The Marijuana Smokers
Chapter 5 - Physicians on Marijuana Use
Introductory RemarksA sociologist of knowledge seeks to explicate whether and to what extent man's social surroundings influence his intellectual efforts. Adopting this perspective toward the sentiments of the various disputants in the marijuana controversy, we are alerted to the possibility that attitudes about, and orientations toward, the use of marijuana, as well as what effects it has, and whether these effects are good or bad, may be at least in part traceable to a specific kind of role one plays, or status one has, in society. It would seem highly peculiar if, somehow, doctors were exempt from the generalization that ideas have a powerful existential referent, that individuals are compellingly influenced by their social locations and interactions. We expect, therefore, that the ideas of physicians in the sphere of marijuana use are influenced by, and can be traced partly to, their social contexts. (This is a testable proposition, not an axiom beyond the reach of empirical investigation.) The question which remains, therefore, is what is the nature of the social expectations, demands, and sentiments related to the position of physician in American society, and what is their articulation with regard to marijuana use.
Physicians act not only as individuals; they also act as representatives. Unlike intellectuals, writers, and professors, their clients comprise everyone, all classes and groups in society. In their hands is entrusted the health of the social body. They are burdened (or blessed, depending on one's point of view) with the responsibility of protecting the well-being of society at large, and therefore are under a pressure to act in a manner that society defines as responsible and mature. The physician knows that when he speaks, many listen. His favored position disinclines him to a radical direction. His prestige and power are a mixed blessing, because whatever he says will be taken seriously. He is highly visible, and he is expected to make sober and responsible pronouncements. The physician and the intellectual, although equally well educated, informed, and occupying roughly the same social class position, differ markedly in their accountability to a constituency, and thus usually differ radically on crucial issues. The question, therefore, becomes not so much: "What is the opinion of the medical profession, trained in the scientific technique and objective about anything affecting the human body, on the dangers of this drug, marijuana?" It is, rather: "What sorts of responses toward marijuana use might be expected from a group of individuals who are highly respected and affluent members of their community, geared to social functions of a distinctly protective nature, and responsible to a public?" I would predict that the responses of doctors regarding marijuana use would not be much different from individuals in positions much like theirs: bankers, politicians, attorneys, executives, judges. Their attitudes, I maintain, stem less from their medical knowledge than from their social position in society.
The position of medical men is a conservative posture, if we understand that as having the implication of "conserving" the status quo—protecting society from any possible danger. The basic thrust of such a position is that any substance has potential dangers that have to be thoroughly examined before it can be released to the unsuspecting public. It is far better, this line of reasoning goes, to restrict access to an innocuous drug than to permit access to one which is truly dangerous. The parallel between marijuana and thalidomide—inadequately tested and prematurely marketed—is obvious and sobering. The physician's stance, then, is paternalistic; certain decisions have to be made for the public, who, without expertise, cannot possibly decide on the danger or safety of a drug, unaided by those whose responsibility it is to perform that very task. As Henry Brill, physician, professor of medicine and hospital director, wrote: "All drugs are guilty until proven innocent."
A guiding principle in this analysis is the specialness of the physician's orientation toward marijuana and its use. I intend "specialness" to bear two distinct but interrelated meanings. First, that physicians' attitudes toward marijuana, as with everyone else, are largely "nonrational," not simply untrue or false in a scientific sense, but that their stance is a possible one out of several competing versions, and that all of these versions "surpass experience," that is, are based on attitudes that are sentiments and values which cannot be either supported or refuted scientifically. It follows from these expectations of society that the physician will act in a manner society defines as "responsible," that is, he will make essentially protective pronouncements.
Let us assume something true that is false, namely that it has been established scientifically that the statistical chance of experiencing a "psychotic episode" while under the influence of marijuana is one in a thousand—or even one in a million. This is, we will assume, a fact on which all observers agree. (It is not, of course.) The manner in which the physician makes his decision, that is, to be "responsible," will lead him to decide that this is too great a price for society to pay for the luxury of allowing a small freedom, and therefore marijuana use ought to be prohibited. Someone with a different set of values would make the decision in a very different way. The civil libertarian would say that the incidence of danger is sufficiently small to offset the larger threat to society's freedom to smoke marijuana. Both may agree on the facts, but it is the sentiments, even among the physicians, that ultimately decide.
The ideas of physicians are "special" in a second sense as well: doctors have been successful in defining the nature of reality for the rest of society in a vast number of areas. They have been successful in claiming that they alone are competent to interpret the reality of marijuana, and that their version of the drug's actions is the only legitimate, valid, and objective one. They have managed, that is, to establish epistemological hegemony. Their position enables their special version of the nature of the drug and its use to be regarded by others as neutral, impartial, and objectively true, and all other versions to be biased and based on special interest pleading. The physician is seen as transcending the accidental and irrational prejudices that blind others. In the area of drug use, physicians are "instant experts," knowledgeable and unbiased.
Since most members of society are not aware of professional and scientific distinctions, they will make little effort to seek out the word of those physicians who are most qualified to speak and write on marijuana, that is, those physicians who have actually done studies themselves, or who have closely read such studies. In fact, it might very well be disadvantageous to publicize the views of those physicians who are best-informed on the effects of marijuana, because they will present a more complex view, one which does not square with official morality. The contrary, in fact, will be true: the public will encourage those physicians whose views are most hostile to marijuana use which, almost inevitably, will be those physicians who are least informed on the subject. As a general rule, doctors whose writings on marijuana indicate dubiousness concerning its dangers are more likely to have done original research. Those physicians who are most stalwartly against its use, and whose writings indicate a strong feeling that clear dangers attend its use, are more likely to be without any systematic research experience on the drug's use, have no real contact at all with users, or be acquainted with them only as patients. (Patients who smoke pot and who visit doctors, especially psychiatrists, in connection with their drug use are, as we might expect, radically different from the average user—as are individuals who visit psychiatrists for any reason.)
It is not only the characteristics of the physician that would enable us to predict the role he would take vis-à-vis marijuana use. We must also look to the tie-in between the doctor's role and the cultural values of American society that generate his concern. It has become a cliché that American civilization still retains many strong traces of a Puritan ethic. Not all clichés are completely wrong; this one has at least a grain of truth. One axiom in the Puritan ideology is that pleasure must not be achieved without suffering. In fact, much of the machinery of Calvinist culture was devoted to making that axiom a self-fulfilling prophecy. Through guilt, ridicule, and punishment, the pleasure-seeker was made to suffer. We consider our age more enlightened. We have lost faith in many of the stigmata that once indicated sin. We no longer believe that it is possible, by outward sign, to "tell" if a girl has been deflowered, and we no longer counsel the adolescent boy against masturbation for fear of insanity or pimples. Yet we have not entirely moved away from this form of reasoning. With regard to marijuana use, we still take seriously the notion that the user must pay for his evil deed. No one is permitted to experience great pleasure without suffering a corresponding pain—a kind of moral Newton's Third Law. This is one of the reasons why alcohol is such a perfect American intoxicating beverage: getting drunk has its price. (There are, of course, historical reasons as well for liquor's acceptance.) It is, however, puzzling to the American cultural mainstream that anyone could enjoy cannabis without suffering any misery. It is necessary, therefore, for the cultural apparatus to construct a pathology explanation on marijuana use. A search must be made for signs of mental and bodily suffering that the marijuana smoker experiences as a consequence of his use. In the vastness and diversity of the many experiences that users have, at least some pathological traces may be dredged up. By searching for and emphasizing these traces, we have satisfied our need for discrediting marijuana use, and have done so in a manner that specifically calls forth the efforts of physicians to verify our cultural sentiments.
It follows that marijuana use will be viewed as a medical matter. And that it is a matter for physicians' attention. It might be presumed that physicians' word is sought on marijuana use because it is a medical matter. The sociologist looks at the issue differently. That marijuana use is a medical matter is an imputation, not a fact. It is because society has already adopted the pathology or "disease" model on marijuana use that it seems reasonable to infer that marijuana use, therefore, is a medical matter. But the prior imputation was necessary to see it that way in the first place.
