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| On Being Stoned, by Charles Tart |
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On Being StonedCharles T. Tart, Ph. D.Chapter 2. The Nature of Drug-Induced States of Consciousness
PEOPLE SELDOM do something without a rationale explicitly or implicitly
guiding their actions. Although I have tried to avoid theorizing
as much as possible in this book, there was a theoretical rationale
that led to the initiation of the present study. The theory presented
here is applicable to most altered states of consciousness, although
this presentation focuses on marijuana intoxication. Application
of this theory to more powerful psychedelics, such as LSD, mescaline,
or psilocybin, should take account of the fact that an even greater
range of effects is potentially available with these drugs than
with marijuana.
VARIABILITY OF DRUG-INDUCED STATESOur common experience with many drugs inclines us to think along the line that "Drug A has effects X, Y. and Z." This is generally adequate for most drugs. Heavy doses of barbiturates make a person drowsy. Penicillin cures certain diseases. Amphetamines stimulate people.When it comes to drugs whose effects are primarily psychological, however, the tendency to think that drug A has effects X, Y. and Z can be very misleading and introduces confusion. That type of statement attributes certain sorts of invariant qualities to the chemical effect of the drug on the nervous system. When dealing with psychoactive drugs such as marijuana or LSD, however, both scientific research and the experience of users have made it clear that there are very few "invariant" qualities that are somehow inherent in or "possessed by" the drug itself. Rather, the particular effects of a drug are primarily a function of a particular person taking a particular drug in a particular way under particular conditions at a particular time.
Potential Effects ModelThe conceptual scheme used in this book for understanding the variability of effects with psychoactive drugs may be called the potential effects model. Basically, the observable effects of a psychoactive drug such as marijuana are of three types. First are what might be considered pure drug effects, i.e., effects almost always manifested when a particular drug is taken, regardless of person, place, situation, and time. Such effects are probably due primarily to the chemical nature of the drug as it interacts with common characteristics of human body chemistry. With many psychoactive drugs, pure drug effects are only a small portion of the total effects possible.Potential drug effects are effects that are made possible by the ingestion of a particular psychoactive drug but that will not manifest (become noticeable to the user or an observer) unless various non-drug factors operate in the proper manner; i.e., potential effects manifest only under certain conditions. These conditions will be discussed at length below. These potential effects constitute the majority of effects for a drug such as marijuana. Insofar as potential effects constitute the bulk of effects for marijuana intoxication, it is misleading to talk about the effects of marijuana per se, as is commonly done. Rather, we must speak of the effects of marijuana on certain types of people under certain types of conditions. (A third category of effects under this model is not, properly speaking, drug effects at all, but placebo effects, or pure psychological effects. These are effects brought about by non-drug factors entirely. If the particular configuration of non-drug factors necessary to produce a particular placebo effect occurs frequently under conditions usually associated with taking a particular drug, the effect will probably be, erroneously, ascribed to the drug.)
Factors Controlling Potential EffectsWe shall consider all of the current known classes of factors, which will determine how a particular individual reacts to a psychoactive drug at a particular time, before looking at the problem of variability from one time of drug intoxication to another.
Drug factors include the chemical composition
of the drug, the quantity used, and the method of administration.
Long-term factors affecting a particular period
of intoxication include the culture (and subculture) of the user,
his particular personality characteristics, his physiological
characteristics, and the skills he has learned for controlling
his intoxicated state in earlier drug use.
Immediate user factors include several factors that
assume particular values for hours to days before using a drug,
such as mood, expectations as to what will happen, and desires
for particular happenings.
The experiment or situation includes the immediate
factors surrounding the taking of the drug, such as the physical
setting and social interactions. In the experimental situation,
both the formal instructions and the implicit demands given a
subject can strongly influence the user-subject's reactions.
