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English Pages [244] Year 1971
~8586 08084
ittee a ie Waleed pease in ney, a radical group of criminologists.
xThe Dopsrakecs is phebsted ina sociology series:
_ under the general editorship of Professor John _
Jock Young
The Drugtakers The social meaning of drug use
WITHDRAWN FROM STOGR
Paladin
:pa Publishing Limited _ Published in 1971 by Paladin :3 Upper James Street, London WiR 4BP
_
First published by MacGibbon & Kee Ltd 1971 — Copyright © Jock Young 1971 _ Made and printed in Great Britain by Cox & Wyman Ltd _ London, Reading & Fakenham Set
Seis
in Monotype Fournier Ce
This: book tek Sela eabieet fo the condilon ‘thatit shallnot, — by way of trade or otherwise, be lent, re-sold, hired out or __ otherwise circulated without the publisher’s price consent in — any form of binding or cover other than that in which it is
published and without a similar condition including this
condition being imposed on the subsequent purchaser. : This book is published at a net price and is supplied subject
to the Publishers Association Standard Conditions of Sale registered under the Restrictive Trade Practices Act, 1956.
"The Nature and Extent of Drug Use : ‘TheSocial Basis of Drug pbemeeney
LAC,
The Absolutist Monolith
Sa
oe 3
,
aThe Origins of Drug Use The Social Reaction against Drugtaking 6 The Subterranean World of Play
9 .8
Youth Culture and Drugs The Hippie and The Negro
139 .
148 :
4 9 The Translation of Fantasy into Reality 10
Social Policy and the Drugtaker
= Index
ee eee ee ee Fe PR
“tna
169 .
198 =
226
Tables
Convictions for Possession of Marihuana in Great
Britain, 1945—69
12
Comparison of the Effect of Marihuana on Naive and Chronic Smokers
35
The Interaction between Community and Bohemian Group
109
Deviancy Amplification Spiral
IIO
Five Types of Deviancy Amplification Spirals Formal and Subterranean Values Contrasted The Psychedelic Experience The Law and Marihuana in Britain
110-13 126 158-9 199
Tam not of the opinion that the sociologist should be remote and unconcerned with social policy and with the current debates of his time. On the contrary, such an ivory-towered approach is based on an ignorance of the implicit, and usually conservative, commitment which forms its basis. Nor am I convinced of the necessary difficulty and esoteric nature of the social sciences to the layman. Opaque jargon and longwinded argument usually conceal theoretical weakness rather than contain revelations unbeknown to the neophyte. Nowhere is this more in evidence than in the study of the illicit drugtaker. It is hardly surprising that the general public is left to the tender mercies of the mass media whilst the drugtaker himself views the conceptual thicket which has been erected with either dismay or amused cynicism. I would like to thank my friends and colleagues of the National Deviancy Symposium for their help and constant encouragement. Their work in the many parallel areas within
the field of social problems has resulted in a promising crossfertilization of ideas and lent humanity to an area notorious for its narrow-minded empiricism. My thanks must also go to Madeleine Neenan for her patient editing and typing of the manuscript and a great deal of helpful and constructive criticism. Jocx
Youne
1
The Nature and Extent of Drug Use
A drug is any substance which has an effect on the metabolism of the body. But it is not drugs in this wider sense that we are interested in in this book; it is a special category of drugs which are termed psychotropic. That is those sorts of chemical substances — whether natural or artificial — which bring about psychological changes, or modify mental activity _ in human beings.t There are three major categories of psychotropic drugs: psycholeptics which depress mental activity (e.g., barbiturates and alcohol), psychoanaleptics which stimulate mental activity (e.g., amphetamines and cocaine) and psychodysleptics which alter the mind so that it experiences distortions or changes in reality (e.g. LSD and mescaline). Now there are very few human societies in which such drugs are not used, albeit that the customary drugs vary immensely: alcohol and tobacco in advanced industrial countries, marihuana in India and North Africa, opium in the Far East, peyote amongst Navaho Indians, amanita mushrooms amongst Norse Warriors, Kava in Polynesia, henbane and thornapple by medieval European witches. Moreover, to the host of naturally occurring psychotropic substances we have added a series of synthetic compounds, for example: heroin, the amphetamines, the barbiturates and LSD. A few social groups have not used drugs at all, for instance, puritanical
religious societies such as the Mormons, but these are exceptions in the context of history. Our subject matter not only includes drugs which are illegal but also focuses on the legal drugs which are used in our society. To a large extent we have created an artificial barrier 1J. Delay, ‘Psychopharmacology and Psychiatry’, United Nations Bulletin of Narcotics, no. 19, 1967, pp. 1-5.
| berweenthe ee which 4is caeenied in1 its.cons
a
ates a reaction against theay
Heme Shickis oft
unparalleled in its viciousness and ignorance. We find ou selves talking glibly of the social forces which drive yout people to drugs, forgetting in the process that 15p in tl pound of consumer spending in this country goes on alcohol
_
and tobacco, and that barbiturates and amphetamines account _
- for 10 per cent of the National Health prescriptions. Surely it _ is obvious that the demand for psychotropic drugs is not _
limited to a psychologically abnormal or perverse few but is _ part and parcel of our day-to-day social life, and is as in_ grained in the average respectable citizen as it is in the mostt.¥ wayout hippie. What has to be explained is why certain groups or individuals select particular drugs, outlining the significance of — drugtaking not only to them but in the context of work and leisure in modern industrial societies. This done, we must go — further and explain why certain drugs are labelled legal and others totally prohibited; we must concern ourselves as much with the reasons for the social reaction against particular forms — of drugtaking as with the causes of drugtaking itself. For the reasons behind prohibition disclose as much about the meaning of drugtaking in society as does analysis of the motivations of the drugtaker. Moreover, it is the social reaction
against the use of illicit drugs which, to a considerable extent, shapes and buffets the way in which the drugtaker lives; circumscribing his activities, and even structuring the effects of the drugs that he normally takes. It is untenable to analyse ~ any social situation in parts; drugtaking, whether it is heavy _ drinking or marihuana-smoking, does not occur in a social vacuum and cannot be explained in terms of a group or particular individual viewed in isolation from the rest of
society. Similarly the pharmacological effects of drugs cannot be understood merely in terms of the metabolic reactions that occur between the human body and the drug which has been Io
eee THE
ea Me NATURE
re ei AND
Se ee EXTENT
OF
ST DRUG
a5, USE
ingested. There is a close-knit interrelationship between social expectations of the effects of drugs and their pharmacological properties, a topic which we will explore in detail later. First, however, I wish to outline briefly the extent of use, the sources of supply and the crude pharmacological effects of — the various drugs which concern us here. It is on this substratum that we must build our analysis and understanding of drugtaking. MARIHUANA
Extent of Use In 1951 the United Nations estimated there to be 200,000,000 marihuana users in the world, the major centres of use being India, Egypt, North Africa, Mexico and the United States. In the latter country marihuana use is prevalent amongst Mexicans, Puerto Ricans and Negroes but there is a growing body of middle-class youth of European background who have taken up the drug. The same is true in Great Britain, where ten years ago the occurrence of marihuana-smoking was minute and largely limited to first generation West Indian immigrants. Since that time there has been an unparalleled growth in use, occurring largely amongst young people, to such an extent that the Wootton Report! estimated that between 30,000-300,000 people in Britain had used marihuana. There can be little doubt that the actual number is considerably larger than the latter figure and that this number is steadily growing. Both in America and Britain use of this drug is increasingly associated with white middle-class youth and particularly students who often embrace a new form of bohemianism which has been popularly termed hippie. Moreover, unlike the vast majority of drug-using subcultures, there are pronounced ideological overtones associated with marihuana use; I will deal in detail with the precise nature of
such cultures later, but suffice it to say at present that this is a phenomenon which although causing grave concern has 1 Advisory Committee on Drug Dependence, Cannabis, HMSO, London, 1968. II
oie
th
ee
Some indication ofthe nature of diasincrease in in Bat
W rmatihinana detailed in Table 1.
e Taste E
1 — Convictions for Possession of Marihuana Great Britain Year 1945 1950 1955 1960 1961 1962
Z
Convictions 4
Increase*
79 115 235
13
288
2
588
20
1963
663
I°t
1964
544
08
626
792)
1965 1966° 1967 1968
1,119
18)
25393 3,071
21
1969
4,683
15
m3
4 q
(Source: Chiefly Advisory Committee on Drug Dependency, eee" * Increase is calculated by ratio of convictions in one year over those _ ‘in the previous year.
Thus the average increase over the ten years between 1960 and 1969 has been about 45 per cent per year. Moreover, the ratio of coloured to white people arrested has changed dramatically: 1963
% white
% coloured
45
55 48
1964 1965 1966 1967
36
31
73
27
and the age structure is markedly skewed towards the young: 65 per cent of cannabis offenders being under twenty-five in 1967.
I2
s
THE
NATURE
AND
EXTENT
OF
DRUG
USE
Statistics such as these must of course be interpreted with —
caution, the Wootton Committee itself noting that: ‘one explanation (for the growth) might be the formation of drug squads in many police areas in the past three years’, resulting in ‘more successful police action against cannabis offenders than previously’ (p. 9). But although this casts doubt on the rate of growth of marihuana use, it does not in any way detract from the conclusion that there has been a considerable increase in use and that this is concomitant with the spread of use to
young white offenders. Source of Supply Marihuana in the United States and Great Britain is chiefly smoked in joints! or pipes, although occasionally it is eaten, usually in the form of cakes or hash cookies. It is bought on the black market in two forms: either the finely chopped up leaves, seeds and stems of female ‘cannabis sativa’ (i.e., grass) or as a resin prepared from the latter (namely hashish). In Britain the resin, mixed with tobacco, is most commonly used, in contrast to the United States where grass itself is smoked. This is presumably because hashish is easier to smuggle into Britain due to its low bulk and the distance the would-be smuggler has to convey it. In the United States, however, the plant is either obtained indigenously or smuggled from Mexico.” The major sources of marihuana entering Great Britain are Morocco, Turkey and Pakistan and the Lebanon, and smuggling is still largely a semi-professional enterprise carried out by seamen and petty criminals. There is, however, widespread evidence of increasingly sophisticated organization and there are signs that the criminal under-
world could, in the future, become increasingly involved in this trade. The factors which will determine this are: 1. The price: if it rises sufficiently then it will compare
favourably in terms of profit with the smuggling of such 1 A cigarette rolled from marihuana and tobacco; the term reefer is outmoded. 2 There has, however, been considerable tightening up of the borders since the advent of the Nixon administration leading to a change in consumption from grass to hashish.
13
36course aeas gold or wrist watches. hee this
be weighed the risk: the higher sentences likely for ‘trafficking compared to ordinary smuggling. 2.
e
The size of the market: if there are sufficient regular
- customers large-scale organization becomes feasible and lucrative. a 3. The awareness of the market: an overlap between underworld and underground is necessary if criminal entrepreneurs are to be aware
_
of its potentiality and have the contacts
necessary to exploit its control (e.g., the heroin market in the _ E: United States). 4. The pre-existing organization of the market: large-scale —
organized crime is a parasitic phenomenon which tends to rationalize and monopolize already existing networks of illicit small businesses. It muscles in on crime at a late stage; it does not create grassroot organizations. The formation of a clearly structured drug pyramid by the takeover of the market is functional for the criminal underworld in that the risk of being arrested is less the higher one’s position in the pyramid. The professional criminal then, if the market were of sufficient size, would be able to cut his risks and deal in attractively large sums of money by selling to the less risky intermediaries
high in the pyramid and — as in the heroin black market in the United States - avoid completely any contact with the criminally ‘unreliable’ drugtaker on the street level. 5. The range of drugs in demand: if there were a sufficient
black market for heroin and other drugs such as LSD and the amphetamines in this country, and these markets overlapped with that for marihuana, then a range of drugs could be sold, some of which — such as heroin - would be immensely more profitable. The trends in all of these factors would seem to point to increased underworld involvement in the marihuana market. The price of hashish has risen from £8 to £12-++ per ounce in the last few years (1967-70). The size of the market has
increased immeasurably and with it both its organization in this country and its links with international trafficking. Professional criminal awareness of the market has risen as hashish becomes — because of ease of smuggling — a commodity
14
_
; ra)
> ti
t+
ee ee ea .
THE NATURE AND EXTENT
ie
ee ee 7
th
al,
OF DRUG USE ©
‘
*
_ available in many English prisons. There is no evidence as _ _ yet that the international market has any degree of central _ _ control but the direction of supplies to the United States may _
well at some time involve the highly organized American crime syndicates which would have eventual repercussions
in Britain. As for the range of drugs in demand, there is a small market for LSD, plus a potential market for
heroin, barbiturates, methedrine, cocaine and methadone which might be exploited if any large-scale organization got under way.
Physical Effects
The active ingredient of marihuana is THC (delta-I-trans- tetrohydrocannabinol) and an average joint contains about 0.9 per cent of this substance. The textbooks of pharmacology are replete with details of the effects of cannabis. It is said to cause dilation of the pupils, reddening of the conjunctiva, impairment of the intellectual functioning, euphoria, distortion of perception and sense of time, a craving for sugar, increased pulse rate, decreased respiratory rate and cold extremities. Its net effect is initial stimulation of the central nervous system associated with sensations of pleasure, followed by sedation, drowsiness and sleep.? Such generalizations about the effects of marihuana must, however, be regarded with caution for the following reasons: 1. They very often rely on animal experimentation and it is tenuous to generalize from such results to likely effects upon human beings.? Indeed, the effect of cannabis on animals varies widely not only between species but also from individual to individual within the same species. Moreover, the most interesting effects of the drug on humans, such as 1Sir Aubrey Lewis, ‘Review of International Clinical Literature on Cannabis’, in Cannabis, Advisory Committee on Drug Dependence, HMSO, London, 1968. Erik Jacobsen, ‘The Hallucinogens’, in Psychopharmacology, (ed.) C. R. Joyce, Tavistock, London, 1968. 2D. P. Ausubel, Drug Addiction, Random House, New York, 1958. 3 C, J. Miras, ‘Some Aspects of Cannabis Action’, in Hashish: Its Chemistry and Pharmacology, Ciba Foundation, J. and A., Churchill, London, 1965.
15
_
a
Pere ties eeeti
THE
oo
DRUGTAKERS
te. a
Tia
d
. be
.
the distortion of perceptions of time, space and ees
4
‘stimuli, are not easily investigated in animals.* 2. They are usually based on oral administration of Pe. “a drug, whereas the usual form of ingestion is by smoking. lf a
oral experiments were to be relevant they would have to utilize the sublimate (i.e., the condensed vapour of burning hashish) which is significantly different chemically.? 3. Experiments with humans are difficult because of the drug laws in both this country and the United States. Up till. now there have been only four of significance, of which only one — which I shall discuss later — has used controls. 4. No allowance is made for personal and social influences on effects. In fact the problem of the determinants of the effects of drugs in human beings is a complex one, involving social factors to as great an extent as pharmacological pro-
cesses. There is no evidence of any physical dependence on marihuana nor of withdrawal symptoms if the use of the drug is abruptly terminated. As far as the lethal dosage of cannabis is concerned, I. Chopra and R. Chopra? have reported this to be in cats 10 grammes per kilogramme of body weight, which if translated into the human equivalent would be something in the region of over 1} lb for a 12 stone man! ALCOHOL
Extent of Use Alcohol is one of the most commonly used psychotropic drugs: 47 per cent of British people over sixteen years of age drink regularly (at least once a week), 11.5 per cent drink every day (Hulton Readership Survey). +A, Weil, ‘Cannabis’, Science Journal, no. 5A, September 1969,
PP- 36-42.
2G. Joachimoglu, ‘Natural and Smoked Hashish’, in Hashish: Its Chemistry and Pharmacology, Ciba Foundation, J. ad A. Churchill, London, 1965. **The Use of Cannabis Drugs in India’, United Nations Bulletin on Narcotics, 1957, pp. 4-29. 16
eee
SR a.
gh ar
AA
oe
ie
Pe,
THE
Pp
NATURE
AND
EXTENT
OF
DRUG
USE
Estimates of alcoholism vary with the precise measure used, but it is generally agreed to be within the region of — -200,000 and 400,000.! In the United States the problem is even greater, with six million people being classified as alcoholic? and it has been suggested, accepting the crudeness of the data, that about one per cent of the population may be alcoholic.3 Source of Supply Alcohol is of course legally available and around its consumption and production has grown a huge industry — providing employment for over 700,000 people.*+ But this figure is grossly overshadowed by countries such as France where one third of the electorate are wholly or partly dependent on the wine and spirit industries for their livelihoods. The expenditure on alcohol in Great Britain is enormous: some £1,846 million in 1969 or over six per cent of consumer spending. The competition for and inducement of such a market leads to a considerable advertising bill (£25 million in 1967) concerned with promoting images of the social drinker and the beneficial effects of alcohol. Physical Effects
In small amounts alcohol acts as a depressant on the central nervous system: subjectively this produces relaxation and euphoria with concomitant impairment of judgement, coordination and vision. In larger doses, consumed regularly over a period of time, physical addiction develops: severe
withdrawal symptoms being experienced when the drug is sharply discontinued. The earliest and commonest withdrawal state is acute trembling (the shakes), anxiety, physical restlessness and weakness. In more severe forms delirium 1 Alcoho! Abuse, Office of Health Economics, London, 1970. XX * Social and Legal Response to Pleasure-Giving Drugs’, J. Fort in - Utopiates, (ed.) R. Blum, Tavistock, London, 1965. *& 3). Fort, British Journal of Addiction, no. 62, 1967, p. 129. x 4 The Brewers Almanac, 1967.
17
x Bae of the most dramatic conditions in the whole calendar of m cine, ... Fear, agitation and great distractability are the domi features, although disorientation and hallucination are the n vivid. In the hospital ward the patient, weak as he is, may have to | restrained by two or more people before he can be got into bed. He is never still, tossing and turning restlessly, constantly engaged in conversation, switching from person to person, from subject to subject at the smallest stimulus and frequently shouting salutations and warnings to distant passersby. His hands, grossly tremulous, clutch at the bedclothes; continuously he tries to pick from them imaginary objects, shining silver coins, burning cigarettes, playing cards or bedbugs. He is a prey to ever-changing visual hallucinations 5; and may shield his face from menacing attacking objects, animals or 5
‘
men. (pp. 34-5.) Serious — often fatal — physical illnesses occur after long periods of excessive consumption, the chief of these being — irreversible damage to the brain (atrophy), peripheral nervous ‘system (neuritis), and liver (cirrhosis). Chronic alcoholics
q
ea e
show a decline in intelligence caused by destruction of the brain cells. The effect of alcoholism and heavy drinking in our society is severe indeed; the Ministry of Transport estimates that drink plays a part in nearly 10,000 fatal and serious accidents every year. In addition to this the cost to industry in absenteeism and accidents could be over £100 million per year.?
TOBACCO
Extent of Use
In Britain 75 per cent of men and 50 per cent of women are regular smokers. 11-15 per cent of boys begin smoking small numbers of cigarettes before the age of ten, there is a 1 Alcoholism, Penguin, London, 1965. 2 Medical Council on Alcoholism, Report on Alcoholism, 29 July 1970. 18
~
4
| THE NATURE AND EXTENT OF DRUG USE
sharp rise at the school-leaving age of fifteen, while adult — smoking habits are established at the age of nineteen. More than 60 per cent of adult male smokers consume over ten cigarettes a day and about 20 per cent over twenty a day.1 The amount spent on tobacco is prodigious — some £1,500
million a year, which is as much as is spent on new cars, furniture, television sets and refrigerators combined.? In fact, 7p of every pound of the British public’s income is spent on tobacco. It is also a formidable contributor to the Exchequer, for the proceeds of the taxation of tobacco account for nearly 20 per cent of the government’s annual income. This is a fact well worth bearing in mind when considering the consequences of an effective government anti-smoking campaign! There would be great difficulty in finding some other source of the £3 million a day that tobacco duty brings in. Source of Supply The supply of cigarettes in this country is largely in the hands of two companies, Imperial Tobacco and Gallaher’s with —in 1970 — 68 and 25 per cent of the market respectively. Moreover, Imperial Tobacco has a 42 per cent shareholding in Gallaher’s. Some £18 million a year is spent on advertising tobacco — over twice as much as the average for goods and services as judged against net turnover excluding duty. It is because of this inordinate expenditure — and the absence of any massive anti-smoking propaganda to combat it — that such a lethal habit remains a ‘taken-for-granted’ activity amongst the mass of the population. The stereotype of masculinity and toughness commonly associated in the media with cigarette smoking is, for example, found to be a major reason why young boys begin the habit.? There is little sign 1 Royal College of Physicians of London, Report on Smoking in Relation to Cancer of the Lung and Other Diseases, Pitman, London, 1962.
"2 N. Tomalin, ‘Cigarettes: The Secrets of the Trade’, Sunday Times, 8 June 1969, pp. 45-6. 3]. Bynner, The Young Smoker, Government Social Survey Report, HMSO, London, 1969.
t9
oa
a
oe
z
So
ae
es
ee
x
_ THE DRUGTAKERS
-as yet that the public health authorities are treating ne Pein with anything like the seriousness that it deserves. — Indeed, the £100,000 spent by the Treasury every year on the anti-smoking campaign looks blatantly derisory when we —
consider that this is about half a per cent of that spent by the — tobacco companies in promoting sales, and a tenth of one per cent of the revenue received by the Treasury from these a sales! Physical Effects
Tobacco smoke is a mixture of gases and minute droplets, about 50 per cent of which when inhaled remain in the lungs.
Although it is extremely complex in composition, the major components of clinical interest are as follows: 1. Nicotine: of which there is about 1 to 3 milligrammes in each cigarette. The chief effects of this are that of causing blood pressure to rise and increasing the pulse rate. It is a stimulant which acts on the autonomic nervous sytem. There have been indications that in the case of heavy smokers at least there may be withdrawal symptoms which occur when tobacco use is abruptly terminated. Injections of nicotine are in fact sometimes used to assist smokers to give up the habit.? 2. Carcinogens: some sixteen different substances capable of initiating cancer are present in tobacco smoke.
3. Irritants: the irritant effect of tobacco upon the mucous membrane is due to a mixture of ammonia, volatile acids, aldehydes, phenols and ketones. Its main consequence is a slowing down of the action of the cilia in the bronchial tubes.
4. Carbon Monoxide: until recently it was believed that the amount of carbon monoxide combined with the haemoglobin in the red blood corpuscles of smokers was seldom large enough to have chemical effects. However, recent evidence points to the occurrence of carbon monoxide poisoning in heavy smokers especially in the case of cigar smoking. Its +L. Johnston, ‘Cure of Tobacco Smoking’, Lancet, 6 September 1952, pp. 480-82. 20
THE
NATURE
AND
EXTENT
OF
DRUG
USE
effects are headaches, shortness of breath and unsteadiness of the limbs. : There is a strong statistical association between smoking and lung cancer and this is most adequately explained on a causal basis. There are carcinogens present in tobacco, cancer can be produced on the skin of animals by repeated application of tobacco tar, and the bronchial epithelium of smokers undergoes microscopic changes of the kind which may precede the development of cancer. Moreover, this hypothesis is substantiated by retrospective studies of lung cancer patients in many different countries; these show correlation between increased cigarette consumption and increased incidence of lung cancer, and increase in lung cancer amongst females which correlates with the increase in women taking up cigarette smoking. There is, however, a complex interrelationship between air pollution, smoking and cancer which is — if anything — of a multiplying nature. A hypothesis which adequately connects the two is that smoking effectively paralyses the bronchial cilia which allows an increased length of contact from carcinogens present in tobacco smoke itself as well as in the atmosphere. In terms of other forms of cancer there is a significant association between smoking and cancer of the bladder, the mouth, the larynx and the oesophagus.” In addition, smoking is an important predisposing factor in the onset of chronic bronchitis and an aggravating factor in coronary heart disease and gastric and duodenal ulcers.3 It heightens the chances of thrombosis in the individual because of the effect of nicotine on the blood platelets, namely to increase their stickiness. This tendency is particularly noticeable with women who use oral contraceptives, both drugs acting in conjunction and markedly increasing the chances of thrombosis in those women who smoke
1 Royal College of Physicians of London, Report on Smoking in Relation to Cancer of the Lung and Other Diseases, Pitman, London, 1962. ”, H. Dorn, Tobacco consumption and mortality from cancer and other
diseases, US Public Health Report 74, 1959, p. 581. 3 Royal College of Physicians of London, Report on Smoking in
Relation to Cancer of the Lung and Other Diseases, Pitman, London, 1962. 21
|
rs Tai than fifteen cigarettes a day.? ‘Thisis an “interes r example of the joint action of two legal yet hazardous « The mortality rate due to the smoking of tobacco is enor mous. It is without doubt the psychotropic drug whi é _ presents us with the greatest public health risk. Previous the number of deaths attributable to tobacco were cautiou: ly estimated at 50,000 per year, an alarming figure in its own |
right. But recent research suggests that this estimate was —
conservative. A more accurate calculation is between 90,000 _ and 100,000, that is over 250 deaths a day.? It remains, then, a the most datigerous psychotropic drug, its position deeply 3 ensconced in the leisure time of the population because of ‘2 habit, entrenched interests and the taken-for-granted inom nocuousness which surrounded its use.
7
7 LSD (LYSERGIC
ACID DIETHYLAMIDE)
4
Extent of Use
The taking of LSD is almost exclusively limited to the
—
middle-class young in advanced Western societies. It is — linked closely with marihuana smoking and with hippie cultures. Unlike marihuana, however, it is a drug which is typically used infrequently, on special occasions rather than being the staple drug of the culture. Source of Supply
LSD is a synthetic drug which can be manufactured by anyone with sufficient knowledge of biochemistry and adequate laboratory supplies and facilities. Information as to its synthesis is widely available in booklets published by under- ~ ground sources. Because of this, control of illicit supply is exceedingly difficult. Mace, the inducements for the person manufacturing the drug are enormous. The normal tA, Byrne, ‘Pill Dangers for Smokers’, Sunday Times, 29 December 1968.
2 Figures derived from a survey of tobacco research and statistics by Michael Hatfield, The Times, 21 September 1970. 22
+
be
so
_ THE
-s-*
NATURE
.
