The Effectiveness of the Subculture in Developing Rituals
and Social Sanctions for Controlled Drug Use
Wayne Harding & Norman E. Zinberg
from: Drugs, Rituals and Altered States of Consciousness,
Brian M. DuToit, editor. ©1977, A. A. Balkema, Rotterdam
Introduction by Peter Webster
The following paper, from 1977, is an example
of the high quality research into the use of psychedelics and
other "drugs of abuse" that continued despite
governmental restrictions and other discouragements to workers in
the field of drug research. As with so many research projects,
the findings were not at all what prohibitionist functionaries
wanted or could accept, and such reports were often vehemently
rejected by their sponsors, and ignored by the media who would
have trumpeted the results on high had they supported
Prohibition. The study here is of particular interest in that it
indicates that drug users in today's societies tend to re-create
in a modern context the methods and rituals of drug use seen in
tribal societies which enable the drugs to be used safely and for
certain defined purposes. The authors conclude:
"Our findings show that, contrary to conventional
wisdom, controlled use of illicit drugs is possible and is
fostered by subcultural rituals and social sanctions that
support controlled use and curtail drug abuse... Ironically,
the present attempt to eliminate all use of illicit drugs
undermines users' ability to control them... What is clear is
that the attempt to eliminate all use of these drugs
contributes to their abuse by people who take them.
"Certainly decriminalization of marihuana should be
extended beyond those few states which have adopted it, and
federal penalties for use should be dropped. Further research
on the possible medical applications of marihuana and the
psychedelics should be undertaken, and results sufficiently
publicized so that their public image as "bad"
drugs can be dissipated. Heroin should be made available to
physicians as a legitimate analgesic, and experimentation
with heroin maintenance clinics for the treatment of addicts
should also begin with careful control.
"Drug education programs which are no more than
disguised campaigns to eliminate use should be replaced with
genuine efforts to provide users and non-users with some
rudimentary pharmacological data and with detailed
information about the consequences of various patterns of
use. Doctors, teachers, counselors, and others who encounter
drug users should be instructed in how to distinguish use
from abuseit simply makes no sense to alienate and
undermine those segments of the population of drug-takers who
stand against abuse.
THE EFFECTIVENESS OF THE SUBCULTURE
IN DEVELOPING RITUALS AND SOCIAL SANCTIONS
FOR CONTROLLED DRUG USE 1
WAYNE M. HARDING & NORMAN E. ZINBERG, M.D.*
from: Drugs, Rituals and Altered States of Consciousness,
Brian M. DuToit, editor. ©1977, A. A. Balkema, Rotterdam
* Wayne Harding is a Research Associate at The Cambridge
Hospital Norman Zinberg is a Faculty Member of Harvard Medical
School at The Cambridge Hospital and of The Boston Psychoanalytic
Institute.
In the United States, social and legal taboos against the
nonmedical use of illicit drugs are reinforced by the prevailing
view that these drugs are almost animately pernicious. According
to this view, marihuana, LSD, cocaine, heroin, and other illicit
drugs are so overpowering and/ or so dangerous that their
continued use inevitably leads to drug abuse. The physiological
and psychological damage evidenced by the most serious abusers of
illicit drugs is regularly invoked as proof of this
"pharmacomythology" (Szasz, 1975) .
There is nothing in the pharmacology of these drugs, however,
that precludes the possibility that they can be used without
being abused. Our study of controlled drug use, sponsored by The
Drug Abuse Council, Inc., has located users of marihuana,
psychedelics, and opiates who, like most alcohol users, manage to
maintain regular non-compulsive use of these drugs, Analysis of
longitudinal interview data indicates that this 'controlled' use
is chiefly supported by emerging subcultural drug-using rituals
and social sanctions. These rituals and social sanctions provide
what the larger culture does not: instruction in and
reinforcement for maintaining patterns of illicit drug use which
do not interfere with ordinary functioning and methods for use
which minimize untoward drug effects.
In this article we discuss these findings and the related
work of other researchers. We also argue that existing
subcultural rituals and social sanctions, elaborated and endorsed
by the mainstream culture, could be a more humane and perhaps
more effective means of preventing drug abuse than legal
prohibition.
Serious consideration of such alternatives is especially
timely given the recent actions of some states to significantly
reduce the legal penalties surrounding the use of marihuana. It
appears that these reductions have been prompted by a growing
realization that our costly social policy has not succeeded in
halting marihuana use by a large number of Americans. Thus far,
however public debate over liberalization of drug laws has not
taken into account changes in drug-using style.
DEFINITION OF TERMS
As used here. 'ritual' refers to the stylized, prescribed
behavior surrounding the use of a drug. This behavior may include
methods of procuring and administering the drug, selection of
physical and social settings for use, activities undertaken after
the drug has been administered, and methods of preventing
untoward drug effects.
'Social sanctions' refers to the norms regarding how or
whether a particular drug should be used. Social sanctions
include both the informal and often unspoken values or rules of
conduct shared by a group, and the formal laws and policies
regulating drug use.2
These two aspects of social sanctions are not always consonant.
Laws prohibiting use of illicit drugs may reflect the values of
the majority of Americans but are often at odds with the values
of drug users. Various segments of society thus observe quite
different social sanctions (and rituals) although each segment is
cognizant of and influenced by the other's. The relationship
among the rituals and social sanctions of controlled illicit drug
users, of compulsive users, and of the mainstream culture is a
focus of concern in later portions of this paper.
Our use of the terms 'ritual' and 'social sanction' differs
from the classic use of the terms 'ritual' and 'ritual belief' in
anthropology. The distinction between drug-using rituals and
social sanctions is one of behavior versus beliefs, or practice
versus dogma. In anthropology, terms such as 'ritual beliefs' and
'ceremonial beliefs' are used instead of 'social sanctions' (
Leach, 1968) . We prefer 'social sanctions' for two reasons.
First, this term emphasizes that beliefs are socially derived and
reinforced. Second, 'social sanctions' conveys more clearly than
'ritual beliefs' the sense that behavior and belief are separable
concepts. While it is true that rituals and ritual beliefs are
intimately related, and sometimes virtually indistinguishable, we
have found that different drug users ( heroin addicts versus
controlled heroin users, for example) may share very similar
drug-using rituals, yet subscribe to dichotomous social
sanctions. In other words, social sanctions can be used to
predict the type of drug use when rituals cannot.
The terms 'rituals' and 'ritual beliefs' have been applied
most frequently to magical or religious phenomena. Goody and
others have included secular events (e.g., civil marriage
ceremony) under the rubric of ritual, but reserve the term to
describe behavior in which "the relationship between means
and ends is not intrinsic is either rational or
non-rational" ( Goody, 1961) . What is usually excluded is
any behavior which "is technical or recreational" (
Gluckman, 1962) .