Selective Amplification, Inhibition, InteractionNone of the above factors affects the intoxicated state in isolation. Some may be important at one time, others unimportant. Users may choose to concentrate on some of these factors, amplifying their effect, or try to inhibit others, with varying degrees of success. Some of the factors may interact at a given time. A cold and sterile setting, an angry or unfriendly experimenter, and a poor mood on the subject's part can all combine to produce negative effects beyond the subject's ability to control.The ranges and combinations of these important factors are enormous, which means that the variety of drug intoxication effects is correspondingly large. We know little about exactly how important some of these are, or how they interact. Some extreme values of these factors, however, do produce known effects. For example, suppose we wanted to know how to produce a pleasant marijuana experience or an unpleasant one. Table 2-1 summarizes some extreme values of controlling factors that will maximize the probability of a "good trip" or a "bad trip." If all the controlling factors take one or the other of the extreme values, success in manifesting the potential effects that constitute a "good" or "bad" trip is highly likely. If some factors take on "good trip" values and others "bad trip" values, the outcome is uncertain.
Feedback Modification of IntoxicationIt should be stressed that the user is not a passive object to which a certain configuration of controlling factors can be applied and, as a consequence, certain results will automatically manifest. The user is monitoring his own state of consciousness; he may deliberately seek to intensify the effects of certain factors and diminish those of others in order to obtain effects he considers desirable.This applies both to specific effects and the level of intoxication. If a room is depressing, the (free) user will leave it. He may select music that will remind him of (and thereby induce) certain experiences, or he may seek out companions more intoxicated than himself in order to raise his level of intoxication by means of a "contact high" (see Chapter 17). The effects of all controlling factors are constantly subject to modification by the actions of the user.[3]
Variability over TimeAny or all of the above controlling factors may vary from one period of intoxication to the next, and many are likely to vary considerably over longer time periods. While long-term factors may generally stay relatively constant for a given user, they can change; as when the user associates with a new subculture. For example, many students who have used marijuana extensively get interested in meditation and, once associated with a formal meditative discipline, are often told that the "spiritual" experiences they have had with marijuana are unreal and diversionary, so that they no longer value such sorts of experience.The increasing skill in control and wider range of possible effects as a drug user becomes more experienced are particularly important. A given user taking marijuana for the tenth time is, in many ways, a very different person from when he took it for the first time.
THE LEVEL OF INTOXICATIONIn the previous discussion, we have treated marijuana intoxication as something that is simply present or absent; but, in fact, it may be present in various degrees, from the lowest degree possible for a user to recognize that he is intoxicated, up to the maximum level of intoxication he may obtain. Variation in level from time to time constitutes another source of variability, as well as being of interest in its own right.In studying drug-induced states of consciousness, it is tempting to assume that the level of intoxication is specified by the dosage of the drug, and this has been done in most laboratory studies. With respect to marijuana (and other psychedelic drugs), however, comments of users indicate that dosage is only an approximate, and sometimes quite fallible, guide to level of intoxication. Neophytes may ingest very large quantities of marijuana without feeling any effect. Experienced users generally report they can become very intoxicated on quantities of marijuana that are small compared to what they originally required. Further, not only will using the same amount of marijuana from the same supply result in different degrees of intoxication for a user at different times, many users have special techniques for raising or lowering their level of intoxication by psychological means. Users commonly evaluate the potency of marijuana offered for sale by smoking a fixed quantity of it and rating the level of intoxication thereby attained. In the present study I formalized this procedure by asking users to rate, on the basis of their extensive experience, the minimal level of intoxication necessary to experience various intoxication effects. That is, certain effects may be experienced at all levels of intoxication, others in the moderate and high levels, others only at the high levels. The minimal-level model, then, assumes there is a threshold level of intoxication below which a certain effect cannot usually be experienced and above which it can be experienced (assuming other conditions are right for a potential effect). Once this minimal level is passed, the effect is potentially available at all higher levels. For example, slowing of time is practically never reported at very low levels of intoxication, but is usually reported at moderate and higher levels. This model is further discussed in Chapter 24. The theoretical rationale for self-reporting of depth of an altered state of consciousness may be found in detail elsewhere (Tart, in press). Briefly, in the course of his marijuana use, a user finds that certain phenomena become available when using more marijuana and that the progression of phenomena with increasing dose follows a fairly regular sequence through most of the times he has become intoxicated. In the future he can then examine what is happening to him, survey the phenomena he can and can't experience, and estimate his degree of intoxication from this. [4] I have found this kind of self-estimation of level to be extremely useful in the study of hypnosis (Tart, 1970a), and Frankenhaeuser (1963) has found estimates of intoxication correlate very highly with dosage levels for nitrous oxide intoxication. [5]