The central point of this book, explained in detail in the chapter on "the politics of reality," is that we all view reality selectively. We notice that which verifies our own point of view, and ignore that which does not. We accept a "world taken for granted," and an exposure to contrary worlds does little to shake our faith in our own. Moreover, when our version of what is real and true is threatened, we marshall pseudoevidence to support this version. Facts used in arguments are rhetorical rather than experimental. Societies whose values do or would oppose a given activity face a tactical problem: how to make a condemnation of that activity seem reasonable and rational? A rationale must be provided, and a personnel whose word is respected must provide that rationale. Thus, by generating statements from physicians, society is utilizing a valuable ideological resource. The antimarijuana lobby will therefore court and win the sympathies of doctors whose word on cannabis is largely negative. Society is searching for verification of an already held ideological position, not for some abstract notion which idealistic philosophers once called "truth." (We all assume that we have truth on our side.) So that the pathology position will be crystallized out of the magma of society's needs and expectations, out of the social and cultural position of physicians, their self-conception —partly growing out of society's conception of them—as preservers of society's psychic and bodily equilibrium, and as experts on anything having to do with what is defined as a health matter. It is these pressures that generate the concern of physicians regarding marijuana, and not any particular expertise they might have.
In lieu of actually doing a survey, it is necessary to examine the writings of physicians on marijuana. However, to use these written statements to characterize the dominant medical view on cannabis use it would be necessary to resolve at least one difficulty first. There is the question of the typicality of published and widely disseminated statements, as opposed to the actual sentiments and actions of the vast bulk of doctors who do not write on marijuana. Those who wish to spread their views by publishing them might, for instance, be those who feel most strongly involved—both for and against; they might be "moral entrepreneurs," to use Howard Becker's phrase. Yet, in spite of the possibly nonrandom sentiment expressed in physicians' printed statements on marijuana, we must also remember that these are the views that tend to have the greatest impact. The American Medical Association makes an official pronouncement, reported by major newspapers and magazines, which means that a position is congealed and more easily utilized in the continuing debate. Published statements take on a life of their own. Although the question of whether or not physicians' published statements are typical is an empirical question, and not one on which we have an answer, nonetheless, the basic thrust of these statements is overwhelmingly negative, largely cast in the form of a pathology model, and used by the antipot lobby to verify its own position. Thus, although we will encounter some diversity of orientations regarding drug and drug use, it is possible to discern a relatively consistent ideology, both in "official" and in working day-to-day terms. In the remainder of this chapter I intend to elaborate on the mainstream medical position on marijuana use. This position is made up of a number of separate elements. Let us examine each element.
Drug AbuseIn the typical medical view, marijuana use is by definition "abuse." Drugs are taken for therapeutic purposes, to alleviate pain, to aid adjustment, to cure a disease, and must be prescribed by a physician. Marijuana has no known or recognized, professionally legitimated role whatsoever. The human body operates best, in the absence of a pathology, without drugs. Drugs are unnecessary without illness. The purpose of getting high is seen by this view as illegitimate. All use of marijuana is abuse; all use of drugs outside of a medical context is in and of itself the misuse of the purposes for which drugs were designed. The AMA writes: "... drug abuse [is] taking drugs without professional advice or direction."Marijuana is hallucinogenic and has no medical use or indication.... Feelings of being "high" or "down" may be experienced. Thought processes may be disturbed. Time, space, distance and sound may be distorted. Confusion and disorientation can result from its use. Reflexes are slowed. Marijuana does not produce physical addiction, but it does produce significant dependence. And it has been known to produce psychosis. With this description of the effects of its use and the total lack of any medical indication for its use, medically it must be stated that any use of marijuana is the misuse of a drug.
The damning constituent of marijuana, like all "recreational" drugs, is that it is used to get high; the normal state is seen as desirable—the state of intoxication, pathological. The use of a drug to get high is abuse of that drug: "There is no such thing as use without abuse in intoxicating substances."
In an essay in what is widely considered the bible of clinical pharmacology, the following is a definition of drug abuse (of which marijuana abuse is discussed as an instance; a distinction is made between obsolete "Therapeutic Uses" and current "Patterns of Abuse"):In this chapter, the term "drug abuse" will be used in its broadest sense, to refer to use, usually by self-administration, of any drug in a manner that deviates from the approved medical or social patterns within a given culture. So defined, the term rightfully includes the "misuse" of a wide spectrum of drugs.... However, attention will be directed to the abuse of drugs that produce changes in mood and behavior.
Etiology of Drug UseIn terms of the etiology of marijuana use, physicians may generally be found within the orbit of the personality theory of causality. Now, no psychologist or psychiatrist would dispute the contention that sociological factors play a decisive role in marijuana use. Clearly, a milieu wherein marijuana is totally lacking, or in which its use is savagely condemned, is not likely to generate many marijuana smokers, regardless of the psychological predisposition of the individuals within that ambiance. Yet, at the same time, a theory of marijuana use set forth by a psychologist, psychiatrist, or physician, will look and sound very different from one delineated by a sociologist. Doctors will tend to emphasize individual and motivational factors in the etiology of marijuana use. It is necessary, therefore, according to this perspective, to understand the individual's life history, particularly his early family relations, if we are to understand why an individual does as he does, particularly if he challenges the established social order—as, to some degree, his use of marijuana does. An individual of a certain family background will be predisposed to specific certain kinds of behavior.
More than merely being generated to a considerable degree by personality factors, physicians (following psychologists and psychiatrists) often see marijuana use as being at least to some degree generated by pathological or abnormal motives. Sometimes this is seen as a general process; marijuana use, like all illicit, deviant, and illegal drug use, represents a form of neurosis, however mild: "The willingness of a person to take drugs may represent a defect of a superego functioning in itself."It is, of course, necessary to specify the degree of drug involvement. Most physicians will not view occasional or experimental use in the same light as frequent, habitual, or "chronic" marijuana use. Probably we can make a safe generalization about the relative role of the factors we are discussing: the heavier and the more frequent the use of marijuana, the greater the likelihood that most doctors (as well as psychiatrists and personality oriented psychologists) will view its etiology as personality-based, as well as pathological in nature, and its user to some degree neurotic; the less frequent and regular the use of marijuana, the greater the likelihood that the cause will be located in accidental and sociological factors, and the lower the likelihood of being able to draw any inferences about the functioning of the user's psyche. This qualification is essential.
Probably the commonest view of marijuana use within the medical profession is that it is a clumsy and misplaced effort to cope with many of one's most pressing and seemingly insoluble problems. Drug use is not, of course, logically or meaningfully related to the problem, but is, rather, a kind of symbolic buffer serving to mitigate it by avoiding it, or by substituting new and sometimes more serious ones. Feelings of inadequacy, for instance, are said to be powerful forces in precipitating drug use.An individual who feels inadequate or perhaps perverted sees in drugs a way out of himself and into a totally new body and mind. For some a drug does give temporary surcease from feelings of inferiority, but for most it provides only numbness and moderate relief from anxiety, with no true or constant feeling of strength or superiority. Often this search for a new self is what leads to escalation and a frantic search for new drugs which may lead to addiction.
Occasionally, this notion of inadequacy is further pinpointed to sexual inadequacy. One prominent physician, analyzing a case history, writes: "Tom began to smoke marijuana and to gamble. He also suffered from impotence. Tom's need for marijuana and gambling was to help him overcompensate for his physical and mental inferiorities. He was underweight, had only a grade school education and suffered from the fear of organ-inferiority, called a 'small penis complex.'" Another physician concurs: "I know of several cases where males would use marijuana to overcome feelings of sexual inadequacy. Their marijuana use ceased after psychiatric treatment."