Our use of ritual and social sanction violates this tradition
in two distinct ways. First, we are applying these terms to drug
use whether the goal of the user is recreation, improved mental
or physical performance, or religious experience.3 Second, drug-using rituals and
social sanctions include both rational and nonrational elements.
The intravenous injection of heroin is causally related to the
subsequent high while booting (drawing of blood
back into the syringe and re-injecting one or more times ) is
not, although users may believe that it is.
Our departure from the more restricted meaning of ritual is
not without precedent among anthropologists. Klauser (1964), for
example, discussed the cocktail party as a ritual. It is worth
explaining, however, why the concept 'ritual', even in modified
form, is so aptly applied to drug use.
Within very broad limits, the objective and subjective
effects of a psychoactive drug depend as much on how the drug is
used and the expectations of the user as on its chemical
properties. Booting does increase some heroin users' sense of
euphoria. A placebo can alleviate pain as effectively as morphine
provided the user believes he is receiving an analgesic. Tobacco
acts as a powerful hallucinogen in some Amazonian tribes where it
is used infrequently in high doses (Weil, 1972). These are but a
few examples of the mutability of drug effect which can be
attributed to the discrete influence of rituals and social
sanctions, whether rational or nonrational, on the drug user.
Szasz (1975) similarly justifies applying the term to drug use
because it reveals the enormous range in the consequences of that
use which are otherwise hidden by a strictly pharmacological
perspective:
Perhaps because of all the major modern nations, the
United States is the least tradition bound, Americans are
most prone to misapprehend and misinterpret ritual as
something else: the result is that we mistake magic for
medicine, and confuse ceremonial effect with chemical cause.
Finally, in this paper we are mainly interested in drug-using
rituals and social sanctions of a specific kind: those which
foster controlled drug use. Drinking muscatel from a bag-wrapped
bottle while squatting in a doorway, or soliciting psychedelics
from strangers on a street corner is not a controlling ritual.
The positive social status attached to the ability to withstand
extraordinarily high doses of LSD, the risk involved in getting
loaded on barbiturates and alcohol, or the size of one's
heroin habit does not constitute a controlling social sanction.
In the following section we outline the nature of social
sanctions and rituals which do promote control, using alcohol as
an example. This discussion will provide a basis from which to
examine the existing subcultural social sanctions and rituals
which facilitate the controlled use of illicit drugs and inhibit
their abuse.
RITUALS, SOCIAL SANCTIONS,
AND CONTROLLED ALCOHOL USE
Although alcohol is a powerful and addictive psychoactive
drug which can produce profound physiological and psychological
damage, the vast majority of Americans who drink alcohol manage
to control it. There are an estimated 105 million drinkers in the
United States compared to some 8 million alcoholics (New York
Times, April 9, 1973). Widespread controlled alcohol use can be
understood in terms of culturally based rituals and social
sanctions which pattern the way the drug is used .
Alcohol-using rituals define appropriate use by limiting
consumption to specific occasions or circumstances. Having a
highball before dinner, wine with a meal, a few drinks at a
cocktail party, a beer with the boys after work, or a drink at a
business luncheon are examples. Positive social sanctions permit
and even encourage moderate use of the drug: one need only
consider the occasions when a drink is offered to appreciate how
well alcohol is integrated into the culture as an approved social
intoxicant. This social acceptance of alcohol is paralleled by
the minimal legal restrictions on its consumption, and by the
negative sanctions which condemn promiscuous use and drunkenness.
"Know your limit," "Don't drink and drive,"
"Don't mix drinks," and "Never drink before
noon" are familiar proscriptions.
The internalization of these social sanctions and rituals
begins in early childhood. The child sees his parents and other
adults drinking. He learns the possibilities of excess and the
varieties of acceptable drinking patterns from newspapers,
movies, magazines, and television. As he matures, he develops a
more unconscious than conscious sense that alcohol use can be
pleasant, controlled, and socially approved. In some cases, this
socialization process is more directchildren sip wine at
religious rituals and celebrations, or taste their parents'
drinks. Many authorities believe that a gradual and careful early
introduction to alcohol by parents contributes to restrained
adult use.4
Many adolescents drink without parental permission, and some
test the wisdom of the social sanctions and rituals with which
they are already familiar by getting drunk and nauseated.
However, the central issue of this testing is not so much how to
drink as it is how long the adolescent must defer approved social
drinking. Neither the adolescent nor his parents have much fear
that occasional undercover experimentation will seriously or
permanently disrupt social relationships and performance at
school or work. Throughout this period of early use, the
adolescent has numerous adult role models for controlled use and
he can easily find friends who share his interest in drinking as
well as his resolve to avoid compulsive use.
At some point the young user receives direct or tacit
approval for drinking from parents and other significant adults,
marking the end of family-centered socialization in the use of
alcohol.5 As
the user begins to drink in public, he melds the general
culture's rituals and social sanctions and his previous learning
into an individualized but socially acceptable pattern of alcohol
use. Social reinforcement for controlled use continues throughout
adult life.
Obviously the influence of rituals and social sanctions on
the alcohol user is partial and imperfect. Other
variablessocial forces, personality factors, and perhaps
genetic differencesalso influence how groups and
individuals use the drug. The social sanctions and rituals
associated with controlled use are not uniformly distributed in
the culture. Some ethnic groups (e.g., the Irish) tend to lack
strong sanctions against drunkenness and have a correspondingly
high incidence of alcoholism (Wilkinson, 1970) . Furthermore,
even when functioning rituals and social sanctions are available,
family-centered socialization may break down. Nonetheless,
prevailing rituals and social sanctions exert a discernible, and
crucial, moderating influence over the way most Americans use
alcohol.
The importance of such rituals and social sanctions has been
dramatized by the disastrous effects of the introduction of
alcohol to societies which lacked them. American Indian tribes
demonstrate long-standing, controlled, highly ritualized use of
naturally occurring psychoactive plants such as jimson weed and
peyote (LaBarre, 1938). The Indians' legendary susceptibility to
alcoholism stems essentially from a lack of similar cultural
conventions for the use of the white man's drug. Because
the Indian has rejected and has been denied full membership in
American society, his inculturation in alcohol-using rituals and
social sanctions has been retarded. Consequently, alcoholism
persists among Indians and the "consequences of alcohol use
are frequently deep inebriation, rather than courtly
pleasantries" (Freedman, 1974). Wilkinson (1970) reports
that when the Eskimos of Frobisher Bay, Baffin Island, were first
granted legal permission to drink, their lack of previous
cultural experience and guidelines for alcohol use resulted in
pronounced abuse .
A similar problem exists for Americans who use illicit drugs.
