percentage as stated in the present study is approximately 41%, a percentage exceeding the aforementioned rate by 25% (chi-square: 10.1***,DF:1). The fact that we may assume crack to have gained in importance in the open drug scene not only illustrates the apparently rising prevalence rate as far as experience in consumption of crack is concerned, crack also seems to play an important role, as far as current drug consuming habits of a large segment of interviewees are concerned.

4.3.1 Current drug use patterns

The following figure gives a first impression of drug consumption patterns practised at present (drugs consumed in the last 24 hours and last week):

Figure 8: Drug consumption during the last 24 hours/in the last week (n=150)

At first glance, this figure discloses that people apparently practice extremely different consumption patterns, 21 persons (14%) stating to have exclusively consumed but one substance during the last 24 hours. As far as the last week is concerned, only 10 persons (7%) state to have consumed but one single of the substances mentioned. In toto, a polyvalent drug consumption pattern is recognisable. The day before, nearly every second interviewee (47%) has consumed three (or more) different drugs. (mean:2.5, SD:1.1). Regarding the last week, three of four drug consumers interviewed (78%) followed this consuming practice (mean:3.3,SD:1.2), this rough sketch of predominantly polyvalent consumption patterns also applies to partial samples ("scene inquiry" / "injection room inquiry"). In this respect, we should visualise that 38 persons (38%) of 100 partners interviewed are persons currently undergoing a methadone-based (33) or codeine-based (5) therapy [The issue of substitution therapies, if any, has been exclusively dealt with within the scope of the " scene inquiry" (n=100) (cf. 3.1.2)]. Moreover, as already mentioned in 3.2.1, it has been only within the scope of the injection room inquiry that interviewees had been asked to state the concrete time of their last consumption of medicaments. Here, interviewers interrogated a group of 20 persons (40%) who have consumed medicaments (mostly "Rohypnol") in the course of the previous week.
An intrinsically differentiated consideration of current drug consumption patterns reveals specific features. Let us consider different drugs in detail:

• ALCOHOL

Figure 9: Frequency of consumption of alcohol

Figure 10: Last consumption of alcohol

As regards the drug consumption patterns of the persons interviewed, alcohol seems to play an important, though not a predominant role. The partial samples seem to be "polarised" on questions about the frequency of consumption and the date of the last consumption of alcoholic beverages. On the one hand, we have a large group of persons conceding daily consumption of alcohol (also in the last 24 hours). On the other hand, nearly every second interviewee states that he/she drinks alcohol less than once per month (or not at all). Anyhow, every third drug user interviewed discontinued consumption more than one .month ago. The break-down of consumption patterns (different partial samples) as shown in the figure does not differ significantly. Let us reduce the figure (last consumption) to the question "Consumption of alcohol during the last 24 hours: Yes or no?". Such a question is likely to produce gender-specific differences, inasmuch as we will find among male persons a far larger group of persons having consumed alcoholic beverages during the last 24 hours (women: 24% - men: 49; chi-square: 6.75 *** DF:1).

• CANNABIS

Figure 11: Frequency of cannabis consumption

Figure 12: Last cannabis consumption

Obviously, cannabis, like alcohol, does not play any eminent role, as regards consumption practices in the open drug scene, this is also being substantiated by the fact that during the week before, only four persons exclusively consumed alcohol and/or cannabis. Interviewers did not observe any considerable differences between female and male persons as well as different samples. Apparently, cannabis is consumed in addition to other substances, that is to say occasionally (on invitation) with consumers not making any remarkable efforts to acquire the substance or attaching much importance to its use. It is true that 89 persons (60%) stated to have consumed cannabis during the last week, however, only every fourth (26%) of this group stated to have spent more money for this drug or attached much importance to this drug, as far as current consumption is concerned.

