PART IX

The Drug Scene

Chapter 61. Scope of drug use

We have now completed our drug-by-drug review of the psychoactive drugs in common use, especially those frequently used for recreational, nonmedicinal purposes. In this and the next two chapters, we shall present some data on the relative popularity of the drugs we have been describing; and we shall offer some comments on the vague and shifting line which separates "good" from "bad" drugs, prescription from nonprescription drugs, medicinal from nonmedicinal use. In subsequent chapters, we shall concentrate on the relatively small portion of the overall drug scene that is of the greatest current concern to most Americans–– the  youth drug scene.

By far the most popular mind-affecting drugs in the United States today are caffeine, nicotine, and alcohol. This is true on every significant measure: number of people who have ever used, number of regular users, number of daily users, number of man-hours spent under the influence of the drug, and money spent for the drug. * The amount of harm done to the human body by nicotine and alcohol, moreover, vastly exceeds the physical harm done by all of the other psychoactive drugs put together (see Parts III and IV). Further, the amount of damage done to the human mind by alcohol alone, as measured by mental hospital admissions, vastly exceeds the mental harm done by all of the other psychoactive drugs put together. Nor is caffeine necessarily a "harmless" drug (see Part II).

* In 1970, for example, Americans spent $15.7 billion for alcoholic beverages, $9 billion for tobacco, and $3.2 billion for the caffeine beverages, coffee, tea, and cocoa total of almost $28 billion. ¹

These facts are commonly masked by the categorization of caffeine, nicotine, and alcohol as nondrugs. Society might equally well seek to solve its amphetamine, barbiturate, and marijuana problems by treating those substances as nondrugs; indeed, as discussed below, there is substantial reason to believe that the United States is moving in that direction. Whether or not such substances are legally defined as drugs however, they are all closely related components of our national drug problem.

Americans have long known that the current drug scene is vast; but its truly gargantuan dimensions came into clearer perspective as data began to emerge, late in 1971, from the computers of a long-term "Psychotropic Drug Study" funded by the National institute of Mental Health in cooperation with two academic research organizations–– the Social Research Group of George Washington University in Washington, D.C., and the Institute for Research in Social Behavior in Berkeley, California. In charge of the study are Dr. Mitchell B. Balter for the NIMH, Drs. Hugh J. Parry and Ira H. Cisin for the Social Research Group, and Drs. Dean 1. Manheimer and Glenn D. Mellinger for the Institute for Research in Social Behavior.

A part of the project, under the direction of Drs. Parry and Cisin, is seeking to determine the facts about psychoactive drug use in the population aged eighteen through seventy-four, excluding those hospitalized or in the armed forces–– based on a probability sample of 2,552 respondents interviewed during the fall of 1970 and spring of 1972. Some of the findings follow (some columns total more or less than 100 percent because of rounding).

Caffeine (coffee and tea). Some 82 percent of respondents in the Parry-Cisin study reported that they drank coffee and 52 percent that they drank tea during the previous year. ²

When use of the two caffeine beverages is considered in combination, it appears that very few Americans aged eighteen and over drink neither coffee nor tea, and that 25 percent drink six or more cups daily. ³

These figures are consistent with sales figures showing that enough coffee (excluding decaffeinated coffee) was sold in the United States in 1970 to provide every man, woman, and child over the age of ten with 2.4 cups per day–– or about 180  billion doses of caffeine a year.

The above figures, moreover, exclude hot chocolate and cocoa, caffeine containing soft drinks (mostly cola drinks), and over-the-counter preparations containing caffeine (such as  NoDoz).

Nicotine. Some of the Social Research Group findings for cigarette smoking have already been cited in Part III; they appear below in greater detail. ⁴

The paucity of women ex-smokers in the table above is worthy of particular comment. Women smokers, however, smoke fewer cigarettes than men. ⁵

The number of cigarettes smoked in the United States in 1970, as noted earlier, totaled 542  billion. Thus, while there are far more coffee and tea drinkers in the United States than cigarette smokers, the number of  doses of nicotine consumed is almost certainly greater than the number of doses of caffeine.

 Alcohol. The Parry-Cisin study asked respondents whether they drank alcohol last year, whether their usual drink was wine, beer, or liquor, how often they drank during the year, and how much they drank. The replies were then grouped under six headings. ⁶

Sales figures add some details. ⁷ Almost 18 gallons of beer were consumed during 1969 for every man, woman, and child in the United States. More than a gallon of wine was consumed. And distilled spirits consumption totaled 1.8 gallons per capita.