Sexual failure may be seen as a manifestation of a general inadequacy; marijuana use is seen as a kind of smoke-screen for the real issues. It becomes a means of avoiding responsibility, of concealing one's failures and inadequacies, of "copping out" of life:Individuals who have a significant dependency on marijuana and use it chronically report a decrease of sexual drive and interest. A reduction in frequency of intercourse and increased difficulty becoming sexually aroused occurs with the chronic user. However, there is usually a concomitant decrease in aggressive strivings and motivation and an impoverishment of emotional involvement. These changes are generally true for the chronic alcoholic, the chronic amphetamine or barbiturate user. Marijuana dependency is a symptom and the person who avoids experiencing parts of himself through the chronic use of drugs, is usually lonely and frightened of impersonal contact prior to drug use. Some of the diminished sexual activity of the marijuana dependent individual is part of his general withdrawal from emotional contacts with other human beings. The temporary gratification of drug-induced feelings are preferred to the gratification of interpersonal closeness which involves the risks and vicissitudes of real emotional intimacy.
Rebellion is another common component in many medical conceptions of marijuana use, especially as applied to high school and college students. Some doctors feel that the use of the drug represents a symbolic rejection of parental values, a desire to shock one's elders, to aggress against them for real or imagined hurts, to use the drug as a weapon in the parent-child struggle:The reason why drugs have so strong an appeal to the adolescent are several. The reason most commonly cited is rebellion, and this probably is a factor of importance in most instances. Children begin at fourteen to gain satisfaction from doing the opposite of what is expected. This is a way of retaliating against parents for years of what is now felt to have been unjustified subjugation.... Anything that is disapproved of by adults begins to have a certain allure.... Drugs are clearly beyond the pale in the eyes of both parents and legal authorities, and thus have a particularly strong appeal. A lot of the mystique that is part of the drug taking experience is directly related to the satisfaction the participants gain from realizing how horrified their parents would be to know what was going on. The secrecy surrounding meetings, the colorful slang words, the underworld affiliations make it all seem very naughty.
The intrinsic appeals of the drug itself, its specific effects, the nature of the marijuana high, are overshadowed by its symbolic appeal as both indication of and further cause of rebellion:Smoking marijuana has become almost an emblem of alienation. The alienated student realizes that the use of "pot" mortifies his parents and enrages authorities....[Marijuana] has become a rallying cause for students, a challenge to adults and a potent catalyst for widening the gap between generations.
Marijuana as a Dangerous DrugThe doctors feel that the drug is prohibited for a reason. It is a dangerous drug, and because it is a dangerous drug, it is (and should be) prohibited: "Certain drugs because of known characteristics are classified as dangerous drugs." They take, in other words, a "rationalist" position that men who make such decisions for society respond rationally and logically to a real and present danger. Medical bodies (like the legal structure of societies as a whole) do not authorize marijuana use; they disapprove of its use because there is enough evidence to be able to decide on the drug's dangers—or there is enough indication that it might be thought of as dangerous. "... those of us who oppose legalization are... implacable in insisting that all cannabis preparations are potentially dangerous. The potential dangers, to our minds, are severe." As a result, "... there is overwhelming consensus that this drug [marijuana] should not be legalized, and no responsible medical body in the world supports such action."
Marijuana, then, according to the medical profession, is a "dangerous drug." The question, therefore, is: In what specific ways does the medical profession see its use as dangerous? Opinion is not unanimous on the questions of what, precisely, the effects are whether certain effects represent, in fact, a clear danger, and to what extent the danger appears. Nonetheless, the differences within the profession should not be exaggerated.
PSYCHOLOGICAL DEPENDENCYWithout question the danger most commonly seen by physicians and psychiatrists in marijuana is its power to engender a kind of psychological dependence in the user. No observer of the drug scene attributes to marijuana the power of physiological addiction; instead, psychological dependence is imputed. "Drug dependence is a state of psychic dependence or physical dependence, or both, on a drug, arising in a person following administration of that drug on a periodic or continued basis."Each drug has its characteristic syndrome, and each must be designated with its own specific title; we are interested in "drug dependence of the cannabis type." Marijuana, then, produces a psychic dependency in the user which impels him to the continued and frequent use of that specific drug—a dependency that is similar in important respects to actual physical addiction.
Marijuana smokers hold the lack of physiological addiction of their drug of choice to be a powerful scoring point in its favor; many physicians, on the other hand, see this point as trivial in view of the parallels between addiction and dependency. The dimension of interest to us is not whether the impelling force is chemical or psychological, but whether the user persists in his use of a substance which physicians have defined as noxious, whose use constitutes "abuse." Thus, a person is defined as being dependent on the basis of whether use of a drug is continued over a period of time, and is ruled undesirable by drug experts. The imputation of undesirability is necessary to the definition, since the repeated administration of crepe suzette is not labeled "dependency"—even though it can occur with the same frequency and with the same degree of disruption in one's life. The fact that a withdrawal syndrome does not appear upon abstinence is outside the focus of this definition; the telling point is that the drug is capable of producing dependency.It has... been customary to distinguish between drugs that are habit-forming and drugs that are addicting... the present writer, however, fails to perceive any value at all in this distinction.... Hence, it would be quite correct to use the terms habit-forming and addicting synonymously and to refer to common habit-forming drugs as addictive in nature.
The troika of abuse, pathological etiology, and dependence combine forces to pull in the same direction. He who tries marijuana is impelled by the same motivational syndrome which may lead to abuse and, ultimately, dependence; the three concepts are seen as part of the same pattern.The chronic user develops a psychological dependence which in view of today's knowledge, is the prime detrimental factor. This dependence soon causes him to lose control of his use of the drug because the psychological factors which drew him to try it in the first place now precipitate a pattern of chronic, compulsive abuse. At this point the user is just as "hooked" as are the persons we used to call addicts.
The fact that, supposedly, marijuana use enlarges the sphere of one's freedom, by broadening the field of the choice of one's actions, can, ironically, have the opposite long-range effect, according to dominant medical views. Dependency limits one's possibilities for acting; by being dependent on a drug, one has severely limited his freedom, although to have taken that drug in the first place meant greater freedom. No physician has presented this dilemma more strikingly than a nonphysician, Seymour Fiddle, a social worker who coined the term "existentialist drugs" to capture this contradiction. Existentialist drugs are those a man takes to enact his fullest human potential, to test the limits of his ability to act, just to see how much he can do and be and still retain his essential humanness—but ends by so severely shrinking his possibilities that he is able ultimately to act out only a single role, virtually identical for everyone: that of street junkie. Thus, we chance upon a paradox: man takes drugs to be free, only to discover that he is enslaved by them. The Fiddle argument, then, would hold the freedom issue to be irrelevant, since drugs are a dead-end trap which ultimately kill off all freedom of action. Drugs produce, in the end, even more narrowly restricted one-dimensional men. As to whether marijuana properly belongs in this category is an empirical question, and cannot be assumed in the first place, but the fact that physicians commonly hold it to be a drug of dependence demonstrates that they do believe that it can in fact act in this manner.
PANIC STATES AND PSYCHOTIC EPISODESCannabis opponents consider the psychotomimetic quality of the drug another potential danger. Physicians and psychiatrists, especially, feel that marijuana is capable of precipitating powerful, though temporary, psychotic episodes—or, more generally, disturbing psychic adverse reactions. There are, of course, problems with this view; to mention only three: (1) What constitutes such a reaction and how do we define an "adverse effect" of marijuana? (2) How extensively does it occur? (3) Under what conditions does it occur?
The smoker, under the influence of the drug, is held to be subject at times to confusion, panic, disorientation, fear, and hallucinations —a schizophrenic break with reality. This point of view holds that this state—ranging from a simple amused befuddlement all the way to a full-blown outbreak of transient psychosis—"can" happen and "does" happen. The fact that it has occurred with at least some modest degree of frequency is, in the eyes of many health figures, powerful damaging evidence that the drug is, or can be, dangerous and harmful.
While physicians are adamant about the existence of these episodes and their attendant dangers, smokers are equally as vociferous in denying to the drug such diabolical powers. Donald Louria writes: "The evidence on panic seems so clear that to deny its existence indicates either abysmal ignorance of the facts or intentional intellectual dishonesty." Yet, writers supporting use of the weed minimize and often dismiss outright its madness-inducing potential. Their claim is that if marijuana can induce psychosis, then the causal sequence posited has nothing intrinsically to do with the effects of the drug itself. Rosevear, for instance, writes: "... a broken shoelace may also be used as a parallel for precipitating psychosis."