• ECSTASY (XTC)

As already mentioned and discussed in 4.3, ecstasy seems to be of only marginal importance in the context of the open drug scene. Only one interviewee stated to have consumed this substance in the last 24 hours and to follow this practice at regular intervals (several times per week/weekend). Moreover, there are only two other interviewees who have consumed ecstasy in the preceding month. Observations made already in 1993 (obviously marginal importance of ecstasy in the scene, cf. KEMMESIES 1995, page 185 ff) are, apparently, also confirmed, as regards the present situation on the open drug scene.

• LSD

Virtually, LSD no longer plays any role within the Frankfurt open drug scene. A total of only three persons interviewed (2%) reported on LSD consumption during the preceding month. As regards the possible background of this obvious loss of importance of this drug enjoying particular symbolic importance at the turn from the sixties to the seventies, we refer to 4.3.

• CRUDE OPIUM - PHARMACEUTICAL OPIATES

• HEROIN

Figure 13: Frequency of heroin consumption

Figure 14: Last heroin consumption

As far as current drug consumption patterns followed by interviewees are involved, heroin is the drug mostly consumed - although only at a gradual distance from cocaine (still to be referred to). Four of five persons interviewed (85%) stated to consume heroin at least once per week, more than half the drug users interviewed (58%) consumed heroin on a daily basis, the absolute majority (85%) having consumed heroin in the last 24 hours. Let us reduce the degree of differentiation of the preceding figures to the information: "heroin consumption every day: Yes or no?" and "Last heroin consumption in the last 24 hours: Yes or no?". Then we shall observe considerable differences between partial samples. Whilst 79% of the drug users interviewed within the scope of the "scene inquiry" mentioned to have consumed heroin the day before, 96% of the drug users interviewed within the scope of the "injection room inquiry" mentioned to have done so (chi-square:7.42***, DF:1), the percentage of people consuming heroin on a daily basis as interviewed in the partial sample ("injection room inquiry") being higher (64% as against 55%) - although not to a significant extent. These results indicate a possible difference in consumption patterns, differences correlated with the intensity of using the safe injection room service offered. The frequency of application (per day) of interviewees consuming heroin on a daily basis also points to this direction, the average number of drug users directly contacted in the scene stating to consume heroin much more frequently than consumers interviewed in Frankfurt’s safe injection rooms (Total average: mean: 482, SD: 2.7, Min - Max: 1 12) "Scene inquiry": mean: 5.5, SD: 2.7 - "injection room inquiry": mean: 3. 6, SD: 2. 1; t: 3.6 ****).
Quantities of heroin consumed per day (in grams) do not differ significantly between the different samples - although the sample ("Scene inquiry") has shown a higher value (about o.5 grams more) (total average: mean:2.9. SD:1.9. Min - max.: 2 - 10). When relating the average daily application frequency to the heroin dosage required every day (in grams), we can observe that persons interviewed in the safe injection rooms use to apply a considerably higher average dosage of heroin (per consumption) [(Total average: mean:.67, SD: .38, Min - max.: 11 - 2.0)] "Scene inquiry": mean:.58,SD:.34 - "injection room inquiry": mean:.82, SD: .39; t: 2.85 ***) These differences concerning practices of consuming heroin are attributable to specific preferences of partial samples carried out for substances consumed in parallel - above all, cocaine (referred to in a chapter to follow). For the moment, this assumption apparently does not prove to be true when considering the answers to the question, whether heroin is currently consumed directly in connection with other drugs.