It is not at all surprising that so many of these people wind up
as compulsive users. There are virtually no socially accepted
models for the controlled use of these drugs, no positive
cross-generational education in how to use them, and no
reinforcement or assistance in moderate use (Abrams, 1972)6 The mainstream
culture not only fails to assist controlled, illicit drug use, it
actively discriminates against it. Any and all use of illicit
drugs is prohibited. Persons who use these drugs are regarded as
deviant: either as sick and in need of counseling and
rehabilitation, or as criminal and deserving of punishment. It is
clear that use and abuse of illicit drugs must be understood from
a socio-cultural as well as a pharmacological perspective.
REVIEW OF PREVIOUS RESEARCH
By and large, the research literature reflects the reigning
cultural outlook on illicit drug use in that it fails to
differentiate between use and abuse. One reviewer of 35 recent
studies states that their most serious flaw is that "they
have lumped together all drug users without considering the
extent of their use" ( Heller, 1972) .
Patterns of drug abuse such as heroin addiction have been
singled out for intensive study, but there has been little effort
to delineate patterns of use lying between the extremes of
abstinence and abuse or compulsive use. The lack of a definite
typology for drug-using behavior bespeaks the continuing and
pervasive tendency to confound quite different patterns of drug
consumption.
The terms in the literature which are closest to controlled
use are 'chipping', 'occasional use', 'experimenting', and
'tasting'. 'Chipping' and 'occasional use' are usually associated
with heroin and the opiates. 'Taster' (Kaplan, 1971) and
'experimenter' (Keniston, 1968-69) have been specifically applied
to marihuana and psychedelic users. All these terms refer to
irregular, nonaddictive, or minimally abusive drug use, but do
not necessarily connote the elements of moderation, regularity,
stability, and non-abuse which we mean by controlled use.
A computer search of the MEDLINE file7 covering a 47-month period
(January 1969 through November 1972) produced no articles
specifically concerning occasional use of any drug. An informal
search for mention of occasional use, however, yielded several
allusions to occasional use. Jordan Scher (1961, 1966) mentions
the existence of controlled heroin use in work done through the
Cook County Narcotic Project. Isador Chein et al. (1964) note the
existence of "long continued, nonaddictive heroin
users." Howard Becker (1963) discusses occasional marihuana
use as a stage preceding regular use during which "the
individual smokes sporadically and irregularly" because he
has not yet established a reliable source for the drug. W.H.Dobbs
(1971) warns that not all applicants to methadone programs who
are using heroin may be drug dependent. John Newmeyer (1974)
found some heroin users who, he feels, should not be regarded as
representative of a junkie population because they "could
sample heroin without becoming addicted."
The focus in each of these sources is more on regular than
controlled use, and little importance is attached to different
using patterns. The authors do not seriously consider regular
controlled use as a stable use pattern for a significant number
of people.
To our knowledge only one published study ( Douglas Powell,
1973), also sponsored by The Drug Abuse Council, Inc., focuses
specifically on occasional drug use or occasional users. Powell
interviewed subjects who had been occasional users of heroin for
at least three years without becoming physically addicted. Many
of the using patterns described in Powell's report, however,
appear so unstable or so damaging that they lie outside the
patterns of controlled use we are investigating. Still, Powell's
study supports our efforts in that he established the existence
of occasional ( if not controlled) heroin users and he found that
such users "are responsive to research and can be studied
reliably with relatively simple techniques."
METHODS OF THE DAC STUDY
The major goals of the Drug Abuse Council study are:
1. to locate controlled users of marihuana, psychedelics, and
opiates;
2. to describe such users and their various patterns of use;
and
3. to identify factors which stabilize and destabilize
controlled use. Potential subjects were initially solicited
through universities, advertisements in the underground press,
and a variety of social service agencies including halfway
houses, drug treatment programs, and counseling centers. Once
underway, we found, as Powell did, that after completing the
screening/interview procedure, subjects were often willing to
refer drug-using friends and acquaintances to the project. Six
indigenous data gatherers ( i.e. members of the drug-using
subculture) were recruited to assist in locating and interviewing
subjects.8
The following are the minimum criteria developed for
participation in the project.
1. Subjects had to have used marihuana, a psychedelic, or an
opiate for at least one year.
2. Subjects had to be willing to participate in follow-up
interviews.
3. A subject had to have used the drug frequently enough to
be considered a regular user, but not so frequently that he was
physically addicted to it ( in the case of opiates ) or that his
level of use was likely to interfere with effective personal and
social functioning. No precise cutoff points for frequency of use
were established. In practice, a marihuana user who had used only
a dozen times in the previous year was not selected because his
use seemed too infrequent to be regarded as regular, and a weekly
user of psychedelics was not selected because such frequency
suggested a possibly abusive drug-using pattern.
4. When subjects were polydrug users, all of the drugs used (
including alcohol) had to be used rather than abused. A subject
who was a moderate bi-weekly heroin user, but who was
physiologically addicted to barbiturates, was not eligible to
participate.
Interviews lasted from one and one half hours to two hours or
more. Subjects were paid approximately $10 per interview. A
flexible interview schedule was adopted to allow the interviewers
to pursue interesting issues as they arose. For each subject data
were gathered on his history of drug use ( including alcohol);
his relations to work and school, as well as to family and mates;
his relations with drug-using and non-drug-using peers; his
physical health and emotional stability; details of drug-using
situations; and basic demographic variables such as age, years of
schooling, and social class.
Profile of the sample
For approximately two years interview data have been gathered
on 105 controlled users.9
The sample consists of 66 white males, 24 white females, 9 black
males, and 6 black females. Subjects range in age from 14 to 70
years with most in the 18- to 25-year-old age bracket.
Eighty-seven interviewees demonstrate controlled use of
marihuana, 42 have used psychedelics in a controlled way, and 46
are controlled opiate users ( categories overlap) . Follow-up
interviews have been conducted and are still in progress.
We found that the 105 controlled users can be distinguished
from compulsive users along several dimensions. Subjects maintain
ties to institutions like work or school, and regular social
relationships with non-drug users as well as users. Drug use is
important to these subjects but is only one of many other
activities, relegated to leisure time. Most subjects are deviant
only by virtue of their drug use. Some have a history of criminal
activity or school disciplinary problems, which does not
generally overlap their controlled use of a drug. No subjects
manifest physiological or psychological impairment as a result of
controlled use .
Our data contradict the notion that the period of controlled
use is a brief transition stage ending in abuse or abstinence.
Subjects with relatively short histories of controlled
useslightly over one year, for exampleare included in
the sample to clarify the manner in which controlled use is first
established. Long-term follow-up will reveal how stable these
subjects' patterns of use are. The majority of subjects, however,
have been controlled users for several years, and some have
maintained controlled use for as long as ten years.