STUDYING MARIJUANA INTOXICATIONIn spite of all the sources of variability and uniqueness discussed above, we still commonly talk of marijuana intoxication as a state, implying that there is a relatively common pattern superimposed on the varied manifestations that result from using marijuana. Our present information as to what that pattern is, is very poor.We presently have two sources [6] of information about marijuana. On the one hand, we have individual anecdotes of marijuana users. These are valuable but cannot be generalized very reliably. We don't know how much of what is reported is a product of marijuana intoxication and how much of the individual writer. On the other hand, we have clinical and laboratory experiments. These are as limited in applicability to the state of marijuana intoxication in general as are the anecdotal accounts, for the reasons detailed in the next section; the laboratory or clinic is an unusual constellation of conditions, which accentuates certain potential effects and inhibits others in a way that is atypical of the general use of marijuana. The ideal study of the nature of marijuana intoxication should proceed in a number of stages. First, we must determine the range of effects; i.e., what are all the various effects supposedly associated with marijuana intoxication? Second, since it is impractical to study everything at once, we must determine which of these effects in the total range are important. We may determine importance on theoretical grounds, which will vary with our own background and beliefs; or we may, somewhat more objectively, decide to study the frequent effects and let the rarer ones wait. Third, we may set up controlled experiments to investigate each important effect in isolation. What causes it? How does it relate to dosage? Do different personality types experience it with important variations? Is it adaptive or nonadaptive for certain individuals? Fourth, we may study the relationships between important effects. Must effect X always appear before effect Y? Does B inhibit A? Does investigator M always observe effects N. O. P and investigator Q always observe effects R. S. and T? Why? Finally, all this knowledge may be put together for a general theoretical understanding of what marijuana intoxication is. As with any scientific theory, this understanding will then be judged on its informational usefulness (does it "make sense" and order the observations conveniently?) and its ability to predict further observations (i.e., if it orders all presently known facts elegantly and can't handle the next new fact, it's not very good). In steps three and four, it is important to remember the restricting effects of the laboratory; i.e., the gain in precision of observation may be offset by the narrowing of the range of potential effects observed and the distortions caused by experimenter bias. However, if we know the range and importance in advance, from steps one and two, we can compensate for the restrictions of the laboratory to a great extent; we will be careful not to overgeneralize and misapply laboratory findings.
THE SCIENTIFIC LITERATURE ON MARIJUANAThere is a vast medical and scientific literature on marijuana, dating back over half a century. The reader interested in perusing this should consult Gamage and Zerkins' A comprehensive guide to the English-language literature on cannabis (1969).It is traditional in a scientific book for the author to thoroughly review all other scientific literature on the subject. I shall not do this, for this literature represents work that is generally methodologically unsound, so no solid conclusions can be drawn from it. Most of this literature rather uniformly attributes almost every human ill imaginable to marijuana intoxication. It is rather reminiscent of the medical literature on masturbation in the last century. As a first methodological warning sign, the intelligent reader might wonder why the practice of marijuana smoking is so widely indulged in if all its effects are negative? More formally, let us consider the literature in two categories, the medical literature and the experimental literature. The medical literature to date on marijuana consists primarily of clinical observations of patients identified as marijuana smokers by physicians treating them. Because marijuana was used before the patient came to the physician, marijuana is considered the cause of the disease. The logic of this is fallacious. Cause and effect cannot be established simply because one thing precedes another unless all other preceding events can be eliminated as possible causes. For example, various medical disorders prevalent among people of underdeveloped nations where marijuana smoking is widespread are attributed to its use. We could equally well reason that the medical conditions in underdeveloped nations lead to marijuana smoking, or that they have nothing to do with it. Thus practically all the medical literature on marijuana is useless, being moralizing under the guise of medicine. This is a particularly regrettable