Figure 15: Combined consumption of heroin and other drugs

Figure 16: Frequency of cocaine consumption

Figure 17: Last cocaine consumption

When comparing these figures with the respective figures 13 and 14 (heroin) , you will see that, as regards our interviewees' drug consumption pattern, cocaine is being consumed at a nearly identical intensity, differences being only of gradual, but not of fundamental nature. Every second interviewee (47%) has been consuming cocaine on a daily basis (heroin: 58), whereas three of four persons interviewed have been using cocaine at least once per week (heroin: 85%). It seems that cocaine has become firmly established within the open drug scene to be, in addition to heroin, one of the most important drugs consumed in the drug scene, this development giving, in particular, rise to a comparison with consumption patterns as ascertained in the KEMMESIES study (1995) of 1993: Whilst, two years ago, six of ten interviewees (62%) stated to have consumed cocaine in the last 24 hours, the present random test is proving that eight of ten persons had been doing so (79%) compared to (chi-square: 5.48 **, DF: 1).
However, when comparing these partial samples, we get a picture of clearly differing cocaine consumption patterns. As far as persons interviewed within the scope of the scene inquiry are concerned, gradually more of these people are stating to have consumed cocaine in the last 24 hours ("Scene inquiry": 83% - "injection room inquiry": 70%; chi-square: 3.36 *, DF:1). Also, clearly more interviewees from the scene inquiry mention daily cocaine consumption ("Scene inquiry": 54% - "injection room inquiry": 34%; chi-square: 5.3 **,DF:1), this group also states a clearly larger number of daily situations of cocaine consumption (In toto: mean: 6.9, SD:48, min - max.: 1 - 20) ("Scene inquiry": mean: 7.6, SD:5.0 - "injection room inquiry": mean: 4.7, SD: 3.5; t:261 ). As already mentioned when considering heroin consumption patterns, we have to clear up, in this respect, a question still to be analysed, namely the question whether different intensity of cocaine consumption is connected
with possibly different intensity of using safe injection rooms as ascertained by partial samples.

• SPEED

As already mentioned in 4.3, speed has apparently lost its former importance as "cocaine of the poor" to a very large extent, this drug having obviously been pushed out of the market by cocaine. Only two interviewees reporting of speed currently used on a daily basis, another three persons reporting of consumption on a "weekly basis" (at least, once) and two persons interviewed reporting consumption of this substance on a "monthly basis" (at least once). So, only five persons were consuming speed the day before - in total, only 14 interviewees (9%) have consumed this substance in the preceding month at least once. In contrast to that, the share of current cocaine consumers (consumption during the preceding month) belonging to the group of persons whose last speed consumption had taken place more than one month ago (or who never consumed speed so far) amounts to approximately 90%(!). This situation clearly substantiates the fact that a loss of importance of the group of "stimulating substances" within the open drug scene cannot be observed, rather than proving cocaine having pushed speed out of the market to a large extent.

• CRACK

We already referred to the obviously significant increase of importance of crack within the open drug scene in 4.3. We can observe an incomparably higher share of persons experienced in consumption than in the Frankfurt sample carried out within the scope of the Dutch - German comparative study (KEMMESIES 1995, page 190 ff). The fact that crack is obviously gaining in importance also, as far as currently practised consumption patterns are involved, is impressively substantiated by the observation that every fifth person interviewed (20%) reports crack consumption in the course of the preceding week, whereas none of the drug users interviewed in 1993 in the course of the aforementioned comparative study reported of current crack use (ibid. 191; chi-square:11.76 ****, DF:1). As to current consumption of crack, we can observe a gradual difference between the partial samples, inasmuch as - by analogy with observations made in connection with cocaine - we have found among interviewees interviewed in the scene inquiry a relatively large group of persons who still consumed crack in the preceding week, this group tends to increase ("Scene inquiry": 24% - "injection room inquiry": 12%) .

• MEDICAMENTS (PRESCRIPTION DRUGS)

As already mentioned in 3.1.2, concrete use of medicaments has only been the subject of questions asked within the scope of the partial sample "injection room inquiry" (n=50): Every second interviewee (54%) reported of regular (additional) consumption of medicaments, six interviewees (12%) consuming medicaments (primarily Benzodiazepine. "Rohypnol") on a daily basis and another 14 persons (28%) once to several times per week. When being asked to state the time of their last use of medicaments, 68% of the persons interviewed reported of such a use in the preceding month and still 40% of a last use in the preceding 24 hours. These figures may be seen as an indication of barbiturates and Benzodiazepine being used obviously continuing to be very popular substances in the open drug scene. They are consumed to avoid and bridge consumption of heroin (cf. for instance: SCHNEIDER 1994).