RITUALS, SOCIAL SANCTIONS, AND CONTROLLED
MARIHUANA, PSYCHEDELIC, AND OPIATE USE
Having outlined our methods and profiled the sample, we will
confine ourselves here to a discussion of preliminary findings on
the relation between rituals, social sanctions, and controlled
use.10 The
most striking feature of the DAC subjects is that they have
acquired and adhere to rituals and social sanctions which provide
a structure and a mythology for maintaining controlled use and
avoiding untoward drug effects.11
Acquisition of rituals and social sanctions took place over
the course of subjects' illicit drug-using careers. The details
of this process varied among subjects: some had been controlled
users from the outset of their drug-taking; others had been
through one or more periods of compulsive use before firmly
establishing control. Virtually all subjects, however, required
the assistance of other users to construct appropriate rituals
and social sanctions out of the folklore and practices of the
diverse subculture of drug takers.
It is this association ( often fortuitous ) with one or more
controlled users which provides the necessary reinforcement for
avoiding compulsive use. The using group redefines what is a
highly deviant activity in the eyes of the larger culture, as an
acceptable social behavior within the group. It reifies social
sanctions and rituals and institutionalizes controlled use. This
is consistent with Jock Young's (1971) observations of drug use
in London where he found that some groups "contain lore of
administration, dosage, and use which tend to keep . . . lack of
control in check, plus of course, informal sanctions against the
person who goes beyond these bounds."
All but two of the DAC subjects have been connected to a
controlled using group. Although subjects sometimes use drugs
alone, upwards of 80 per cent of their use takes place with
others. Use in the company of drug abusers is rare. Controlled
heroin users, for example, tend to limit their contact with
heroin addicts to those occasions when it is necessary to obtain
their drug and to decline invitations to shoot up with their
addict-suppliers.
While association with controlled drug-using groups is the
primary source of controlling rituals and social sanctions for
illicit drug use, it appears that the alcohol education process
may be a secondary source, especially in the case of marihuana
use. Subjects often draw pointed comparisons between social
drinking and their use of illicit drugs. Younger subjects apply
the same languagephrases like getting high and getting
offto both alcohol and illicit drugs. Subjects describe
social gatherings where both alcohol and marihuana are available
and where an individual's preference for one of these drugs over
the other is interpreted as a matter of personal choice rather
than as a symbolic ideological statement about being in or out of
the drug culture. Some subjects treat alcohol and marihuana in
much the same way. John L., 26, is enrolled full time in a
university and holds down a part-time job. When he returns home
he usually has a drink or a joint before dinner, depending, he
explains, on his mood and his plans for the remainder of the
evening. It seems then that controlled users adapt alcohol-using
rituals and social sanctions to their use of illicit drugs.
Taken as a whole the rituals and social sanctions toward
controlled illicit drug use have several major features:
1. They define and approve controlled use and condemn
compulsive use .
2. They limit use to physical and social settings conducive
to a positive drug experience.
3. They incorporate the principle that use should be kept
infrequent enough to avoid dependence/addiction and to maximize
the desired drug effect .
4. They identify potential untoward drug effects and
prescribe relevant precautions to be taken before and during use.
5. They assist the user in interpreting and controlling his
drug high.
Rituals and social sanctions vary with the pharmacology of
the three drug types we are investigatingmarihuana,
psychedelics, and opiatesand with the acceptability of
these drugs within and outside the drug subculture. Therefore,
the following, more detailed discussion of rituals and social
sanctions proceeds by drug type.
Marihuana
Marihuana use is less ritualized than psychedelic and opiate
use. Subjects use the drug in a wide range of settings and
circumstances: before going to a movie, at a party, while
watching television, or during a walk in the woods. Controlled
users do not usually come together specifically to take
marihuana; they meet to socialize and the drug is sometimes taken
as an adjunct to the occasion. Marihuana is also more likely to
be used alone than the psychedelics or opiates.
This flexibility in marihuana rituals is in part due to the
pharmacology of the drug. Marihuana is a relatively mild and
short-acting intoxicant. Our subjects, as experienced users, find
no difficulty in controlling the drug high,12 and they are able to function
normally if that becomes necessary. The high state, therefore, is
compatible with a variety of public and private settings.13 A marihuana
high is also easily arranged, requiring neither the apparatus to
inject an opiate nor the planning to accommodate a 6- to 8-hour
psychedelic high.
Flexibility in marihuana rituals can also be explained in
terms of the drug's status. The expanding number of marihuana
users as well as the growing acceptance of the drug among users
and non-users alike14
has created an environment in which rigid external controls in
the form of rituals are no longer necessary. They have been
supplanted by controlling social sanctions which are less
specific and can be adapted to various using circumstances. DAC
subjects 25 years old and over who began using marihuana in the
early to mid-1960's describe the more marked ritualization of
that period. They recall with nostalgia and humor the dimly lit
room, locked doors, music, candles, incense, people sitting in a
circle on the floor, and one joint passed ceremoniously around
the circle. They now regard this behavior as quaint and
unnecessary. As the number of intermittent marihuana users has
risen to some 8 million Americans and the number who have tried
the drug to 26 million ( Boston Globe, 1974), marihuana use has
lost much of its deviant character. Concurrently, social
sanctions for controlled use have been strengthened and have
become available throughout most of the using subculture.
Under these conditions considerable learning about controlled
use can take place before use actually begins. The choice of
whether or not to use marihuana has become a reality for American
adolescents, and most are well aware before making that choice
that marihuana does not cause people to go crazy or to fall
apart. Younger DAC subjects ( 18 to 20 years) had known of
teachers in their high schools who used marihuana. Many had older
siblings who they knew used the drug. These subjects had also
acquired a sense of what marihuana was like from friends, the
underground press, popular music, novels, and other sources.
Their first few experiences with marihuana were usually
ritualized affairs with one or more newcomers introduced to the
drug by a more experienced user in a secure setting.15 The
experienced users typically provided guidance, demonstrated how
best to smoke the drug, and soothed newcomers' lingering fears.
Very quickly, though, neophyte users moved beyond these
structured situations and began the process of adapting use to a
variety of social settings. Most were able to locate friends with
whom to use the drug and with whom they also shared
non-drug-centered interests. The lack of highly specific rituals
should not, therefore, be construed as evidence that controlled
users are reckless in the way they use marihuana. Rather, the
rituals that earlier served as rigid and external controls have
been replaced over the last decade by more general but equally
effective social sanctions. Due to growing familiarity with every
aspect of marihuana use, these sanctions, like those of alcohol,
are internalized; the rituals developed to support these
sanctions no longer need to be so closely adhered to. Interviews
with subjects reveal how these social sanctions operate to ensure
control.