Those who seek psychiatric and medical help as a result of an untoward reaction to marijuana are far from typical of potheads, or the mental state of the characteristic marijuana intoxication. The average smoker has probably never seen any evidence of an untoward reaction of any seriousness—so that he denies its existence completely It is difficult to deny that marijuana can potentiate panic or a psychotomimetic experience, given the "right" person and setting. To assert, however, that such reactions are typical, widespread, common, or even more than merely occasional is, I think, entirely incorrect, since, by all accounts, extreme psychosis-like reactions to the drug are extremely rare. Even the staunchest opponents of the drug are careful to point out that they are of relatively infrequent occurrence. The Medical Society of the County of New York informs us that cannabis "is an unpredictable drug and is potentially harmful even in its mildest form. Even occasional use can produce (although rarely) acute panic, severe intoxication, or an acute toxic psychosis." A pair of physicians, reporting on panic reactions in Vietnam, inform us that at the extreme of the continuum, cannabis is capable of touching off in some individuals "a frank schizophrenic-like psychosis," but, at the same time, are careful to point out that "smoking marijuana for most persons is a pleasant, nonthreatening, and ego-syntonic experience."
Work by physicians on cannabis psychosis breaks down into clinical and laboratory research. In general, clinical work must, of necessity, be unsystematic since it is impossible to detect the degree to which the patients who come to a physician for problems connected (or unconnected) with their drug use are in any way representative of users in general. It is impossible to know just what it means when a number of marijuana-using patients show up in a physician's office. How typical are their experiences? What universe of individuals are they supposed to represent? How widespread are their complaints? What role does marijuana play in their problems? Clinical work can answer none of these troublesome but central questions. But clinical reports do have the advantage that they describe people in real-life situations. Laboratory work suffers from the opposite problem. Although it is systematic, the laboratory situation is artificial and outside the marijuana-using situation in which the smoker actually conducts his activities. Although this qualification in no way invalidates either form of research, it should be kept in mind when generalizations from clinical and laboratory situations are made to the use-patterns of the typical marijuana smoker in real-life situations.
The complexity of the issue increases when we consider the relative potency of the various cannabis preparations. Hashish, as we know, is more powerful than the varieties of marijuana commonly available in the United States. Although heavily used in the Orient, it is less commonly, but increasingly, consumed in America.Many of the differences between the gloominess of the findings of many studies conducted on hashish and charas users in North Africa, the Middle East, India, and Greece, and the relative lack of mental pathology associated with use in the United States, can be attributed to the strength of the drugs available. Marijuana grown in the United States is weak; and even Mexican varieties generally lack the strength of their Oriental sisters. The fear, therefore, is that were marijuana to be legalized, it would be impossible and irrational to disallow hashish. "If all controls on marijuana were eliminated, potent preparations probably would dominate the legal market, even as they are now beginning to appear on the illicit market. If the potency of the drug were legally controlled, predictably there would be a market for the more powerful illegal forms." Thus, could it be that hashish, were it freely available to Americans, would produce many of the symptoms described in the Eastern studies?... no amount of qualification can obscure the fact that marijuana can produce psychotic reactions (this is a simple medical fact) and that a psychotic state can release violence and precipitate criminal behavior. This is not to say that it will in every case but that it can and has. Because of the relative mildness of Mexican and American varieties of cannabis we have seen very little of this kind of cannabis-induced reaction. But with the coming of hashish, we can look for more instances of psychosis and violence as a result of a cannabis use.
MOTOR INCOORDINATIONA third reason why physicians consider marijuana dangerous and not to be legalized or made freely available is that it supposedly deteriorates one's motor coordination, rendering the handling of a machine, particularly an automobile, hazardous. The fear is that the current slaughter on the highways of America—partly due to drunken driving—will increase dramatically with the increase in marijuana use. The assumptions underlying this supposition are that marijuana use characteristically leads to intoxication; that intoxicated marijuana smokers are likely to drive; and that one's ability to drive is, in fact, impaired by the use of marijuana. These are all, of course, empirically verifiable (or refutable) propositions, and cannot be assumed. But whether true or false, this line of reasoning will be encountered frequently in antimarijuana arguments: "The muscular incoordination and the distortion of space and time perception commonly associated with marijuana use are potentially hazardous since the drug adversely affects one's ability to drive an automobile or perform other skilled tasks." More dramatically, the marijuana smoker, intoxicated, "may enter a motor vehicle and with "teashades (dark glasses worn because of the dilated pupils) over his handicapped eyes and with impaired reflexes he may plow through a crowd of pedestrians."
Not only is there the fear that widespread use of cannabis will increase the highway death toll, but since there is no reliable or valid test at the moment for determining whether the driver is high on marijuana, there are, therefore, no possible social control mechanisms for preventing an accident before it happens. Since effective tests exist for alcohol, physicians hold that this makes marijuana a more dangerous drug than liquor, at least in this respect. "With marijuana, there are currently no adequate methods for measuring the drug either in the blood or urine.... Under such conditions, the thought of legalizing the drug and inflicting marijuana-intoxicated drivers on the public seems abhorrent."
LOSS OF AMBITION AND PRODUCTIVITYA common concern among members of the medical profession is that marijuana—particularly at the heavier levels of use—will produce lethargy, leading to a loss of goals and a draining off of potential adolescent talent into frivolous and shiftless activities. One physician speculates whether marijuana might be America's "new brain drain." The AMA states that frequent use "has a marked effect of reducing the social productivity of a significant number of persons," and that as use increases, "nonproductivity" becomes "more pronounced and widespread."As the abuse pattern grows, the chronic user develops inertia, lethargy and indifference. Even if he does not have psychotic or pseudopsychotic episodes or begin a criminal or violent existence, he becomes a blight to society. He "indulges" in self-neglect. And even though he may give the excuse that he uses the drug because it enlarges his understanding of himself, it is the drug experience, not his personal development, which is his principal interest.
Physicians with academic responsibilities particularly see a negative impact of marijuana use on achievement and motivation. Dana Farnsworth, director of Harvard's health services, writes: "... the use of marijuana does entail risk. In fact, we find it to be harmful in many ways and to lack counterbalancing beneficial effects. Many students continue to think it is beneficial even when their grades go down and while other signs of decrease in responsible and effective behavior become apparent." Harvard's class of 1970 was issued a leaflet which contained a warning by the Dean of the College, which read, in part: "... if a student is stupid enough to misuse his time here fooling around with illegal and dangerous drugs, our view is that he should leave college and make room for people prepared to take good advantage of the college opportunity." The message was that learning and drug use are incompatible. However, the amount of marijuana smoking and the degree of involvement with the marijuana subculture are not specified. Since possibly close to a majority of all individuals who have smoked marijuana at least once do so no more than a dozen times in all there is no reason to suppose that marijuana smoking should have any effect on the ambition of the average smoker. The problem, as the doctors realize, is with the frequent user. It is entirely possible that heavy involvement in marijuana use (as with nearly any nonacademic activity, from heroin addiction to athletics) leads to academic nonproductivity. It is difficult to say whether or not this is due directly to the action of the drug itself. Involvement with a subculture whose values include a disdain for work probably contributes more to the putative "nonproductivity" than the soporific effect of the drug.
THE EFFECT ON THE ADOLESCENT PERSONALITYIt would be naive of marijuana legalization enthusiasts to think that the average age of first smoking the weed would not drop if their demands were somehow realized, in spite of any potential age restrictions—think of the facility with which adolescents obtain cigarettes and liquor. I suspect that if the antimarijuana arguments carry any weight at all, the noxious effects of the drug will be aggravated among the very young. And even if the promarijuana arguments turn out to substantially sound, that is, that the effects on a well-integrated, fully developed adult personality are either beneficial (within agreed-upon definitions) or negligible, the impact on adolescent and pre-adolescent children (taking eighteen as a rough demarcation line) is a matter to be investigated separately. It is a legitimate question to raise as to the influence of marijuana on the young. The following questions might present themselves as heretofore unanswered requests for much-needed information:
- Are adolescents able to assimilate and integrate the insights of a novel and offbeat perspective into a rewarding day-to-day existence in society?