AND
Ene. rose
=
Fiat
EXTENT
xe) F
wien
i
y
OF DRUG
, “t
:
’
USE
dose of LSD is 100 microgrammes,! which at the current market price of £1 a trip? represents an eventual selling price for the drug of £10,000 a gramme! Such profits make LSD, where the market is sufficiently great, a possible field of intervention by organized criminal groups. LSD is by far the most common hallucinogen used in this country. The naturally occurring Mescaline (from the Peyote cactus) and Psilocybin (from the mushroom Teonanactl) are
also used in the United States but make only rare appearances on the illicit market here. Significantly, hippie groups have developed a considerable body of knowledge as to potential hallucinogenic drugs and are constantly experimenting with possible new agents. Of these, the naturally occurring substances present well-nigh impossible problems of control. For instance, morning glory seeds, banana skins, henbane, thornapple and the leaves of the wild carrot have all been subject to experimentation. More significant, however, because of their greater strength, are the plethora of new and
powerful hallucinogens which are constantly being discovered by Chemical Warfare laboratories in this country and the United States. The synthesis of such substances filters through the professional literature until it reaches illicit hands. One of the first new drugs to arrive in the black market in reputedly originated under the
this fashion was STP, a hallucinogen with effects stronger and longer lasting than LSD, which in the laboratories of the United States Army code name BZ.
Physical Effects Richard Blum describes the effects of LSD as follows:
Sensory changes, including alterations in intensity in attention, imagery, and hallucinations; transient feelings of anxiety, excitement, 1 Users will talk of 250 or 500 microgrammes as the normal trip but the actual quantities taken are rarely as high as this because of deterioration and dilution. 2 i.e., a dose. 3J. Robinson, ‘Chemical Warfare’, Science Journal, no. 3, 1967, PP- 33—40-
23
2
ee =
s
okae , Y
~
THE
DRUGTAKERS
despair, power, terror, release, clam, intoxication, euphoria or detachment, new perspectives about oneself, including insights, _ recollections, redefinitions, acceptances or rejection; new views or
emotions about others, including felt objectivity, closeness, withdrawal, loathing and lovingness; changes from prior chronic states, including reduction of tension, anxiety, or anger, reduced competitiveness or increased depression; shifts in interest, including reduced work interests and goal striving, increased artistic or philosophical concerns, greater preoccupation with internal events and self, and greater interest in drugs per se; and new integrative experiences, which may be culturally acceptable, psychotically delusional or mystically religious.’
As this list demonstrates, LSD is the most flamboyant
of the drugs which we have to consider, its effects displaying a wide variety dependent on the personality and ‘milieu of the taker. But what of the widely quoted deleterious consequences of use of this drug? The literature is extremely contradictory, a situation which is only exacerbated by the alarmist, exotic and usually one-sided statements in the press. First, in terms of the danger of prolonged psychosis, writers such as Smart and Bateman? quote psychosis, suicide and homicide as likely adverse reactions. On the other hand, Glin Bennet, writing in the British Journal of Psychiatry (1968), reports that a postal survey of 5,000 people who took LSD on 25,000 occasions the incidence of psychotic reactions lasting more than forty-eight hours was o-o8 per cent in experimental subjects and 0-18 per cent in patients undergoing therapy. He writes: ‘Disasters do occur with LSD, but they are rare. If all the homicides, suicides and
accidental deaths associated with alcohol consumption were written up in the same detail as those associated with LSD we might see the problem in a clearer perspective’ (p. 1219). There is also considerable doubt whether such incidents are
causally attributable to LSD or whether it is a precipitating factor in individuals who already exhibit psychotic tendencies. As far as direct physical effects are concerned, it has been *R. Blum (ed.) Utopiates Tavistock, London, 1965, pp. 265-6. Canadian Medical Association Journal, no. 97, 1967.
24
THE
NATURE
AND
EXTENT
OF
DRUG
USE >
claimed that prolonged use of LSD results in chromosome damage and that this may give rise to deformed children and leukaemia. Most of this information is based on very tenuous evidence. Recent work, for instance, by R. Tijo and colleagues! reports no visible damage to chromosomes. Second, the links between chromosome damage and deleterious effects
on offspring or the user himself are far from understood. Fitzgerald and Dobson? are very critical of the assumed — connections and, moreover, point out that many commonly administered agents, such as aspirin, are also reported to cause a striking increase in chromosome breakage. Neither of the above criticisms, of course, negate the fact
that LSD may well in certain individuals have profoundly deleterious results. Rather it calls for a scepticism concerning many of the ex cathedra pronouncements both in the lay and medical press. To regard tentative conclusions based on limited evidence as the truth belittles scientific research subjugating it to the tide of hysteria which hampers rational discussion of the problem of drugs in our society. BARBITURATES
Source of Supply and Extent of Use
Six to.seven per cent of all prescriptions under the National Health Service are for barbiturates. Extrapolating from Bewley’s figures the number of individuals dependent on barbiturates in Britain is between 75,000 and 125,000 and the number who are regular users without dependence is between 400,000 and 600,000. Although the commonest addicts are women in the 45-64 age group, the mass media limits its attention to the tiny minority of young people who have taken to injecting barbiturates intravenously. 1 Advances in Biochemical Psychopharmacology, vol. 1, Raven Press, New York, p. 191. 2 ‘T ysergide and Chromosomes’, in Lancet, 11 May 1968. 3 ‘Pattern of Drug Abuse in London and the UK’, in Adolescent Drug Dependence, (ed.) C. Wilson, 1968.
25
‘THE ‘DRUGTAKERS
.< : (Piysical Effects - Barbiturates are depressants similar to alcohol. Large doses_ ‘cause intoxication, slurred speech, lapse of memory, un-—
;
_ co-ordinated movement and unsteady gait. There are strong withdrawal symptoms when drug use is abruptly terminated; these include convulsions and blackouts which share a strong — _ similarity to the delirium tremens experienced by alcoholics. - Death occurs from accidental or intentional overdosage (it isone of the most common methods of suicide); the average __ number of annual deaths in Britain attributable to barbiturate poisoning was 1,020 during the years 1958—62.! AMPHETAMINES
Extent of Use and Source of Supply Amphetamines represented 24 per cent of National Health prescriptions in 1961. There are between 50,000 to 100,000 people who regularly take prescribed amphetamines and probably a similar number who illicitly use these drugs. The typical legal user is a middle-aged woman (similar to the barbiturate user) whereas the usual illicit user is a teenager living in one of our large cities. Examples of the specific amphetamines taken by the latter group are dexedrine, methylamphetamine (methedrine) or amphetamine-barbiturate combinations such as drinamyl (purple hearts). Physical Effects
Amphetamines are powerful stimulants of the central nervous system. They cause a lessening of fatigue, an increase in
mental activity and a general feeling of wellbeing. There are no withdrawal symptoms if use is terminated abruptly. The effects of large doses are irritability, dizziness and tremor; very high doses may give rise to paranoid *M. Glatt, “Recent Patterns of Abuse and Dependence on Drugs’, British sacienal of Addiction, 1968, pp. 111-28. 26
THE
NATURE
AND
EXTENT OF DRUG
USE
psychosis, disorientation, hallucinations, convulsions respiratory failure.
and
c
3
OPIATES
(i.e., opium and related compounds, chiefly morphine andheroin)
Extent of Use
1. Numbers: the number of known addicts to opiates has increased regularly over the last ten years; thus whereas there were 454 in 1959, in 1967 this had risen to 1,729.1 2. Drug Used: whereas ten years ago the most common drugs used were morphine and pethidine, now heroin is overwhelmingly the most typical opiate used; 15 per cent of all addicts used heroin in 1959 whereas in 1967 the figure was 75 per cent. 3. Origin of Addiction: in 1959 the majority of addicts (79 per cent) had become addicted during a stay in hospital where morphine or pethidine was administered therapeutically; by 1967 this was reduced to a small minority (18 per cent). By far the largest proportion of addicts is addicted from illicit purchase of heroin on the black market. 4. Age: in 1959 only 11 per cent of known addicts were between 20-34 and none was under the age of twenty. The largest age category was over fifty (61 per cent). By 1967 52 per cent of addicts were between the ages of 20-34, 23 per cent below twenty and only 16 per cent above the age of fifty. Moreover, almost all these young addicts were addicted to heroin. 5- Occupation: the major occupation of addicts in 1959 was in medical or allied professions (15 per cent of all addicts); 1 The figures for 1968 are 2,782 and for 1969 2,881. No precise deductions can be made from these figures because counting procedures changed in 1969, and since 1968 statistics have been more complete in that doctors have a statutory obligation to provide the Home Office with notification of addicts attending the clinics. All one can say is that there has been a steep upward trend in opiate addiction since 1959.
27
THE
DRUGTAKERS
now this has dwindled to only 3 per cent. Today, in contrast,
a large proportion of addicts come from skilled working-— be class backgrounds.1 _ (57 women were addicts of majority the 6. Sex: in 1959 cent. per 27 to 1967 by reduced was this per cent) whereas There has been, then, in the last ten years a dramatic shift in the sort of person who has become addicted to opiates. In the past the most typical addict was female, over the age of fifty and addicted to morphine, which was initially
obtained either during a course of treatment at hospital or illicitly during the practice of some medical occupation such as physician, midwife or nurse. Today the addict tends to be male, under the age of twenty-five, unemployed, from a skilled working-class background, and addicted to heroin which was initially purchased through a black market. Whereas the addicts of the fifties were isolates, those of the sixties are members of a ‘junkie’ subculture with its own distinctive argot and ethos. Both the quantity and quality of addicts have, therefore, changed radically. The American and British Addict Compared
The number of known addicts to opiates in America is 57,000, which even allowing for the greater population is over ten times the size of the British addiction rate. The American addict is typically a young man but there is a more equitable age distribution overall than in Britain. A major difference is in the ethnic composition of heroin users in America and Britain; a high percentage originating from underprivileged groups. Thus 52 per cent are Negro, 13 per cent Puerto Rican and 6 per cent Mexican. In Britain, in contrast, Negro addicts are rare (1-4 per cent), by far the largest group being white and non-immigrant, although there is an important minority of Americans, Canadians and Australians (15 per cent) who emigrated here largely to *M. Glatt et al., The Drug Scene in Great Britain, Edward Arnold, London, 1967. J. H. Willis, ‘Drug Dependence: Some Demographic and Psychiatric Aspects in UK and US Subjects’, British Journal of Addiction, no. 64, 1969, pp. 135-46.
28
y
THE
NATURE
AND
EXTENT
OF
DRUG
USE |
benefit from the British system of dealing with narcotic — addiction. Supply of Heroin In America there is no legal supply of heroin and the addict must buy his drugs from the black market. This trade, involving a gross expenditure of $350 million annually, provides an important economic base for organized crime and is linked © with international criminal networks concerned with production, refining and distribution of the drug, with centres in Syria, Lebanon, Italy and France. The heroin available is diluted with adulterants and sold usually at about 7 per cent concentration. In Britain, the vast bulk of heroin used is pure, undiluted and obtainable at low cost through the
National Health Service. There are three means of obtaining heroin in this country. 1. Legally: before April 1968 from a doctor but after that
date only from doctors with special licences working at hospitals designated as Treatment Centres. 2. The Grey Market: which is the result of addicts selling their legitimate supplies to others. Before 1968, because of the gross overprescribing of a few doctors many addicts had an excess of heroin and the grey market though small was of immense significance in so far as the ‘spread’ of addiction was concerned. Since the setting up of Treatment Centres, how-
ever, overprescription has been cut down to a minimum and the grey market has diminished. 3. The Black market: derives from illicit heroin either stolen from pharmacists or imported. This market was insignificant before 1968 because of the superfluous heroin available on the grey market. There would seem to be strong indications, however, that a sporadic black market has begun to emerge since this date. This is largely ‘Chinese Heroin’ which is 1C, Wilson (ed.), Adolescent Drug Dependence, Pergamon Press, London, 1968. M. Glatt et al., The Drug Scene in Great Britain, Edward Arnold, London, 1967. 2C, Wighton, Dope International, New English Library, London, 1964.
si
a Paiieved by aduiterants and imported from Honskode : : oo of such a black market would make feasible t and Aes development of drug openrtids in the American z :style.
Se
Physical Effects
Opiates act chiefly on the central and systems. Effects on the central nervous t depressant, although larger doses may properties. The addict who is taking
autonomic nervous system are primarily bring out stimulant heroin to achieve a
‘high’ will after a period of time find that he is developing a tolerance to the drug. He will need increasing amounts of heroin to achieve the desired effects. Abrupt cessation of use of heroin results in the characteristic withdrawal symptoms: dizziness, nausea, body cramps and perspiration. Heroin is usually billed as an exceedingly lethal drug whose continued use leads inevitably to the early death of its victim. There is little evidence that heroin per se is in fact such a dangerous drug. Rather it is the particular circumstances of administration, life style and market which explain the exceedingly high mortality rate of certain groups of addicts. As Schur puts it: It has been widely believed that opiates produce definite and extreme organic disturbance and deterioration in the users, yet, as an authoritative report recently emphasized (he is referring to Chein ez a/.)? there are no known organic diseases associated with chronic opiate addiction — such as are produced by regular cigarettesmoking, and even chronic overeating. Although opiate use does produce such effects as pupillary constriction, constipation, and sexual impotence, none of these conditions need to be fully disabling, nor are they permanent. Similarly, many characteristics and ailments, such as unkempt appearance and symptoms of malnutri1 Association for the Prevention of Addiction, Report for August 2969, no. 2.
? Narcotics, Delinquency and Social Policy, Tavistock, London, 1964,
Pp. 356. 30
TN en Pe Ve THE
NATURE
Fn AND
ae
EXTENT
i OF DRUG USE
tion, which often are exhibited by addicts in our society, are attributable to the difficulties they experience in obtaining drugs rather than to the drugs’ direct effect.
In America the major causes of death connected with heroin addiction among street addicts are as follows: | 1. Overdose. This occurs in the following circumstances: (a) The most common, where the addict is unaware of the strength of the heroin in his illicit purchase. The dilution of
heroin is a function of the desire for profit amongst pushers. The heroin content of 122 American street samples were analysed by Helpern? who found that the content ranged from o to 77 per cent heroin. The addict, then, because of the
illicit market situation is unaware of the strength of the heroin he has purchased and is liable to misjudge the amount necessary to safely maintain his habit. (b) When a major distributor is concerned about imminent
arrest he may dump heroin on the market above the normal strength. (c) The blackmarket in heroin is an extremely vicious affair and sometimes pushers will deliberately give addicts who have crossed them unusually potent heroin in order to kill them (a hotshot). (d) Following incarceration the addict may injudiciously give himself an overdose having forgotten that his tolerance is no longer as high as it was previously. 2. Infection: endocarditis, hepatitis, pulmonary disease and tetanus are caused largely by the use of unsterile needles and methods of cooking heroin. 3. Adulterants: the dilution of heroin by pushers is achieved by using a wide range of adulterants: lactose, talc, amphetamines, barbiturates, quinine, all of which may cause deleterious side-effects. Talc for instance may cause pulmonary fibrosis when particles lodge in the lungs. In addition, the makeshift
syringes used by the addicts themselves and the habit of filtering heroin through cotton may have pathological 1 Crimes Without Victims, Prentice-Hall, New Jersey, 1965, p. 121. 2 National Association for the Prevention of Addiction to Narcotics Newsletter, no. 2, 1964. 31
7Soh aE Nea Ne ISen THE DRUGTAKERS a bg J is
f q Me
+ x
'
\
we
*
RU
a ak
consequences because of deterioration of rubber teats —
ys @
the injection of cotton fibres respectively. 4. Malnutrition: the desire for heroin often takes priority_ a
- in the addict’s life over the need for food. This factor, plus the % poverty-stricken situation that many addicts find themselves 3 in, results in their gross malnutrition which lowers their resistance to infection and ability to survive overdosage.
The social position of the addict, the subculture he belongs
to and his relationship to the market for heroin determine the degree to which these four causes of death operate. To take the physician addict as a point of contrast: he is unlikely to overdose unintentionally because of his knowledge of medicine and his source of a pure opiate (probably morphine) which enables him to calculate precisely his dosage. Nor, for similar reasons, does he face much danger from adulterants. His medical knowledge minimizes the chances of infection or malnutrition, because he will be well aware of the necessity for using sterile needles and eating adequately. Furthermore, because of his subcultural (i.e., professional) values, he is less likely than the street addict to take opiates in order to get a dramatic ‘high’ and is therefore able to keep his habit within manageable levels. The tolerance will rise slowly and the calculation of the amount of opiate necessary to satisfy his needs will be a simple predictable matter.! The British addict has a mortality of twenty times the expected figure whereas the American addict has a death rate of only two to five times.? This would seem at first surprising, as the heroin preponderantly used in Britain is pure and thus deaths caused by adulterants and from overdose due to mis* The preceeding explanation is complicated by the fact that many addicts take cocaine or methedrine with their heroin, so as to counteract
its depressant properties. These powerful stimulants are exceedingly dangerous. The social structuring of mortality applies here as well, however, in that overdosage is more common where blackmarket drugs are available; large quantities of stimulants are often taken (as a counterbalance) where heroin habits are high (as in Britain where supplies are pure and easily available); and stimulants tend to be taken more by addicts in hedonistic cultures than those unattached to such groups. *J. P. James, ‘Delinquency and Heroin Addiction in Britain’, British Journal of Criminology, no. 9, pp. 108-24. 32
yRewn
aed
_
, i
ee
THE
NATURE
AND
EXTENT
OF
DRUG
USE
calculations are not as likely to occur. But on the negative side the British addict uses very large quantities of heroin, — and is much less likely than his American counterpart, because of the amount involved compounded with the widely accepted ‘sick’ role of the addict held in British society, to be in regular
employment either legitimate or criminal. He is, because of this, comparatively emaciated and debilitated, thus increasing
his susceptibility to severe and sometimes overwhelming infections.t On top of this, like the American addict he has until recently tended to disregard aseptic techniques of administration. However, Briggs et a/.2 report a recent drop in the number of lethal infections. This they attribute to the compact nature of social groups of heroin addicts in Central London who, alarmed by the publicity given to the early deaths of their fellows, have begun to use disposable equipment and sterile water for injection. This is an interesting and important example of the way in which drug subcultures, providing they are cohesive and fed the right information, can considerably control and eliminate the worst effects of drug abuse. Unfortunately, the rapid rise of heroin addiction in this country tends to undermine any extensive and consistent subculture of addiction so that many new addicts are inadequately socialized by their elders and the lore of drug use is not transmitted adequately. One would expect, because of this, that the semi-isolated addict in the provinces would have a far greater mortality rate. Moreover, the rise of a black market in heroin has given rise to the emergence in this country of risks of overdosage due to miscalculation and infection due to adulterations similar to those found in America. This is aggravated by there being only minimal
knowledge among British heroin addicts of the safest use of such diluted, contaminated substances. 1J, Briggs et al., ‘Systemic Infections in Heroin Addicts’, Lancet, 2 March 1968, pp. 473-4. C. Cherubin and J. Brown, ‘Systemic Infections in Heroin Addicts’, Lancet, 10 February 1968, p. 298.
2J. Briggs et al, ‘Systemic Infections in Heroin Addicts’, Lancet, 2 March 1968, pp. 473-4-
33
|
We have seen how the nature of dependency and the life of © the drugtaker cannot be understood merely in terms of the drug. Heroin addicts in Britain, in the United States, in Hongkong, in Japan all take the same drug but the pattern of their addiction is remarkably different. The social reaction against the drugtaker, the policies which are designed to
_
control the drug, have remarkable effects on the role within ©
which the drugtaker finds himself. For example, in the United States he is cast as a criminal, he is legally harassed, he is forced into crime (thus substantiating the stereotype) in order to find money for the high black market prices. As a consequence of this illegality organized crime grows up as an © unintended consequence of the narcotics legislation. An exploitative culture is set up which dominates the life of the — addict. The very strength of the drug is low, variable and — adulterated, this having very tangible effects on the type of © addiction found in the States. Death itself is not an inevitable consequence of the drug heroin but is related to these exigencies of the market. The addict is periodically and coercively institutionalized, he is subject to therapeutic onslaughts from a body of experts who have themselves particular conceptions of the ‘essential’ nature of the addict. Criminal exploitation,
police harassment, therapeutic correction, social stigmatization all give rise to a culture partly defensive against these st Uh OY ien Pie pe hoet agencies, partly introjecting and accepting their notions of — him, altogether an adaption to his situation. It is not then the — study of drugs in a vacuum, as isolated pharmacological— effects, which will help us understand drug addiction; rather — it is the social meanings ascribed to a particular drug in a _
specific society or culture that we must analyse. But furta
34
i
oa it ig aliat a
Pee
’
rusts ,
pe
ie THE
SOCIAL
BASIS
OF
DRUG
DEPENDENCY
than this: it is not only the life style of the addict which is shaped by social forces; the very effects of the drugs themselves are intimately related to the social values, expectations and milieu in which they are taken. In 1968, N. Zinberg and A. Weil! performed the first controlled experiment on the effects of marihuana. They compared the effects of smoking the drug on a series of naive subjects contrasting them with a control group of chronic users. TABLE 2 — Comparison of the Effect of Marihuana on Naive and Chronic Smokers
1. pulse rate
N Naive subjects increase
2, respiratory rate
no increase
3. blood sugar level 4. muscular co-ordination performance test 5. cognitive functioning performance test 6. judgement of time
no change decreased performance decreased performance impaired
7. pupil size no change 8. conjunctival reddening occurred
9. subjective effects
little understandable effect
C Chronic users significantly greater increase than N small but significant increase no change improved performance slight improvement impaired but conscious allowance made for distortion no change occurred euphoria, high
I have detailed the results in Table 2. As can be seen, the only common effects between users and naive subjects were conjunctival reddening, increase in pulse rate and distortion of time sense. Blood sugar level and pupil size did not alter, 1*Cannabis: The First Controlled Experiment’, New Society, 16 January 1969.
35
~
Seat RRR ell TON 4
~ FSET
Li Po
:
ob Loo -
THE DRUGTAKERS
©
disproving much of the literature. But the most important finding was the divergent effects found between the naive —
‘subjects and chronic users. Both motor and cognitive performance improved in the regular users but deteriorated in
the naive subjects. The latter did not feel any euphoria whereas the users experienced a characteristic high. Moreover, the naive subjects had only a slight increase in pulse rate and no increase in respiratory rate whereas the chronic users had an increase on both counts.
Examining this data, Zinberg and Weil note how: ‘there are suggestions in this study — like greater increase in the heart rate and respiratory rate of chronic users — that users and non-users react differently to the drug not only subjectively but also physiologically’ (p. 86).
To explain this, the authors suggest two hypotheses: 1. That marihuana has a cumulative effect in the body. This they reject as unlikely because once a user is able to get high, the amount of drug necessary remains the same. 2. That some sort of pharmacological sensitization occurs giving rise to a unique example of ‘reverse tolerance’, i.e.,. unlike other drugs — such as alcohol — one does not become more but less tolerant of its effects. This I feel is not substantiated by the evidence: a user, for example, can quit smoking marihuana for several years but can come back to it and experience a high readily. Rather I wish to suggest a third hypothesis: 3. That chronic users learn to experience a high and that this learning process has physiological consequences. In other words, that the subjective and physiological levels are tightly interrelated and users in the process of achieving a high effect changes on their own metabolism. This notion is akin to the classic trauma reaction in the individual, where he subjectively experiences fear and this fear translates itself on the physiological level in the release of adrenaline into his bloodstream. Fear is a socially defined process where the subjective state of the individual effects his metabolism and, moreover, fear like a high is experienced by the individual as a subjective mood which is automatically substantiated on the bodily level. But this is, of course, only half of the process. Drugs 36
THE
_
SOCIAL
BASIS
OF
DRUG
DEPENDENCY
by their very nature affect the metabolism of the individual, | but the ways the individual interprets these changes in his _ body are related to his own subjective notions of what is happening to him. What I am arguing is that a two-way process occurs in drugtaking: the drug alters the metabolism
of the individual, he interprets these bodily changes into subjective experiences according to his expectations, social situa-.
tion and prevailing mood, and these subjective experiences react back on to and change the already altered metabolism. In short, the’ drug experience can only be understood in terms of an ongoing dialectic between the subjective mood of the individual and the objective psychotropic effects of the
drug. I wish now to turn to the various authors who have studied precisely this type of relationship. _H. S. Becker, in his classic article ‘Becoming a Marihuana User’, outlines the learning process involved in marihuana use. The novice — the naive user — does not experience a high at first; he may feel, it is true, slightly strange but that is all; he is unable to interpret the meaning of the physiological sensations that he is experiencing. Indeed, as Becker notes, the novice may feel nothing at all has happened to him — he may feel totally cheated by the drug — and it is not until a
sophisticated user has indicated to him the likely effects that he realizes that he is in fact being affected by the drug. Moreover, it is not until the naive user learns firstly how to smoke marihuana and then — more importantly — how to interpret his feelings as pleasurable that he experiences a high. Before this the effects of the drug are physically unpleasant or at least ambiguous.
A situation very similar to this exists with the opiate drugs. Thus Lindesmith writes: Perhaps one of the most interesting features of the effects of drugs is the marked differences at all stages of drug use between the reports of addicts and those of non-addicts or persons who do not know what they are receiving. It has been observed, for example, that when non-addicts were given small injections of heroin or placebos without knowing which, those who received the placebos 1 Outsiders, The Free Press, Glencoe, Iil., 1963.
37
ek -
“phate somewhat aepubl effects than hosewi -=
os ‘ heroin,*
Isbell and White? note how effects ae percei unpleasant by the uninitiated, when the heroin is first are valued positively by the addice who has learned to re; them as evidence of the potency of the shot. Lindesmith in - another context writes: The learning process involved in the first trials of the drug is illustrated by incidents related to me by addicts. For example, a man _ who experimented with opiates in the presence of two addicts — reported that he felt nothing except nausea, which occurred about — half an hour after injection. It took a number of repetitions andsome _ in
instruction from his more sophisticated associates before this person learned to notice the euphoric effects. In another instance an — individual who claimed that she felt nothing from two closely -spaced injections amused her addicted companions by rubbing her nose violently while she made her complaints, A tingling or itching sensation in the nose or other parts of the body is the common effect of a large initial dose.?
The effect of subjective beliefs on the metabolism of the individual is clearly indicated when ‘fake’ withdrawal symptoms are evidenced by individuals who are in fact not at all addicted. Lemert* notes in a similar vein how pharmacological generalizations about alcohol are often manifestly applicable to particular cultures only: At this point it is necessary to interject a note of caution with reference to various physiological and psychological studies on the effects of alcohol consumption, We should not let ourselves forget that the subjects for these investigations have been drawn from our own culture and that there are very few cross-cultural studies of 1*Problems in the Social Psychology of Addiction’, in Narcotics, (ed.) D. Wilner and G. Kassebaum, 1965, p. 123. 2H. Isbell and W. White, ‘Clinical Characteristics of Addiction’, American Journal of Medicine, no. 14, 1953, p. 558. 3A. Lindesmith, Addiction and Opiates, Aldine, Chicago, 1968,
24-5. os E.ye 38
Social Pathology,
McGraw Hill, New York, 1951, p. 341.