Subjects describe marihuana as a relatively innocuous drug,
easily controlled, and difficult to abuse.16 Some expressed genuine surprise
when we asked if they had ever had any difficulty in maintaining
controlled use. Subjects are not, however, messianic about
marihuana. They recognize its potential for abuse and offer
guidelines for sensible use:
In spite of all the rationalizations about how good dope
is, I don't see that I have to have a reason for getting high
every time but yet getting high consistently without a reason
for it seems to be a reason to sort of check things out with
yourself.
Another subject comments that if marihuana is used too much
the quality of the high declines and when this happens one should
stop for a while and then return to a pattern of more infrequent
use. Subjects generally subscribe to the ethic that they should
not be high at work or at school. Susan S. works as a housekeeper
several days a week. She explains that although she can clean
when she is stoned, she prefers to restrict her drug use
to leisure time.
Controlled users also express the idea that too much
marihuana should not be used at any one time. There are two
reasons cited for this:
1. to avoid transient but unpleasant panic reactions or
paranoia, and
2. to keep the high controllable so that other activities can
be better enjoyed .
While passing a joint around a group is no longer de
rigueur, it still serves on many occasions to assist the
process of adjusting the intensity of the high. It allows time to
pass between each inhalation during which the user can monitor
his own degree of intoxication. Several subjects state that when
using alone or with one or two other people, they stop after
several tokes to let the high catch up with them and then
decide whether they want more. One subject comments that this is
an especially sensible way to proceed when trying out a new batch
of marihuana.
Psychedelics
Psychedelics include a wide range of substances that vary
both in potency and duration of effect: LSD, mescaline, peyote,
psilocybin, MDA, DMT, and others. The illicit status of these
drugs creates a major problem for the user; he cannot be certain
what is in the drug he is sold.17 What is presumed to be mescaline
may be LSD. It may be adulterated with PCP, amphetamines, and
other substancesand its dosage can only be guessed at.
Unlike the marihuana high, the psychedelic high18 usually lasts for several hours.
It is an intensive though not uncontrollable experience,
characterized by perceptual changes, sometimes of a hallucinatory
or illusory nature. The risk of a bad trip is always
present and to some degree increased by the lack of quality
control over the drug. For these and other reasons, psychedelics
are regarded as real, i. e., dangerous, drugs within the
drug subculture. They do not have the widespread appeal of
marihuana nor are they treated casually. Most of the rituals and
social sanctions related to the psychedelics deal with making the
drug experience as safe as possible for the user.
For the subjects, psychedelic use is almost invariably a
drug-centered, group activity. Subjects talk about having others
with them who can be relied upon to help cope with a bad trip or
unforeseen events as a requisite for safe tripping: "I have
to do it . . . with someone that I really know well, that I
really trust, and there are some people like that." People
who are less intimately acquainted are sometimes included in the
group but if so, the trip is commonly preceded by a discussion in
which everyone tries to get comfortable with one another, to
determine who may need extra help or attention, and to establish
ground rules for the trip. During this preliminary discussion, an
experienced user may be assigned to act as a guide for a more
inexperienced or uneasy user. Group members may decide to forbid
wandering off from the group without letting someone know because
it causes people to worry, and worrying is felt to be detrimental
to a positive drug experience.
Subjects agree that planning the trip is an important matter,even when participants have taken the drug together before and
feel quite close to one another. The need for structure varies,
but pre-trip planning includes issues such as: what foods or
beverages to take along, what activities to engage in during the
trip, whether thorazine or niacin should be available in case of
a bad trip, or whether talking people down is preferable to
medicating them. This planning reaffirms the participants' sense
of shared intentions and strengthens their capability to control
the drug high.
Subjects are adamant about using psychedelics in a proper
setting a good place. For many this means tripping
in a relatively secluded spot in the country. What seems
important, however, is that the space is secure and comfortable.
A city tripper said, "I'll take a walk outside but it'll
always be with the notion that I can come back to this kind of
sanctuary for myself in the house, and so it's no threat."
This subject and many others expressed surprise and some disdain
for users who violated the principle that psychedelic use is a
taxing experience that should be confined to special settings:
I'm amazed that . . . I was living last year with a dude
who's 17 years old and is from the West Coast. He was telling
me that when he was going to junior high school he would just
drop acid in the morning and go to school, which completely
weirded me out . . . and just could ride with any kind of
horrible thing . . . Amazing.
Another social sanction/ritual which subjects observe is the
need to be internally prepared for psychedelic use. One subject
describes this as "making peace with the public reality . .
. mentally putting your house, your affairs, in order, you know,
like, what's the Zen thing . . . emptying out the teacup
first." Others talk simply about needing to be in a
"good mood" and needing "energy" to undertake
the experience. Some subjects appear to ritualize this internal
process by tidying up the space in which they are going to use
the drug.
All the conventions described above represent attempts to
ensure a good trip and prevent a bad one. We now
turn to the issue of how rituals and social sanctions may inhibit
compulsive psychedelic use.
Subjects repeatedly advocate using psychedelics at no less
than two-week intervals. In practice, their use is far less
frequent than thisless than once a month is the most
typical using pattern and, with time, use consistently becomes
even less frequent. Avoidance of compulsive use, however, is
probably not so much the consequence of negative sanctions as it
is the result of a combination of two other factors:
1. the positive value controlled users attach to the
consciousness-altering properties of psychedelics, and
2. the fact that tolerance to these consciousness-altering
properties goes up very rapidly as use becomes frequent. Our
subjects who are interested in experiencing precisely these
effects find that too frequent use of the drug is
counterproductive.
Some psychedelic users who are not interested in the
consciousness-changing qualities of these drugs may become
compulsive users. For them, it is the speedy, stimulating
effects of psychedelics that are appealing19 -effects which are enhanced with
larger, more frequent doses of the drug. Although we have little
direct evidence to support it, we would guess that this kind of
compulsive psychedelic user is associated with those groups in
the subculture which negatively value consciousness change or do
not recognize it as a primary drug effect.
By comparing older and younger subjects we have identified
some shifts in psychedelic-using rituals and social sanctions.
Subjects who began use in the mid-sixties share a sense that
psychedelics should be used for "personal growth"
rather than recreational purposes. They discuss tripping as an
activity which is undertaken to accomplish a worthy goalto
learn more about oneself, to grow intellectually, to transcend
ordinary perceptual boundaries, and so on. However, subjects who
began use in the past five years have broadened their reasons for
using psychedelics to encompass plainly recreational goals.