- Will they be able to avoid making the drug the focus of their lives, a complete raison d'être?
- How aware will adolescents be of the distinction between situations in which marijuana is relatively harmless (such as with friends, or watching a film), and those where it may be dangerous (such as, perhaps, in stressful situations )?
Physicians are acutely aware of the potential damaging effects of the drug on the adolescent personality. (In fact, even many nonmedical observers who take a relatively tolerant view of marijuana use in general are concerned about its possible impact on the young.) The Director of the National Institute of Mental Health, a physician, writes:One needs to be particularly concerned about the potential effect of a reality distorting agent on the future psychological development of the adolescent user. We know that normal adolescence is a time of great psychological turmoil. Patterns of coping with reality developed during the teenage period are significant in determining adult behavior. Persistent use of an agent which serves to ward off reality during this critical development period is likely to compromise seriously the future ability of the individual to make an adequate adjustment to a complex society.
THE USE OF MORE POTENT DRUGSFinally, some physicians oppose marijuana use on the sequential grounds that it leads to the use of more powerful, truly dangerous and addicting drugs. At one time, heroin was the primary concern of society, but within the past six years, it has had to share society's concern with LSD. Physicians have absorbed a good deal of sociological thinking and generally deny that there is an actual pharmacological link between marijuana use and the use of LSD and heroin. Being high does not make one crave another, progressively more potent, drug. As Dr. Brill says, there is no connection between marijuana and other drugs "in the laboratory," but the association "in the street" is undoubtedly marked. The pusher line of reasoning as to progressive drug use is sometimes cited: "... marijuana is frequently the precursor to the taking of truly addictive drugs. Those who traffic in it often push other more dangerous substances."
Another argument is that the reason for the progression from marijuana to either heroin or LSD is experiential: marijuana use leads one into patterns of behavior which make more serious involvement likely. The less potent drug acts as a kind of "decompression chamber" gradually allowing the user to get used to increasingly more serious drug use, getting used to it bit by bit.There is nothing about marijuana which compels an individual to become involved with other more potent drugs. Marijuana use, however, is often an individual's initiation into the world of illicit drug use. Having entered that world—having broken the law—he may become immersed in the drug subculture and in sequential form progress to abuse of a variety of other drugs, including amphetamines LSD, amphetamines, and heroin.... Marijuana does not in any way mandate use of other drugs, but it may be the beginning of the road at the end of which lies either LSD or heroin.... [If] certain individuals... did not begin with marijuana, they would never get around to using the more potent and dangerous drugs.
THE ALCOHOL-MARIJUANA COMPARISONAs we stated earlier, marijuana's supporters take seriously the argument concerning the relative dangers inherent in marijuana and alcohol usage; physicians, on the whole, are not so impressed, and tend to dismiss it as irrelevant.
As we said in the last chapter, potheads draw the conclusion from a comparison of marijuana with alcohol that marijuana is unfairly discriminated against; the laws represent a double standard, just as if there were laws permitting one social group to do something and prohibiting another from doing the same thing. If alcohol (which is toxic, lethal, and dangerous) is legal—then why not pot? Marijuana is certainly no more dangerous than alcohol. Why aren't both allowed?
The medical answer to this argument is basically that it is irrelevant. Physicians rarely attribute marijuana with a more dangerous temperament than alcohol. The disagreement is far less on the facts than on the conclusion to be drawn from the facts. Potheads will say that alcohol is far more dangerous than pot, which is relatively innocuous, while doctors will say that pot is no more dangerous than alcohol—both of which are dangerous drugs. Yet this is a matter of emphasis only. Even were marijuana smokers to grant the medical argument, the disagreement concerning the implications of this position would still be rampant. Dr. Bloomquist, author of an antimarijuana book, in testimony before the California Senate Public Health and Safety Committee, when asked a question on the relative dangers of the two drugs, replied: "I would almost have to equate the two of them." And Donald Louria wrote: "Surely alcohol itself is a dangerous drug. Indeed, marijuana's dangers... seem no greater than the documented deleterious effects of alcohol. If the question before us were a national referendum to decide whether we would use... either alcohol or marijuana, I might personally vote for marijuana—but that is not the question" Physicians say that the damage to society following the legalization and widespread usage of marijuana would only be additive to the harm inflicted by alcohol. Whatever thousand deaths traceable to alcohol we actually experience now would be increased by a considerable number if marijuana restrictions were removed.... the existence of alcoholism and skid rows is not an argument in favor of cannabis but one against it. If alcohol has ruined six million lives in this country, how can it possibly be an argument for permitting cannabis to do the same, or worse? Logic compels those who argue against alcohol to excuse cannabis to take another stand: they should be arguing for the control of alcohol and the elimination of its evils, not for the extension of those or similar evils to a wider segment of society.
The attack on alcohol implicitly acknowledges the evils of cannabis and goes on to urge that we let two wrongs make a right.... legalization of cannabis will in no way alleviate the problems of alcoholism but is very likely to add problems of another sort.... one drug is as socially and personally disruptive as the other. The question is whether we, as a nation, can afford a second drug catastrophe.
A Minority OpinionAlthough mainstream medical opinion holds marijuana to be damaging, potentially dangerous and, on the whole undesirable, a minority of doctors demure. We have claimed that the dominant view of physicians is that marijuana is a dangerous drug, capable of causing adverse psychic reactions and psychotic episodes. Yet David E. Smith, physician, toxicologist, pharmacologist, and director of the Haight-Ashbury Medical Clinic in the midst of a heavy drug-using population, writes that he has never seen a "primary psychosis" among his 30,ooo patients, and, outside the clinic, he says that he has witnessed only three cases of marijuana-induced psychosis—"extreme paranoid reactions characterized by fear of arrest and discovery."
I have stated that most physicians dismiss the pothead's point that marijuana is less dangerous than alcohol as irrelevant. Yet, Joel Fort, a physician, claims that alcohol is the most dangerous of all drugs currently available in America, whether legally or illegally. He has developed a scheme characterizing dimensions of drug "hardness," i.e., dangerousness. Fort's feeling is that any impartial observer will arrive at least the following list of dimensions of hardness: addiction (or psychic dependency), insanity, tissue damage, violence, and death. Thus, some drugs may be hard in one way, but not in other ways. Fort claims that alcohol scores high on all of these dimensions; barbiturates and the amphetamines are also extremely hard as well. Marijuana, says Fort, is probably the least hard of the drugs available in today's pharmacopoeia. The fact that a truly dangerous drug (alcohol) is legal and freely available, while the possession of a far less dangerous drug (marijuana) is severely penalized, is patently absurd, according to Fort.
Andrew T. Weil and Norman E. Zinberg, both physicians, after detailed controlled tests on subjects high on marijuana, concluded that the drug is relatively safe, and its effects, mild. James M. Dille and Martin D. Haykin—pharmacologist and psychiatrist respectively, and both physicians—along with several nonphysicians, minimize the drug's deleterious effects on simulated driving performance. And Tod H. Mikuriya, director of the San Francisco Psychiatric Medical Clinic, in a pamphlet entitled "Thinking About Using Pot," refuses to persuade readers not to use marijuana; he rejects the contention that marijuana leads to heroin and states, with regard to psychosis, that "marijuana is exceedingly safe." His advice to those who "choose to turn on" concerns understanding how to use marijuana wisely. What is more, Mikuriya employs marijuana in his therapy. In treating alcoholics, one of his recommendations is that they give up alcohol, in his view the more destructive drug, for pot, which is far less damaging. It is obvious that this doctor disagrees with the majority view on at least two points: (1) marijuana no longer has any therapeutic value, and its use constitutes "abuse," and (2) it is a dangerous drug whose use should be avoided.