_
THE SOCIAL BASIS OF DRUG DEPENDENCY the physiology and ‘psychology’ of alcohol ingestion. Such comparative studies as have been made raise more than fleeting doubts _ that what often passes for constant ‘physiological effects’ of alcohol in American research in reality may be manifestations of a variable cultural overlay. Thus, for example, in one study of the function of alcohol in a primitive Mexican culture located in the mountains of Chiapas few of the more extreme types of behaviour which arise in connection with intoxication in our culture were found to occur. There, in the stage of feeling high, native men could play guitars or handle a machete with perfect safety. In extreme intoxication there seemed to be less interference with speech than that observable in inebriation in our culture, and even in stuporous states the natives carried through with familiar routines and transacted complicated business of which later they had no memory. There seemed to be very little vomiting after overindulgence, and there was little evidence of hang-overs beyond mild tremors and shakiness. Little fighting arose in drinking parties, and there was no evidence of lowered inhibition in erotic behaviour. These people typically drank for the sense of warmth it induced and as a prelude to sleep.
It is impossible then to make generalizations about the effects of drugs in a vacuum. For the effects of drugs are shaped by the culture of the user and are learned by the novice from the more sophisticated drugtaker. To this extent, the effects of a particular drug form a role in that group, in so
far as they are shaped in terms of certain permitted and prohibited behaviour and that other drug users have a set of expectations vis-d-vis a person under the influence of a par-
ticular drug. Such roles are the heavy drinker, the comic drunk, the cool marihuana smoker, the righteous dope fiend.
Now and then deviations occur from these roles especially when an overdose of a particular drug puts the individual in a position where he cannot control the effects he is experiencing. But drug groups contain lore of administration, dosage and use which tend to keep this lack of control in check, plus, of course, informal sanctions against the person who goes beyond these bounds. Witness the shame experienced by the man the morning after who hasn’t been able to hold 39
wi
_ _ —
—
ee ~
THE DRUGTAKERS
.
ts
i a
his liquor or the LSD user who has freaked out and has to ~ talked down (i.e., back to normative limits) by his fellows. Not all drugs, of course, have finely spun norms surround- _ ing their use, and even where such norms do exist, not all q people have a working knowledge of them. Becker’ has sug- _
gested that in these instances there is a high incidence of — psychosis associated with drug use. Psychotropic drugs have, by definition, effects on the subjective experience of individuals. If there is a body of culture available to interpret these experiences, to say that such and such a mental state is pleasant — or at least normal in the circumstances — then the individual will feel in control of the situation. But if he has perceptual distortions, hallucinations, physical sensations which he does not know how to interpret, he may well think that his sanity has become impaired, that his mind is out of control. Such unstructured drug experiences may trigger off bouts of extreme alarm and anxiety. Unfortunate mental or physical harm to the individual may ensue from such a panic. Moreover, Becker notes that in the absence of a drug subculture the isolated individual’s only knowledge of the effects of the drug which he has taken may derive from the mass media. Such reports are invariably ‘newsworthy’, that is they emphasize bizarre, psychotic effects of drugs. The individual’s interpretation of his experiences may thus be both shaped and understood in alarming terms. Furthermore, even if he seeks help from a physician his fears may remain undiminished; for the psychiatrist will often regard dabbling in drugs as indicative of personality problems and his diagnosis will merely confirm the patient’s suspicions about himself. Becker substantiates his thesis by referring to the history of marihuana use in America, noting how, as a subculture concerned with its use built up, the reports of cannabis psychosis gradually disappeared. This is corroborated by events in this country where in the fifties it was quite common to hear of individuals who experienced the horrors after smoking marihuana but such incidents — despite the increase in marihuana smokers — are rarer today. 1H. S. Becker, ‘History, Culture and Subjective Experience’, The Journal of Health and Social Behaviour, no. 8, 1967, pp. 163-76.
40
Se aa
THE
THE
SOCIAL
IMPORTANCE
OF
BASIS
THE
OF
DRUG
DRUG
DEPENDENCY
SUBCULTURE
_ This approach to the sociology of drug use may be summed up in the following eight postulates: I. 2.
3.
Different groups in society have different problems. Drugs are a common means of problem-solving. Groups select drugs which have psychotropic properties seemingly suitable for their problems. The effects of the drugs are shaped and interpreted in terms of the culture of the drugtaker. If the drug is seen as unsuitable, dangerous, or uncontrollable, in terms of the aims of the group, its use is discontinued. Individual drug users usually learn the necessary dose, administration of drug and interpretation of the resulting experience, from individuals who are already drug users. If there are no norms surrounding drug use there is danger of overdosage, psychosis and physical harm occurring to the individual. That such normless or anomic situations occur when: (a) The individual is isolated from any subculture which possesses knowledge as to appropriate use of the drug, e.g., the middle-aged barbiturate addict. (b). The drug has only recently been introduced, e.g., LSD on its introduction in Britain. (c) The number of drugtakers is increasing rapidly without an adequate transmission of subcultural norms, e.g., heroin addiction in Britain. (d) Harsh social reaction disintegrates an originally viable culture, e.g., the recent disintegration of hippie ‘subculture’ in San Francisco.
Now the usual assumption implicit in theories of drug control is that subcultures connected with drug use must be eliminated in order to limit the spread of the ‘epidemic’. My contention here is that the notion of an automatic transmission of drug use whenever individuals contact drug sub-
cultures is a fallacy based on analogies with the germ theory AI
- disease. People accept socialization into ina culty
because they find the cultures attractive in terms of solvir _ problems which they face; they do not ‘catch’ drug addictio _ they embrace it. To end drug abuse you must find alternative solutions to these problems which do not involve the use
drugs. Meanwhile, the cultures themselves serve to contain
and regulate drug use. True, they often contain false premises: beliefs about drugs that are not necessarily rational. For instance, to believe that cigarette smoking calms your nerves isolates the fact that the nicotine content of tobacco is more likely to exacerbate the situation by making you jittery. Further, to believe that cigarettes are harmless is a product of the ‘taken-for-granted’ innocuousness foisted on the individual by advertising and his fellow smokers. What must be attempted here is to feed rational tested information into the cultures which support drug use. This may seem to be only a useful interim palliative in tackling the problem of drug abuse, but until we make determined efforts to tackle the root causes of drugtaking, it remains the most likely way of minimizing deleterious physical and psychological effects in the populations at risk. THE
NATURE
OF
ADDICTION
The World Health Organization in 1957 sought to make a distinction between drug addiction and drug habituation. The distinction between the two can be seen as follows: I. attitude to drug
Addiction compulsion to
Habituation desire to continue use
continue use
2. tolerance
tendency to increase dose present
3. psychic dependence 4. physical generally present dependence 5. detrimental effects on individual and
no such tendency
present absent (no withdrawal symptoms) primarily on individual
society (WHO Expert Committee on Addiction-Producing Drugs)
42
© — — — — _ —
hesand Aul abl
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DEPENDENCY >
At first glance, this distinction would seem to be one of
considerable convenience. Thus hashish was commonly regarded as a drug of habituation and heroin as one of addiction. But unfortunately this distinction led to considerable confusion and to debate as to the correct classification of particular drugs which involved terminological disputes having little connection with reality. The reasons for this were as follows: 1. The pharmacological profiles of already known drugs and the rapid number of newly introduced drugs did not fit this simple dichotomy. For example, amphetamines produce tolerance but not physical dependence; there is therefore doubt whether they should be called habituative or addictive. Or more significantly there is considerable controversy over whether hashish is socially harmful or not, and how to distinguish the desire for it from the notion of a compulsion. 2. Addiction and habituation tend to be constantly used inappropriately. Thus addiction is often seen as being equivalent to any misuse of drugs outside of medical practice. It has become an emotive term based more on the implicit demand that something should be done to stop a drug’s use than on any empirical description of how a drugtaker relates to a specific drug. Habituation, in contrast, is often applied merely to indicate that a person is dependent on a drug which is socially acceptable. The distinction between habituation and addiction assumes that a drug’s effects can be studied apart from the social context in which they are taken. This, I have argued, is palpably false — thus, the degree of compulsion involved in heroin use depends to an extent on the social beliefs as to the reality of this addiction. For instance: does the individual addict believe that it is impossible once he sees himself as ‘hooked’ ever to give up the drug (‘once a hype always a hype’ as some junkies put it)? Does he see his addiction as an alien force compelling him to continue use or as merely a desire which he has decided to continue fulfilling (‘you either ride the horse or let the horse ride you’)? Similarly, the actual severity of withdrawal symptoms where physical dependence occurs varies — as we will see later — with the lore surrounding a 43
>
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DRUGTAKERS
particular drug. Nor is the pattern of drug use divorced fron a the market in which the drug is purchased. For this determines the quality, quantity and often mode of administration Me a of the drug. Thus the detrimental effects of a drug are closely related to the social factors which surround its use. As we have seen the mortality rate of heroin users in Britain and America differs both quantitatively and qualitatively. Even the question of whether heroin is detrimental to the individual depends on the social setting in which it is used. Furthermore, judgements of social harm are even more variable. Amphetamines taken by people in periods of stress (astronauts and soldiers for instance) are approved of, whereas when the same drug is taken for hedonistic reasons it is deemed socially culpable. Thus I would argue that the distinctions between habituation and addiction are fallacious in that they assume that the same drug in different social settings will have essentially similar effects. Compulsion, tolerance, psychic and physical dependence, social and individual disfunctions, are all factors which vary not only with the drug but with the individual or group who have cause to use that drug. The World Health Organization Expert Committee on Addiction Producing Drugs decided in 1965 to combat the confusion in existing terminology by invoking a concept which would be wide enough to cover all kinds of drug abuse. With this in mind they introduced the umbrella term ‘drug dependence’, which was defined as: ‘A state, psychic and sometimes also physical, resulting from the interaction between a living organism and a drug, characterized by behavioural and other responses that always include a compulsion to take the drug on a continuous or periodic basis in order to experience its psychic effects and sometimes to avoid the discomfort of its absence. Tolerance may or may not be present...’ ‘Dependence’ adequately answers two of the three criticisms of the use of ‘habituation’ and addiction. It does not assume that there are automatically deleterious effects, either social or individual, of drug use; this is a matter that must be decided apart from the fact of dependence; nor does it presume that all drugs can be described in terms of two profiles: habitua44
‘ey
THE
SOCIAL
BASIS
OF
DRUG
DEPENDENCY
tion and addiction. Instead it argues that: ‘it is neither possible nor desirable to delineate or define the term drug dependence independently of the agent involved. It should be remembered. that it was the desire to achieve the impossible and define a complex situation by a single term (addiction or habituation) which has given rise to confusion in many cases. Therefore, the description of drug dependence as a state is a concept for clarification and not, in any sense, a specific definition.t Thus, within the broad spectrum of drugs of dependence there are detailed a series of specific ‘dependencies’ based on the par-. ticular pharmacological action of the drugs involved, e.g.,
drug dependence of morphine type, i.e., morphine, heroin, methadone, etc.; drug dependence of barbiturate-alcohol type. Now this reformulation by the Expert Committee is un-
doubtedly a step in the right direction. Its single fault is that it fails to answer my third criticism concerning the relationship between drug use and the social context of drug uses. For as I have argued the focus for the study of drug use must be neither concentrated on the norms of the group
involved nor the pharmacological effects of the drug but on both. The Expert Committee being composed of pharmacologists and medical doctors has been understandably myopic in its concentration on drugs as the basis of a suitable classification. To describe adequately a particular form of drug use, then, we must use what I will term a socio-pharmacological classification. Thus we will need to divide drug users up into categories which describe patterns of drug use involving similar social meanings and beliefs, on one hand, and drugs with closely related pharmacological effects on the other: e.g., morphine/meperidine/pethidine, dependency by members of medical and allied professions which occurs in most advanced industrial countries, or marihuana dependency by bohemians which occurs chiefly in Britain, North America, France and Holland. Implicit in this revised terminology is the notion that it is invalid to generalize about drug use without reference to a specific cultural context. Thus, to explain and describe 1 Eddy et al., ‘Drug Dependence: Its Significance and Characteristics’, World Health Organization Bulletin, no. 32, 1965, pp. 721-33-
45
| THE DRUGTAKERS we
~ marihuana dependency in i Morocco may throw lightoe but _ does not warrant the construction of immediate parallels conclusions as to the likely causes and outcomes of pot a_ smoking amongst British hippies. The problem of the proper _ classification of drug use is, in this light, not a mere academicowith which to explain the reasons why certain groups of - individuals take drugs and the likely consequences of such
behaviour. |
At the same time it is essential that we make clear what we —
mean by dependence on a drug so that when referring to two
types of drug dependency we may have some ready means of — comparison. The Expert Committee insists that the primary criteria of dependency is compulsion to take a drug because of its psychic effects; physical dependence is a variable which may or may not be present. To this extent they are in agree-
ment with the majority of authorities like Lindesmith and Chein and Rosenfield, for whom craving is the central characteristic of addiction. But concepts such as ‘craving’ and ‘psychic dependence’ are, I feel, not sufficiently elaborated to be useful. With this in mind I would suggest that dependency is best understood in terms of three interrelated levels: physiological, subjective and social. 1. Physiological level. A person is physiologically dependent
on a drug to the extent that he experiences withdrawal symptoms when its use is abruptly terminated. This bodily discomfort may be because constant use of the drug has brought about a situation where it plays an intimate role in the body’s metabolism (such as in the case of heroin, alcohol and the barbiturates); or it may be merely because the body has become so used to its effects that it takes a while to adjust to its absence (e.g., amphetamines, tobacco, caffeine). But it should be stressed that the extent to which withdrawal symptoms are evidenced is closely related to social beliefs as to the addictive powers of a drug, and the degree of
discomfort experienced is evaluated by individuals who vary
in their tolerance of what they are suffering and the degree to which they crave a renewal of the drug’s effects. Thus, it is impossible to speak of a physiological level in isolation from 46
THE
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BASIS
OF
DRUG
DEPENDENCY
the individual who is conscious of changes in his metabolism and who belongs to a group who have a given set of beliefs as to the meaning of this experience. 2. Subjective level. A person is subjectively dependent on a drug to the extent which he craves for its effects. This desire may be to a limited extent, related to its ability to remove unpleasant withdrawal symptoms, but is more usually explicable in terms of the effects being deemed pleasant in terms of the values of theindividual drugtaker. Thus, subjective craving relates both to the physiological and the social level and must
be viewed in this context. It is important here to make a distinction between a craving which is seen as a desire which is freely fulfilled and which is compatible with the individual’s values and self image (e.g., the bohemian’s desire to smoke marihuana), and a craving which is seen as a compulsion, enslaving and compelling the individual despite himself (e.g., heroin addicts). Alienated compulsions to take drugs often but not necessarily have a physiological basis, but the degree to which people embrace the notion of themselves being powerless to control their activities is related to their social conceptions of themselves. 3. Social level. A person’s dependency on a drug is related to the degree to which his self-conception involves viewing himself as a drugtaker. For example, the role bohemian involves smoking marihuana, just as the role merchant seaman involves heavy drinking. Such people find themselves because of their position in society in a matrix of social pressures which make for continued dependency, and espousing values which evaluate the effects of the particular drug as desirable. A special case is the individuals mentioned earlier who feel that they are compelled to use a particular drug despite themselves. These people are in fact embracing a role which is characterized by their feeling alienated and powerless over their own actions. This ‘sick’ role is common in drugtaking and is maintained both because of its advantages to the individual himself — which we shall explore later — and because of the pressures of outsiders who insist on viewing the drugtaker in such a light. There are, after all, no physiological reasons why a person should not be able to terminate 47
_
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a the use of any drug whatsoever, but there area multimde of 4
social and individual reasons why this does not occur. A person becomes dependent on a drug to the extent that— in his reckoning— efficiently produces effects which he judges as valuable. Moreover, the calculus of value against which such effects are judged is derived from the group of which he is a member. Thus the doctor who becomes a secret morphine addict often does so in order that he may work hard under pressure without fatigue and depression; the bohemian smokes marihuana so that he can more easily enjoy -aesthetic, sensual and group experiences; and— more subtly — the heroin addict may find the abdication of responsibility which the role junkie gives him the only way of avoiding the pursuit of values which he is loath, or unable, to achieve. The need for drug use is therefore, in the last analysis, a product of discrepancy between the ideals espoused by a group or individual and the absence of any means of achieving them without recourse to drugs. Cultures, like individuals, can become dependent on drugs in order to promote the type of behaviour which they value. Our analysis of the meaning of drug dependency has led us to pursue what I have called a socio-pharmacological approach. That is, we must focus not on the isolated individual taking a drug with foregone effects, but on the drugtaker as a person belonging to a particular culture in terms of which the effects of the drug are structured and his drug use understandable. Similarly, when we refer to dependency we must state both the drug and the group or individual we are.concerned with. And in our description of the nature of this dependency we must not talk of physiological needs for drugs or a subjectively experienced craving in isolation from the social context in which they occur. We must see the physiological, subjective and social levels of dependency as a highly interrelated whole.
48
__
4
©
J a i pipeda on ig ihe a > Bis aaa
% 3.
ae
en
ees
The Absolutist Monolith
There exist two contrasting ways of approaching the explanation of drugtaking and these two different world views are evidenced throughout the study of human behaviour as a whole. They can be found not only in the works of sociologists and psychiatrists, but in the commentaries of politicians, journalists, priests, or of anyone, in fact, who tries to understand and interpret the social world around him. I will term these two perspectives absolutism and relativism. Absolutists view society as an organic entity, comparable to the human body: each part has its place to play in an organized division of labour, and there is, over and above individual ends, the notion of the general social good. Relativists, on the other hand, would contest this, seeing society as a multitude of groups. each with their own ends and interests who agree and co-operate over certain issues but who conflict, sometimes drastically, over others. Now from these initial stances a number of fundamental points of contrast between the two schools can be made,
concerning both their explanations of drugtaking and their advice as to what ought to be done in order to ameliorate the problem. I will deal with this point by point, illustrating by quotation the absolutist approach, for this is the perspective that almost totally dominates the study of drugtaking.?
1] have dealt with the absolutist position in relation to the phenomenon of crime in general, elsewhere. See J. Young, “The Zookeepers of Deviancy’, Catalyst, Summer 1970, pp. 38-46.
49
1. Unanimity of Values The absolutist sees the vast majority of people as agreeing as _ _
; ;to what is correct behaviour and what is reprehensible; more-
_ over, that there is a large degree of agreement over the ends— that people should pursue and little conflict between the interests of different groups. Behaviour according to this
consensus is seen to be functional to the organic system they
_. envisage as society, and behaviour which violates this con-sensus is disfunctional to society. Legal drugtaking — alcohol,
- nicotine, caffeine, amphetamines and barbiturates on prescription —is seen in this light as behaviour in tune with the values of society and as activities which help to keep the system functioning. Illegal drugtaking, on the other hand, is contrary to these values and deleterious to the body politic. Thus: ‘Hashish is a social evil and the International Conventions are of great importance for the protection of society.”+ Relativists would deny the possibility of speaking ex cathedra on behalf of society. Different groups, they would argue, have different norms as to appropriate drug use. What is deviant or normal then cannot be judged in an absolute fashion: one cannot say in a definitive matter that to act in a certain way is absolutely deviant or normal; one can only judge the normality or deviancy of a particular item of behaviour redatively against the standards of the particular group you choose as your moral yardstick. To act in a certain way then can be simultaneously deviant and normal depending on whose standards you are applying. In this perspective, the smoking of marihuana may be normal behaviour amongst young people in Notting Hill and deviant to, say, the community of army officers who live in and around Camberley; similarly, to drink to the point of collapse may be valued behaviour amongst merchant seamen but would ‘be anathema to members of the Temperance League. Relativists do not deny a consensus in the sense that a G. Joachimoglu, ‘Natural and Smoked Hashish’, in Hashish: Its Chemistry and Pharmacology, Ciba Foundation J. and A. Churchill, London, 1965. 50
_
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+
majority of opinion can occur concerning a particular type of behaviour — e.g., the use of heroin — but that this is not sufficient to justify embracing an organic image of society. There is a vast difference of opinion in Britain, for example, as to the proper use of alcohol and cigarettes, and there are sizeable minorities which take barbiturates, marihuana or amphetamines. Moreover, the relativists would suggest that a consensus, where it exists, is often created by the persuasive -
manipulation of public opinion through means such as the mass media, by groups possessing sufficient power to propa-
gate their own particular values and notions of appropriate and reprehensible behaviour. In the field of drug use they would point to the activities of the Temperance Movement in the States before prohibition, and the Federal Bureau of Narcotics before the 19377 Marihuana Tax Act. Drugtaking, then, is not necessarily deviant nor essentially a social problem; it is deviant to groups who condemn it and a problem to those who wish to eliminate it. To talk of a personified society which must be protected is to camouflage a simple conflict between two groups: those who wish to pursue a particular activity unmolested and those who feel that this activity threatens their interests or conceptions of proper behaviour. 2. The Pathology of Dissent
The absolutists pursuing their organic metaphor regard what they term ‘deviant’ drug use as pathological, analogous to the diseases of an organism, and society like a human body is said to reject such behaviour in order to maintain its status quo, its equilibrium. Drug use arises, they argue, in areas of society which are ‘disorganized’, where there is ‘anomie’ or lack of norms as to appropriate behaviour. Drugtakers are seen as existing beyond society, as being amoral and without norms. Thus a group of Paris ‘beatniks’ are described as ‘more asocial than anti-social, and their
“protest” remains passive. In their escape from society, the drug is the passport to an existence divorced from reality —a “trip”, which despite the appearance of a group life which is 51
aS
Ene
DRUGTAKERS
- more gregarious than communal, remains a solitary one. This Seoup is composed not so much ‘ofpsychopaths as of young, _ immature persons for whom the drug may be the cause of complete desocialization.” They exist in a private world, concerned with their own individual pleasure and desires, relating to others only to obtain further drugs.
The relativist rejects the notion of drug use as a pathology; it is simply not possible to regard all the various activities popularly considered as deviant (for example, homosexuality, communism, heavy drinking, marihuana smoking, sexual promiscuity, abortion, prostitution and ‘petty theft) as diseases in the body of society. For if we were to extract all these
deviants we would have precious little left of the organism which the absolutists postulate! Rather, the relativists suggest that what is a deviant form of behaviour is a matter of opinion, that this opinion varies, and that the use of the word ‘pathology’ and organic metaphors are subtle means by which one group (who consider themselves normal) combat the yalixes of those they consider different from themselves. Further, there is a tendency for the middle-class observer to view social organization aimed at goals which he disapproves of as disorganized, normless behaviour. Instead, many drug groups, the relativist would argue, are subcultures with finely spun norms, dictating what is appropriate and inappropriate behaviour for the drug user. The tendency to view alternative values as an absence of values is, I suggest, a convenient method of ignoring groups whose existence questions the basis of one’s own social world. Nowhere is this practice more prevalent than in descriptions of those drug subcultures which espouse values concerned with hedonism and excitement as major goals of life. Thus D. P. Ausubel writes of the heroin addict: He fails to conceive of himself as an independent adult and fails to identify with such normal adult goals as financial independence, stable employment, and the establishment of his own home and 1 Some Cases of Addiction to New Drugs Among the Paris “‘Beatniks”’, United Nations Bulletin on Narcotics, 1969, vol. 21, p. 30. 52
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et.
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MONOLITH
family. He is passive, dependent, unreliable, and unwilling’ to _ postpone immediate gratification of pleasurable impulses. He demonstrates no desire to persevere in the face of environmental difficulties or to accept responsibilities which he finds distasteful. His preoccupation with a search for effortless pleasure represents both an inappropriate persistence of childhood motivations which he has not yet outgrown and a regressive form of compensation for his inability to obtain satisfaction from adult goals,*
Again, 55 per cent of addicts at the US Public Health Service Hospital were classified as having ‘psychopathic diathesis’, which was recognized by nomadism, irregular employment, unstable marital history, and tolerance to all forms of thrill-seeking vice. What is forgotten in these reports is that hedonism, thrill-seeking, lack of employment, unstable formal marriages, are often the norms of the groups from which drug users emanate. The middle-class social scientist with his nuclear family, planned life and careful leisure takes his pattern of life as the only possible form of civilized existence, any deviation from this being regarded as profoundly asocial. 3. The Denial of Personal Integrity The absolutists’ view of society is that of a vast area of apreement on the edge of which lie a tiny minority of deviants. These are the diseased cells in the body of society. Now this is seen as a pathology not only on the social level but of the
individual as well. That is, the individuals who make up the social pathology are personally inadequate. A person is seen as being unable to act ‘normally’ because he, for various reasons, has not inculcated the norms of society. There are
two major reasons given for this: either he is undersocialized or he is ‘sick’. The undersocialized drugtaker is seen in Freudian terms to have a weak superego, an inadequate ego and — if a man —lack of proper masculine identification. He is, in short, 1D—. P. Ausubel, Drug Addiction, Random House, New York, 1958, p- 42.
53
Si psychopathic. His lack of norms is alee ee ‘iefactt he has a personality which is immature and infantile. Th ~ Most individuals addicted to drugs are considered self-centred and narcissistic and are interested only in satisfaction of their own primitive needs. This is a very infantile form of behaviour; it is acceptable in infancy but not in adults. These individuals have not matured in a healthy way and so do not accept mature roles, They make poor husbands and wives, fathers and mothers; they are poor sexual partners because their sexual development has been retarded. They experiment with many types of sexuality but usually they cannot accept a mature heterosexual role, They are not interested in giving to anyone; they are interested only in receiving.
This sexual inadequacy is often seen as lack of correct masculine identification. Thus Chein and Rosenfield write in a revealing passage: An extraordinarily high proportion of adolescent addicts can be seen as ‘pretty boys’. They would not appear out of place in a musical comedy chorus. They are vain in their appearance. They spend much time preening. They are preoccupied with clothes, which they wish to be of the finest materials and the latest styles. They spend much time before their mirrors experimenting with their hair, moustaches, and goatees. . . Adolescent addicts do not look, behave, or deport themselves as adolescent boys usually do; they do not try to appear manly, rugged, vigorous, energetic, rough-and-ready. These deviations suggest that they have strong feminine identification. . . They try to impress the observer with their independence and bravery, with their ability to function well in the most difficult circumstances. They know better than any middle-class professional person what life really is. They boast of their exploits with women, crime, and narcotics, to prove what strong men they are. In one of Shakespeare’s telling observations, ‘they do protest too much’; the psychologically trained observer cannot help but see through to the problems of masculine identification beneath the veneer of masculinity.? *R. Rasor, ‘Narcotic Addiction in Young People in the USA’, in Adolescent Drug Dependence, (ed.) C. Wilson, 1968, p. 18. 2 Chein et al., Narcotics, Delinquency and Social Policy, Tavistock, London, 1964, pp. 224-5.