Younger subjects may trip for a highly rationalized purpose
but they are equally inclined to trip simply to enjoy the high
state. This trend is difficult to interpret and we have yet to
make final judgments. We speculate, however, that the expanded
goals of psychedelic users indicate a growing familiarity with
psychedelics and less guilt about their use. Without wishing to
demean the motives of older users we hypothesize that they needed
to assign some constructive purpose to tripping to justify their
use of drugs which were then seen as more dangerous and powerful
.
We anticipate that as the psychedelic-using population grows,
recreational use will increase and, as with marihuana, will
become less ritualized although not less controlled. We do not
expect, however, that psychedelic-using rituals will ever
approach the degree of flexibility and diversity of
marihuana-using rituals. Quite probably psychedelic use will
become more acceptable and social sanctions more available; but
because of the high impact, long duration drug effect and the
related tendency to keep psychedelic use infrequent there is both
less need and less social opportunity to internalize social
sanctions. Thus, there will remain a dependence on rituals ( on
external controls) which should limit the flexibility and
diversity of psychedelic use.
Opiates
The larger culture condemns the illicit use of opiates more
than any other drug. Popular mythology about the evils of the
opiates and heroin, in particular, extends deep into the drug
subculture itself. Many of the marihuana and psychedelic users in
the DAC study do not recognize the possibility of controlled
opiate use, even though they have identified and dispelled many
of the larger culture's myths about their own drugs of choice.20
The controlled opiate users21 in our study are painfully aware
that they are seen as deviant. They tend to keep their use a
closely guarded secret from everyone but their one or two dealers
and other controlled opiate users. One of the researchers knew a
woman he considered to be a reasonably close friend for several
years, and although he had been previously involved in
drug-related research, it was not until he became part of the DAC
study that she felt free to "confess" that she had been
a controlled heroin user all the while. ,
The relationship of controlled opiate users to
addict/compulsive opiate users is as fraught with dangers and
difficulties as it is necessary. One way controlled users can
assert their normalcy is to spurn and condemn junkies, but they
must rely on junkies to obtain opiates.22 Addicts do not understand and are often
threatened by controlled users' peculiar relation to opiates. So,
on the one hand, controlled users get poor quality opiates at
great cost from junkies ("You're always getting
burned"), while on the other hand, they are repeatedly and
seductively invited to become full-fledged members of the junkie
subculture. The controlled user's constant dilemma is to become
friendly enough with an addict to establish a reliable contact
for quality opiates, but not so friendly that his refusals to
fully participate in the addict's subculture insult the dealer
who might then cut off the supply.
Beset on all sides, controlled users are bound together in
small isolated groups that develop idiosyncratic, rigid rituals
and social sanctions. These groups are fragile and drug-centered
because it is difficult to find controlled users who are
compatible as friendsthe inverse of the situation with
marihuana we described earlier.
Most of the rituals of controlled opiate users are
indistinguishable from those of compulsive users. In both groups,
people squabble over who gets off first, belts are used as ties,
eye-droppers are used instead of syringes, booting is common, and
works are cleaned but not boiled. The main reason for this
ritual-sharing is that there is no highly visible, communicative
population of controlled users from whom discrete rituals can
evolve. Rituals are still being borrowed from the addict
subculturethe only readily available source of expertise
about the drug. There are also two other explanations for this
phenomenon. First, while the life style of the addict is
repugnant to most controlled users, they sometimes find the
addict's bold outlaw stance attractive; partaking of the addict's
ritual may be an expression of wistful identification. Second,
several subjects were addicts before they became controlled
users, and they have retained their former drug-using rituals
(booting is probably the best example) .
Several controlled users have added new elements to the
addict ritual. One subject, for example, shifts the emphasis away
from getting off by tacking on middle-class amenitieshe
plays the good host by serving wine and food to his user guests (
this without any of the nausea which commonly accompanies opiate
use) and all spend the evening together in conversation. Another
user protects herself from a possible overdose by shooting a
little of the drug, waiting to gauge its effect, and then
shooting the remainder. By and large, however. controlled users'
rituals are not well distinguished from those of compulsive
usersespecially in details of drug administration.
The social sanctions around controlled use are distinctive.
Controlled users adhere to a variety of rules for opiates, most
of which are summarized by the maxim: "Don't become
dependent." They well appreciate that they can become
addicted or compulsive users.
Ex-addict subjects have firm rules about frequency of use.
One is a woman who has used heroin on an average of three to four
times a month for over four years. Occasionally, when a break in
her commitments to work and to her child permits, she goes on a
using spree that lasts about a week. Even while on vacation,
however, she will not use heroin more frequently than every other
day. In general, subjects limit their opiate use far more than is
needed to avoid addiction. One subject has confined his heroin
use to weekends only for the past five years. One woman used
heroin twice a month and on special occasions such as birthdays
and New Year's, for a year and a half. Then, troubled by her
tolerance to some of the drug's effects, she deliberately cut
back use to only once a month. She ignored the fact that the
variability in the potency of black market drugs could have
accounted for her requiring the use of two bags instead of
the usual one bag (on only two occasions) to obtain the
same effects as when she used previously.
These and other examples indicate that many controlled users
regard heroin as more rapidly addicting than is warranted, though
they feel that it can be used moderately. This is understandable
in view of the prevailing myths about heroin's power and the
exposure controlled users have to addicts who have succumbed to
the drug.
Controlled using subjects observe common sanctions against
behaving like or becoming overly involved with junkies and
compulsive users. Controlled users may chastise one another for
manifesting irresponsible junkie-like behavior. Users who are
unable to control the drug's effects may be chastised. A user of
codeine-based cough syrup and of Doriden indicated that despite
the somnolence induced by these drugs, people are expected to act
responsibly "One (cigarette) burn and you're thrown
out. " Being cheated by dealers is a fact of life, but a
controlled user who cheats fellow users is punished by being
called a junkie. Controlled users frown upon spending too much
money on heroin because it suggests the junkie's lack of control:
"Just 'cause I had the money don't necessary mean I would
cop . . . of course, I wouldn't steal to get the money to cop,
there's no need for it 'cause I don't have a habit."
Shooting up like a junkie is O.K., but shooting up with
junkies is not, because this symbolizes a loss of control. A
couple who had regular access to opiates through the woman's
addicted sister and brother-in-law stopped relying on them for
opiates because of the social pressure to use the drug with them.
They began borrowing a car and driving several miles to a copping
site in another city where they knew they could obtain heroin
from street dealers.
DISCUSSION AND NEW DIRECTIONS
Our findings show that, contrary to conventional wisdom,
controlled use of illicit drugs is possible and is fostered by
subcultural rituals and social sanctions that support controlled
use and curtail drug abuse. We have also observed how the
controlled use of alcohol is patterned by established, broad
based rituals and social sanctions. These findings and
observations strongly suggest that the evolution and widespread
acceptance of social controls for illicit drugs, similar to those
for alcohol, would provide a viable means of preventing drug
abuse.