situation. It seems a priori likely that prolonged use of any drug would have some effects on the body (good or bad), and we very much need factual medical knowledge of marijuana's effects. The experimental literature on marijuana, with an occasional and notable exception, represents research carried out under a set of circumstances that are almost certain to produce results that have practically no applicability to the normal use of marijuana; i.e., they emphasize certain potential effects that are atypical of our society's normal use of the drug. Some of the most notable atypicalities of the experimental research to date are as follows. Control of the drug has been in the hands of the experimenter. The subject usually had to take one of a number of unknown substances in an unknown dosage. This can produce a good deal of anxiety and an intensified need for control and defense. As discussed earlier, marijuana users prefer to control their own level of intoxication. (User control of dosage could be allowed, even if it is somewhat less convenient for the experimenter.) Note also that subjects in many laboratory studies of marijuana have been given what are, judging by the effects reported in Chapter 11, overdoses, i.e., dosage levels they would not choose for themselves because of the probability of unpleasant symptoms and loss of control. Physical setting has usually been a hospital or laboratory, typically ugly and impersonal. The social sciences generally, in their pursuit of "objectivity," have adopted cold and impersonal settings in order to gain it. In reality this gains a particular set of limiting conditions, not objectivity. Scientists are just beginning to become aware of how physical settings affect people (Sommer, 1969). Social setting often paralleled the physical setting. Experimental personnel tended to be impersonal, evasive in answering questions, and manipulative of the subject. There were seldom the sort of people the experienced user would have chosen for companions. They were often typical of our culture in that they considered drug use "bad" or "sick." Learned drug skills were typically non-existent in that naive subjects were almost universally used because their reactions were supposedly "uncontaminated." Thus much of subjects' reactions in such experiments represented coping activities of naive people under stress in an unknown situation. The effects of coping may have been much more prominent than many drug effects and may have been mistaken for them. Studying adaptation to drugs is fine and necessary if the experimenter realizes that that is what he is studying, a realization rare in the literature. Implicit demands, difficult as they are for a reader of the literature to judge, often seem to have been negative in that "sick" or "maladaptive" reactions were expected. Aside from the unknown degree to which such demands might have been communicated by the verbal interaction of the experimenter with his subjects, such practices as keeping psychiatric attendants nearby, locking the subject in a room and keeping him under surveillance, and having subjects sign legal release forms prior to the experiment, seem sufficient to communicate strong expectations of adverse effects to subjects. Orne and Scheibe (1964) carried out a classical study demonstrating that demand characteristics of sensory deprivation experiments might be responsible for many of the effects supposedly resulting from the "drastic" treatment of depriving a person of sensory stimulation for prolonged periods. Because the procedure in so many sensory deprivation experiments parallels that in laboratory studies of marijuana and other psychedelic drugs, it is worth reporting this study in some detail. Two groups of normal male college students, naive as to what sensory deprivation was about, took part in the experiment. The experimental group reported individually to the hospital where the experiment was to be held and were greeted by an experimenter dressed as a physician. The experimenter interviewed the subject about his medical history, including dizziness, fainting spells, and so forth. A tray of drugs and medical instruments, labeled "Emergency Tray," was clearly visible in the background. No reference was made to it unless a subject asked about it, in which case he was told that this was one of the precautionary measures taken for the experiment and that he had nothing to worry about. Instructions for the four-hour experimental period, termed "sensory deprivation," were given. They included the fact that a physician was always available should anything untoward develop, and pointed out that if the subject couldn't take it, he could push a button, labeled "Emergency Alarm," to summon assistance. The subject then had his blood pressure and pulse taken to further reinforce the "medical" atmosphere and was asked to sign a form that released the sponsoring organization, all affiliated organizations, and their personnel from legal consequences of the experiment. The actual experimental treatment, spending four hours in a small, well-lighted, comfortably furnished room, had nothing to do with sensory deprivation. Except for the observation window through which the subject could be observed, it was essentially a normal room and all that happened to the subject was that there was no one to talk with for four hours. A second group, the control subjects, were greeted by the same experimenter but he wore ordinary business clothes and acted in a less officious manner. There was no "Emergency Tray" in the interview room, nor was a medical history taken. The subject was told he was a control subject for sensory deprivation studies. The procedures typical of such studies were