54
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MONOLITH. :
Thus, drug use is associated with both social and personality disorganization. Moreover, the two are easily linked, as it is argued that the ‘weak’ family structure associated mee socially disorganized areas gives rise to personality inadequacies. The absolutists substantiate their thesis by pointing to the groups where the incidence of drugtaking is high, namely the lower working class and the Negro, both groups which, they
— 4 — _ — _
would argue, have poor childrearing techniques and are therefore populated by inadequate personalities. Addition-
ally, the high prevalence of adolescent drug users would be attributed to their as yet immature personalities, coupled
with the aggravating factor of living in areas where social control is weak (e.g., the ghetto or the large university — campus). A few absolutist theorists, however, would argue that a proportion of drug use occurs in individuals with essentially normal personalities, but that these personalities have been
‘infected’ by contact with the ‘virus’ of addiction. The spread of addiction is thus often seen — especially by medical epidemiologists — as similar to an epidemic and the victim is regarded as being ‘sick’. The relativists would not denigrate the notion of undersocialization, but would insist that it is used over-often and without reference to the particular group of which the person referred to is a member. If there are many different ‘correct’ ways of behaving in a society, then there are as many ways of being ‘normal’. To suggest that a person with different norms from oneself is psychologically inadequate is merely a very convenient method of negating any argument as to the validity of one’s own way of life. Drugtaking groups are seen by relativists as having their own particular norms against which the non-drugtaker would seem personally inadequate and undersocialized. The teetotaller in an Irish
drinking group would soon find that the —- in his eyes — asocial gathering has a finely developed set of values and required behaviour, against which he would have a hard job measuring up. Moreover, if he were to find himself immersed in such a society for any length of time, he might begin to
interpret his own lack of social ease as a sign of personal >)
i THE DRUGTAKERS>
inadequacies. We might well take note here of the finding of Richard Blum,} that regular LSD users have a conception of the straight world as consisting of people who are uptight or — if they deigned to use the vocabulary of psychoanalysis — consisting of obsessive neurotics pursuing material and social status in an unbalanced manner! There is, however, a proportion of drugtakers for whom the rhetoric of the absolutist theorists is appropriate. But
these individuals are a product of this school of thought rather than initially fitting their conceptions of weak superego, inadequate ego and lack of masculine identification. For the sick role of the drug-determined individual, unable to make adult choices in terms of sex and occupation, is attractive to certain individuals. In short, the absolutist notions of the inadequate personality are embraced in a self-fulfilling manner by a proportion of drugtakers, This is especially true as the therapeutic roles in clinics and hospitals are manned by doctors who invariably sport an absolutist perspective on drug dependency. These clinics, in fact, can be viewed as institutions where drugtakers are socialized into fitting absolutist theory. The relativist would deny the simple connection implied between social and personality disorganization. For the apparent social disorganization of slum areas is often merely organization centring around different ends than those of respectable society. And what is perceived as the faulty childrearing practices of individual families is more easily understood as differential socialization occurring in different groups and utilizing different techniques. To grow up as a mature adult in Harlem demands the inculcation of different norms by different means than does that needed to produce a wellbalanced citizen of Manhattan. The transparency of the absolutist fallacy of personal inadequacy becomes most apparent when one considers that gigantic segments of the population, for example, the Negro and the working class, are all cast into the limbo of supposed social inferiority. For instance, Hans Eysenck writes that: * R. Blum (ed.) Utopiates, Tavistock, London, 1965.
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there is no reason to assume any differences between social classes with respect to conditionability [i.e., genetic difference], but, there are very good reasons for assuming considerable differences between them with respect to the degree of socialization to which they are subjected [i.e., childrearing differences]. Particular attention has been drawn, for instance, by Kinsey in the United States to the different value laid on the repression of overt sexual urges by middle-class and working-class groups. He has shown that where, for middle-class groups, parents put very strict obstacles in the way of overt sexual satisfaction of their growing children, and inculcate a very high degree of ‘socialization’ in them, working-class parents, on the whole, are much more lax and unconcerned. In many working-class groups, for instance, he found pre-marital intercourse viewed as not only inevitable, but as quite acceptable to the group. Similarly, with respect to aggression, there is a considerable amount of evidence from a variety of sociological studies, carried out both in the United States and in Great Britain, to show a tendency for middle-class groups to impose a stricter standard upon their children than the working-class groups. The open expression of aggressiveness which is frowned upon in the middle-class family is often not only accepted but even praised in the working-class group.
That premarital sexual intercourse and overt aggression should be considered as essentially asocial is a gross middleclass ethnocentrism which demands that all sexuality must be expressed in marriage and all aggression channelled for the sake of King and Country, if it is to be allowed the designation of truly ‘social’. Considering, then, the blind prejudice which the word ‘drug’ arouses, it is not surprising that the insinuation of personality defects is automatically affixed to all and sundry who stray beyond the narrow psychotropic limits of the middle-class behavioural scientist. 4. The Printed Circuit Theory of Socialization
The absolutists and relativists have basically different perspectives on human nature. To the absolutist, man’s psychic 1H. Eysenck, Sense and Nonsense in Psychology, Penguin, London,
1958, P- 294 57
ere % aE DRUGTAKERS make-up is like a blank sheet of metal on to which are trar planted the homogeneous values of society. Men are, so speak, programmed to react in the right way at the ri time:
to emit appropriate responses to prearranged cues.
—
Here and there, however, the machinery goes wrong: childrearing is inadequate, social control of adults is weak, or the — norms inculcated are unclear, and then imperfections enter into the printed circuits of normality. Individuals, through no fault of their own, are unable to fulfil the ‘normal’ roles expected of them. Human deviancy is seen as not morally reprehensible, because it is a product of forces which are beyond the control of the individual. For the relativist man, in contrast, is seen as standing apart from the values and ideas which he receives from his surroundings; accepting or rejecting them as he sees fit and, more important, creating new values in order to make meaningful his particular social and material situation. Now, if culture is seen as a collection of approved solutions to problems occurring amongst members of society, then what the relativists are suggesting is that here and there groups of people experience problems for which there are no suitable available solutions in their culture. They therefore in certain situations create new cultural responses and forms in the face of the inadequacy of the ‘given’ society in which they find them.
.
selves. The widespread use of drugs in our society suggests that they provide potent solutions to certain problems pre-
valent through the population. The difference between legal and illegal drugtaking, however, is that by and large the taking of illegal drugs indicates the evolution of hitherto forbidden solutions to individual or collective problems which the legitimate drugs — alcohol, caffeine, and nicotine — are unable to solve acceptably. In terms of the relativist’s framework, man is morally res-
ponsible for his choices to the extent that his fate is not determined, but partly in his own hands. Moreover, if people have free choice it is a mystification to regard people who deviate from your own standards as ‘ill’; it is better to say candidly that one disapproves of a particular form of behaviour (e.g., the use of amphetamines) for moral reasons and 58
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will do all in one’s power to eradicate such practices, than to _ hide behind a mask of therapy and a vocabulary of healing.
At the same time, the relativist will freely admit that a certain _ proportion of drugtakers willingly act as if they were determined creatures but would argue that such fatalistic life styles are initially chosen and introjected; they are not proof that man in essence is devoid of free will. 5. The Meaninglessness of Deviancy Ronald Laing, writing about his work in psychiatry, notes how the circumscribing of mental illness in a medical metaphor makes it appear meaningless. For even sane behaviour can be seen as unintelligible if one omits the social context in which it occurs: Someone is gibbering away on his knees, talking to someone who is not there. Yes, he is praying. If one does not accord him the social intelligibility of his behaviour, he can only be seen as mad, Out’ of social context, his behaviour can only be the outcome of an unintelligible ‘psychological’ and/or ‘physical’ process, for which he requires treatment. This metaphor sanctions a massive ignorance of the social context within which the person was interacting.*
What must be done is to perceive madness as a rational, intelligible process seen in the light of a particular social context, rather than a disparate psychological or biochemical sequence existing in a vacuum.
The absolutist approach to the study of drugs closely parallels the traditional perspective on mental illness. For not only are drugtaking groups regarded as asocial, but drugs themselves are seen to be ‘desocializing’. Thus drug-induced behaviour is seen as bizarre, meaningless and uninhibited; it represents the release of primitive, instinctual passions. The drugtaker is seen to be temporarily transported beyond the control of society. The focus for the study of drugtaking is, therefore, limited to the pharmacological properties (the programmed effects) of the drug in question or to the presumed 1R, Laing, The Politics of Experience, Penguin, London, 1967, p. 17.
9
THE
DRUGTAKERS
: repressed psychotic or asocial tendencies inherent in the psychic make-up of the individual drugtaker. Both these
_ approaches are essentialist: the former pharmacological analy-
sis assumes that a certain type of behaviour is automatically released in any individual under the influence of a specific drug; whilst the latter, psychological explanation, insists that the drug merely triggers off inherent repressed tendencies which are part of the essential nature of the individual in question. Both assign to social factors a minor role: they may cause peripheral variations in drug-induced behaviour but are never a major focus of analysis. Because of the tendency to focus on drugs rather than on the groups which take drugs, the absolutists frequently overemphasize the importance of drugtaking to a group. Moreover, they often explain the totality of a group’s behaviour by reference to the pharmacological properties of the drugs used. Thus, a sizeable percentage of students who smoke marihuana do not place more than a peripheral importance on its use. But the alarmed observer may well perceive such casual use as a central activity of the group and attribute personal difficulties — dropping out, alienation of individuals — directly to the use of drugs. The relativist would argue that one must understand druginduced behaviour in terms of the interaction between the physiological effects of the drug and the norms of the group of which the drugtaker is a member. The effects, as I have outlined in the first chapter, are socially induced and structured. Drugs are vehicles in which, in the majority of cases, alternative values are realized in the form of behaviour rationally comprehensible in terms of these norms. Drugs enable individuals to discard easily the precepts and parameters of one form of social reality and immerse themselves in the values of another. Thus it is only where the individual is atomized and isolated from any culture concerned with the regulation and interpretation of drug experiences that overtly bizarre and psychotic behaviour occurs. In short, the relativist position sees drug-induced behaviour as meaningful, and obeying more or less distinct norms. The task, therefore, is to explain the origins and content of the cudrure the drug60
_-
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taker belongs to and then, and only then, the role drugs play in it. Carrying on from this basis, one turns to discuss the effect of the drug itself on the culture in terms of its physical effects on its members and, indirectly, through the manner in which its norms are structured and changed because of social reaction against the use of the specific drug in question. 6. Machiavellianism of a Few According to absolutist theory, drugtaking is embraced willingly only by a small number of individuals with severe personality defects. But where the numbers of individuals taking drugs is manifestly large, an extra twist to the theory is added, namely the notions of the corruptors and the corrupted. Drugtaking is seen as the result of a small clique of maladjusted individuals (the corruptors) manipulating or seducing a majority of innocent or immature bystanders (the corrupted). Thus every marihuana smoker is induced to begin the habit because of the activities of a machiavellian and economically motivated pusher. This is a subtype of the general approach to deviancy which sees, for instance, every strike as being engineered by a small group of Trotskyites and student sit-ins as due to the work of foreign agitators. The corollary of this, as far as the social control of drugtaking is concerned, is that the ‘corrupted’ must be viewed in a humanitarian light and treated leniently whilst the ‘corruptors’ must be dealt with in a severe manner. They are the ‘real’, intransigent deviants. Thus, typically ‘enlightened’ opinion distinguishes between the penalties doled out for the possession and the supply of drugs. Now, contrary to this analysis, the relativists would maintain that the antagonism directed towards the “corruptors’ is a mystification which, by scapegoating a few, manages to maintain the illusion that everything would be alright in the social system if only we could eliminate the small minority of saboteurs intent on destroying its organic unity. For the corruptors — corrupted notion is part and parcel of the organic view of society; the corruptors being seen like germs which are infecting an otherwise healthy organism. When GI
aes fiend upon HiseSiokmoststpris ~asense ahawe ria of all weapons. They transported Lenin in a sealed tru elike a plague bacillus from Switzerland into Russia, he was | utilizing such a simplistic model: offensive in its naiveté as. it is brilliant in its rhetoric.’ The relativist would argue that illicit drugtaking is a response — to particular problems faced by individuals. They are not corrupted, but willingly embrace particular solutions to their social difficulties. William Burroughs understood this well when he wrote: If we wish to annihilate the junk pyramid, we must start with the bottom of the pyramid, the addict in the street, and stop tilting quixotically for the ‘higher ups’ so called, all of whom are immediately replaceable. The addict in the street who must have junk to live is the one irreplaceable factor in the junk equation. When there are no more addicts to buy junk there will be no junk traffic. As long as _ junk need exists, someone will service it.
7. Denial of Authenticity The meaning that individual drugtakers ascribe to their activities is ignored. Junkies, for instance, are said to be notorious liars and, besides, the ‘real’ causes of their action are only
understandable by experts who possess ‘insight’ into the problem. Distant and obscure occurrences in the drugtaker’s past are evoked as the ‘real’ explanations for such present actions. Thus, for instance, he injects heroin into his veins because his father was a weak and ineffectual figure, or he smokes marihuana because he was fixated at the oral stage of his development as a child. Thus the present action — the taking of a drug — is denuded of any meaning that the individuals themselves attribute to it. Their ideas are merely rationalizations for the hidden forces which impel them to take drugs. There is a prevalent tendency to analyse dependency in terms of the distant past: the addict is either seen to have a + William Burroughs, The Naked Lunch, Corgi, London, 1968, p. 1o. 62
_ _
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- personality predisposed to drug use, which was laid down in — the early years of his life or, as theorists like Lindesmith would have it, a conditional reflex acquired in the early stages of addiction. Both these approaches are characterized by ignoring the present situation of the drugtaker and suppressing any meaning that drug use may have to him. It is a strategy which serves to take attention away from the present by invoking individual failings or weaknesses which have occurred in the past. As for the drugtaker’s own interpretation
of the present, it is ‘unrealistic’; far from being closely related to the cause of addiction, this lack of realism is seen as a typical effect either of drug-prone personalities or of the drug itself. Thus Chein and Rosenfield! note how the addict is characterized not only by a weak ego, defective superego and lack of masculine identification, but also by his unrealistic
aspirations and ‘irrational’ distrust of major social institutions. (AU these ‘deviations’ being a function of the addict’s family background.) By realistic aspirations they mean ‘ambitions which are plausibly related to potential and existing opportunities with the desire and ability to defer gratification in the service of long-term goals’. That is, there is the implicit notion that ‘lack’ of realism or discontent is not an authentic
interpretation of the addict’s universe but a product of his unsatisfactory family background. The most gross mystification occurs however when they discuss ‘distrust of major social institutions’. ‘Normally’, they write, ‘we take for granted that the governmental agencies which protect our lives, property, and rights, and that the educational, religious, and charitable organizations which are concerned with our welfare and personal development have a core of humanitarian concern, honesty, and trustworthiness. This does not prohibit us from regarding particular instances of such institutions with disapproval, anger or cynicism. But, despite such instances, we accept the institution as a valid and potentially useful social arrangement. We generally trust persons who embody these institutions until they betray this trust; should they deceive us, we criticize them as individuals, though we 1 Chein et al., Narcotics, Delinquency and Social Policy, Tavistock, London, 1964, p. 265.
63
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maintain much of ourates for the institution per s “eNormality, then, is spelt out here as involving a basic accept- _ ance of society as it stands; distrust even by the dispossessed _ or the underprivileged is regarded as symptomatic of Pes 4 sonal and family pathology. The relativist, although interested in the biography of the — individual dtdpiaken would maintain that events distant in his past are likely to provide only vague insights into his
present drug use. Moreover, we must analyse dependency not in terms of impersonal forces impelling the individual on the road of addiction, but in terms of the meanings which the - drugtaker gives to the forces which impinge upon him. We must know Ais interpretation of the situation, his assessment
of reality. To do this we are concerned with the examination of such phenomena as the argot, imagery, values and ideology of the drug user. This is not to say that the drugtaker has a — necessarily accurate perspective on his position, but that zs evaluation of Ais own universe is a major component governing his behaviour. Furthermore, it can be argued that the inability of the absolutists to take cognizance of the opinions of the drugtaker is a function of their consensus notion of society. For consensus implies that reality is monolithic; it embraces the notion that there is no other ‘reality’ from where the total system can be criticized, and in doing so effectively translates cultural failure into accusations of personal inadequacy. “There is one effect (of marihuana)’, Winick writes, ‘that may be among the most insidious of all: the habit of “‘tuning out” on reality when reality appears to offer some discomfort. The habit of escaping from reality and side-stepping problem situations by taking marihuana may lead to a potentially valuable member of society becoming a regressed and minimally functioning person.’! Here we have in a nutshell the absolutist fallacy concerning reality; namely, that the only ‘reality’ worthy of such a name is that which involves the individual embracing the work ethic and
contributing fully to his role in the, hypothetically agreed upon, division of labour within society.
C. Winick, ‘Marihuana Use by Young People’, in Drug Addiction in Youth, (ed.) E, Harms, Pergamon Press, London, 1965, p. 25.
64
| 8. Affirmation of Objectivity The study of social phenomenon, it is argued, should be ;
pion
and should utilize objective concepts such as in —
the natural sciences. Values merely decide which problems — ;we are interested in; they must not be allowed to distort the evidence we examine.
, Robin Blackburn has criticized this position on the groundsa _ that it suggests that: ‘once theories are thoroughly cleansed _ of all “value judgements” it is believed that they will be — _ governed by the wholesome discipline of objective facts. The predictable consequence of this attempted purge of values is to orient theory and research towards certain crude over-
__ abstracted value notions masquerading as scientific concepts.” An ‘ideology of objectivity’ emerges which pretends to have evolved value-free concepts but which in fact has as its yardstick of objectivity middle-class values. ‘Psychopathy’, ‘anomie’, ‘social disorganization’, ‘undersocialization’, ‘weak superego’, ‘lack of masculine identification’, ‘retreatism’: all the jargon of the psychiatrist or sociologist specializing in
the study of drugtaking is loaded despite its semblance of impartiality. It is a view of one group’s behaviour as seen from the perspective of members of the liberal professions, the ‘enlightened’ middle class. It ‘tells the story’ as it appears from their position and, as Becker? has so rightly pointed out,
there is a ‘hierarchy of credibility’ so that the tales of those at the top are viewed as more ‘realistic’ than those of the lower echelons of society. Now what does it mean to obtain an unbiased picture of, say, the heroin user, when the police, the psychiatrist and the addict in the street are spinning widely contrasting stories: each maintaining they know it as it really is? The subject matter of the social scientist is radically different 1R. Blackburn, ‘A Brief Guide to Bourgeois Ideology’, in Student Power, (ed.) A. Cockburn and R. Blackburn, Penguin, London, 1969,
Pp. 205. 2H. S, Becker, “Whose Side are We On’, Social Problems, no. 14, Winter 1967, pp. 239-47-
65
that of se isinfh scientist. For,whereas ie chen ; Som or physicist creates concepts by which the physical universe becomes meaningful, the data of the social scientist is already ~; conceptualized. Molecules do not give meaning to = ‘ir behaviour, only scientists do; human beings on the other
_~ hand are social animals to the extent that their péluvions has ._ purpose and meaning. It is the meanings individuals give to.; their behaviour that is the starting-point of analysis, for _ without understanding the norms of particular groups or individuals their actions become mere physical movements, + random gestures without rhyme or reason. The social scien_tist then, a man in the world with values, faces the problem of describing and analysing the behaviour of other men whose values are different from his own. Now all would be well if the sociologist could put aside his values and merely record in an ‘objective’ fashion the values of others. But three major problems occur here: contradictions of meaning; conflicting models of social action; and the possibility of translation of values. If we take a British heroin addict, for example, we might find there to be several interpretations of his actions: the psychiatrist defining him as a sick, asocial individual with lack of will power and a weak personality; his neighbours who see him as a libidinous ne’er-do-well, voluntarily pursuing illicit pleasures; his own peer group who define heroin use as a freely chosen esoteric and exotic cultivation of pleasure; and the ‘junkie’ himself who is not sure whether he is sick or whether he is ‘free’, whether he is morally right or wrong. He is surrounded therefore by individuals who conceptualize and evaluate his world differently and he himself reflects many of these basic contradictions. To explain his behaviour we must understand how it is meaningfully related to the addict’s definition of the situation and how the position he finds himself in has come about. What meaning, then, does
heroin have to the addict, why does its use seem appropriate
to him, and what has Senerited this situation? The meaning that the addict gives to his addiction is a product of the culture which he associates with (e.g., his peers), powerful 66
;
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individuals and groups whom perhaps he respects (e.g., the
"
psychiatrist), and the degree of relevance which these in- —
terpretations have to his own problems. Various groups — compete, then, to provide meaning for the addicts. The social scientist, by choosing one interpretation of the situa- _ tion (e.g., by using a psychiatric model), enters into this conflict by promoting one definition of reality at the expense of others. And the majority of deviants in our society — with the exception of highly ideologically buttressed individuals such as Marxist revolutionaries — are, because they are imperialistically surrounded by groups intent on redefining their reality, exceedingly vulnerable to such moral advances from significant experts in the outside world. Thus, the situation is radically different from that of the physical sciences in that it is inconceivable, for instance, that molecules could introject the theories of the physicist and begin to proceed in accordance with his notions; but this is precisely what often happens in society. The theories of the social scientist reflect his own value position and restructure, and
at least superficially self-fulfil themselves in the world they attempt to objectively interpret. This is not to suggest, of course, that all theories whatever their content will have equal validity as long as they are accepted by the individuals involved. Many are false in their premises although causal in their effects, and as such are mystifications which transform the world whilst at the same time concealing the reasons for their efficacy. For instance, it may be incorrect that all heroin addicts come from broken homes and have inadequate personalities, but an addict believing himself to be such may well behave dependently in the future and seemingly substantiate
the theory. That he has willingly embraced such an image of himself because of its utility to the problems that he faces is an interpretation which both psychiatrist and patient for their own separate reasons are no longer willing to admit as a possibility. Moreover, as a diagnosed ‘dependent’ person he will be constantly placed in institutions designed officially to deal with such psychological ‘types’, yet which have the self-
fulfilling consequence of changing the individual in precisely this direction. The values held by the social scientist have a 67
but on the aie that occur within it. < The various models which are used to analyse social 4 behaviour contain within them important valuations as to the nature of man and the sanctity of the system. Thus the image of man as a mechanism, a printed circuit responding to — stimuli of his environment, contains the value premise that _ man’s capacity to create, his ability to choose his action rather than be propelled by circumstance, is grossly limited. It amputates a significant portion of human potentiality. It is, moreover, political in the sense that it provides a ‘potent’ myth which it is in the interests of many to propound, as it is the fate of a multitude of others to unwittingly embrace; for its espousal severely limits man’s ability to conceive of both radically alternative social orders and modes of human consciousness. As David Ingleby in a recent critique of prevalent trends in psychology argues: ‘It is through its potency as a myth that the psychological (i.e., mechanistic) model of man can be seen as serving ideological interests: to the extent that the human sciences are taking over from religion the function of providing man with a self-image, they should be seen in the same light as religious myths.”+ For absolutists, the meanings which drugtakers assign to their experiences will be ignored; instead they will explain the sensations in terms of the dehumanized language of physiology and pharmacology. The ecstatic religious rites of the Native American Church are reduced to disturbance of the balance between sympathetic and parasympathetic nervous systems, or an accumulation of adrenochrome in the system. It cannot be overstressed that to explain the biological basis for a social phenomenon is merely to explain the substratum that makes it possible, not to explain the phenomenon itself. In contrast, therefore, we must look at the language and argot which the drugtaker has evolved himself. Herein lies the key to the meaning of the drug-induced experience. Some drugtakers will of course have no special vocabulary 1D. Ingleby, ‘Ideology and the Human Sciences’, Human Context, no. 11, June 1970,
68
aes
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at all (e.g., housewives who use barbiturates). This signifies that they are interpreting and structuring their experiences in terms of the wider culture to which they belong. Others, however, will evolve elaborate and sophisticated argots which involve the genesis of alternative value systems and radical _ _ reinterpretations of ‘reality’ (e.g., hippies). The well-intentioned social scientist may wholeheartedly agree that the subjective interpretations of the effects of drugs are invaluable in the study of drug use. What is necessary, however, is to measure these subjective states scientifically or else be thrown back on fairly incomprehensible impressions. In other words, we must translate the language of the drug-using subculture into that of the scientific community using objective concepts and precise calibrations. But what if such a translation represents a violation of the reality we are depicting; what if by the very fact that a subculture has arisen in opposition to middle-class values the translation of its language is in itself a political act; a neutralization of an argot which had arisen in order to describe a new type of reality, back into the language from which it had evolved? Language contains within it its own valuations and limitations. As Aldous Huxley put it: Every individual is at once the beneficiary and the victim of the linguistic tradition into which he or she has been born — the beneficiary inasmuch as language gives access to the accumulated records of other people’s experience, the victim in so far as it confirms him in the belief that reduced awareness is the only awareness and as it bedevils his sense of reality, so that he is all too apt to take his concepts for data, his words for actual things. That which, in the language of religion, is called ‘this world’ is the universe of reduced awareness, expressed and, as it were, petrified by language.!
Thus the language of the scientist can contain both the value judgement that authentic human experience exists only within particular limits and, in addition, compresses cultures which are intuitive, non-linear and symbolic into the rational world of the logically linear, analytic and literate. The 1 Aldous Huxley, The Doors of Perception and Heaven and Hell, Penguin, London, 1959, p. 22.
69
a ee
cea experience ares pt
badly as
> into the jargon, for example, of experimental psycholo This is not to suggest that we are limited to reprodu
wt meanings suggested by the individuals involved in a particular social situation. _In terms of our own values and; _ perspective we can, for instance, say that the explanation of oe behaviour given ws.a particular heroin addict is a smokeRe: screen behind which his real motives are hidden, or that the categorization of a particular drug experience is a mystification or at least a misconception. But we must take cognizance of the meanings given to the situation by the actor whilst at —
the same time making clear where we stand, what values — underline our conception of human nature and the social order. 9. Reification of Reality Reification is the apprehension of human phenomena as if they were things, that is, in non-human or possibly supra-human terms. Another way of saying this is that reification is the apprehension of the products of human activity as ifthey were something other than human products — such as facts of nature, results of cosmic laws, or manifestations of divine will. Reification implies that man is capable of forgetting his own authorship of the human world, and, further, that the dialectic between man, the producer, and his products is lost to consciousness, The reified world is, by definition, a dehumanized world. It is experienced by man as a strange facticity, an opus alienium over which he has no control rather than as opus proprium of his own productive activity.