Another medical figure, Dr. Eugene Schoenfeld, writes a column syndicated by a number of "underground" (and invariably pro-pot) newspapers, such as The East Village Other. His stance is usually skeptical concerning the putative dangers of marijuana. One piece attacked the AMA's June 1968 statements condemning marijuana use, "Marihuana and Society." The critique is replete with such phrases as "the AMA... has chosen ... to ignore... ," "casting itself into the role of prophet the Council demonstrates its lack of familiarity with the current American marihuana situation by the following statement ... ," "contrary to all known evidence, the AMA statement denies...." The review concludes with the claims: ". .. the scientific judgment of the AMA will now be looked upon with some suspicion by the millions of American marijuana users ... the AMA would certainly be surprised by the great numbers of medical students and young residents who chronically use marijuana with no observable detriment to their physical or mental well-being."
It is clear, then, that some physicians do not accept the dominant current medical views concerning marijuana. They underplay its dangers and hold that smoking pot is less a medical matter than a social and political question. Medically, they say, there is relatively little problem with marijuana. It is important to recognize that this is a minority opinion. Yet it is also interesting to speculate on some of the roots of this "different drummer" opinion. Probably the safest bet on the characteristics of the minority physicians has to do with age: the younger the doctor, the greater the likelihood that he will minimize its dangers; the older the doctor, the more danger he will see in pot smoking. Because of this generational difference, it is entirely possible that a tolerant attitude in the medical profession toward cannabis use will become increasingly common and may, in time, become the reigning sentiment. That day, in any case, will be a long time in coming.
It is also possible that doctors engaged in research will be more tolerant than those who have more extensive patient responsibilities. Issues of welfare and security will become predominant when others are in one's care, and decisions will be inclined in a conservative and protective direction. Risk will be minimized. Moreover, when one's actions and decisions are constantly scrutinized by one's clients, one feels pressure to conform to the stereotype of the responsible, judicious, reliable physician. The greater the accountability to a public, the more that the physician will perceive dangers in marijuana. (It may also be that doctors who decide to do client-oriented work are more conservative and cautious to begin with than the research-oriented physician.) The more independent the physician is—"safe" from retaliation and free of accountability—the less danger he will see in marijuana use.
Third, the possibility exists that the positive correlation between the quality of one's college and tolerance for marijuana use also applies to medical schools. We found this relationship with students in general; it seems natural to assume that it would hold up for physicians specifically. What is distinctive about the more highly rated schools, whether medical or otherwise, is that the student lives in an ambiance of experimentation, of greater tolerance for diversity and deviance and ambiguity. The better schools offer a richer, more complex view of the universe. It is not that better medical schools offer a more advanced technical training. It is that the more highly rated the school, the more daring the intellectual environment, the greater the willingness to diverge from conventional opinion, the more attuned both faculty and students will be to avant-garde cultural themes which presage later dominant modes of thinking and acting. Whatever the virtues or drawbacks of marijuana, it is clear that it shares a place with other developments which are thought to be fashionable among those who consider themselves (and who are also so considered by others), progressive, knowledgeable, and ahead of their time. This is, in any case, speculation. Yet is capable of being tested empirically. Anyone interested in the appeal of marijuana has to consider this side of its attraction.
As a qualification, it must be stated that the attitudes of many physicians are in flux, in large part moving in the direction of a decreased severity of criticism of marijuana. Many doctors are becoming aware of the vastness of the phenomenon of use, as well as the predominance of relatively infrequent users in the ranks of potsmokers. Data on the effects of use are beginning to refute many of the classic antimarijuana arguments, and physicians sufficiently respect the empirical tradition to be influenced by this. Many influential medical figures have shifted their position from the "pathology" model outlined in this chapter to one which minimizes pot's actual or potential danger. Dr. Stanley Yolles, for instance, Director of the National Institute of Mental Health, cited earlier in this chapter as typifying some aspects of the antipot pathology argument, has made recent statements to the Senate Judiciary Subcommittee on Juvenile Delinquency which minimized marijuana's medical dangers; his statements were summarized in an article written by himself entitled: "Pot Is Painted Too Black." It may very well be, then, that the medical profession is moving in the direction of a more "soft" stand on the dangers represented by marijuana.
If polled, the vast majority of physicians in America would certainly oppose the relegalization of marijuana possession. However, nearly all medical commentators admit that the marijuana laws are unnecessarily harsh. Very few will support the present legal structure. Although nonmedical figures who do—principally the police—invoke medical opinion on pot to shore up their own position, utilizing the pathology argument in regard to use, they do not mention the doctors' opposition to the laws as they are presently written. Their conclusions on the justness of the present legal structure is made contrary to medical opposition to it.
2. Henry Brill, "Drugs and Drug Users: Some Perspectives," in Drugs on the Campus: An Assessment, The Saratoga Springs Conference of Colleges and Universities of New York State (Sponsored by the New York State Narcotics Addiction Control Commission, Saratoga Springs, New York, October 25 to 27, 1967), p. 49. (back)
3. The literature on the "specialness" of the medical view of reality—as the term is defined here—particularly regarding psychosis, is among the most impressive and exciting in the entire field of sociology. For examples of sociological lines of attack on the medical view see Thomas Scheff, Being Mentally Ill (Chicago: Aldine, 1966); R. D. Laing, The Politics of Experience (New York: Ballantine, 1968); Thomas Szasz, The Myth of Mental Illness (London: Secker and Warburg, 1962). (It should be noted that both Laing and Szasz are themselves physicians.) For the process of the dynamics of constructing this reality in the patient relationship, see Thomas Scheff, "Negotiating Reality: Notes on Power in the Assessment of Responsibility," Social Problems 16 (Summer 1968): 3-17. (back)
4. The sword cuts two ways, however. Physicians who have conducted research on marijuana use may also be employed as rhetorical devices by the pro-pot lobby. In fact the scientific method may be employed as a rhetorical device for the purpose of convincing the opposition. As many of the arguments of the antimarijuana side fail to be substantiated empirically, the scientific rhetoric will tend to be invoked correspondingly less, but will become increasingly emphasized by the opposition.(back)
5. This concept of the disease or pathology model is precisely equivalent to what Dr. Norman Zinberg independently calls a "medical model" on marijuana use.(back)
6. American Medical Association, Committee on Alcoholism and Drug Dependence Council on Mental Health, "The Crutch That Cripples: Drug Dependence," pamphlet (Chicago: AMA, 1968), p. 2. For some reason, a small but vigorous contingent of marijuana supporters maintain that the drug may actually be therapeutic. For instance, in the vast and decidedly promarijuana anthology, The Marihuana Papers, edited by David Solomon, several articles were included which dealt specifically with marijuana's healing powers in some regard or another. A physician-psychiatrist, Harry Chramoy Hermon, is licensed to employ cannabis in his therapy. See Hermon, "Preliminary Observations on the Use of Marihuana in Psychotherapy," The Marijuana Review , no. 3 (June-August 1969), 14-17. (back)
7. E. D. Mattmiller, "Social Values, American Youth, and Drug Use" (Paper presented to COTA, January 22, 1968), p. 5 (my emphasis, in part). (back)
8. Brill, op. cit., p. 52. (back)
9. Jerome H. Jaffe, "Drug Addiction and Drug Abuse," in Louis S. Goodman and Alfred Gilman, eds. The Pharmacological Basis of Therapeutics, 3rd ed. (New York: Macmillan, 1965), p. 285. (back)