To enable interviewers to get a better impression of the aspects of "last consumption" and "frequency of consumption", interviewees have been asked (in the form of a question of order of precedence) to state the drug deemed personally most important for them in the preceding week and to specify the drug for which they spent most of their money. The following figures show the types of drugs classified by interviewees as important as well as the drugs for which they spent money.

Figure 18: Drug(s) deemed "significant" / last week (multiple statements)

Figure 19: Drug(s) bought / last week (multiple statements)

At a first glance these figures give rise to the assumption that, at present, heroin and cocaine apparently have an enormous importance and acceptance as regards drug consumption patterns favoured in the open drug scene, these substances ranking far before any other substances. Furthermore, percentages shown in the figures confirm observations crystallised in the previous analysis. These observations indicate that the drug consumption patterns of the partial samples differ, above all, regarding substances like heroin and cocaine: The vast majority of our interviewees within the scope of the injection room inquiry stated to have spent money for heroin in the preceding seven days. Frequently heroin has the status of a subjectively significant drug. The same applies to cocaine regarding the partial sample "scene inquiry" - although in a moderate form.
Another consciousness was observed with regard to medicaments (prescription drugs). Although our interviewees from the scene inquiry had not been asked to state details of concrete use of medicaments (unlike those interviewed during the injection room inquiry), they are frequently - though not significantly - attributing to medicaments a certain importance. These people more frequently state to have spent money for medicaments within the period under report. Even though we may proceed on the assumption that this tendency to differentiate is insinuating a different drug consumption pattern oriented by medicaments according to the partial samples, this phenomenon is, nevertheless, to be considered to evidence that interviewees concede the use of medicaments. But, at least, it is rather questionable to evolve the thesis that, in general, persons interviewed in the course of such studies use to state too low quantities of medicaments consumed, such use "contradicting the image of cool users" (VOGT 1992, 21). When reconsidering the exceptional rank of heroin and cocaine, we get a picture as vividly illustrated in the following figure:

88% of all persons interviewed stated that heroin (49%) or cocaine (39%)[The respective share of cocaine as ascertained in the study of KEMMESIES (1995, 210) is 16%. This significant difference (chi-square: 916 ***, DF: 1) gives evidence again for the clear increase in importance of cocaine within the open drug scene] were their most important drug. No less than 91% spent most of their money for such drugs (heroin: 49% - cocaine: 41%) during the previous week. Above all, the diagram on "drugs with financing priority" illustrates, that cocaine is being attributed more importance in the scope of the partial sample "Scene inquiry".
Let us try to draw a summary picture of the drug consumption pattern as currently primarily practised in the Frankfurt open drug scene. When doing so, we can first of all observe that by now cocaine is obviously being attributed an importance nearly identical with that attributed to heroin: Seemingly, heroin only hardly maintains its dominating position as the drug used in the open drug scene. When, considering further that - as already mentioned - consuming practices tend to be characterised by polyvalent drug consumption patterns, the definition of an "open drug scene" as a "heroin scene" is not (no longer) applicable. To get a better survey of extremely different individual drug consumption patterns, the following chapters are to summarise typical different drug consumption - patterns in accordance with VOGT (1992, 18).

Habitual consumers of hard drugs

This group of consumers (89%) represents the vast majority (133) of interviewees. It comprises persons consuming "hard drugs" (heroin and/or other opiates and/or cocaine and/or speed and/or crack) several times per week or every day. As regards the persons to be classed with this type, 89% (118) of them have been intravenously consuming on a daily and 9% (12) on a weekly basis. Only three interviewees currently smoke (preferably) crack. Therefore, intravenous application can be considered as an essential characteristic of "habitual consumers of hard drugs".