Thus Berger and Luckmann! describe the fashion in which social reality is viewed like the physical world as a phenomenon which exists out there, beyond the creation of man. It is perceived as a world wherein we can discover laws and regularities and by judicious application of these principles manoeuvre men into positions more favourable in terms of this reality, but we cannot alter reality. The heroin addict, for instance, is seen as suffering from a well-nigh incurable *P. Berger, and T. Luckmann, The Social Construction of Reality, Allen Lane, The Penguin Press, London, 1967, p. 106. 7O
THE ABSOLUTIST
MONOLITH oo|
disease; it is one in which the stages can be clearly mapped out _ and where the outcome is a foregone conclusion. It is an
illness for which a cure has not yet been discovered, a sick- eeCh ness which the experts attempt to unravel but which is not within the addict’s own comprehension or making. Similarly, in terms of the relationship between a particular drug and crime or the likelihood of escalation between mari-— : huana and heroin, generalizations obtained from a certain number of cases are assumed — as in the physical sciences — to have a high probability of accuracy, in whatever situation the
particular drug is used. Thus Professor G. Joachimoglu, a distinguished member of the United Nations Drug Supervisory Body, writes: In a paper presented to the International Congress of Criminology in Paris in 1950, Professor C. G. Gardicas mentioned a group of 117 individuals, by no means criminals initially, who became addicts and criminals after smoking hashish and were sentenced for threats, blackmail, murder, offences against property, and other offences, It is not necessary to go into further details, Hashish is a social evil and the International Conventions are of great importance for the protection of society.1
Thus, because marihuana use correlates with crime in 117 cases this connection is endowed with the same causal significance as the observation that the ignition of hydrogen and oxygen together invariably yields water. It is seen to involve universal laws unrelated to the desires of the individuals
involved or the theoretical aspirations of the investigators. A more recent example is the reports that appeared in the same week in the newspapers of the Sharon Tate murders and the My Lai massacre in Vietnam. It was suggested that the film star and her friends were murdered by Charles Manson and his family because they were high on speed. Likewise, the My Lai massacre occurred decause American troops had been smoking marihuana. From these observations, marihuana and methedrine were linked irrevocably 1G, Joachimoglu, ‘Natural and Smoked Hashish’, in Hashish: Its Chemistry and Pharmacology, Ciba Foundation, J. and A. Churchill, London, 1965, p. 5. 71
understandable
and Manson and the GI’s were somehow
excused of responsibility for their behaviour. In fact, whereas —
it is undoubtedly true that drugs facilitate many forms of behaviour, it cannot be argued that they cause behaviour. This is a reification of their properties and of human nature. — It is to the strange cults of Hollywood that we must look for : an explanation of the murder of popular film stars. It is in the dehumanizing effect of predatory wars that we will find the reasons for the murder of innocent Vietnamese peasants. _ mit
It is deep in the matrix of American culture that the violence of both incidents becomes understandable. The relativist would argue that generalizations about drugs — must be always grounded in specific cultures and particular - social situations. Moreover, that the theories evolved by social scientists often have self-fulfilling effects on the very drug users about whom the theories are erected to explain. Thus they may introject the meanings given to the situation and act ‘predictably’, or they may be placed in certain structural situations where they have no option but to fulfil the prophecies. Either way the social world is not merely interpreted by the social scientist; it is changed by him. Observer and object exist in the same interconnected universe, not in watertight inviolate compartments.
10. Missionary Nature of Therapy and the Mystification of Protest There has arisen in modern societies concomitant with the division of labour in technological spheres, and the widespread segregation of groups one from the other, an elite of specialized experts whose task it is to explain ‘the deviant’ to the hypothesized ‘normal’ citizen. These latter-day priests must explain what is perceived as unusual in terms of the values associated by their audience as usual. In this process, _ utilizing the theoretical and therapeutic ploys listed above, they circumscribe and negate the reality of values different from their own. They do not explain, they merely explain away. They are well-trained men, but the rigour of their 72
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training has enabled them to view the world only from the narrow-blinkered perspective of their own discipline. The fragmentation of knowledge concomitant with specialization has encouraged the strict compartmentalization of analysis. In this instance, pharmacology, medicine, psychology, sociology have approached the subject of drugs as if true knowledge could be obtained by the simple addition of the knowledge accumulated in each field. The tight interplay between different levels of analysis is thus omitted (e.g., the dialectic between social values and pharmacological effects of a drug), and the phenomenon appears as a meaningless asocial activity. As a result such experts can, from the vantage of their cloistered chauvinism, scarcely grasp the totality of the social world even in terms of their own values let alone take a critical stance outside of these values. We are
producing what Lucien
Goldmann has described as the
specialist who is simultaneously illiterate and a graduate of a university.
The task of the expert is not only to explain the deviant to the rest of society; he is also expected to reform or treat the rulebreaker. Certain personnel are therefore selected to mediate between society and the deviant; chief of these — apart from the police and the clergy — are the social worker, the psychiatrist, the psychologist and the criminologist. These individuals perceive themselves as having primarily the therapeutic role of assimilating ‘the poor’, ‘the maladjusted’, ‘the immature personality’, ‘the undersocialized’, ‘the sick’, ‘the adolescent gone wrong’ into the ranks of a posited consensus of decent well-integrated people to whom they perceive themselves as belonging. That their clients, the deviants, often interpret their attempts at therapy as being punitive and coercive is regarded as lack of self-insight; that a few renegade experts attack them as being professional ideologues of middle-class values is regarded as a sad loss of objectivity. The expert, because of his position of power vis a vis the deviant, will tend to maintain his theoretical ‘insight’ by a process which has been called negotiating reality,’ that is, he 1T. Scheff, ‘Negotiating Reality’, Social Problems, no. 16, Summer 1968.
73
verify his theories and this is a negotiated situation based _ the notion that if you — the deviant — are co-operative and ~ helpful and show insight into your problem, we will be cooperative with you in so far as we will obtain material help - for you, obtain you an early release, not give you shock
therapy, give you warmth and sympathy or protect you from the law. In short, successful therapy involves convincing the deviant of the stupidity of his own ideas of what he is doing and a translation of these ideas into those of the therapist’s. This is called self-insight.1 But the expert has not only the power to negotiate reality, to determine the sort of information which he is willing to see and hear; he has also, as we have seen, the power to change reality. W. I. Thomas’s famous dictum, that a situation defined as real in a society will be real in its consequences, — has immediate relevance here. For one would expect the stereotypes that the expert holds of the deviants to have very real consequences for their future behaviour and the way they perceive themselves. Thus, particularly in those cases where individuals are incarcerated in total institutions for therapeutic reasons, the drugtaker begins through a selffulfilling process to begin to look, to act, and to feel like the anomic, undersocialized, psychotic, amoral individual which the therapeutic personnel portray in their theories of deviancy. Any protest by the deviants themselves against the treatment which they receive is tackled and mystified by subsuming its explanation in terms of the general theory. Thus Chein and Rosenfield write of heroin users: When the hospital staff attempts to impose controls which would be accepted, though not enjoyed, by most adolescents, adolescent addicts perceive this as a threat to their masculinity, so they are regularly involved in such problems as truancy, keeping late hours, refusing to get up in time for breakfast and refusing to turn the lights out at some curfew hour. They will let nobody tell them how *P. Berger and T. Luckmann, The Social Construction of Reality, Allen Lane, The Penguin Press, London, 1967.
74
THE
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to conse themselves, for to aeso implies that they are not man enough to know themselves. . . Ca Many displayed difficulties in establishing rapport, some to almost a psychotic degree, Evasion, suspicion and hostility were common responses to the diagnostician or to the therapists who sought to intervene in their maladjustment.? The fragmentation of knowledge, the segregated middleclass existence of the expert; his power to negotiate reality and ignore protest, the seeming fulfilment of his hypotheses, all combine to ensconce him securely in an absolutist position. The tendency towards absolutism is even more marked amongst experts on drug dependence than those in other fields. For as drug use poses obvious medical and physiological problems, there has been a tendency for physicians and pharmacologists to specialize in this field. Now the natural scientific training of such professions militates against the likelihood of their perceiving fundamental differences between physical and social phenomena and their study of the human body encourages them to utilize organic and functionalist models of society. But to explain the prevalence of absolutist theories merely by the restricted empirical knowledge and theoretical perspectives of its practitioners is insufficient. It is also in the interests of such individuals to maintain such a viewpoint. First, the deviant threatens the reality of the expert. As R. Laing put it: Only when something has become problematic do we start to ask questions. Disagreement shakes us out of our slumbers, and forces us to see our own point of view through contrast with another person who does not share it. But we resist such confrontations. The history of heresies of all kinds testifies to more than the tendency to break off communication (excommunication) with those who hold different dogmas or opinions; it bears witness to our intolerance of different fundamental structures of experience. We seem to need to share a communal meaning to human existence, to 1 Chein et al., Narcotics, Delinquency and Social Policy, Tavistock, London, 1964, p. 226. 2 Thid., p. 209.
73
HE DRUGTAKERS give with others a common :consensus.
ae sense to the world, to maintain a
. i+
'
To view the deviant in a new light would demand that the expert views his own position in society in terms of a new 48 perspective. Thus the drugtaker often embraces cultures _ which contain notions of hedonism or of transcendental * experience which challenge the taken-for-granted world of the expert. Moreover, even for those experts who reject the values which typically underwrite their social position, there are controls and fears of a less subtle kind. As Dennis Chapman succintly urged: : The social sciences accept the stereotype of the criminal, for to challenge it would involve heavy penalties. The penalties are: to be isolated from the mainstream of professional activity, to be denied resources for research, and to be denied official patronage with its rewards in material and status.”
Whereas absolutist myopia buttressed by self-interest explains the reluctance of the social scientist to stray beyond ' the narrow terms of reference which are the limits of his _ discipline, it does not indicate why such a model should be acceptable in the first place. True, by denial of authenticity, affirmation of objectivity, imputation of pathology, etc., the _ deviant act is rendered both meaningless and unattractive, and powerful weapons of social control are manifest. But further than this, there is a correspondence between this model of human nature and the type of man necessary if the
system is to function efficiently and without effort. David Ingleby has expressed this better than anyone when he writes: A reifying model of human nature, by definition, presents men as less than they really are (or could be): to the extent that a society requires men (or a certain proportion of them) to be thing-like in *R. D. Laing, The Politics of Experience, Penguin, London, 1967, Pp. 65.
VY
*D. Chapman, Sociology and the Stereotype of the Criminal, Tavistock, London, 1968, p. 23.
“76
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THE ABSOLUTIST MONOLITH > their work, orientation, thinking and experiencing, such a model _ will constitute both a reflection and a reinforcement of that society (reinforcing because men tend to become what they are told they are). If labour is mechanical, it is convenient that those who have to do it should think of themselves as a species of machine: if freedom of choice, imagination, the pursuit of untried goals and experiences, are seen as threats to a sacrosanct ‘social structure’, then man should learn he is a species of simple computer, a ‘limited capacity information channel’, incapable by definition of creating such goals and meanings. Above all, he is confronted in the possibility of being understood as a species of thing, with the threat of ultimate banality: denied the facility to transcend in any way the material out of which he is made, all value must lose value for him.1
~ It is a peculiar irony that it is only when men act like scientific objects that they become precisely understandable objects of physical science. It would be unfair to see the experts on human behaviour as cynical men; they are often as not sincere and dedicated people who see their role in a progressive light. They seek to treat the criminal and the drug addict, not to punish him. But this ideology of therapy is immensely more insidious and allows dimensions of coercion and punishment which even the most ‘unenlightened’ and vindictive supporter of the moral order would never have the tenacity to pursue. Ronald Laing writes: To work smoothly, it is necessary that those who use this stratagem do not themselves know that it is a stratagem. They should not be cynical or ruthless: they should be sincere and concerned. Indeed, the more ‘treatment’ is escalated — through negotiation (psychotherapy), pacification (tranquillization), physical struggle (cold-packs and straitjackets), through at one and the same time more and more humane and effective forms of destruction (electroshocks and insulin comas), to the final solution of cutting a person’s brain in two or more slices by psycho-surgery — the more the human beings who do these things to other people tend to feel sincere concern, dedication, pity; and they can hardly help but feel 1D. Ingleby, ‘Ideology and the Human Sciences’, Human Context, no. 11, June 1970.
77
Ps!
moreaN shits se i as display; fimoreee ae ace desive debeing at feel they persecuted more need to be pacified; the it of end the at And them, destroy to necessary gtroyed, the more for gratitude express even may they , ‘cured? be indeed : all, they may Bat many do not. This only goes to show, as one leading pvehte * trist said to me: ‘It’s the white man’s burden, Ronald. We can’t expect any thanks, but we must go on.”!
It is possible, therefore, for the expert to intervene in — social situations with the. self-righteousness of a humani= tarian; his position buttressed by a monolithic conception of reality, a value-free notion of the truth and with the __-varied stratagems of absolutist theory available as weapons - against any challenge to this order. I will close this section with a quotation which illustrates the extremes to which absolutism can evolve. I do this not because its physical manifestations are any more dangerous than its social and psychological interventions, but to draw attention to the consequences of believing that a science of society is possible without the intervention of human judgement and value. Those who have learnt something of the damage to intellect and personality which resulted from the old-fashioned operation of leucotomy may well recoil from the idea of using operation in the treatment of drug addiction or in any other psychiatric condition for the fear that it may do more harm than good, introducing undesirable new features both physical and mental from the destruction of vital areas in the brain, However, stereotactic surgery, in which a needle is guided by X-ray control to a small target area, allows very accurate lesions to be formed without any damage to the normal function of the brain, In 1960 I showed that a small lesion in a portion of the brain known as the substantia innominata, by selective division of tracts *R. D. Laing, The Politics of Experience, Penguin, London, 1967,
pp. 18-19. 78
oo
THE ABSOLUTIST
MONOLITH
concerned in emotional reaction, could produce a profound influ- Bf Pi ence upon the intensity of depression, anxiety, or tension without _ harmful effect on the intellect or personality of the patient. Thisa: method has been shown to be helpful as an aid to the therapy of 4 addiction in three ways: by eliminating the emotional reaction of — : the withdrawal period, by diminishing craving for drugs after — operation, and in selected cases by producing long-term effects in relieving
depression, p ¢ anxiety, Y> and P personality
defects which other- —
wise contribute to the all too frequent relapse which occurs after medical treatment. Primitive emotions are damaging emotions in psychiatry and are subserved by primitive cortical areas of the brain which are located in the cingulate region on the inner side of the frontal lobe, in the posterior orbital aspect of the frontal lobe, and in the anterior temporal regions, I have been able to show that fibres from each of these widely scattered areas can be divided at a point of convergence where they traverse the substantia innominata on their way to the area in which emotional reaction is produced, The insertion of radioactive seeds which only produce necrosis in the brain for a distance of 2 mlms on each side of the seeds, ensures that division of these fibres is obtained without any disturbance of the normal function of the brain which remains capable of fulfilling all its normal functions without any blemish to intellect or diminution in the intensity of normal emotional feeling or normal emotional reaction and control.t 1G, Knight, FRCS (Consultant in Neuro-Surgery at Brook Hospital, London), “The Approach of the Neurosurgeon to the Treatment of Drug Addiction’, St Anne’s Soho Drugs Group, London, 1969.
79
»
The Origins of Drug Use
a a
eae
a
QUESTIONS ANSWER
-
WHICH A THEORY OF DRUGTAKING MUST
We have seen that the absolutists’ theories of drugtaking
focus entirely on the drug used without considering its cultural meaning, take social reaction against the drugtaker for granted without attempting to explain it, picture themselves as having the objectivity of physical scientists by ignoring the fact that they view reality from the perspective of their
own values and that their pronouncements often — if they possess power in the world — effect the ‘reality’ which they are studying. _ What is needed is a theory of drugtaking which will take into account all the above mentioned factors, which will provide an explanatory framework in which to analyse any type of drugtaking, legal or illegal, ‘soft’ or ‘hard’, but which will at the same time be based on the cultures to which the particular group of drugtakers being investigated belong. There are to my mind eight basic questions that must be answered in order to understand the life history of a particular type of drugtaker. I will detail both the questions and the way in which I feel they can best be answered. 1. Immediate Origins of Drugtaking Society consists of a large number of groups of people with their own norms and values. Now, each of these subcultures
consists in their desired people, 8a
of solutions to the problems experienced by people own part of the social structure; that is, they represent ends and approved means of achieving them. Old young people, working class, middle class, West
THE
ORIGINS
OF
DRUG
USE
Indian, Irish, criminals and doctors all face their own patticular set of problems and all evolve cultures with which to solve them. Moreover, certain of these problems are solvable in terms of the use of psychotropic or consciousness-altering drugs. That is, the effects of the drugs are compatible with the problems faced by the individual or group concerned. A complication arises at this point in that, as explained earlier, the effects of drugs are also partially controlled by the culture itself. But only partially so; for certain drugs are more pharmacologically suited for aiding certain activities than others. Amphetamines, for instance, are, because of their stimulant effect, a much more feasible solution to the problem of a high work load (e.g., in the case of a physician or student) than would be the depressant alcohol. The use of a specific drug is therefore hit upon because of its availability and pharmacological suitability, but after that its effects are restructured and given meaning by the subculture concerned. The psychotropic drugs, alcohol, nicotine and caffeine are freely available in our society, as — to a slightly less extent — are prescribed barbiturates, amphetamines and tranquillizers. Their widespread use indicates that they provide a most important solution to the problems of a vast number of individuals. The extent and nature of their use is not, however, uniform but varies with the particular subculture which we refer to; to take alcohol, for example, there are wide differences between the drinking habits and ritual of merchant seamen and businessmen, between Frenchmen and Englishmen, between Italians and orthodox Jews. Each subgroup of society will have a conception of what is the appropriate situation to have a drink (what are the cues?), what are the permissible and desirable effects of alcohol, how much it is necessary to drink to achieve this desired state, what meanings are associated with the drunken state (e.g., feelings of masculinity), what is normal and deviant drinking behaviour. They will have a definition of the social drinker but they will also have a notion of the alcoholic; for instance, the phrase ‘It is enough to turn a man to drink’ indicates that there are definite theories as to the inception of alcoholism and there are in addition undoubtedly notions of how an alcoholic 81
|
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rims the social ‘diiaker in ur society is.
ommonly se
as someone who holds his drink and enjoys ¢
2himself whilst the alcoholic is seen as someone who is sick: +
he is determined and controlled by the drug alcohol. Now, as we have argued, the effects of drugs are related to the
conceptions people have of them. We may note that although alcohol is physiologically addictive, the ease with which one is able to cure oneself of this addiction, the speed at which one becomes addicted and the type of ‘behaviour displayed during addiction will be az /east partially related to the social pressures and beliefs surrounding alcoholism. Both the roles ‘social drinker’ and ‘alcoholic’ are, I suggest, culturally defined solutions to particular problems. That is, the person who needs to relax and enjoy himself will find himself attracted to social drinking, and the individual who feels that it would be preferable to exist in a state where he is ‘out of control’ (i.e., where he is determined) will be recruited readily to the role ‘alcoholic’. In the latter instance, our definition of the alcoholic as the
determined person will attract those who wish to opt out of particular social situations and be able to say, it’s not me who is doing this it’s the ‘liquor’ or the ‘booze’. Similarly, the definitions and roles held by a subgroup of society as regards the typical marihuana smoker or heroin addict will attract certain individuals and, obversely, of course, repel others. That is, the way we define the type of person who takes a certain drug and its likely effects controls to some extent the people who take a specific type of drug. Society to some extent creates a series of psychotropic boxes into which the right individuals jump, and of which inappropriate individuals steer clear. For instance, the alcohol molecule per se _ does not contain a solution to a man’s problems; rather, the culture he belongs to defines the problem, states if alcohol is relevant to its solution, and programmes and structures the administration of alcohol so as to provide an array of possible and permissible effects. In short, the psychotropic box erected around alcohol in the particular subculture to which the individual belongs may or may not be capable of con-
taining the problem which he faces. 82
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THE ORIGINS
OF DRUG
USE
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Now and then, however, certain individuals or groups will _ question the ‘taken-for-granted’ effects of specific drugs and will utilize these drugs to obtain different results than defined
by those people from their culture of origin. For instance, the — college student in his drinking group may begin to define the
consumption of an amount of alcohol his temperate parents would associate with alcoholism as merely having a good night out. He will learn to control his intoxication. Or bohemians may define the effects of marihuana as expressive and facilitative of aesthetic experience rather than as inducing libidinousness and aggression of an essentially amoral nature. Or, again, a group may appropriate a synthetic drug such as LSD and erect a cult of initiates around it. Why do these changes in definition occur? I suggest that this occurs when the culture to which a group belongs becomes inadequate for solving their particular desires and problems. People have certain aspirations from the social world: sexual, economic, expressive, etc. Their culture attempts to provide solutions to these particular problems and when there is a disparity between people’s aspirations and their means of achieving them a situation occurs which sociologists term anomie. In
face of this contingency, people tend to create new means of achieving their aspirations or will alter their desires to achievable ends. For instance, a group of boys may find that the working-class culture of the area in which they live does not provide them with solutions to the particular problems they experience. They may crave a measure of excitement and fun in their lives but find their work repetitious and boring, and the leisure activities available in their area staid and uninteresting. As a result, in certain circumstances, they may develop a subculture which involves delinquency and vandalism. That is, they create their excitement in illicit ways.
Now as psychotropic drugs are used in nearly all societies we would expect them to have the role of solving certain problems and realizing aspirations inherent in these cultures. Their effects become valued as a means of relaxation, enjoyment, to forget one’s workaday worries, etc. New sub-
cultures, however, will have different conceptions of what is desirable and how to achieve it. For instance, the delinquent
83
_ subculture we referred to may lay a particularly important stress on extreme hedonism; it may value kicks and thrill-
‘
8 x _ .
seeking behaviour. Drugs — alcohol, marihuana or even _ perhaps heroin — may be used to achieve these ends. The important fact to note, however, is that such groups would
redefine the nature of these drugs and often radically restructure their possible effects. To explain then the use of a new drug such as LSD or the new use of an accepted drug such as alcohol we must first explain the rise of a subculture of people who are using this drug. And to explain the rise of - subcultures the most potent concept is that of anomie. Once again our focus must not be the drug per se but the culture within which it is used and within which its use becomes intelligible. 2. Structural Origins It is necessary to go beyond the immediate origins of drug use and try to explain why the immediate origins themselves occur in terms of wider processes occurring within society. For instance, it is not sufficient to say that the bohemian student faces at college a state of anomie because his aspirations for an interesting and meaningful course are not met, and that this gives rise to a culture of bohemianism within which drug use becomes a means of obtaining the desired goals of the new subculture. We must also explain why it is that the course is unable to meet the demands of the students and what determines the specific terms in which the student’s demands are couched. This brings us to the consideration of
the educational system, and the relationship of the latter to the economy, in short for us to view the anomie and drug use of bohemian students in the context of the total society. 3. Individual versus Collective Solutions
The problems faced by an individual may well be solved by the normal behaviour suggested by his culture. In terms of drugs, the man who feels it difficult to relax after work will find that there is a programmed psychotropic drug, alcohol,
84
Be
eat Taett
ae!
THE
Wee
atSa
ORIGINS
OF
a
DRUG
ad
USE
available and centred around the approved role ‘social drinker’ which will solve his problem. But what of those for whom _ the culture provides no normal solutions? The individual who faces a particular strain can either solve his problem in isolation or join with like-suffering others to create a collective solution. Taking the individual solution first: a person facing severe strain, yet unaware that there are others who feel likewise, will probably interpret his troubles in terms of self-blame and personal inadequacy rather than as a result of stresses commonplace in society. He will take recourse to the
pervasive absolutist explanations of deviancy which are commonly held legitimate in our society. He will individualize his problem and will fail to see himself — or indeed be seen by others — as a man whose troubles are explicable in terms of the wider social context. In such a fashion the deviant is scalpeled off from society, he exists and is understandable only within the narrow limits of his personal pathology, his behaviour is circumscribed within a medical metaphor. The individual with such a definition of his problems may well find that there are roles associated with certain types of drug use and effects which are appropriate to him. The chief ‘pathologically caused’ psychotropic box which we have in our society is, of course, that of the isolated alcoholic, but subgroups within our society often have conceptions of the heroin addict which are very similar. Thus, for the adult middle-class Briton the social drinker is the normal role for drinking alcohol, whilst the alcoholic is the deviant role. For his bohemian son on the other hand marihuana smoking may be the normal psychotropic activity with heroin use as a deviant role. That is, both ‘straight’ and ‘hip’ cultures have a concept of the ‘sick’ drug user. Into such a role individuals in the particular cultures involved would slot, taking drugs in response to what they and others perceive as the ineluctable disposition of their personalities. The individual is thus playing a pathological role defined for him by his group and heavily underwritten with absolutist premises. Not all isolated drugtakers, however, would view themselves as having pathological personalities. An alternative, and more insidious analysis, would be that although the
85
toies = has bee | | pieneiis ‘normal’ the Fiat:
a
a introduced— whether it be alcohol or heroin or tobacco —- has
such a power to addict that it is impossible to resist its use. i both he, and the social commentators who surround That is, him, mystify his relationship with drugs. The dependence is $ " seen as unrelated to his problems; it is an external disease like _ chicken pox which he has unfortunately ‘caught’. , : Each way, the individual is seen to be sick: he has either a _ sick personality which has led him to addiction or has caught
the ‘sickness’ of drug addiction. Such determined roles, — which seemingly rule out any possibility of free choice or — __voluntarism are — as I have suggested — peculiarly attractive to people who find themselves in impossible and irreconcilable situations. They enable them to continue a particular line of action, for example mainlining heroin, and at the same. time to condemn the practice. They make it possible for the drugtaker to deny responsibility for condemned behaviour which is in the last analysis functional to him. An extreme instance of this is the study by Charles McCaghy! of child molesters. Their behaviour was frequently castigated by themselves but was commonly excused by the suggestion that it was the drink which impelled them to act in such a deviant manner. Studies in the sociology of illness have often intimated that the sick role is not always an accidental occurrence. As Aubert and Messinger put it: ‘any situation in which an individual stands to gain from withdrawal is such as to render suspect his claim to illness’. Not only, then, are certain drugtaking activities categorized as ‘sick’ but particular individuals will struggle to achieve this label. For example, in place of the current image of the heroin addict mechanistically propelled against his wishes by his growing physical addiction, I would portray a man who, in the final analysis, is at some
stage attracted to the role. What has evolved is a fantasy involving the systematic mystification of his own make-up. Thus, when physical sickness occurs because of withdrawal ? Charles McCaghy, ‘Drinking and Deviance Disavowal: The Case of Child Molesters’, Social Problems, no. 16, Summer 1968, pp. 43-9. 2'V. Aubert and . Messinger, ‘The eclaet and The Sick’, Inquiry,
NO. I, Pp. 137-60, 1958, p. 142.