Beer, as might be expected, is the most popular drink among men; surprisingly, hard liquor is the most popular among women. When asked what alcoholic beverage they  usually consumed during the past year, respondents answered as follows. ⁸

Psychoactive prescription drugs. Though these drugs show substantial use, the Parry-Cisin data suggest that they hardly compare in popularity with caffeine, nicotine, or alcohol. ⁹

First, respondents were asked whether they had used  any psychoactive prescription drug even once during the past year.

The greater number of females using these drugs will be commented on below.

Among the users, a substantial proportion of the respondents used psychoactive prescription drugs only occasionally rather than daily. ¹⁰

Among the occasional users, moreover, a substantial proportion used psychoactive prescription drugs ten times or less during the year. ¹¹

Similarly among the daily users, quite a few used psychoactive prescription drugs daily for less than six months in the year. ¹²

When asked what  kinds of psychoactive prescription drugs they used during the past year, the user-respondents answered as follows. ¹³

Thus it appears that the use of sedatives and minor tranquilizers by women (20 percent) is the dominant form of psychoactive prescription drug use in the United States.

Finally, the age distribution of users of psychoactive prescription drugs proved of considerable interest. Respondents who had used any psychoactive prescription drug at any time during the previous year were distributed as follows. ¹⁴

Frequency of use was also somewhat greater in the older age brackets. Thus 8 percent of those aged sixty through seventy-four reported taking a psychoactive prescription drug daily for six months or more during the previous year as compared with only 2 percent of those aged eighteen through twenty-nine. ¹⁵

The figures above, it must be stressed, apply only to psychoactive drugs  secured on prescription. When over-the-counter and black-market stimulants, depressants, and tranquilizers are added in (see below) a quite different picture emerges. Further, the figures above should be corrected to allow for underreporting by respondents. ¹⁶ This is a point to which we shall return.

Marijuana. This drug, as noted above, has been used at least once bv an estimated 12,000,000 to 20,000,000 Americans; annual consumption was estimated in 1970 at five million marijuana cigarettes a day, or 1.8 billion a year. The Parry-Cisin study, together with a study by Dr. Jack Ellinson of the Columbia-Presbyterian Medical Center in New York City, covering young people under the age of eighteen, indicates that age is a major determining factor in marijuana use. ¹⁷

Among respondents aged eighteen to twenty-nine the frequency of use was reported as follows. ¹⁸

 Other illicit drugs. While the Parry-Cisin study did not cover other illicit drugs such as LSD, heroin, illicit barbiturates, illicit amphetamines, and so on, it is clear from data in earlier chapters (and in the following chapter)–– that the amounts of those drugs used is trivial compared with the amounts of caffeine, nicotine, alcohol, and marijuana used. One conclusion is thus inescapable: the United States has been focusing an overwhelming proportion of its anxiety and concern on a very small corner of the drug scene.

Another obvious inference to be drawn from the above estimates is that we Americans–– like almost all other human cultures, ancient and modern, primitive and civilized–– are a drug-using people. Indeed,  Homo sapiens is a drug-using species, and has been for thousands of years.

A third obvious inference is the relative rarity of non-drug-users in our culture. No estimate has been made of the number of American adults who have  never used a mind-affecting drug, including caffeine, nicotine, and alcohol–– but the number must be very small, a few percent of the population at most. The nonuse of mind-affecting drugs, indeed, can be described as aberrant behavior, deviating from the norms of American society.

Caffeine, nicotine, and alcohol were universally recognized as drugs during the nineteenth century, and were denounced as such. Their treatment as nondrugs today protects them from prohibitionist proposals and other repressive measures; it also enables coffee, tea, and alcohol drinkers, along with cigarette smokers, to decry the widespread use of "drugs."

1. "Summary of 1970 Consumer Expenditures,"  Supermarketing, 26 (September, 1971): 39.

2. Data supplied by Social Research Group, George Washington University, Washington, D.C.; Unpublished.

3. Ibid.

4. Ibid.

5. Ibid.

6. Ibid.

7. The Liquor Handbook (New York: Gavin-Jobson Associates, 1970), p. 18.

8. Data supplied by Social Research Group, George Washington University.

9. Ibid.

10. Ibid.

11. Ibid.

12. Ibid.

13. Ibid.

14. Ibid.

15. Ibid.

16. Hugh J. Parry, Mitchell B. Balter, and Ira H. Cisin, "Primary Levels of Underreporting Psychotropic Drug Use,"  The Public Opinion Quarterly, 34 (Winter, 1970-71): 582-592.

17. Data supplied by Social Research Group, George Washington University.

18. Ibid.