10. Paul Jay Fink Morris J. Goldman, and Irwin Lyons, Recent Trends in Substance Abuse," The international Journal of the Addictions, 2 (Spring 1967): 150.(back)
11. Graham B. Blaine, Jr., Youth and the Hazards of Affluence (New York: Harper Colophon, 1967), p. 68. (back)
12. Frank S. Caprio, Variations in Lovemaking (New York: Richlee Publications, 68), p. 166. (back)
13. Duke Fisher, "Marijuana and Sex" (Paper presented to the National Symposium on Psychedelic Drugs and Marijuana, April 1l, 1968), p. 3. (back)
14. Ibid. (back)
15. Blaine, op. cit., pp. 67-68. Blaine qualifies his assertion by distinguishing the "hard core" user, who would be impelled to drugs in the absence of the rebellion motive, and the "experimenter," for whom parental rejection is a strong impetus to sporadic and eventually discontinued use of drugs. (back)
16. Seymour L. Halleck, "Psychiatric Treatment of the Alienated College Student," American Journal of Psychiatry 124 (November 1967): 642-650. (back)
17. Mattmiller, op. cit. (back)
18. Donald B. Louria, The Drug Scene (New York: McGraw-Hill, 1968), p. 101. (back)
19. Henry Brill, "Why Not Pot Now? Some Questions and Answers About Marijuana," Psychiatric Opinion 5, no. 5 (October 1968): 19. (back)
20. Nathan B. Eddy et al., "Drug Dependence: Its Significance and Characteristics," Bulletin of the World Health Organization 32 (1965): 721. (back)
21. The parallel with agents of which society approves was made by Eliot Freidson, in "Ending Campus Incidents," Letter to the Editor, Trans-action 5, no. 8 (July-August 1968): 75. Freidson writes, with regard to the terms psychic addiction and habituation: "What does this term mean? It means that the drug is pleasurable, as is wine, smoked sturgeon poetry, comfortable chairs, and Trans-action. Once people use it and like it, they will tend to continue to do so if they can. But they can get along without it if they must, which is why it cannot be called physically addictive." (back)
22. David Ausubel, Drug Addiction (New York: Random House, 1958), pp. 9-10. (back)
23. Edward R. Bloomquist, "Marijuana: Social Benefit or Social Detriment?" California Medicine 106 (May 1967): 352. (back)
24. Seymour Fiddle, Portraits From a Shooting Gallery (New York: Harper & Row, 67), pp. 3-20. (back)
25. Louria, op. cit., p. 103. (back)
26. John Rosevear, Pot: A Handbook of Marihuana (New Hyde Park, N. Y.: University Books, 1967), p. 90. (back)
27. The Medical Society of the County of New York, "The Dangerous Drug Problem—II," New York Medicine 24 (January 1968), p. 4 (my emphasis). (back)
28. John A. Talbott and James W. Teague, "Marihuana Psychosis: Acute Toxic Psychosis Associated with Cannabis Derivatives," The Journal of the American Medical Association 210 (October 13, 1969): 299. (back)
29. For some representative clinical work by physicians on the use of marijuana, see Martin H. Keeler, "Adverse Reaction to Marihuana," The American Journal of Psychiatry 124 (November 1967): 674-677; Doris H. Milman, "The Role of Marihuana in Patterns of Drug Abuse by Adolescents," The Journal of Pediatrics 74 (February 1969): 283-29c, Aaron H. Esman et al., "Drug Use by Adolescents: Some Valuative and Technical Implications," The Psychoanalytic Forum 2 (Winter 1967): 339 353, Leon Wurmser, Leon Levin, and Arlene Lewis, "Chronic Paranoid Symptoms and Thought Disorders in Users of Marihuana and LSD as Observed in Psychotherapy," unpublished manuscript (Baltimore: Sinai Hospital 1969). (back)
30. The most well-known of the cannabis laboratory experiments are those conducted in the Addiction Research Center in Lexington, Kentucky. (Actually, THC is used, not natural marijuana.) See Harris Isbell et al., "Effects of (-)A9-Trans-Tetrahydrocannabinol in Man," Psychopharmacologia 1l (1967): 184-188, and Harris Isbell and D. R. Jasinski, "A Comparison of LSD-25 with (-)A9-Trans-Tetrahydrocannabinol (THC) and Attempted Cross Tolerance between LSD and THC,"Psychopharmacologia 14 (1969): 115-123. See also Reese T. Jones and George C. Stone, "Psychological Studies of Marijuana and Alcohol in Man" (Paper presented at the 125th Annual Meeting of the American Psychiatric Association, Bal Harbour, Fla., May 1969). (back)
31. The use of hashish in America is, as we stated earlier, increasing rapidly certainly much faster than the use of the less potent cannabis preparations. As a rough indication of this trend, consider the fact that more hashish was seized by the United States Customs in the year 1967-1968 than in the previous twenty years combined. See The New York Times, September 19, 1968: The California police in 1968 seized over seven thousand grams of hashish, whereas none was recorded as having been seized in 1967. (In neither year was a category for hashish provided on the official police forms.) See State of California, Department of Justice, Bureau of Criminal Statistics, Drug Arrests and Dispositions in California, 1968 (Sacramento, 1969), pp. 40-41. In 1969, this tendency was further accelerated by the "Great Marijuana Drought" caused by increased federal vigilance in reducing the quantity of Mexican marijuana entering the country. Thus, hashish, which comes from Asia, was more in demand and imported in far greater volume than previously. And, of course, used with greater frequency. (back)
32. American Medical Association, Council on Mental Health, "Marihuana and Society," The Journal of the American Medical Association 204, no. 13 (June 24, 1968): 1181. (back)
33. Edward R. Bloomquist, Marijuana (Beverly Hills, Calif.: Glencoe Press, 1968) p. 102. For some of the Oriental studies on marijuana use referred to, see Ahmed Benabud, "Psycho-Pathological Aspects of the Cannabis Situation in Morocco: Statistical Data for 1956," United Nations Bulletin on Narcotics 9, no. 4 (October-December 1957): 1-16; Ram Nath Chopra, Gurbakhsh Singh Chopra, and Ismir C. Chopra "Cannabis Sativa in Relation to Mental Diseases and Crime in India,"Indian Journal of Medical Research 30 (January 1942): 155-171; Ram Nath Chopra and Gurbakhsh Singh Chopra, The Present Position of Hemp-Drug Addiction in India, Indian research Memoirs, no. 31 (July 1939); Constandinos J. Miras, "Report of the U. C. L. A. Seminar," in Kenneth Eells, ed., Pot (Pasadena, Calif.: California Institute of Technology, October 1968), pp. 69-77
It should be made clear that the validity of many of these studies has been severely called into question. For instance, in the Leis-Weiss trials in Boston during 1967, conducted by Joseph Oteri, it was revealed that the Benabud data were collected at a time when there was not a single certified psychiatrist in the entire nation of Morocco, the admitting diagnosis cards were filled out by French clerks, who recorded the opinions of the police who brought in the suspect. The transcript of the court proceedings in which Oteri reveals these facts is to be published in book form by Bobbs-Merrill. (back)
34. Stanley F. Yolles, "Recent Research on LSD, Marihuana and Other Dangerous Drugs" (Statement Before the Subcommittee on Juvenile Delinquency of the Committee on the Judiciary, United States Senate, March 6, 1968). Statement published in pamphlet form by the National Clearinghouse for Mental Health Information, United States Department of Health, Education and Welfare, National Institute of Mental Health. (back)
35. Bloomquist, "Marijuana: Social Benefit or Social Detriment?" p. 348. It should be noted that dark glasses may be worn because the user thinks that his pupils are dilated, but not "because of the dilated pupils," because, as we shall see in the chapter on the effects of marijuana, the pupils do not become dilated. (back)
36. Louria, op. cit., pp. 107, 108. (back)
37. Brill, "Why Not Pot Now?" p. 21. (back)
38. American Medical Association, "Marihuana and Society," p. 1181. (back)
39. AMA, "Marihuana Thing," Editorial, Journal of the American Medical Association 204, no. 13 (June 24, 1968). (back)
40. Bloomquist, "Marijuana: Social Benefit or Social Detriment?" p. 352. (back)
41. Dana Farnsworth, "The Drug Problem Among Young People," The West Virginia Medical Journal 63 (December 1967): 434. (back)
42. J. U. Monro, unpublished memorandum to the Harvard class of 1970 April 13, 1967. (back)
43. William Simon and John H. Gagnon, "Children of the Drug Age," Saturday Review, September 21, 1968, pp. 76-78. (back)
44. Yolles, op. cit. (back)
45. Brill, "Why Not Pot Now?" and "Drugs and Drug Users." (back)
46. Blaine, op. cit., p. 74. (back)
47. Louria, op. cit., pp. 110-111. (back)
48. Edward R. Bloomquist, Testimony, in Hearings on Marijuana Laws Before the California Public Health and Safety Committee (Los Angeles, October 18, 1967, afternoon session), transcript, p.43. (back)
49 Louria op. cit., p. 115. (back)