described to him, such as white noise on earphones, translucent goggles to block out all patterned vision, soft beds to reduce touch sensations, and rules prohibiting physical movement. There was no "Emergency Alarm" button in the experimental room. Each control subject then spent four hours in the experimental room; experimental conditions were thus the same except for the demands. Both groups were interviewed after the experimental period and given various psychological tests. The experimental group showed a number of significant changes on the psychological tests typical of those found in sensory deprivation studies. Further, this group reported many more classical sensory deprivation effects than the control group, including more perceptual aberrations, feelings of intellectual dulling, unpleasant emotions, spatial disorientation, and restlessness. Thus many of the effects commonly attributed to a "powerful" treatment, sensory deprivation, can be obtained by the implicit demands in experimental instructions. I fear that the reader who is not himself a physician or psychologist (i.e., who accepts such experimental conditions as "normal") will find the above description of experimental conditions rather ludicrous. How can we expect to find anything but unpleasant and unusual reactions under such circumstances? I regret to say that such conditions have been standard for almost all the research that has been done on marijuana intoxication or studies of other psychedelic drugs. Indeed, practically all the conditions outlined in Table 2-1 as maximizing the probability of a "bad trip" are standard conditions in laboratory studies of marijuana. This was not a result of deliberate malice on the part of earlier investigators, of course, but stemmed from inadequate knowledge of the importance of non-drug factors and from the pervasive belief in "pure" drug effects. Future experimental studies of marijuana intoxication should note the importance of the many controlling factors discussed above and report their values in particular studies. If this is done, we may begin to round out our overall picture of marijuana intoxication. Further, these controlling factors should be systematically varied. Different environments, varying from cold and sterile to warm and esthetically pleasing along various dimensions, can be tried. Experimenters and experimental personnel can be deliberately selected in terms of their personal attitudes toward drug use in order to assess how important this parameter is, and so on. On a very practical note, political pressure is now very strong for scientists to produce better knowledge about the effects of marijuana in order to guide changes in legislation. If experimental results are to be socially relevant, priority must be given to studies carried out under conditions comparable to the ordinary use of marijuana today. Overdosing a naive person under very stressful conditions is not very relevant to answering questions about the dangers of marijuana, for an overdose of multitudes of common substances under stressful conditions can produce adverse effects. Experimental research can be both valid and relevant. I hope it will be. The previous scientific literature on marijuana intoxication, then, generally represents sets of conditions under which an extremely limited range of potential effects is likely to emerge. This set of potential effects is quite unrepresentative of the effects ordinarily associated with marijuana intoxication. The old research literature can be of some scientific value in detailing the effects of marijuana on people under conditions of high stress.
THE PRESENT STUDYThe present study is intended to begin to provide answers to the first, second, and fourth questions discussed earlier under the general question of how do we scientifically study marijuana intoxication. That is, it is intended to investigate: (1) the range of effects associated with marijuana intoxication under its usual conditions of use; (2) the importance of such effects in terms of which effects are frequent and which infrequent; and (3) the relationships of these effects to level of intoxication, to some important background factors, such as education, and the relationships of some of the effects to each other.By asking experienced users to report on various intoxication effects in the course of their last six months' marijuana experience, all the various controlling factors, which determine potential effects, will have obtained most possible values many times, so the range can be determined. By knowing these sorts of things about the ordinary use of marijuana, we may then estimate whether a given experimental study's results may be generalized to non-laboratory conditions, and, more importantly, we may plan future experimental studies from this base to be relevant to normal marijuana use. Also, because of the lack of scientific information about the entire range of marijuana effects, the data of the present study provide a unique kind of information about the experiential effects of marijuana intoxication that cannot be obtained elsewhere. They are of considerable interest to the reader who simply wants to know "What do people experience when they use marijuana?" and to the marijuana user who would like to compare his experiences with those of others. It should again be emphasized that the present study is itself limited; the marijuana users studied were mostly young college students or rather well-educated older users, and the results should not be glibly generalized beyond such groups. I hope that this study will serve as a stimulus to better and broader studies that will supersede it, both general studies and intensive laboratory research.