Occasional consumers of hard drugs

8% [12] of persons interviewed are to be assigned to this type defining - by referring to so-called "weekend users" - consumption patterns according to which hard drugs are consumed once a week at most, however, at least once per month. Also, consumers to be assigned to this category currently favour the intravenous use of drugs.

Habitual consumers of soft drugs

As far as the typology of consumption patterns outlined in this context are concerned, there are no differences between the different partial samples (or gender - specific differences). The drug consumption patterns as practised being characterised, to an absolutely predominant extent, by the parallel use of sundry substances, different partial samples tending to differ, as regards consumption patterns orientated to heroin and cocaine: The present consumption pattern as typical of interviewees directly contacted in the open scene is orientated by cocaine, that is to say, to a greater extent than consumption patterns established by the random sample "Injection room inquiry". Heroin on the other hand, is comparatively more popular among persons interviewed in the safe injection rooms. Moreover, against the background of the specific interest in obtaining knowledge this study is based on, we have to note that "injecting" is the consumption form absolutely dominating within the Frankfurt open drug scene, 96% of people interviewed being, at present, assigned to the group of IDU. Therefore, drug users in the scene must be assigned, almost without exception, to the target group the safe injection room offer is aimed at. We observe however, a conspicuous tendency towards differences between the partial samples: On an average, the group of users injecting intravenously on a daily basis (groups composed of almost identical numbers of people interviewed in the course of the partial samples), i.e. people interviewed in the scene inquiry, signify clearly more situations of consumption per day (Altogether: mean:6.14, SD: 4.9, min. max.: 1 - 20. "Scene inquiry": mean:7, SD:5.5 - "injection room inquiry": mean:4.1, SD: 2.6; t 3.9 ****). The conspicuously higher consumption intensity/frequency is, most probably, attributable to the consumption pattern of drug users directly contacted in the open scene who show consumption patterns orientated, to a great extent, by cocaine. This also relates to the fact that intensive (simultaneous) consumption of cocaine generally motivates shorter intervals of application and use. "Because of the short lasting effects and the subsequent high frequency administration schedules, the perceived availability of the drug is for most users much lower than of heroin (although the drug may be just as easy to purchase, provoking increased drug craving and thus higher drug use levels)" (GRUND 1993, 76). Thus, the application frequency of drug users injecting on a daily basis is typical of the sub - group of people stating cocaine use on a daily basis. The frequency more than doubles the frequency rates of groups of people not consuming cocaine on a daily basis ore even abstaining from using this substance (mean:8.3, SD:5.4 - mean:3.2, SD: 1.9; t: 7.11 ****). When considering this constellation, the increasing importance of cocaine, as far as the open drug scene is concerned, embodies considerable implications for the (quantitative) conception of safe injection room services offered.

4.4.1 Physical, psychical general condition

Let us "approach" the general physical condition of interviewees by considering first their subjective self-assessment of their physical condition. Although 47% (70) of the persons interviewed assess their present physical condition, on the basis of a five-degree scale (1= "very good" to 5 = "very bad"), between good to very good (cf. figure 20), the majority of 53% (80) assesses their general physical condition less sufficient up to very bad. In this respect, we cannot observe any differences in individual partial samples or in gender. Nevertheless, we have to observe that homeless people generally assess their physical condition as worse.

Figure 21: Self-assessment of physical condition

chi-square: 14.9**, DF:4

The picture as shown in this figure is more or less identical with the observations made by VOGT within the scope of the Frankfurt scene inquiry in 1991. So - to speak in terms of VOGT (1992) - we can draw the following "interim conclusion": "While nearly half of the persons interviewed are - contrary to common opinion - physically very well or well, one quarter of them are stating to be in a bad or very bad physical condition " (ibid. 23).
To get a concrete idea of the general condition of drug users interviewed, they have been asked to report on physical and mental troubles they had been suffering from in the last three months or still have been suffering from and whether they had been or still have been undergoing medical treatment:

(n - 134 / several mentioned)
[16 interviewees stated that they did not suffer from any troubles during the last three months]

Except for "Epileptic attacks" and "Other", all clinical pictures as indicated in the figure are mentioned by every fifth or even every fourth interviewee, the respective therapy quota being clearly lower. In this respect, we had to observe in particular that two of five interviewees - above all women (women: 57% - men: 37%; chi-square: 4.4, ** DF: 1) - reported of having suffered from depressions in the last three months. In this context, we may proceed on the assumption that these depressions are, in general, depressions due to exhaustion, a phenomena that may be deemed a reaction on the enormous psycho-social stress potentials in the every day scene (primarily: Pressure of procurement, cf. here: KEMMESIES 1995, 247) [To what extent depressions possibly caused by increased consumption of cocaine are meant (cf., for instance: GUNKELMANN 1989, 358; COHEN 1990, page 137 ff) (cocaine meeting with increasing popularity within the open drug scene), remains unanswered considering the insufficient degree of differentiation of the evaluation instrument, justification of this presumption being supported by the observation that the percentage of people suffering from (temporary) depressions (group of habitual [daily] cocaine consumers) is higher (although not significantly) than the respective percentage of people consuming cocaine at a moderate level (48% - 37%)]. In general, interviewees are complaining of three different troubles (mean:2.9, SD:2.1, min. - max.: 0 - 8), this average nearly doubling the value ascertained by the VOGT study (1922, 22) showing a respective value of 1.5 (own evaluations based on data presented). Even the average number of medical treatments stated (a comparatively "harder" indicator) (1.9) (SD:1.4, min. - max: 0 - 6) is still considerably higher than the average number of troubles mentioned (figures showing the VOGT study). Presumably, this dissimilarity is attributable to the fact that the present study reflects a situation following massive suppression of public scene concentrations (cf. in this context: OSTHEIMER/et al 1993, 20). We may proceed on the assumption that the currently considerably reduced open drug scene (quantitative reduction) represents a somewhat "negative picture" of drug users confronted with specific problems, differing entirely from the situation preceding the expulsion of the scene from "Taunusanlage" in 1992/1993. The mentioned phenomenon relates to drug users facing specific problems, i.e. people who - in the absence of any other alternatives - are dependent on the social context of the open drug scene (in particular, the large group of homeless people).
Considering the fact that no more than 16 interviewees (11%) stated they did not suffer from any troubles during the last three months, we may summarise the aforementioned observations by stating that, apparently, the vast majority of drug users of the open drug scene has been still in an extremely bad physical condition.

4.4.2 HIV status

Except for two cases, so far all interviewees have undergone a HIV test. 39 (26%) of the 148 persons tested (99% of the total sample) stated to be HIV positive. It is interesting to observe that the percentage of HIV positive women exceeds the percentage of interviewed male drug users by more than 100% (women: 47% - men: 20%; chi-square: 10.7 ***,DF:1) - an observation resembling an observation made by OSTHEIMER/et al (1993, 16), however, contrasting with the VOGT study (1992, 24) which shows an identical HIV prevalence rate for women and men. Whilst in the present study every fourth interviewee states to be HIV positive, scene inquiries made by OSTHEIMER/et al (1993, 16: 17%) did not produce such results. Nevertheless, for every fifth interviewee this rate should not be deemed an absolute indicator of an increase in HIV prevalence rate among IDU in general. On the contrary, we should proceed on the assumption that the present composition of the open drug scene in Frankfurt am Main is representing, primarily, an extreme picture of drug users facing extreme problems.

4. 4. 3 Overdose experiences

This survey representing the total sample gives us an impression of the overdose frequencies. The partial samples producing an almost identical picture without any significant deviations. On an average, the last overdose dates back for 21 months (SD:26, min - max: 0 - 120); nearly every fourth interviewee (22/23%) of those experienced in overdosing having experienced overdose during the last four weeks.