86
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from heroin he will interpret this as a confirmation of the —
social or psychological sickness from which he long Sg si _ himself as suffering. He then self-fulfils his predictions about_ himself by acting upon these false estimations of his own nature. He relaxes his control on his heroin use because he Tf believes that it is useless to resist. His perceptions of the— significance and severity of his withdrawal pains will be distorted as he re-evaluates them in the light of his notion of himself as an addict. At no time does he resist this involvement in the vortex of dependency because the benefits of sickness are greater than the pains of freedom. His desire to avoid choice has become translated into a notion of himself as a being unable to make choice. He is ill; and is so obviously really sick because he experiences tangible physical symptoms which informed medical opinion describes as being both painful and tenacious. Not that such a process of self-engulfment in the sick role is realized immediately; rather a spiral of _ involvement occurs. The greater the physical sickness experienced the more the confirmation that one’s self is sick; the more the belief in the inherent sickness of one’s position the greater the likelihood both that withdrawal symptoms are perceived as chronic and irresistible and that one will be impotently ‘forced’ into using a greater dose. Because of this physical dependency will indeed become greater, withdrawal distress increase, and so on.
There is a strong parallel between the world view of the ‘sick’ drugtaker and the schizophrenic. This is where, as Ronald Laing puts it: ‘the central split is between [the individual’s] own “‘self”’ and what he calls his ‘‘personality”.... What the individual variously terms his “own”, “inner”, “true”, “real’’, self is experienced as divorced from all activity that is observable by another.’! The schizophrenic sees his actions as determined and beyond the control of his real self: the sick addict sees his actions as determined either by the drug or a weak part of him which he dislikes. Recently Peter Laurie has suggested that perhaps heroin is used as a method of avoiding incipient schizophrenia, and Laing in a letter to him corroborates this suggestion: ‘From my own clinical practice, I have 1R. D. Laing, The Divided Self, Penguin, London, 1965, p. 73.
87
had the impression on a number of occasions ne theuse of heroin might be forestalling a schizophrenic-like psychosis. a For some people heroin seems to enable them to step from
2
the whirling periphery of the ewresiope as it were, nearer
to the still centre within themselves.” | Interestingly, William Burroughs in his novel The Naked Lunch comments: ‘I have never seen or heard of a psychotic - morphine addict, I mean anyone who showed psychotic symptoms while addicted to an opiate. In fact addicts are _ drearily sane. Perhaps there is a metabolic incompatibility between schizophrenia and opiate addiction. On the other hand the withdrawal of morphine often precipitates psychotic
reactions — usually mild paranoia’.?
This sick role, which involves a split between the patient’s ‘real’ and ideas of Goffman to clients
‘false’ self, is corroborated and confirmed by the addiction held by psychiatrists, and, indeed, as has so ably indicated, by the profession’s attitude as a whole. Thus he writes:
The key view of the patient is: were he ‘himself? he would voluntarily seek psychiatric treatment and voluntarily submit to it, and, when ready for discharge, he will avow that his real self was all along being treated as it really wanted to be treated. A variation of the guardian principle is involved, The interesting notion that the psychotic patient has a sick self and, subordinated to this, a relatively ‘adult’, ‘intact’, or ‘unimpaired’ self carries guardianship one step further, finding in the very structure of the ego the split between object and client required to complete the service triad.?
The alternative type of ‘sick’ addict, where the individual believes himself to be normal yet inflicted with the disease of addiction seen as some external inhuman agent, is in some ways a more successful strategy than the ‘sick self’ theory. For, in this case, there is no necessity for the individual to *P. Laurie, Drugs: Medical, Psychological and Social Facts, second edition, Penguin, London, 1969, p. 148.
? William Burroughs, The Naked Lunch, Corgi, London, 1968, p. 276.
3 E. Goffman, Asylums, Penguin, London, 1968, p. 326.
88
THE ORIGINS
OF DRUG USE |
bifurcate himself; here, all his weakness is projected outside him on the ‘virus’ of dive dependency, his self being seen as_ united and irreproachable in any part. The drug-dependent individual then, in both of fee modes of adaption, regards his actions as beyond control. He has taken up the sick role available in his culture and perceives himself as a reified ‘thing’ acting out the pre-determined script which has been allotted to him. But I would argue that this helplessness is fake; it is a mystification because
it is a role which is at some point chosen and which is meaningful in terms of its advantages rather than an unavoidable deleterious occurrence. Most appalling of all, it is a myth which by social expectation and confirmation becomes, in part, a reality increasingly difficult for the addict to deny or extricate himself from. It is necessary, therefore, in order to understand the behaviour of this type of alcoholic or heroin addict to — as in the case of schizophrenia — examine the complex of relationships the individual finds himself in primarily at the moment and in his near and relevant past. We must ask:
what problems are thrown up by this human matrix, rather than what are the inherent qualities of the drug involved or the essential nature of the man’s personality emanating from his far distant childhood experience. And to explain the man’s intimate relationships we must then turn our attention to the wider society in which they occur. There are, however, built-in blocks to the acceptance of such an analysis of this important type of drug dependency. Both society and the individual are unwilling to accept the responsibility which such a demystification would demand. Society will not accept, because it is expedient to lay causal blame on the individual or drug in a vacuum. To suggest that the alcoholic or ‘junkie’ is grossly dependent on drugs because of his relationship with his family or employer, and that this relationship is a reflection of, for example, the repressive nature of the family and employment in our society, is to make too radical a pronouncement. Such a viewpoint would receive scant support, outside progressive circles, for it involves a culture which questions its own validity. It is likely to demand more change than can be willingly accepted.
89
a any:forae individual to acknowledge ‘in —tarily opted for an alienated mode of activity, tha ‘rejected his own freedom, would undermine the carefully -constructed shield that he has evolved to guard him against - the encroachments of his fellows. A parallel situation occurs with homosexuals. As Anthony Storr points out: ‘all have a vested interest in affirming that their condition is an inborn abnormality rather than the result of circumstances; for any other explanation is bound to imply a criticism either of ‘themselves or of their families and usually of both’. Individuals choose to be determined because it is functional
=
|
to them, and by defining themselves as such and being labelled by relevant authorities likewise they become determined. Physically addictive drugs merely lend a plausibility
to these determinist notions. Absolutism in social and psychiatric thought, with its implications that human action is determined like that of physical particles, in effect buttresses, sustains and often creates these situations. We have distinguished two types of drugtaker: those who engage in the normal psychotropic activities of their culture (that is the collective solutions presented to the individual by his group); and those who, facing isolated strain, embark
upon individual solutions which are available to them in terms of certain deviant psychotropic roles present in their culture (that is, the collective definitions of permitted deviancy presented to the individual by his group). Thus, either we engage in drugtaking behaviour which is normal for our group, or else we, admitting our own weakness or sickness, act out the role of the deviant drugtaker held by our group. These latter individuals are, so to speak, ‘tame’ deviants;
they admit their failings and interpret their behaviour in terms of the values of the group to which they belong. They have entered into a contract with society in which they are allowed to act deviantly and opt out of normal adult responsibilities, provided they will admit that this is because of some sickness which impels them to behave in such a fashion
despite the inclinations of their own real self. Sometimes, it is true, the alcoholic or heroin addict who adopts such a sick ? Anthony Storr, Sexual Deviation, Penguin, London, 1964, p. 83. go
tel nti Re
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“THE ORIGINS
OF DRUG
US!
re is condemned as being criminal or voluntarily deviant. But it is the task of the ‘enlightened’ middle class to defend on these underdogs and to explain to those of lesser ‘understanding’ the true nature of the affliction which they castigate. ;
But not all drugtakers choose to accept the definitions of© :
drug use taken as given in society. Some come together realizing that they have similar problems, and collectively evolve a new solution. That is, they create a culture where drugs are used, but where the drug use is given a different meaning from that existing previously. First of all, then, a group of people experience anomie: there are no ready solutions to the problems which they experience available in their culture. Then, through communication and interaction they realize that there are others in a like situation, and collectively they create a new culture; innovating solutions to the prob-
lems which face them. Such subcultures will involve — if drugs are relevant to their problems — new conceptions of drug use. It is the use of drugs in radically different ways to achieve ends condemned by powerful groups in society which, as we shall see later, evokes reactions of a substantial and punitive nature. 4. Constraints
In evolving new subcultures invoking novel conceptions of drug use social groups will vary with the degree to which they are — so to speak — supervised by the surrounding society. The hallmark, for instance, of delinquent slum areas is the degree to which adolescents are left unsupervised to seek their own entertainment, usually in and around the streets. Compared to the middle-class child they have a high degree of freedom as far as the development of deviant sub-
cultures is concerned. Similarly, students are often isolated in communities of their peers, unwatched by college authorities. This is not to suggest that social groups which are thus unhampered by control from the outside world will develop deviant norms; merely that the potentiality for such a development exists and will be realized if the group experiences OI
_ — — — —
—
sufficient problems for which there is no ready solution available in their culture of origin.
é
bs
sy The Immediate Solution
_ The solution initially devised by an individual or group will be a product of their culture of origin. That is, cultures are transmitted from one generation to the next and then transformed in order to meet the exigencies of the new social - situation which their members find themselves in. The old
culture is a moral springboard for the emergence of the new. If the solution to the particular problem faced involved drugs we would expect them: (1) to have properties which are roughly pharmacologically related to the problem; (2) to be accessible; (3) to be in turn shaped to fit these problems by the culture of the group. Thus, to take the example of the doctor who faces the problem of overwork combined with a painful gastrointestinal disorder. As a member of the subculture of medicine he has a considerable knowledge of drugs, both in - terms
of their effects and also in terms
of their required
prescription. He has also high accessibility to a multitude of drugs. Secretly, therefore, he prescribes himself daily shots of morphine. He does not see himself as likely to become addicted, as his expertise in medicine equips him with the belief that he can control its use.t He will take the opiate in order to pursue ends compatible with his profession (i.e., to continue working) rather than for pleasure as with the lowerclass addict. If he becomes, eventually, dependent on morphine the addiction will be shaped, timed, administered and resolved in terms of his culture. All in all, therefore, the
solution to his problem is understandable only in terms of the subculture of medicine to which he belongs. A contrasting example would be that of a group of middleclass students who because of their disillusionment with the rewards of further education drop out and create a bohemian subculture. The values of this emergent culture will be related * C. Winick, ‘Physician Narcotic Addicts’, in The Other Side, (ed.) H. Becker, The Free Press, New York, 1964. Q2
THE
ORIGINS
OF
DRUG
USE
to the values of their middle-class background. It will be 4 _ understandable in terms of their culture of origin, changed in. order to meet the problem they collectively face. That is, if _ will be like the culture of the working-class delinquent in that it extols expressivity, hedonism, and spontaneity but will have a middle rather than a lower-werldag-class orientation. Thus it will value expressivity through non-violent aesthetic — pursuits and hedonism through a cool (i.e., controlled) mode of enjoyment rather than a frenzied pursuit of pleasure. Drug use in this group will involve the smoking of marihuana, which is available in bohemian areas (largely because, in Britain, of the co-presence of immigrant populations), and which has the culturally defined properties of enhancing aesthetic appreciation and bodily enjoyment in a restrained — and non-violent manner. Bohemianism, then — unlike in the case of the physician — involves the emergence of a new culture which structures and selects the effects and use of the particular drug concerned. Drug use can therefore be part of a newly evolved culture — or be contained within the values and restrictions of the old.
93
Thave linked the problems that individuals face in their daily lives to the specific drug chosen to facilitate their solution. ‘But human action, even although it hurts no one but the agent himself, is seldom free from outside interference and control. In this chapter I shall turn to the final three questions necessary to an explanation of drugtaking. I shall examine why social reaction occurs against drug use and the manner in which it structures and, sometimes, radically alters both the problems the drugtaker faces and the experiences which the drugs themselves induce. The absolutist social scientist assumes social reaction against the deviant. He does not question, for example, why society reacts against the person who smokes marihuana but not those who smoke tobacco. In contrast, the relativist regards deviancy as not a property herent in any activity
but something which is conferred upon it by others. He turns the searchlight of inquiry, therefore, not only on the drugtaker but also on the people who condemn drugtaking. His interests are consequently wider than the absolutist for he must examine the power structure of society; explaining why certain groups have the ability to proscribe the behaviour of others and in what terms they legitimize their activities, As an illustration of the importance of social reaction it is useful to examine E. M. Jellinek’s! distinction between Delta and Gamma alcoholism. In France, many workers have a
hear-intoxicating quantity of alcohol in their bloodstream both day and evening. They do not, however, become
obviously drunk although tolerance and withdrawal symp1E. M. Jellinek, The Disease Concept of ee New Haven, Conn., 1960.
94
Hillhouse Press,
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_ THE SOCIAL REACTION
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AGAINST
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toms not infrequently occur. This Jellinek called Delta alcoFs holism: for although in a tissue sense these men are alcoholic, psc such a state is so common in French culture (i.e., it is normal. psychotropic behaviour) that no deviant role compounded— of intense psychological misery and social rejection occurs. _ He contrasts this with the Gamma alcoholism of America — where stigmatization is intense. Thus the lifestyles of two — men, one American, the other French, may be widely at variance despite the fact that each is heavily dependent upon ~ alcohol. It is because of such differences that I have insisted — on utilizing a socio-pharmacological approach to the study of drugtaking. What then are the major factors which determine the intensity, direction and nature of social reaction against the drugtaker? The Basis of Reaction
There are three major reasons why there should be reaction against drug use: (i) Direct Conflict of Interest. Here the drugtaker is seen as directly affecting the interests of certain groups in society. For example, prohibition in America was supported by some industrialists because they felt it would ensure more manageable labour. In contrast, the breweries and distilleries of course staunchly opposed restrictions on the freedom to drink. (ii) Moral Indignation. A. K. Cohen wrote:
¢
“The dedicated pursuit of culturally approved goals, eschewing of © interdicted but tantalizing goals, the adherence to normatively sanctioned means — these imply a certain self-restraint, effort, discipline, inhibition. What is the effect of others who, though their activities do not manifestly damage our own interests, are morally undisciplined, who give themselves up to idleness, self-indulgence, or forbidden vices ?what effect does the propinquity of the wicked have on the peace of mind of the virtuous ?* 1 A. K. Cohen, ‘The Sociology of the Deviant Act’, American Sociological Review, no. 30, 1965, pp. 5-14.
95
"THE DRUGTAKERS | What Cohen is arguing is that deviant activities, even _ although they may have no direct effect on the interests of those who observe them, may be condemned because they - represent concrete examples of individuals who are, so to speak, dodging the rules. For if a person lives by a code of conduct which forbids certain pleasures, which involves the deferring of gratification in certain areas, it is hardly surprising that he will react strongly against those whom he sees to be taking shortcuts. This is a partial explanation of the vigorous repression against what Sehur calls ‘crimes without victims’: homosexuality, prostitution, abortion and drugtaking. Following on from this it is interesting to note how the social reaction against a particular form of drugtaking is, in general, proportional to the degree to which the group involved embraces values which are hedonistic and disdainful of work. Conversely, where drugtaking is linked to productivity, either in that it aids work or facilitates relaxation before or after work, it is viewed with much greater favour — if not encouraged. This becomes evident if we take a specific drug and note how social reaction to it varies with the group who use it and the ends which its use facilitates. Thus: (a) Amphetamines Legal Use. Seventy-two forces during the war astronauts carry stocks them on prescription to
million tablets were issued to British to be used to combat exhaustion; in case of emergency; civilians use slim and counteract depression.
Tolerated Use. Benzedrine by medical students to swot for examinations.
Condemned Use. By teenagers to stay awake at all-night clubs and parties. (b) Alcohol Tolerated Use. ‘Social’ drinking at business functions or to relax after work at approved leisure times.
Condemned Use. ‘Problem’ drinking, the clinical definition of which involves the disruption of work habits and marital duties. 96
ae
he
-
THE SOCIAL REACTION AGAINST DRUGTAKING (c) Opiates Legal Use. Morphine to alleviate pain amongst the sick. Condemnation, but little social reaction. The use of morphine
by physician addicts to enable them to continue working. It is true that such addiction is only discovered after admission
to hospital for a ‘cure’ but the retrospective reaction of the doctor’s community is usually amazingly slight.t Condemnation and harsh reaction. Use of heroin by ‘street addicts’ for hedonistic reasons. It is interesting to note how social reaction towards the heroin addict is less punitive in Britain, where addiction is perceived as an unpleasant sickness, than in America where the prevalent image is of the criminal hedonist. (d) Tobacco
Probably one of the most universally acceptable drugs in the West despite the immense health risk smoking involves. It is one of the few drugs which is tolerated during the performance of many occupational roles and this is directly related to the fact that it does not interfere with efficiency and in fact has a reputation for aiding concentration on the job at hand. (e) Marthuana
A drug which has been associated in a large number of cultures with hedonistic pursuits which tend to undermine productive roles. It is often precisely on these grounds that a rationale is based for its continued illegality. Thus Sir Aubrey Lewis in his survey of the international clinical literature notes that: ‘the degradation that most writers report in the excessive cannabis user is apparent in several ways. He is irritable and impulsive or inert and dreamy; he neglects himself grossly and is incapable of sustained effort; he may become a beggar or a vagrant, taking no responsibilities for his family ...’? Or as H. Anslinger and W. Tompkins note: 1C, Winick, ‘Physician Narcotic Addicts’, in The Other Side (ed.) H. Becker, The Free Press, New York, 1964. 2 Sir Aubrey Lewis, ‘Review of International Clinical Literature on Cannabis’, in Cannabis, Advisory Committee on Drug Dependence, HMSO, London, 1968.
97
| THE DRUGTAKERS ‘in the earliest stages of intoxication the willpower is destroyed — and inhibitions and restraints are released; the moral barri-
-cades are broken down and often debauchery and sexuality occur... constant use produces an incapacity for work and a _ disorientation of purpose.”? Now —in contrast — an example ofsocially tolerated marihuana use is the use of bhang: an infusion of the stems and
leaves of the hemp plant by Brahmins in India. As Chein et al. put it: _ Among the Brahmin priesthood large quantities of bhang may be taken to facilitate entering devotional trances. Although they appear drunk — their co-ordination and gait are grossly impaired, and their orientation in time and place is disturbed — they regard themselves, when under the influence of bhang, as empty of all worldly distractions, concerned only with God, The god Shiva is cited by them as a bhang drinker and a paragon of the contemplative life. The use of bhang is consecrated to achievement of their contemplative and ascetic ideal, to the practice of severe and prolonged austerity, to the withdrawal of their attention from the attractions of the sensible world.*
They contrast the Brahmin use of bhang with the Western use of marihuana, one epitomizing austerity and the other enjoyment and hedonism. Thus it is not against the use of a drug in itself that repressive measures occur, but only where it is used by groups or individuals with deviant values to achieve ends disapproved of by the dominant groups in society. As Alisdair MacIntyre
put it: Most of the hostility that I have met with occurs from people who have never examined the facts at all. I suspect that what makes them dislike cannabis is not the belief that the effects of taking it are harmful, but rather a horrifying suspicion that here is a source of 1H. Anslinger and W. Tomkins, The Traffic in Narcotics, Funk and Wagnalls, New York, 1953, pp. 21-2. 2 Chein et al., Nuarcouee Delinquency and Social Policy, Tavistock, London, 1964, p. 344. 98
eet St Ree THE
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ee
ee
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DRUGTAKING
pure pleasure which is available for those who have not earned it, who do not deserve it. .
The social reaction against drug use, the aim of which is perceived as purely hedonistic and detrimental to the individual’s productive capacity, is an example of moral indignation involving a condemnation of those who opt out of the notions of deferred gratification, hard work and responsibility implicit in the basic normative rules of Western society. This clash between groups stressing productive and hedonistic values is central to our understanding of attitudes to drugtaking and it is to this theme that I will return in the next chapter. (iii) Hlumanitarianism occurs where powerful groups seek to change the behaviour of others. They act, overtly at least, in the better interests of the socially inferior group they define
as a social problem. The group thus designated may or may not accept this designation (cf., sick ‘addict’ to marihuana smokers). Absolutist social science, however, tends to regard the existence of social problems as undebatable; the question is not which groups are problems? but rather: how can we ameliorate the conditions of groups A, B and C who everyone knows are social problems? Now humanitarianism is, I would argue, an exceedingly suspect motive; for it is often — though not necessarily — a rationalization behind which is concealed either a conflict of
interests or moral indignation. For example, Alex Comfort in The Anxiety Makers? has charted how the medical profession have repeatedly translated their moral indignation over certain ‘abuses’ into a clinically-backed humanitarianism. For example, masturbation was seen as causing psychosis, listlessness and impotence and various barbaric clinical devices were evolved to prevent young people from touching their genital organs. I want to suggest that there is an absolutist tendency in our
society to cloak what amounts to moral or material conflicts behind the mantle of humanitarianism. This is because serious 1 Alisdair MacIntyre, ‘The Cannabis Taboo’, New Society, 5 December 1968, p. 848. 2 Alex Comfort, The Anxiety Makers, Nelson, London, 1967.
99
_ THE
DRUGTAKERS
conflicts of interest are inadmissible in a political order which
obtains its moral legitimacy by the invocation of the notion of a widespread consensus of opinion throughout all sections of the population. Moreover, unlike in the Middle Ages, we are loath, because of the ubiquitous liberalism, to condemn another man merely because he acts differently from us, providing that he does not harm others. Moral indignation, then, the intervention into the affairs of others because we think them wicked, must necessarily be replaced by humanitarianism which, utilizing the language of therapy and healing, intervenes in what it perceives as the best interests and wellbeing of the individuals involved. Heresy or ungodliness, in short, become personal or social pathology. With this in mind, humanitarianism justifies its position by invoking the notion of an inbuilt justice mechanism which automatically punishes the wrongdoer; thus premarital intercourse is wrong because it leads to VD, masturbation because it causes impotence, marihuana smoking because a few users
will step unaware on the escalator which leads to heroin addiction. The Direction of Reaction
It is commonplace to imagine the reaction to drugtaking as invariably negative, but this is an obvious oversimplification. In the case of the legal psychotropic drugs, alcohol, nicotine and caffeine, powerful commercial interests exhort the population to increase their consumption and easily overshadow bodies such as the Temperance Alliance and the British Medical Association which attempt to restrict drug use. The pharmaceutical industry — no mean pressure group — spends considerable sums on the advertisement of tranquilizers, barbiturates and amphetamines available largely through the National Health Service. There is thus a large industry intent on producing and promoting drug use. As far as illegal drugs are concerned, criminal organizations, especially in the United States, attempt to maintain and expand the market. Underground culture in the Western world might be seen as proselytizing the use of marihuana and the hallucinogens and tending bee)
THE
SOCIAL
REACTION
AGAINST
DRUGTAKING
to dissuade its members from using ‘hard’ drugs heroin and speed (methylamphetamine). From the point of view of the policy-maker, interest are those negative reactions which have intended consequences of maintaining drug use. The
such as of great the unpsychia-
tric portrayal of the heroin addict as ‘sick’, which makes real the fiction of inevitable relapse, and the legal reaction against the marihuana smoker, which merely increases the import of marihuana as a symbol of rebellion, are two of the more blatant instances of such actions. A common reaction to drug use is that of ambivalence for, as with so many social relationships between ‘normal’ and ‘deviant’, the normal person simultaneously both covets and castigates the deviant action. This, after all, is the basis of moral indignation, namely that the wicked are undeservedly realizing the covert desires of the virtuous. Richard Blum captured well this fascination-repulsion relationship to drug use when he wrote: Pharmaceutical materials do not dispense themselves and the illicit drugs are rarely given away, let alone forced on people. Consequently, the menace lies within the person, for there would be no drug threat without a drug attraction, Psychoanalytic observations on alcoholics suggest the presence of simultaneous repulsion and attraction in compulsive ingestion. The amount of public interest in stories about druggies suggests the same drug attraction and repulsion in ordinary citizens, ‘Fascination’ is the better term since it implies witchcraft and enchantment. People are fascinated by drugs — because they are attracted to the states and conditions drugs are said to produce, That is another side to the fear of being disrupted; it is the desire for release, for escape, for magic, and for ecstatic
joys. That is the derivation of the menace in drugs — their representation as keys to forbidden kingdoms inside ourselves. The dreadful in the drug is the dreadful in ourselves."
Moral indignation, then, is based on a conflict of values and desires; its existence explains the remarkable interest in certain drug-using groups despite their minute size. It explains 1R, Blum, et al., Society and Drugs, Jossey-Bass Inc., San Francisco,
1969, P: 335: Ior
3
‘oe we are regaled by more information in the mass media about the heroin addict (who presumably is ‘enjoying himself’) than the methylated spirits drinker (who presumablyis too ~ miserable to be attractive), why we hear more of marihuana use than hardcore poverty. Itis the social basis of this bifurcation of values that I will attempt to outline in the next chapter. _ Who reacts against drug use?
Within modern society there are four major groups who _ initiate action against the drugtaker: moral crusaders, experts, law-enforcement agencies and the mass media. Each have their own particular motives for their concern.
__H.S. Becker used the term ‘moral crusaders’ to signify those individuals who unite together in order to eliminate social evils from society. Their direct interests are not involved and they usually express themselves in the language of humani-
tarianism. An example is the Woman’s Christian Temperance Union which campaigned successfully for prohibition in the United States. Joseph Gusfield, who has studied such groups, notes that: ‘moral reformism of this type suggests the approach of a dominant class towards those less favorably situated in the economic and social structure’. It has great concern for the reform of the conditions of the lower classes, in this case indicting the drug alcohol as a blight, both on their health and moral condition. Such a stance, I have suggested, is often simply moral indignation over the behaviour of lower social groups fronted by an air of benign humanitarianism. This century has witnessed the emergence of a vast array of experts in deviancy. Although the majority of them inter-
pret their subjects in an absolutist fashion, there is still room for a considerable amount of interdisciplinary conflict. It is in the interests of the various scientific bodies — psychiatrists,
psychologists, criminologists etc. — to insist that deviant drugtaking comes within the arena of their professional competence. There is a competition, therefore, for government J. R. Gusfield, ‘Social Structure and Moral Reform’, American Journal of Sociology, no. 61, November 1955, p. 223. I02
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funds, for therapeutic power and for public recognition and ~ attention. Their reaction is, of course, underpinned by moral indignation and inimanitarianisin, in terms of their own ‘enlightened’ middle-class values. Law-enforcement agencies often have direct interests in extending their sphere of influence to control hitherto ignored forms of deviant drugtaking. The classic case is the agitation of the Federal Bureau
of Narcotics under Commissioner
Harry Anslinger which led to the prohibition of marihuana use in the United States. Donald Dickson! has revealed the
interests which lay behind the Bureau’s political manoeuvres. Anslinger in 1936 faced a situation where the Bureau’s budgetary appropriation had decreased by almost 26 per cent in four years. The Bureau’s response was to try and “appear more necessary; to, in short, widen its scope of operations. It had previously campaigned successfully for the prohibition of marihuana by State narcotic laws; now it argued that it was necessary to control marihuana on a
Federal level. As a result the Marihuana Tax Act of 1937 was passed and the up till then declining arrest, conviction and seizure statistics of the Bureau soared. In 1938 one out of
every four Federal narcotic convictions was for marihuana violations. Unfortunately for the Bureau its arguments for increased funds were to no avail, for in a few years’ time there
was to be a massive redirection of income for military purpose. But the Marihuana Tax Act can only be fully understood in terms of the bureaucratic interests of the Federal Bureau of Narcotics at that time. The mass media in Western countries are placed in a competitive situation where they must attempt constantly to maintain and extend their circulation. A major component of what is newsworthy is that which arouses public indigna-
tion. Thus the media have an institutionalized need to expose social problems, to act as if they were the personified moral censors of their readership. Direct interests, moral indignation
and humanitarianism blend together inextricably here. 1D, T. Dickson, ‘Bureacracy and Morality: An Organizational Perspective on a Moral Crusade’, Social Problems, no. 16, pp. 143-56, 1968.