Ironically, the present attempt to eliminate all use of
illicit drugs undermines users' ability to control them. Users
receive no assistance from the larger culture for control.
Instruction in how to use illicit drugs is now relegated to peer
using groups which are, at best, an inadequate substitute for
family-centered socialization. Association with controlled users
is as much a matter of chance as it is of personal choice.23 Because
illicit drug use must be a covert activity, newcomers are not
presented with an array of using groups from which to choose.
Early in their using careers, many DAC subjects became involved
with groups in which members were not well schooled in controlled
use, or with groups in which compulsive use and risk-taking were
the norms. In both cases subjects went through periods when drug
use interfered with their ability to function and when they
frequently experienced untoward drug effects such as bad trips.
These individuals were later able to achieve controlled use, but
many are not. To revoke personal commitments and realign oneself
with new using companions is a difficult and again uncertain
process.
The culture's active opposition to illicit drug use also
alienates users from adult guidance. Asking adults for advice or
approval even in a guarded way is risky, and raises difficult
issues for parents and users alike. The deviant subcultures
become more attractive because they insulate the user from the
mainstream culture's disapproval and facilitate drug use.
Of course, the mainstream culture's opposition to illicit
drug use is not wholly negative in its effects. Present legal and
social sanctions do dissuade some people from taking these drugs
and no doubt influence others to abandon their use, thereby
preventing some unknown quantity of abuse. Unfortunately, it is
not clear how many people would take these drugs if they were
given an unobstructed choice about it, nor is it clear how many
would go on to become abusers. What is clear is that the attempt
to eliminate all use of these drugs contributes to their abuse by
people who take them.
It seems safe to assume that no matter how massive the
investments in law enforcement and education, neither the drugs
themselves nor people's interest in taking them will be
eliminated. There is every indication that illicit drug use will
continue to rise as it has over the last decade. Given this
prognosis and the failings and high social costs of our present
restrictive social policy, it seems not only reasonable but
necessary to place illicit drugs under social control so that
their abuse can be minimized.
Ideally, social management of drug use affords advantages
which prohibition does not. Drug use is normalized with other
life activities and is transformed from a covert to an overt
activity subject to the pressures of public scrutiny. Drug users
regulate themselves and other users . Social learning in proper (
controlled) drug use becomes available. Rituals and social
sanctions provide freedom to pursue a recreational activity,
albeit a complex and at times risky one, in an individualized way
while discouraging detrimental drug-using behavior. Drug-taking
loses its appeal as "forbidden fruit." Users who
experience difficulties are more likely to seek assistance
because they can do so without having to declare themselves
deviant and morally bankrupt, and without the risk of punitive
reprisals. The quality of drugs can be regulated and thus,
untoward drug effects greatly reduced.
The chief difficulty in achieving social control over illicit
drugs is that enormous changes would have to occur in both public
attitude and social policy for effective controlling rituals and
social sanctions to develop. Rituals and social sanctions cannot
be supplied ready-made to drug users or potential users. We
would, therefore, not recommend wholesale immediate legalization
of marihuana, psychedelics, and the opiates precisely because too
abrupt a shift in policy would leave many users without the
elaborate social support needed to prevent abuse.
It is possible, however,
1. to alleviate major legal obstacles to their development,
and
2. to provide more comprehensive and value-neutral
information about licit and illicit drugs to the general
population, making more user/ non-user contact and discussion
possible and, in turn, permitting further dissemination of
controlling conventions. Some steps could be taken now which
would both strengthen the existing subcultural rituals and social
sanctions and serve to demystify the power and danger of these
drugs generally.
Certainly decriminalization of marihuana should be extended
beyond those few states which have adopted it, and federal
penalties for use should be dropped. Further research on the
possible medical applications of marihuana and the psychedelics
should be undertaken, and results sufficiently publicized so that
their public image as "bad" drugs can be dissipated.24 Heroin
should be made available to physicians as a legitimate analgesic,
and experimentation with heroin maintenance clinics for the
treatment of addicts should also begin with careful control.
Drug education programs which are no more than disguised
campaigns to eliminate use should be replaced with genuine
efforts to provide users and non-users with some rudimentary
pharmacological data and with detailed information about the
consequences of various patterns of use. Doctors, teachers,
counselors, and others who encounter drug users should be
instructed in how to distinguish use from abuseit simply
makes no sense to alienate and undermine those segments of the
population of drug-takers who stand against abuse.
These recommendations represent the first in a number of
changes which would be required before illicit drugs could be
made available under minimal legal restraints. We cannot detail
here the entire sequence of such changes. In general, we
recommend that social policy keep better pace with developments
among drug users themselves than has so far been the case.
In closing, we suggest that the policy goals and changes we
have outlined are part of a larger historical process by which
drugs are gradually incorporated into a culture and by which use
replaces abuse as a dominant using pattern. Turning again to
alcohol as an example, in the seventeenth and eighteenth
centuries 75 to 80 per cent of those who drank were alcoholics
(Harrison, 1964) . A few decades ago alcohol use was prohibited
and the temperance movement pronounced it an evil and dangerous
substance. Today 95 per cent of those who drink are controlled
users. This figure might still be improved by further normalizing
and not glorifying alcohol use, e.g., by banning advertising
which relates alcohol use to sexual prowess.
In fact, illicit drugs are much further along in the process
of becoming acceptable and controllable than the culture has been
willing to acknowledge. If the incidence of untoward drug effects
is an indication, we can see clear movement with respect to
marihuana and the psychedelics. Becker (1963) notes that shortly
after World War I the incidence of "panic reaction" to
marihuana was higher than in the mid-1930's by which time
marihuana use had increased in a number of groups. Today, such
reactions are quite rare and are more typical of older (30+)
users who have had no prior experience with marihuana. A few
years ago the treatment of bad trips (resulting from use of
psychedelics) accounted for as much as 20 to 35 per cent of
hospital emergency admissions. Since that time psychedelic use
has grown at a faster rate than the use of any other illicit drug
( Drug Use in America, 1973), but the number of hospital
admissions has dropped markedly. As of July 1974 the
Massachusetts Mental Health Center did not know when they last
had such an admission, but they were sure that it had been years
rather than months ago (Grinspoon, 1974) . The Haight Ashbury
Free Medical Clinic, which furnishes emergency medical teams to
rock concerts, reports ( Smith, 1975) that at a recent concert
attended by some 10, 000 persons where psychedelics were openly
distributed only two adverse reactions came to the attention of
the medical team. In both cases, the patients were quickly
quieted by talking with members of the team and sent home after
fifteen to thirty minutes. A recent National Drug Abuse Council
Survey Project shows that the majority of college and high school
students who use drugs cannot be distinguished from many of those
who do not and never have used drugs (Yankelovich, Skelly &
White, 1975, Yankelovich, 1975) .