SUMMARYMost psychological effects of psychoactive drugs such as marijuana are primarily potential effects; i.e., the drug action makes certain experiences and actions possible if and only if various non-drug factors are just right.This means there is a tremendous range of experiences possible with marijuana, depending on conditions. Previous experimental and medical studies of marijuana have been carried out under such an unusual and restrictive range of conditions that their results have little applicability to the ordinary use of marijuana in our culture today. The present study, by inquiring about intoxication experiences of many experienced users over a long period, provides information on nearly the total range of potential effects, because the many controlling factors have varied over most possible configurations in that time. This study thus provides basic data on the range of intoxication experiences, their relative frequency or rarity, their relationship to level of intoxication, and the effects of various background factors on them. This information provides an answer to the question "What is it like to be high on marijuana?" and provides experimental and psychological guidelines for making future experimental research more relevant and profitable. Note that the method of the present study can provide valuable data on the general effects of marijuana intoxication in experienced users, but it is not suited to investigate questions about individual differences among users. Some users, for example, might experience primarily cognitive alterations while others might experience primarily sensory enhancements. Individual differences are an important topic for future study.
Footnotes1. Note that a pattern of functioning is not the same thing as the observed effects per se. Different restructurings of mental functioning may lead to the same overt effect in some cases, the report that one event followed rapidly after another could stem either from a change in experienced time rate or from falling asleep between events. Relationships between observed effects determine the overall patern. (back)2. Ironically, users generally feel that increased government crackdowns on marijuana usually result in more adulteration as dealers attempt to pass off the poor quality marijuana then available as higher quality material. (back) 3. The great importance of the user's modification of his effects was strikingly (and humorously) demonstrated to me some years ago when, as a graduate student, I participated in an experimental study in which psilocybin (a psychedelic drug similar to LSD) was administered. I had to take a "symptom check list" type of test, sort a bunch of cards into true and false piles. Each card had a phenomenon on it, such as "I feel dizzy." As I started to sort these, it became clear that, by reading the card several times, I could make the effect manifest. So if I read a card that said, "My palms are sweating green sweat," I would decide that that would be interesting to experience, and, sure enough, in a few seconds I could see green sweat on my palms! If I read a negative effect, such as "I feel anxious and afraid," I would immediately toss that card in the false pile, and the effect wouldn't happen. (back) 4. For example, one of my informants, an engineer, reports that he can scale his level of intoxication on a ten-point scale by whether or not certain phenomena are available. He uses zero as non-intoxicated; one as a level where he feels a little different but nothing is clear enough for him to be sure he is intoxicated; two as the lowest degree of clear intoxication manifested by a full feeling in his head, clearer and more beautiful sounds, and calmness; five for the level where he first experiences time slowing down; eight for clear shortening of the memory span; and ten for the maximum level of intoxication, where he has large visual distortions and may begin to feel ill. (back) 5. A simplifying assumption underlying the present study is that there is one state of consciousness, marijuana intoxication, common to all users and that it vanes in a continuous fashion. It is possible that there are several states across individuals and/or that there may be qualitative alterations in patterns large enough to be called a different state of consciousness for a given individual (Tart, in press). The latter possibility cannot be properly investigated with the present data. (back) 6. The user has a third source of information, his own experiences, and may consider our other two sources quite secondary to this. If he is interested in understanding the nature of marijuana intoxication in a general sense, however, he should realize that his own experience is limited just as the other two sources are; namely, it is a selection from the total range of potential effects determined by his own personality characteristics and life situation. (back)
Table
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