103
=>
tc THE DRUGTAKERS =
_
Whatever group initiates the reaction against the drugtaker it is necessary for them to enlist support. Thus groups who have vested interests in drug control are approached _and experts are found to confirm in an academic fashion the opinion of the campaigners. At this point if the power of the 1
supporters is insufficient an appeal is made to public opinion. An attempt is made through the media to change the image of the drugtaker to fit in with the new conceptions. Joseph Gusfield! describes such a successful transition as the moral
passage of a form of deviant behaviour. He cites the case of alcoholism in the United States, where there was a shift in
power from the Temperance Movement, who defined heavy drinking as sinful, to experts in alcoholism who defined it as a sickness. Recourse to media is best exemplified by the Federal Bureau of Narcotic’s generation of public anxiety about marihuana by inspiring and instigating a large number of articles on the subject in magazines and newspapers.” There may well, of course, be opposition to the moral crusade. Vested interests and other experts may oppose the control of the drug in question. For instance, in the case of the Marihuana Tax Act there was opposition from hempgrowers and a number of experts. Marihuana users themselves were, however — at that time — of low socio-economic status and unable to exert any pressure on the legislature. Thus the outcome of an attempt at social control of drug use depends on the relative power and ability to drum up support for the campaign. The Definitions of Reality in which Reaction Occurs The desire to react against the drug user and the manner with which the reaction occurs depends on two interrelated factors: the theory of why people take drugs held by the campaigners, and their perception of the typical drugtaker. Criminologists, following in the tradition of Durkheim, note how all human groups, by virtue of their having norms 1]. R. Gusfield, ‘Moral Passage: The Symbolic Process in Public Designation of Deviance’, Social Prodlems, no. 15,'Autumn 1967, pp. 175-88. 2H. S. Becker, Outsiders, The Free Press, Glencoe, Ill., 1964.
104
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of action and at the same time variation in behaviour, create deviants. There is little point in having rules if you have no rule-breakers; norms occur where there is, at least, a perceived possibility of infraction occurring. Now these deviants perform important functions for groups. They demarcate the boundaries where ‘people like us’ end and ‘people like them’ begin. They inform members of the points beyond which their behaviour will be sanctioned. In small societies it is
possible for everyone to have at least a modicum of face-toface contact with their deviant members. In Tonga, for instance, women will gossip about the sexual incapacity and inconsiderateness of heavy Kava drinkers. But in industrial societies, like Britain and the United States, our direct knowledge of, in this instance, deviant drugtakers will for most of us be limited to the man at work who had to go to hospital for alcoholism. Out there, at what is perceived as the edge of society, there will be a varied assortment of drugtakers with whom the average citizen will have very little, if any, contact: methylated spirit drinkers, heroin addicts, marihuana smokers, methylamphetamine users, glue-sniffers, etc. We will have, as in small societies, deviants within our own circle of acquaintances, but we will also be aware of drugtakers who exist completely beyond the normal realms of our daily intercourse. These individuals, like other minority groups, are the subject of immense misperceptions. On to their ill-perceived and indistinct forms are projected the worse fears and most hidden desires of the ‘normal’ citizen. Although there is invariably a grain of truth in the perception, this is blown up out of proportion into a larger than life fantasy of all the traits that the in-group desires to suppress. The heroin addict is seen as the epitome of enslavement (lack of free will), the marihuana smoker as a pursuer of undeserved yet unspeakable pleasure, the LSD user as a reckless seeker after an extramundane world of enlightenment. The stereotypes held are like negatives, which when developed tell us more about the in-group than the drugtaker himself. It is only in this context that it becomes comprehensible — as we shall see later — that the illicit drug user can be conceived of as more threatening than the organized criminal. 105
‘THE DRUGTAKERS
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The mass media playamajor part in the production of such _ distorted images. For the commercial media, in their attempt
to arouse moral indignation, will accentuate, confirm and irritate the scapegoating process which is part and parcel of large-scale societies. The prejudiced individual will, on his bie part, self-select those newspapers, magazines and programmes which serve to perpetuate his stereotype. Reaction against illicit drugtaking will, therefore, be phrased in terms of particularly biased conceptions of reality. The actual contact between the user of drugs and the community is mediated through special agencies: the police, the social worker, psychiatrists etc. These individuals play a vital part, therefore, in determining the impact of social reaction on the deviant. The more banal of stereotypes are, therefore, although held by large sections of the population, considerably altered by the time that the drug user encounters the main impact of social control. The police are a possible exception to this rule but even the social worker and psychiatrist hold views which are often merely more conceptually refined, rather than cognitively superior, to those of the man in the street. The paradigm used by the expert is more logically consistent, makes recourse to more substantial ‘proof’, contains within it a more explicit humanitarianism than the folk-beliefs held within the wider society. But it upholds the same absolutist presumptions; it is based on an identical ‘taken-for-granted’ world, accepted values and standards current amongst significant sections of the lay population. Whilst the experts may overtly scorn the sensationalist media, they belong in the same universe of discourse, and the élite media of professional journals and learned societies with which they are involved serve to confirm constantly their absolutist premises. Progress is seen to be made: but it is a progress of detail within the matrix of their unchallenged world view rather than the evolution of new and significant interpretations of the social universe.1 It is of considerable importance that we analyse the therapeutic and control strategies of absolutist theory in order to ie
*Cf. T. S. Kuhn, The Structure of Scientific Revolutions, Chicago University Press, 1962. 106
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be able to understand the particular terms of reference of the social reaction against specific drugtakers.
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The Present Solution
The individual, because of problems which he is unable to — resolve via culturally approved ways, adopts illicit drugtaking as a solution. Now the way society, or, to be specific,
significant and powerful groups within society, reacts to this initial deviance determines the nature of the environment within which the drug user must survive. Every solution creates its own problems, and new difficulties arise because of social reaction and contradictions within the emerging culture itself, which must in their turn be solved. It is not a question merely of the forces of social order acting against the drug user and his being buffeted once and for all by this reaction. The relationship between society and the deviant is more complex than this. It is a tightknit interaction process which can most easily be understood in terms of a myriad of changes on the part of both society and the drug user. To take, for example, the relationship between the community and the bohemian marihuana smoker:
(1) A group of young people face a problem of anomie (i.e., their aspirations cannot be realized in a culturally approved manner). (2) They begin, therefore, to evolve a bohemian culture in order to solve their problem. (3) Marihuana smoking is chosen as a vehicle for achieving the ends of this new subculture. (4) Significant groups in the wider community face the problem of controlling undesirable behaviour. That is, behaviour which either threatens their direct interests or offends their moral code. (5) They perceive the bohemian subculture as just such a threat and attempt to solve this problem by, first, creating support through the mass media and personal contact and, then, by pressurizing the police and courts ‘107
aa THE
DRUGTAKERS
into taking action against marihuana use amongst bohemians. (6) The social reaction against the marihuana user creates
new problems for the group. (7) The group adapts and changes in an attempt to solve
these problems. (8) The community reacts against the slightly changed group. (9) This either increases or decreases the problems of the group and they change and adapt once more. (10) The community reacts against the new changes and so on. (I have diagramatized this in Table 3 on p. 109.)
Now one of the most common sequences of events in such a process is what has been termed deviancy amplification, the major exponent of which is the criminologist Leslie Wilkins. This is where the social reaction against the initial deviancy of a group serves to increase this deviance; as a result, social reaction increases even further, the group becomes more deviant, society acts increasingly strongly against it, and a spiral of deviancy amplification occurs! There are four mechanisms by which such a process can come about. The social reaction against the deviant can progressively increase his problems and therefore demand even more deviant solutions than before. Thus, young people may form bohemian
groups because of the meaninglessness and boredom of conventional jobs. After a period of dropout, however, they will find it even more difficult than before to obtain passably interesting work. For their aspirations will have risen and their possibilities declined. They are ‘beatniks’ with bad work records, whom no one will employ. In terms of drug use this increase in anomie may lead to experimentation with drugs other than marihuana in order to solve their rising problems and perhaps eventual escalation to heroin.? Drugtaking is a peculiar form of deviancy, in that the activity itself may make it impossible for the individual to re-enter normal society, it is not merely the social reaction 1See Table 4 on p. 110. 2 See Type A in Table 5, p. 110. 108
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TABLE 3 — The Interaction between Community and Bohemian Group
GROUP OF YOUNG PEOPLE
WIDER COMMUNITY
PROBLEMS
PROBLEM OF CONTROL OF UNDESIRABLE BEHAVIOUR
RA OS i
BOHEMIAN SOLUTION ee
SOCIAL REACTION
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NEW PROBLEMS BECAUSE OF REACTION AND INTERNAL CON= TRADICTIONS
BOHEMIAN CULTURE ADAPTS AND CHANGES
SOCIAL REACTION TO CHANGED
CULTURE
NEW PROBLEMS
ADAPTION AND CHANGE
SOCIAL REACTION
etc,
109
social reaction —>
~ feedback
increased — social reaction
l
TABLE 5
increased deviancy
—Five Types of Deviancy Amplification Spirals
(A) ANOMIE INDUCED
initial problem
drugtaking as a solution social reaction at
illicit drugtaking increase in initial problem positive feedback
increased social reaction
I
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increase in drugtaking
feedback
taking
_ of use of drugs
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increase in
initial problem
(C) REBELLION
INDUCED
initial problem
drugtaking as a solution social reaction at
illicit drugtaking ————_> increase in perceived social injustice
positive feedback
increased social reaction increase in commitment to drugtaking as a symbol of deviant identity
and rebellion
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Possession
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Wootton
Drugs Act 1965
Recommendations*
'
of Drugs Bill
2970 Misuse
Conviction
£25o0/one year
Indictment
{£rooo/ten years
£100/four months unlimited fine/
£400/six months unlimited fine/
Summary
f#1000/ten years
two years
five years
unlimited fine/ two years
unlimited fine/ fourteen years
* Two of the committee members had reservations. P. E. Brodie thought the
indictable sentence too low and ‘suggested five years and/or an unlimited fine and Michael Schofield thought the recommendation too severe, suggesting that illicit possession of less than thirty grammes of cannabis should be a summary offence punishable by a maximum fine of £50, with no possibility of imprisonment; summary conviction with more than thirty grammes for a fine exceeding £100 and/or imprisonment for four months, and indictment reduced to a fine and/or imprisonment not exceeding two years. All of the committee, including Brodie and Schofield, wanted a reduction in penalties.
made under Section 6 of this act. This section was put in as a late amendment and accepted by an unwatchful House of Commons almost without discussion, It should be repealed.t
The reaction to the Wootton Report was immediate, destructive and totally misinformed. A few extracts from the newspapers will convey the extent of alacrity and prejudice resorted to: DANGERS IN THIS CONSPIRACY ofthe DRUGGED (George Gale, Daily Mirror, 28 November 1968). For society to adopt a more permissive attitude towards pot smoking is in fact to open the gates of servitude to countless thousands
(Daily Express editorial, 8 January 1969). PSYCHIATRIST SAYS: IT’S A JUNKIES’ CHARTER (Evening News, 8 January 1969). Lady Wootton’s Committee have a lot to answer for NOW THE DRUGS FLOOD IN (News of the World, 12 January 1969). 1 The Wootton Report, pp. 38-9.
199
“THE DRUGTAKERS RUSSIAN ROULETTE — WITH A FULLY-LOADED WE MUST
REVOLY!
FIGHT DRUGS LoBBY (Daily Express, 13 January :
1969).
3
If there has been pressure it has come from the legalize pot lobby. © : ... The best thing to do with this report is to dump it in the waste- _ 4 paper basket (Daily Sketch, 8 January 1969).
The model which the mass media used to analyse the Report was in a classic absolutist mould: a permissive and powerful minority had pressurized a misguided committee into an unwise decision. A motley collection of experts were interviewed and quoted as opposing the report; dubious figures about escalation, derived from numerous and inapplicable social situations, were generalized to Britain as a
% 3 — _ —
whole, and worse, to a Britain where hashish was freely _
available. Correlation does not, as any first-year sociology student well knows, mean causation. That correlation be-
tween the rise of marihuana smoking and heroin addiction might be the result of complicated relationships directly affected by the illegal status of marihuana was largely ignored. The campaign against the ‘softening’ of the drug laws was immensely successful. ‘The Home Secretary, James Callaghan, speaking in a debate on the Wootton Report in the Commons, took up the model of interpretation which the media had disseminated: The House should recognize that the lobby existed [in favour of legalizing cannabis] and from his reading of the report he thought the committee was overinfluenced by the existence of the lobby. [Cheers] The existence of the lobby was something the House and public opinion should take into account, and be ready to combat, as he was. It was another aspect of the permissive society and he was glad that his decision had enabled the House to call a halt to the
advancing time of permissiveness, The Shadow Home Secretary concurred on this, stating
that the effects of hashish were well known; they were associated with crime, abnormality, poverty and misery all over + The Times Parliamentary Report, 28 January 1969. 200
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the world. A few months later he wrote in the Sunday Express:' “The real vice of the advocates of permissiveness in society, particularly those in the academic world, is their intellectual arrogance; they refuse to acknowledge the value of experience jin assessing the dangers of human weakness and folly.’ The Report was rejected and the combined medical, psychological, police and judicial experience of the committee ignored out of hand. It did not fit the facts as the politicians and the popular press saw them. It was hardly surprising that Lady Wootton, harassed and insulted as she had been, should note later in the House of Lords that: “The causes of the [hysteria] are familiar to students of social
psychology. They occur in other connections as well, particularly in relation to sexual crimes, and they are always liable to recur when the public senses that some critical and
objective study threatens to block an outlet for indulgence in the pleasures of moral indignation.’2 In April 1969 the Release Report was published. It was an analysis of the work done by the underground organization of that name in aiding young people who were being prosecuted for drug offences. It contained allegations of police planting evidence and other malpractices. Michael Schofield contributed an Afterword to the Report. He was dismayed at the unofficial actions which the experienced criminal can counter but which confuse and depress the young drug offender to the extent that he really does not get the justice he deserves. The police station where the messages never get through and the telephone is never free. The policeman who obstructs the search for sureties even after the magistrate has granted bail. The untrue promises of ‘We'll see you off lightly if you tell us what we want to know.’ The one nice and one nasty interrogator, such a common trick that I think it must be part of a policeman’s training. Of course it is to be expected that the police are anxious to make the charge stick once they have taken a man in. But it is an attitude that can be taken too far, especially when it is used to defend rough 173 July 1969. 2 The Times Parliamentary Report, 27 March 1969. 201
Bcxice such as — ‘Well, maybe he hasn’t actually got a dru this time, but we know he’s an addict.”* i
from Release and my own research corroborate, and whic any professional criminologist or practising lawyer in this field would find unremarkable, if unpalatable. The immed reaction, however, was that he was asked to resign both by chairman of the Advisory Committee on Drug Dependence and the chairman of the Subcommittee on Hallucinogens, which had produced the Wootton Report, within which he
had played such an important role. Schofield, who had also 7 been a signatory to the famous adverieeiien (a in The Times? — calling for a radical change in the marihuana laws, obviously — fitted the ‘pro-pot lobby’ model and was regarded as a
dangerous influence on the Advisory Committee.
For-
tunately, after exclusion from at least two meetings he was — once again allowed to participate in the Committee’s work.3 — This case well illustrates how political parameters delimit the — possible universe of discourse for what purport to be openended scientific debates. The possible legalization of marihuana, the innocuousness of its effects, and criticism of unofficial police practices, are three areas which are only to be |
entered into with caution and in which diffident and ambi-
_ __
guous pronouncements are mandatory, preferably hedged in with a call for the need for further research and a note on the dangers of relaxing control. ; The Misuse of Drugs Bill introduced to the Commons in March 1970 was the direct expression of the absolutist model which dominates the thinking of British politicians on drugs. It was the final dismissal of the Wootton Report’s recommendations. It is useful to tie the various items of this model to their manifestation in the legislation controlling marihuana use. The pusher is seen as the corruptor of the innocent youth, and in this light the maximum sentence is increased to an
aaa
1C, Coon and R. Harris, The Release Report on Drug Offenders and the Law, Sphere, London, 1969. 2 Monday, 24 July 1967. 3 Daily Telegraph, 30 May and 19 July 1969. 202
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unlimited fine and/or a fourteen-year jail sentence. (The - Wootton Report would have reduced the maximum gaol _ sentence to two years.) For the first time a sharp legal distinction is made between possession for use and possession for sale. The user, seen as a misled victim, is treated more lightly. Thus the maximum jail sentence is reduced from a year to six months, although the maximum fine is raised from £250 to £400. (The Wootton Report would have reduced the maximum fine to £100, and the jail sentence — only to be used in exceptional circumstances — to four months.) By this means, possession is by no means seen as a mere ‘technical offence’, permissiveness is avoided, and the ‘pro-pot lobby’ strongly opposed. Marihuana is, however, removed from the same — legal category as heroin, although by some curious logic LSD is now included with the opiates! The powers of search and arrest remain unchanged. (The Wootton Report’s uncertainties about police powers are thus completely ignored.) The press reaction to the Bill was summed up by the Daily Mirror editorial: DRUGS: THE REAL CRIMINALS The drug pusher — the contemptible creature who peddles poison for profit — deserves no mercy from the law. The criminal who sets out to hook young people on drugs deserves far more implacable retribution than the victims of the evil. Home Secretary Jim Callaghan recognizes this in his new Misuse of Drugs Bill... Some penalties for possession of drugs will go down. Others will be increased. Possession will still remain a serious offence. But the thinking behind this Bill will command approval from everyone who has given serious thought to the drug menace. There is no permissiveness about it, There IS understanding and justice. Mr Callaghan has stood firm against all the pressures to legalize use of the so-called ‘soft’ drugs. He has refused to ease the law against drugtaking in any form. The argument that ‘soft’ drugs can lead on to the killing ‘hard’ drugs has been given full weight — and parents as well as medical experts on addiction will applaud this realism, It is tough legislation.
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It can be effective legislation because it sharpens the vitaldis-= tinction between the trafficker and his victim. ie This is a valid twentieth-century diagnosis for an agonizing —
twentieth-century problem.+
e
Stirring rhetoric; the absolutist case defended in a nutshell; but it has little if anything to do with the empirical reality of — drug use in Britain, and its effects are likely to be unfortunate — in the extreme.” Possible Future Trends
If the use of marihuana continues to increase at the present rate it is likely that courts, if not the law, will come increasingly to regard possession as a mere technical offence and impose only small inconsequential fines. Its most active aficionados are middle-class youth, and courts have always been most reluctant to stigmatize their more privileged children. Moreover, it is well on the way to becoming a trendy, if rather shady, indulgence of people in the liberal professions. How will this affect the hippies in bohemian areas such as Notting Hill? If my thesis is correct, their position will only be marginally ameliorated. For it is not drugs per se, but hedonistic cultures which society reacts against. Marihuana has been a perfect weapon, suspicion of use justifying harassment and arrest, and signifying disturbed personalities. But the deviancy amplification of hippies is only historically tied to marihuana use. Reaction would still proceed even if the drug was legalized overnight. In the meantime, the hippie is more likely to be apprehended for marihuana offences than his working fellow smoker. He is more open in his use of the drug, he fits the stereotype of the ‘serious’ marihuana user, it is a useful offence to prosecute him on when he is causing a disturbance to neighbours or landlords, and, underlying it all, there are the
fundamental conflicts which exist between him and the community. 112 March 1970. ?I consider the various myths evolved by the mass media to depict deviants elsewhere; see Media as Myth (forthcoming).
204
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SOCIAL POLICY AND THE DRUGTAKER Moreover, for those hippies who have become full-time dealers in marihuana, arrest will mean even more severe sentences than previously. This slackening of police vigilance on marihuana in general will not necessarily benefit the bohemian community a great deal. Deviancy amplification will still operate and social injustice be experienced on a considerable scale. Other groups, especially immigrants, will also feel the brunt of such selective reactions against marihuana use. Simon Jenkins, in an astute analysis of racial unrest in Notting Hill, explains the widespread resentment against the police as follows: The area is so riddled with drugs, everyone is involved — the police, the black community, everyone, It is a small wonder the police role is reduced to attempting to control drug use rather than stamp it out. And this control has led to its own frictions and demarcation disputes, As far as the local police are concerned, they feel they are judged on their ability to operate the drug laws however inoperable such laws may be. The frustration this entails only exaggerates the already great difficulties of maintaining law and order in such depressed areas as Notting Hill. The police are undermanned and often undertrained. And in this demoralized situation it is understandable that they should pick on the most easily definable minority group as culprits for their job being a hard one.4
The British System The British system of treating opiate addicts was until recently disarmingly simple. Addiction was regarded as a
medical, not a-criminal, problem and doctors were empowered to supply heroin or morphine to addicts. The doctor was under a professional obligation to attempt a cure, but there was no close surveillance of his practice. Limited provisions for withdrawal were available in hospitals, but there were no powers of compulsion to enter or remain during the course of treatment. Heroin and morphine were, of course, available 1*An Open Letter to Mr Maudling’, Evening Standard, 18 August 1970.
205
| Bees of 1926 which stated that oe drugs were no be given for the ‘gratification of addiction’, they cou
properly administered if part of a gradual withdrawal pro-| gramme or where it had been ‘demonstrated after prolonged ©
attempt at cure’, that the drug could not be safely discontinued, or
if ‘the patient, while capable of leading a useful and rela- —
tively normal life when a certain minimum dose is regularly — administered, becomes incapable of this when the drug is — entirely discontinued’. This is a near perfect example of an absolutist model of deviancy, underscored as it is by abeyance to the ethos of productivity. Heroin use for pleasure was not to be condoned, but where it was part of an incurable sickness or necessary to maintain the patient at work it would be allowed. This model in fact corresponded reasonably accurately to a large proportion of the known British addicts priorto the early sixties. Therapeutic and professional addicts, in particular, do conceive of themselves as having a sickness, do collaborate willingly with their doctors, often continue at work although still addicted, and are ambivalent if not negative towards opiate use for purely pleasurable ends. The British system, moreover, received a great deal of praise from world experts. Legal heroin was seen as a means of avoidinga black market. The absence of an illicit market would take the backbone out of any possible addict subcultures and minimize proselytization. It would further eliminate the crime associated with expensive black market heroin, as the addict could obtain his supplies inexpensively without resort to illicit
means. But this model and the conjectures surrounding it were valid only for a time. For the emergence of a new brand of addict in the early sixties exploited and finally caused its transformation. For he was part of a subculture which was more unashamedly hedonistic. Being less likely to view himself in a sick role, he often recommended and actively spread heroin use to others. The small number of doctors who were willing to deal with what the profession usually regarded as the unpleasant and tedious business of treating junkies were 206
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- totally unprepared for these new style addicts. For they
“¢~ wheedled, cheated and extorted excess heroin from their
© physicians. The motive behind their sale of surplus was to :- supplement unemployment benefits and maintain a style of life without work, concomitant with the values of the subculture. Thus the British system broke down because the type _ of addict it had to deal with changed remarkably. The drug __ subculture was not necessarily a function of a black market, although the latter is transformed and intensified when heroin is illegal. Absolutist theory failed because it could only imagine organization amongst addicts as a product of the need for drugs. Heroin users being depicted as psychopaths could only evolve minimal social norms and regulation of their behaviour. The actual sequence of events belied this cruelly, for heroin dependency spread rapidly, concomitant with the rise of a junkie subculture, despite the fact that the blackmarket remained throughout only peripheral to the British drug scene. In the face of the radical changes in heroin use, the model of analysis had to be considerably revamped, although the underlying absolutist premises remained.? The sick designation was unaltered, but the sickness was portrayed as wildly infectious. The heroin user was cast as the passive victim of an
insidious plague. The metaphor removed all active human agency from the process; the subculture itself being seen as an epidemic, not a social group with norms and values and proselytizing powers. Because of this the pusher could not be easily depicted, at least by enlightened opinion, as the corruptor. He himself, as likely as not, was an addict and gained 1 The classic statement on this position is the description of the retreatist subculture in Delinquency and Opportunity by R. Cloward and R. Ohlin (The Free Press, Glencoe, Ill., 1960). American advocates of the British system believed that its avoidance of a black market minimized the danger of an addict subculture (and therefore proselytization) occurring. See E. Schur, Crimes Without Victims, Prentice-Hall, New Jersey, 1965, pp. 144-5; A. Lindesmith, The Addict and the Law, Vintage Books, New York, 1965, p. 169. 21 consider the various models of heroin addiction and their corresponding notions of ‘the cure’ elsewhere. See ‘Images of Addiction andIts Cure’, in Drug Abuse (ed.), J. Ford, Harper 8& Row, 1971.
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‘immunity from the sick role he was seen as occupying. Br scapegoating was not impossible, for in the face of rising addiction rates the doctors who released the ‘germs’ on their — patients were fixed upon as the villains of the piece. Over-
prescription, or Petroism as it became known, was seen as the ‘Be — cause of the problem. Now, there is little doubt that some * doctors who were willing to treat heroin addicts acted irres-_
ponsibly. But it makes more sense to see themas unprepared for _ the new addict, and overworked by the increase in addiction, — than as malicious agents. They were cajoled into providing_ for an existing demand rather than the primary cause of this — demand. But the denial of both the existence of a proselytizing subculture and the active pursuit of heroin by the — non-addicted made such insights impossible. The passive — deviant of absolutist theory must be seen at all times as more sinned against than sinning, and the junkie doctor admirably fitted the corruptor role which the press and interest groups demanded. The Interdepartmental Committee on Drug Addicsiag recommended in 1965 that, although addicts were still to be treated as sick people and not criminals, treatment was no longer to be carried out by general practitioners but by doctors in special treatment centres. Only these doctors would have the right to prescribe heroin and cocaine. Moreover, they suggested that treatment centres should have powers to detain addicts compulsorily. The Dangerous Drugs Act 1967 implemented these suggestions with the exception of compulsory detention. In 1970 the Misuse of Drugs Bill tightened the control over doctors who became liable to a maximum of fourteen-year jail sentences for wilful overprescribing of dangerous drugs. The corruptor part of the model thus eventually received strong legal underpinning. The Treatment Centres instituted in 1968 a much more cautious and restrictive programme of heroin dispensing. To this extent they have eliminated the problems associated with overprescription; that is, the development of a proselytizing grey market of surplus heroin. But when illicit heroin supplies
are available, and this at the moment is infrequent, a blackmarket quickly springs up to replace it. Moreover, the 208
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displacement of drug use to other more readily available drugs
(described in Chapter 9) occurs repeatedly. In addition, the limited aftercare available, plus the restricted and, in my view, falsely based cure programmes in operation, do not, in the long run, add up to anything but interim measures ill-designed — _ to tackle the problem of heroin dependency. The future of heroin control in Britain may well involve
further implementation of the epidemic metaphor in the form of the compulsory treatment of addicts. Powerful bodies of opinion are intent on the realization of this policy. A recent report of the Magistrates’ Association is illustrative: We recognize that drug dependence is an illness requiring treatment. It is a contagious illness, from which society needs protection. ‘There is existing legislation providing for the compulsory removal to hospital of persons suffering from smallpox and other notifiable diseases for the protection of others, (Public Health Act 1936, ss. 169 and 170.)