These data suggest that the development of controlled using
patterns for illicit drugs by substantial numbers of users is
probably a recent occurrence. The legal system is not able to and
probably should not reflect every shift in using patterns. But,
if controlled using patterns stabilize, as our work indicates
they have for marihuana and the psychedelics, and viable social
sanctions which permit this use develop, then in time the laws
should respond to the new social position of the illicit drug and
the drug user. Obviously, it is difficult to develop rituals and
social sanctions which are against the law; both the drug user
and the public must tolerate a serious amount of ambiguity and
anxiety. The user takes real risks by breaking the law ( greater
risks than are imposed by the chemistry of the drugs ), and the
public suffers the disruptions of laws which now punish more than
they deter.
It does not seem likely that this situation will be rectified
immediately. However, it is possible to monitor changing using
patterns in order to determine how best to integrate these
changes into the legal system. Until now there has been
considerable resistance not only to legal changes but even to
recognition of changing drug-using patterns. The study and
dissemination of new information on how people develop successful
drug-using patterns can proceed without neglecting the study of
drug abuse when it occurs. Our work shows that controlled use of
illicit drugs exists in this country and is the result of
subcultural rituals and social sanctions.
N O T E S
1. The material for this paper was
gathered as part of a study of the social basis of drug abuse
prevention funded by The Drug Abuse Council, Inc. 1828 L Street,
N.W., Washington, D. C. The work of Richard C. Jacobson and
Deborah Patt on that study was invaluable to this paper. Since
July 1 1976 research on controlled use has continued under
National Institute on Drug Abuse Grant No. 1 R01 DA 01360-OlAl. (back)
2. "In more tribal cultures social
sanctions are rarely institutionalized in a body of abstract law.
Principles of rightness which underlie the activities are largely
tacit And they are not the subject of much explicit criticism, or
even of very much reflective thought . . . Legislation, though it
may occur, is not the characteristic form of legal action"
(Redfield, 1971). (back)
3. Presumably drug use for religious
purposes, such as the use of peyote by members of the Native
American Church, would qualify as a ritual in the more classical
sense. (back)
4. Wilkinson (1970) reviews the relevant
research in his Appendix A. Several references to Wilkinson
follow as his work on alcohol closely parallels our own on the
social determinants of controlled illicit drug use. (back)
5. In many families the formal offer of a
drink constitutes an important quasi-rite de passage from
adolescence to adulthood. (back)
6. Research has shown that in abstinent
families where parallel conditions exist with respect to alcohol,
the potential for children becoming alcoholics is greatly
enhanced (Wilkinson, 1970, Appendix A). (back)
7. The MEDLINE file contains 400,000
citations from 1,100 of the journals indexed for Index Medicus. (back)
8. Indigenous data gatherers were trained
in interviewing technique. All interviews were tape recorded,
allowing research staff to monitor their work. Three of the data
gatherers were recruited from within the sampletwo women
and one manand proved extremely capable and reliable. They
contributed the bulk of the data which were not gathered by the
research staff. (back)
9. Interviews have also been conducted
with approximately 20 non-controlled drug users. Especially at
the outset of the DAC study, potential subjects were referred to
us who turned out, in fact. to be compulsive users. Interviews
with these subjects provided valuable comparative data and were
used as a basis to refine the interview schedule. (back)
10. Further information on methods and
other aspects of our findings are reported elsewhere: (1) R. C.
Jacobson & N. E. Zinberg, 1975, The social basis of drug
abuse prevention. Drug Abuse Council Special Studies Series,
SS-5. Washington, D. C.: The Drug Abuse Council, Inc. (2) N. E.
Zinberg, 1975, Addiction and ego function. The Psychoanalytic
Study of the Child, 30:567-588. (3) N. E . Zinberg, R. C.
Jacobson & W. M. Harding, 1975, Rituals and social sanctions
as a basis of drug abuse prevention. The American Journal of Drug
and Alcohol Abuse, 2:165-182. (4) N. E. Zinberg & R. C.
Jacobson, 1976, The natural history of chipping. The American
Journal of Psychiatry, 133:37-40. (back)
11. While the influence of personality,
family background, social class, availability of the drug, and
other variables on drug use could be traced for individual
subjects, no consistent relationship has been found between these
factors and controlled use. (back)
12. Weil & Zinberg (1968) found
differences in ability to control the drug high among naive and
experienced marihuana users in a controlled setting. Becker
(1963) observed that users' appreciation and control of the drug
high is learned; and that this learning allows the user to
function adequately while under the influence of marihuana. (back)
13. Users of the psychedelics and
opiates were also able to control their highs but found it more
difficult and usually limited use to protected settings. (back)
14. Most Americans view marihuana as an
illicit, "bad" drug, but as less "bad" than
heroin, LSD, cocaine, etc. (back)
15. In effect, new users recapitulate
many of the elements of marihuana rituals of the early sixties in
their preliminary use of the drug. (back)
16. We found it more difficult to locate
marihuana and psychedelic abusers than controlled users. This
situation was reversed for the opiates. (back)
17. Access to correctly labeled
psychedelics is confined to a few knowledgeable, experienced, and
wed connected users. One user in the DAC sample was able to
obtain psychedelics from a reputable source, and often had the
drugs tested by a chemist before use. (back)
18. There are substantive differences in
the high states induced by the various psychedelics, which are
beyond the scope of this article (Zinberg, 1974). (back)
19. Psychedelics are chemically related
to amphetamines. We are presuming here that these compulsive
users are, in fact, using psychedelics and not wrongly labeled
amphetamines. (back)
20. Standing with the larger culture
against opiate use may help marihuana and psychedelic users to
view their own drug use as comparatively "good". (back)
21. The preponderance of controlled
opiate subjects were heroin users who used dilaudid, codeine, and
other pharmaceutical opiates on an occasional basis. Only three
subjects did not use heroin ( see footnote following) .
Therefore, discussion will center on heroin use. (back)
22. Three controlled users had regular
access to opiates without going through a dealer: a physician who
used morphine; a hemophiliac who could obtain pharmaceuticals
from physicians under the pretense of relieving the pain of a
hematoma; a user, whose drug of choice was codeine, who obtained
cough syrup from a pharmacist willing to ignore existing legal
regulations. These cases are described in some detail in Zinberg
& Jacobson (1975). (back)
23. This is less true for marihuana
users than for psychedelic and opiate users. (back)
24. We are not assuming that the results
of this research will be uniformly positive. Whatever the
results. by making these drugs the object of medical research the
idea that no drug is inherently "good" or
"bad", that any drug can be used in a variety of ways,
would be advanced. (back)
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