Similar compulsory powers for removal to hospital exist under the Mental Health Act 1959 in the case of persons suffering from mental disorder, and under section 47 of the National Assistance Act 1948 where persons are unable to look after themselves. Hence compulsory powers already exist for the treatment of contagious, mental and other illnesses, and there appears to be no ethical reason why the illness of drug dependence should not be treated compulsorily. We feel that in many cases compulsion is necessary, particularly to support the patient when his motivation for cure vacillates. Accordingly we urge the establishment of centres for the treatment of drug dependence having a secure perimeter and a liberal hospital regime within this perimeter. The security should be such as to prevent absconding and the smuggling of drugs into the centre.
The dangers of such a policy cannot be exaggerated. It could result in nothing but an intensification of the problem. Compulsory incarceration gives rise either to the institutionalized addict who willingly and often irremediably adopts the 1 Fiftieth Annual Report of The Magistrates’ Association
1969-2970,
PP- 43-4-
209
Bie role, or to a process of deviancy ‘enpliieaiea on intense feelings of social injustice. Its ethics are ba the disease analogy, which is false; it ignores completely more vital problem of aftercare, of the return back to th problems which instigate the dependency. Finally, it has been § tried systematically and variedly in the United States where i : rR pe soul and manifestly failed.
: ;
Sa willconclude with a series of ten rules derived from discussion within this book, and, in my opinion, delineating
the path by which a sane and just drugs policy may be
reached.
= 1, 7*ee
Combat Absolutist Dogma
_ [have suggested that the notion of a science of society or the_ human psyche, based on an unthinking parallel to the natural sciences, is both empirically unfounded and morally dangerous. The absolutist scientist, by ignoring problems of human — value, has unwittingly seated a powerful weapon of group — conflict. To punish a man because he threatens your interests or offends your morality makes no bones about the configura-
tion of power and the existence of conflict. But to treat him because he is ‘objectively’ ill is to denude his deviancy of any meaning; it is to mystify conflict and conceal the mainsprings © of power. Objectivity in the social world is only conceivable — where there is a consensus of value. Such agreements are unknown and perhaps impossible. There are always individuals somewhere who cast doubts on the taken-for-granted reality of their fellows. But it is towards the maintenance of an unquestioned reality that much social science is committed. 54 There are, of course, rational and consistent reasons for these attempts to define reality in mundane and workaday terms. This progressive disenchantment of the world is a function of the myopia of the social scientist and the human requirements of the system. Liam Hudson! has ably sketched a portrait of the scientific psyche as comparatively unemotional, puri*L. Hudson, 2r0
Contrary Imaginations,
Methuen, London,
1966.
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__ tanical, closed-minded, and suspicious of complexity inhuman _ _ relationships. His ‘convergent’ mind is probably a defence; he _
_ is able ‘to turn his back on all those human issues which upset _ him’, ‘thinking’ is compartmentalized from ‘feeling’, just as social facts are supposed to be kept separate from human — values.' T. S. Kuhn has hinted at the structural reasons for _ this: ‘normal science’ is based on unquestioning acceptance of particular paradigms of reality. It is only at revolutionary
epochs in science that the perspectives themselves are questioned; elsewhere, hypotheses derived from theories are tested but never the basic axioms themselves. This has led to
‘a narrow and rigid education, probably more so than any other except perhaps orthodox theology’.? The young scientist who questions everything and totally distrusts authority may stand at a crippling disadvantage in career terms. This blinkered approach has been magnificently successful in the physical sciences, and, although it has the disfunction of impairing fundamental creativity, this is not our concern here. What is, is scientism: the pretence at absolute objectivity, the masquerade of consensus, which occurs when such principles are applied to study of human behaviour and social reality.
2. View Drug Use Holistically
The study of drugs must have as a base human individuals studied as whole men, not the sum of the various ‘levels’: physiological, psychological, and social. This additive
approach is a function of the narrow division of labour of absolutist science. Rather, we must view physical man as made social by his existence in society, his consciousness created by social reality yet at the same time creating society.
All levels interpenetrate and make sense only in the context of
each other. The dialectic which occurs, for instance, between physiological and social levels makes nonsense of generalizations about drugs made im vacuo ignoring how cultural
11, Hudson, Contrary Imaginations, Methuen, London, 1966, P. 104. 2 The Structure of Scientific Revolutions, second edition, Chicago University Press, 1970, p. 166. 211
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differences mediate and transform both the meaning : reality of these effects. Laboratory experimentation and use of animal subjects have only a limited, if necessary, part t play in the study of psychotropic substances. They can pro‘
- duce contributory data but they can never provide explans e tions of human behaviour. At the same time as looking at the total man, we must be aware of the interrelationship of the various parts of the social _ universe. For instance, legal action taken to suppress a particular item of behaviour will have repercussions in other — parts of the system, on other items of behaviour, which at first are seemingly unconnected. I have argued that intense police action against the marihuana smoker will have unforeseen repercussions on heroin addicts and within the criminal underworld. Like the ecologist tracing complex food chains and the possible effects of human intervention, we must tread warily, knowing exactly what goals we wish to achieve, choosing
appropriate means to realize them, and eliminating unintended consequences. To do this will require analysis of the culture as a whole, and may uncover vested interests which militate against change in drug laws. For instance, American Government investigations in France are reported to have uncovered links between powerful regional government officials and the Marseilles heroin-traffickers. Making heroin illegal creates a most lucrative black market which has the widespread effect of encouraging the corruption of police and politicians. This, in turn, has the unintended consequence of very effectively shielding trafficking from the intrusion of control agencies. The campaign against psychotropic drugs carried out under the auspices of the United Nations is, despite the medical and scholarly language used in its pronouncements, typically underscored by distinctly political considerations. A major
force in the formulation and implementation of policy is the United States. For example, in order to restrict the supply of heroin entering the United States from Mexico the White
House task force, set up under the Nixon administration, put considerable economic pressure on the recalcitrant Mexican Government. Operation Intercept dictated that every car 212
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after 21 September 1969 crossing the American border from . Mexico should be searched. Within hours there was chaos, with cars waiting up to six hours. Within weeks unemployment in Mexican border towns dependent upon American tourism was running well over 50 per cent. Damaged economically, the Mexican Government sued for peace. On 10
October Operation Intercept became Operation Co-operation.4 Similar political and economic pressures have recently occurred against Turkey (an opium producer) and Lebanon (a marihuana grower). The structure of the world drug market — is at one level affected by the ploys of international politics. The rise in amphetamine use in Montreal and the degree of
organization of the marihuana market in Britain are probably repercussions of political decisions taken in the United States, which resulted in a reduction of the supply of grass into North America. The subjective effects experienced, the degree of psychosis, mortality and organization, the cultural standards of drug-using groups, can be radically altered by highlevel political decisions. To understand the drugtaker in the street, to explain his behaviour, we must trace lines of causation which involve factors immediately relevant to his social position: job opportunities, accessibility of drugs, social attitudes to subterranean values, etc. We must also understand how this array of immediate factors come about. Both to explain drugtaking and to suggest methods of implementing changes in drug use leads us to a consideration of the total political and social context in which the consumption of drugs occurs. The absolutist, by considering the drug user as an isolated pathological atom, and, proceeding further, splitting this atom into discrete levels for analysis, utilizes a model which, however useful it is in maintaining unquestioned the status quo, is heuristically unsatisfactory in the extreme.
3. Avoid Designating Behaviour as Sickness I have argued that to designate drug dependency as a sickness will, especially in those instances where psychiatric institutions have considerable power and prestige, result inevitably 1 Sunday Times, 27 September 1970.
213
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mented in a manner which removes decision from the ir mates, and by clinical definitions of addiction as ‘a disease
with a pronounced tendency to relapse’. It is no accident t the
most
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involved demanding that the addict regard himself as a — responsible individual who chooses to stay off drugs, and — which provide relevant and plausible solutions to the prob- | lems which led to addiction in the first place. Synanon and the Black Muslim treatment programme are cases in point.! Here again, we see how the interpretations that social scien- _ tists make of behaviour have unintended consequences on the subjects themselves. What absolutism sees as a confirmation © of its theories is, thus, merely its product. That is not to say, — _ then, that behaviour akin to physical sickness does not occur; only that it need only be temporary and is understandablein _ terms of human motivation. Nor that the identity of an addict _ does not in some circumstances appear pathological; only that this is not his inalterable essence. : Tt should not be thought that changes in treatment methods __ will be accomplished without considerable resistance. As in the field of mental illness, professional competence and previous investments in career and specialized knowledge are _ severely threatened when the dominant psychiatric ideology
comes under attack. Nor, even if the profession were willing to make radical changes, would their course be an easy one. Because the sick deviant is a neutralized entity, the reconceptualization of him as a free agent, motivated by meaning_ ful social pressures and capable of choosing or repudiating addiction as a solution to his problems, defuses strategic patterns of social control just as it often supports solutions less tolerable to the population than addiction itself. Here again,
_
we are not faced with a scholarly debate which can be solved merely by rational argument and recourse to appropriate empirical evidence. The existing structures which control 1 I discuss these treatment programmes in detail in ‘Images of Addiction and Its Cure’, in Drug Abuse (ed.) J. Ford, Harper & Row, 1971.
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_ drug use relate to society as a whole. They can only be changed by an analysis which embraces the total culture, and _ action which candidly assesses the configuration of bas interests, both moral and material. 4. Avoid Scapegoating
Current models of behaviour not only offer explanations of deviancy; they also serve as social control mechanisms. I have argued that to ascribe unwelcome behaviour to personal sickness or inadequacy subtly removes all authenticity of meaning from such actions. As such it can be said that deviancy never freely occurs; like chickenpox it is caught, or like mental deficiency it is merely an absence of normal attributes. But the drawback to this model is that it does not explain where the ‘germ’ of deviancy arises, or why personal inadequacy leads to
one form of deviant behaviour rather than another. To do this would demand that the deviant chooses or creates his miscreant path. And such an admission would severely flaw the major thrust of the model. It is for this reason that scapegoating is an almost universal concomitant of the absolutist portrait of deviancy. It is the corruptor, who infects or sways the weak minded, who is to blame for deviancy. And it is against him that the full wrath of the law is aimed. This analysis would argue that such rage against the ‘drug pusher’ or the §unkie doctor’ is misconceived, irrelevant and often sadly unjust. 5. Avoid Deviancy Amplification
The basic premise for control is Wilkin’s stipulation that ‘a society can control effectively only those who perceive themselves to be members of it’. That is, we must do all in our
power to retard the formation of processes of deviancy amplification. As it is, by isolating, alienating and exacerbating the social circumstances of the drugtaker we contribute significantly to the criminality, psychosis and physical injury associated with drug use. The antagonism is directed invariably at socially vulnerable groups. Troy Duster has brought 215
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this out well in his fascinating history of opiate use in United States:
Certain social categories lend themselves more to moral condemnation than others. Whereas the lower and working classes had the
overwhelming majority of known addicts, Whereas blacks were — less than 10 per cent of the addict population in 1900, they arenow more than half of the addicts known to law enforcement agencies. _ Whereas there were formerly more women than men addicted, the ratio is now at least seven to one for men. Whereas the middle- _ aged predominated in 1900, youth is now far and away the most 4 likely of known offenders. The list could go on, but the point is simply that middle America’s moral hostility comes faster and easier when directed toward a young, lower-class Negro male, than toward a middle-aged, middle-class white female.t
The middle-class white American addict was regarded as a medical problem; the lower-class black addict an object of unbelievable hostility. The sense of social injustice arising from such victimization is immense. The Canadian Le Dain Committee grasped this when they wrote: The harm caused by a conviction for simple possession appears to be out of all proportion to any good it is likely to achieve in relation to the phenomenon of non-medical drug use. Because of the nature of the phenomenon involved, it is bound to impinge more heavily on the young than on other segments of the population. Moreover, it is bound to blight the life of some of the most promising of the country’s young. Once again there is the accumulating social cost of a profound sense of injustice, not only at being the unlucky one whom the authorities have decided to prosecute, but at having to pay such an enormous price for conduct which does not seem to concern anyone but oneself.2
To ameliorate deviancy amplification it would be necessary
to educate both the general public and the personnel manning the agencies of social control. Policemen, social workers and *'T. Duster, The Legislation of Morality, The Free Press, New York, 1970, pp. 20-21. 2 Le Dain Report, p. 520. 216
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‘magistrates would have to drastically revise their stereotypes. Social agencies would have to be constantly aware of the unintended consequences of their actions and the underlying conflict mediating their relationships with drug-using — cultures. Especially important, here, is an awareness of the role of the press in fanning up moral panics. The educational system is the other major channel for the organized dissemination of information. It is of the utmost priority that it should form a critical counterbalance to the aggressive distortions _ that the mass media abound in.
6. Restrict Legislation
To call for restraint in implementation of the drugs laws is not sufficient. The laws themselves have proved damaging and unworkable. Troy Duster makes his central thesis in The Legislation of Morality the contention that to legislate against victimless acts, carried out privately and willingly, is fruitless: Drug use is engaged in privately, not publicly, and there is no party to the act who has an interest in being the plaintiff. For these reasons, the law will not be effective in bringing about a change in the behaviour or morality of the law violators, Thus, millions of dollars are spent in a fruitless attempt to stamp out the problem, that could better be used upon some constructive program. At the very least, the negative gain would involve the elimination of the pursuit of an impossible task.t
The Canadian Royal Commission would seem to concur on the question of cost: ‘We intend during the ensuing year to attempt to determine the relative cost in actual dollars and allocations of time of the enforcement of the drug laws, but it is our initial impression from our observations so far that it is out of all proportion to the relative effectiveness of the law.’ Worse than this, the legislation against private drug use creates a black market, increases drug prices and adulteration, and 1T. Duster, op. cit., p. 244. 2 Le Dain Report, p. 518.
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invites criminal involvement. Edwin Schur, in his stu ‘crimes without victims’, puts this position clearly: Itis widely recognized by disinterested students of crime fl whatever drastic methods are employed, law enforcement ffs
place the illicit supplier in a particularly strong economic posted Law Professor Herbert Packer has suggestively referred to a kind _ of ‘crime tariff’ that goes into operation in such situations. He points _ out that ‘Regardless of what we think we are trying to do, if we make it illegal to traffic in commodities for which there is an inelastic demand, the actual effect is to secure a kind of monopal profit to the entrepreneur who is willing to break the law.’ While the various kinds of illicit traffic may vary considerably in degree of organization and monopolistic concentration, at the very least, as _ economist Thomas Schelling notes, ‘any successful black marketeer — enjoys a “protected” market in the same way that a domestic — _industry is protected by a tariff, or butter by a law against margarine, — The black marketeer gets automatic protection, through the law itself, from all competitors unwilling to pursue a criminal career. — The laws give a kind of franchise to those who are willing to break _ the law.”
The problem in a nutshell is that if there is a strong demand for an illicit activity, then legislation, far from removing that — demand, will merely pervert and distort it. & Advocates of the strict legal control of supplies have to © contend not only with illicit importers springing up and the displacement of drug use to other, sometimes more damaging drugs. They also have to reckon with illicit manufacture. For advances in chemical synthesis, together with the spread in chemical know-how, have made their task impossible. As the
control of the means of production of advanced psychotropic agents become increasingly diffuse, the law will be reduced to the position of sniping in a desultory fashion at obvious scapegoats. Control, let alone elimination, will become a eee impossibility. 1 Our Criminal Society, Prentice-Hall, New Jersey, a Pp. 199. 218
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_ This is not to suggest that some legislation cannot usefully protect the consumer; merely that laws cannot direct or stamp out consumer demand or illicit supply. Like it or not, we live -inasociety which makes extensive and repeated use of psychotropic drugs. Effective controls must be instituted if we are to
avoid a vast amount of unnecessary misery and hardship. 7. Maintain Cultures
Subcultures which involve drugtaking have often a body of stipulations and controls as to the use of particular drugs. They have also a system of values which judges the effects of a particular drug as being either good or bad. Research on drinking behaviour has shown that heavy pathological drinking is associated with backgrounds which have an absenceof directives for the act of drinking alcohol. That is, those groups who have a finely spun code of when to drink and when not to drink produce ‘social drinkers’, and those which have no directives tend to produce alcoholics. It is vital to enmesh the taking of any drug in a system of norms and controls, if deleterious effects are to be avoided. The call for sexual abstinence is pathetically ineffective in controlling illegitimate births and venereal diseases. Only contraceptive knowledge and hygiene is workable. Similarly, to control the amount, type and administration of drugs needs sound knowledge accumulated over time. With this in mind, it is strongly disfunctional to harass and undermine existing drug subcultures. The example of Holland should be followed, where underground clubs (e.g., Fantasio and Paradiso) are allowed to exist comparatively unhindered by the police despite the fact that marihuana is smoked regularly and openly. Likewise, in the cure of addiction or the treatment for bad trips, non-professional people from the respective subcultures are often more successful than medical men whose values are alien, and knowledge extensive yet sadly inapplicable. The appropriate role of the doctor here should be parallel to that of the 1 See E. Mizruchi and R. Perucci, ‘Norm Qualities and Differential Effects of Deviant Behaviour’, American Sociological Review, no. 27,
1962, Pp. 391-9. 219
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8. Positive Propaganda
The majority of information fed to the public as to the nature and effects of psychotropic drugs is misleading and inaccurate. —
This results in widespread scepticism. Thus the Ke Dain = Report notes: q
Wehave been told repeatedly that many young peoplewereinitially deterred from experimenting with cannabis by reports of the dangers of drugs. However, from the personal experience of friends _ many soon learnt that some of these accounts were exaggerated. Asa _ result, the credibility of much of the literature critical of the drug — experience was lost, and with it much of the credibility of tradi-— tional authority figures such as teachers, parents, physicians and the _
police. On the one hand, the neophyte to the subculture soon learns to be cynical of outside information, on the other, the _ solitary drug user is particularly prone to such misinformation. As William Braden, reporter with the Chicago SunTimes, suggests:
— — _ —
Just suppose. Here all of a sudden is this Greek chorus of doctors and psychiatrists warning young peopleto avoid LSD: it might drive them crazy. And the warnings are dutifully passed on by the press. This doesn’t stop the young people from taking LSD, of course; but it could possibly create a subliminal anxiety that results in either a bad trip or in a panic reaction at some later date. Since LSD subjects are so highly suggestible, as is well known, it could be that they oblige the doctors and the press by doing exactly what they were told they would do, They flip out.
;
A recent anti-drug poster, showing a padded cell complete
with a straitjacket and the caption ‘LSD is a terrifyingly 1 Le Dain Report, p. 311.
2“°LSD and the Press’, in Psychedelics, (ed.) B. Aaronson and H. Osmond, Doubleday, New York, 1970, p. 410. 220
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_ dangerous hallucinogenic drug’, and ‘LSD can take you places _ you never dreamt of’, is pernicious. As is the headline: ‘LSD induces urge to kill, report says.’ The myths about drugs are not their reality but, especially where the user is not part of a _ strongly based subculture, they can profoundly shape and alter the drug experience. Given that the present legislation
against the use of drugs, combined with widespread police action against drugtakers, have failed to to curb the extent of drugtaking, it would seem to be advisable that authoritative facts about the effects of drugs be fed into the drug subculture itself. For it is the subculture of drugtaking which has the only viable authority to control the activity of its members. Moreover, developments have already begun in this direction: witness the campaign waged against the use of amphetamines, especially methedrine, by the underground newspaper International Times, and the information organization BIT. There is an element of self-regulation and control occurring within groups of drugtakers themselves and this is compounded of thousands of individual experiments with drugs. I am not arguing that this body of knowledge is superior to that of the outside world in all aspects, but that, however unscientific this knowledge is in parts, it at least has the benefit of being based on first-hand experience. What is necessary is that this knowledge is supplemented and corrected where necessary by authoritative outside sources. You cannot control an activity merely by shouting out that it is forbidden; you must base your measures on facts, and these facts must come from soutces that are valued by the people you wish to influence. Moreover, information aimed at controlling drug use must
be phrased in terms of the values of the subculture, not in terms of the values of the outside world. It is useless to try to forbid marihuana by pointing out cases where it led to young people becoming beatniks and being permanently out of work. A culture which disdains work, which values hedonism
and expressivity, would be little impressed with this: on the other hand, to indicate that heroin addiction leads to an existence where human relationships become secondary to the daily fix, where mobility is impaired, where constant increase in dosage is necessary to combat tolerance and maintain 221
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_ pleasure, would inhibit any tendency ieee e _ the marihuana smoker because it would indicate°
‘is really like — a hang-up in terms of the smokers’ o and argot. Authoritative information must not be based on a conceptions of values — it must relate to the values and aspirations of the individuals concerned. It must take account the extent to which drug effects are shaped by so situation, and this in turn by the existing system of control. In the last analysis, the most fundamental criterion drug abuse is health risk. This is not to suggest that ind
viduals should be forced to avoid actions which endanger th lives. Merely that they should be aware of the consequence: their actions. I am in complete agreement with J. S. Mill’s dictum here. Namely that: ‘the only purpose for which power _ can be rightly exercised over any member of a civilized community against his will is to prevent harm to others. His own” good, either physical or moral, is not sufficient warrant.’ Such — a statement, however, does not reckon with the moral indignation of the temperate and virtuous. I have argued that such — moral crusades must be strongly resisted, as must the pseudo-— humanitarianism which inevitably accompanies them. We must learn to live with psychotropic drug use; it is only by — treating citizens as responsible human beings that any sane and long-lasting control can be achieved. The hypocrisy of the existing system of control is a major = obstacle to the creation of a workable public policy. How can _ one condemn marihuana use, with its non-existent mortality — rate, and cash in, through taxes, on tobacco which kills 250 — people a day? Extensive education is needed but this must be based on a sense of priority. It is morally offensive that the — tobacco companies should be allowed to foster, through vast —
1 At the moment, Young’s Law of Information on Psychotropic : Drugs would seem to be in operation. Namely, that the greater the — public health risk (measured in number of mortalities) of a psychotropic ; substance, the /ess the amount of information (including advertising) in the mass media critical of its effects. Tobacco, alcohol, the barbiturates,
amphetamines, heroin, LSD and marihuana (listed in declining public health risk) would all seem to fit this proportion (apart from those — exceptional, and short-lived, occasions when health report scares cocci) 222
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z‘expenditure on advertising, the taken-for-granted innocuous- _ ness of its products. Any educational programme must be _ based on a wide front to include all psychotropic drugs, and _ tobacco, alcohol and the barbiturates must necessarily, because __ of their prominent health risk, be its major targets.
oe
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9. Examination of Motives
_ The Le Dain Report displayed remarkable insight into the _ world of illicit drug use: _
Young people speak often of a desire to overcome the division of life into work and play, to achieve a way of life that is less divided, less seemingly schizophrenic, and more unified. They seem to be talking about the increasingly rare privilege of work that one can fully enjoy — of work that is like one’s play. They claim to be pre-
pared to make considerable remuneration or sacrifice of traditional satisfactions like status and material success for work in which they can take pleasure. Indeed, one of their frequent condemnations of the older generation is that it does not seem to enjoy its work, that it does not seem to be happy. This is said sadly, even sympathetically. It is not said contemptuously. The young say, in effect, ‘why should we repeat this pattern.’ The use of drugs for many is part of a largely hedonistic life style in which happiness and pleasure are taken as self-evident valid goals of human life.’
Our society places individuals in a peculiar double bind where work is sacrosanct yet alienating, and leisure is precious, yet, if pursued seriously, non-respectable. We create a bifurcation where both spheres of life are underlined by anxiety and guilt. Parallel to this is a high valuation of insight and religious experience on the one hand, and an insistence on workaday realism on the other. But if insight questions reality it becomes disturbing. Fleetingly, then, we cross the barriers into play, and sometimes into mystic experience, through the
use of psychotropic agents. Undiluted hedonism and the psychedelic experience simultaneously fascinate and repel the guardians of the taken-for-granted world.It is the use of drugs to achieve these illicit goals, by individuals who overtly 1 Le Dain Report, p. 343.
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embrace edetgsae and/or peyheii values used to close up all discussion on the subject. Ifit were h alone
that were the major concern,
many
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agents would be legal and research would be directed at the _ production of safe and useable drugs. a We must therefore open up the debate by insisting onthe . freedom of the individual to pursue goals which do not _ directly harm the welfare of others. The roots of moral indi
nation must be publicly examined and understood. The vested interests of powerful groups and control agencies must be ~ systematically exposed. Only then can we be said to be ‘ = =e the drug problem’ in any realistic sense of the phrase, : 10. Structural Change
The natural history of drug use leads inevitably topale politics3 of experience. Social control is not a given constant in analysis — a fixed and unquestioned reaction; both deviancy _ and the reactions against it must be examined thoroughly and their causes understood. Moreover, at a high level, both action _ and reaction, drug use and control, are explicable in terms of _ the same existing structure of relationships within society, the © dominant value system, and the constellation of interests that
revolve around the way men earn a living. To fundamentally change patterns of psychotropic drug use we must therefore
ome Tas
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alter both the structures which give rise to drugtaking and ~ those which generate exacerbating and intensifying reaction. _ To desire to make such a change will depend on valuations as to the proper range of human experience, the correct relationship between work and play, and the norm of consciousness.
It cannot be decided by medicine or by absolutist social science. There is a body of opinion in this country which sees the
Pay ar Oe
solution to the drug problem in terms of more vigorous legislation. The answer to this is simple: the evidence both in the United States and Britain shows this endeavour to be both
_
quixotic and totally inappropriate. There is another faction
a a
which sees the solution in terms of the redefinition of drug use 224