50. Actually, Bloomquist misses the point here somewhat. Potheads do not say that marijuana is as dangerous as alcohol—and that both are dangerous—and therefore marijuana ought to be legalized. They say that alcohol is dangerous and legal, while pot is not dangerous, but illegal, and legalizing marijuana would reducethe seriousness of the drug problem, because more pot and less alcohol would be consumed. See Bloomquist Marijuana, pp. 85, 86. (back)
51. David E. Smith, "Acute and Chronic Toxicity of Marijuana," Journal of Psychedelic Drugs 2, no. 1 (Fall 1968): 41. (back)
52. Of Fort's many publications, perhaps the most relevant to these points is "A World View of Marijuana: Has the World Gone to Pot?" Journal of Psychedelic Drugs 2, no. 1 (Fall 1968): 1-14. See also "Pot: A Rational Approach," Playboy, October 1969, pp. 131, 154, 216, et seq., in which Fort argues for the legalization of marijuana. See also The Pleasure Seekers (Indianapolis: Bobbs-Merrill, 1969). (back)
53. Andrew T. Weil, Norman E. Zinberg, and Judith M. Nelsen, "Clinical and Psychological Effects of Marihuana in Man," Science 162, no. 3859 (December 13, 1968): 1234-1242; Zinberg and Weil, "Cannabis: The First Controlled Experiment," New Society/ (January 19, 1969): 84-86; Zinberg and Weil, "The Effects of Marijuana on Human Beings," The New York Times Magazine, May 11, 1969, pp. 28-29, 79, et seq.; Weil, "Marihuana," Letter to the Editor, Science 163, no. 3872 (March 14, 1969): 5 (back)
54. Alfred Crancer, Jr., James M. Dille, Jack Delay, Tean E. Wallace, and Martin D. Haykin, "A Comparison of the Effects of Marihuana and Alcohol on Simulated Driving Performance," Science 164, no. 3881 (May 16, 1969): 851-854. (back)
55. Tod H. Mikuriya and Kathleen E. Goss, "Thinking About Using Pot" (San Francisco: The San Francisco Psychiatric Mental Clinic, 1969), p. 24. (back)
56. Eugene Schoenfeld, "Hip-pocrates," The East Village Other 3, no. 36 (August 9, 68): pp. 6, 16. (back)
57. I am not making the claim that marijuana is inherently part of an intellectual avant-garde movement. At certain times and places, it may be looked upon as reactionary. It is just that today, in America, it is so considered. We also do not say that it is only among those who consider themselves in the historical vanguard that marijuana will appeal; it is just that those who do think this way will be more likely to try marijuana than those who do not. (back)
58. Stanley F. Yolles, "Pot Is Painted too Black," The Washington Post, September 21, 1969, p. C4. Compare this later statement with those made in the National Clearinghouse for Mental Health Information, NIMH pamphlet, published in part in the March 7, 1968 issue of The New York Times, p. 26, and the article "Before Your Kid Tries Drugs," The New York Times Magazine, November 17, 1968, pp. 124, et seq. (back)
59. In an actual mail-in questionnaire study by a physician of the attitudes of psychiatrists and physicians in the New York area on the legalization of marijuana, it was found that the large majority (about 60 percent) said that they were against legalization. Only a quarter were for it. See Wolfram Keup, "The Legal Status of Marihuana (A Psychiatric Poll)," Diseases of the Nervous System 30 (August 1969): 517-523. (Another way of looking at these figures, however, is that there is far from unanimous agreement within the medical and psychiatric professions on the status of marijuana.) (back)
Chapter 6 - Turning On: Becoming a Marijuana User
The verb "to turn on" has many meanings within the drug-using community. It is a rich and magical term, encompassing an enormous variety of situations and activities. Its imagery is borrowed from the instantaneous processes of the electrical age, which McLuhan has described with perverse brilliance. An electric light is turned on, and one's inept fumbling about a once-dark room ceases; a machine is turned on, and one can do what previously was impossible; the television is turned on, and a naked glass eye becomes a teeming, glittering illusion. The most general meaning of the verb to turn on is to make knowledgeable, to make aware, to open the senses, to sensitize, to make appreciative, excited. Thus someone may turn on someone to another person, a recording artist, an author worth knowing. A certain woman may turn on a man sexually. Reading a book may turn on its reader to an area of knowledge—or onto himself. A teacher may turn on his students. Someone may simply be turned on to the excitement of the world. Turning on is an enlargement of one's universe.----------------------------
The specific meaning of the word is using drugs. Within the drug context, "to turn on" has at least three interrelated connotations: (1) to give or have one's first drug experience—usually with marijuana; (2) to become high for the first time—with marijuana; (3) to use a drug—usually marijuana. "Let's go to my place and turn on," would nearly always mean to smoke marijuana and become high. A significant element in the marijuana subculture is that marijuana use is a turning on, an enlargement of one's awareness, an opening up of the receptivity of one's senses and emotions. To turn on with marijuana is, at least to its users, a part of living life as fully as possible.
We will now use the term in its first meaning: using marijuana for the first time—the process of "becoming a marijuana user." Our guiding concern will be the dynamic transition between being a nonuser to trying the drug initially. It is the story of the initiate, the neophyte's first drug exposure. What are the factors which make for such a transition? What sorts of experiences does the convert go through, and why? What are the appeals of this drug to the young, to the drug-naive, to the inexperienced, that make this transition so widespread? It should be kept in mind that we are describing an event that took place in the past. The smoker today was turned on previously, not today, perhaps a few days ago, perhaps a few years ago. Thus, there exists the possibility for distortion in our respondents' reports of their turn on. They may make their past consistent with present sentiment or events. The past may be shaped to tell an interesting story based on how they feel today. We have no idea how this tendency distorts the respondents' stories about their initial use of marijuana, but we ought to be attuned to the possibility of such a distortion.
Every marijuana user passes through the process of being turned on. Not all experiences will be the same, of course, but a hard core of common experiences will prevail among most users. Certain features will parallel any new experience, while some will be unique to marijuana use. Nearly all human activities at least indirectly involve other people, and being introduced to marijuana offers no exception to this rule; in fact, marijuana use in general is exquisitely a group phenomenon. Only six of our interviewees (3 percent) turned themselves on, that is, the first time that they ever smoked marijuana, they were alone. (They all had, of course, obtained their marijuana from someone else.) Eight individuals (4 percent) were turned on exclusively in the company of other neophytes. At their initial exposure to the drug, the user-to-be is subject to the tribal lore of the marijuana-using subculture, a distinctive and idiosyncratic group in society; his experience with the drug is, in a sense, predefined, channeled, already structured. He is told how to get high, what to do when he is high, how to recognize the high, what to expect, how he will react, what is approved high behavior, and what is disapproved, what experiences are enriched by the high, and which are not. The nature of the experience itself is defined for the initiate. Although these definitions in no way substitute for the experience itself, they are a variable which goes into its making. They do not determine the nature of the high experience, totally irrespective of any and all other variables, but they are crucial. It is necessary, therefore, to examine the impact of group structure in the experience of turning on.
Not only is the initiate turned on by experienced marijuana users rich in the collective wisdom of their group, but these proselytizers are also intimates. In no case did a peddler turn on the respondent—unless he was a friend. The profit motive in these conversions was simply and frankly absent. Friends were involved in every stage of the process—supplying information about marijuana, or supplying the opportunity, or the drug. But equally as important is that a friend or group of friends supplied a kind of legitimation. They were an "example." Prior to any first or second hand acquaintance with the drug, many users have a stereotype in their minds about the kinds of people who use marijuana. They might have been convinced that smoking pot is an undesirable thing to do because, in their minds, only undesirable people used it. Even more important than any knowledge about the effects of the drug in convincing them that turning on might have merit was their association with and attitudes toward people who endorsed and used marijuana. At the point where the individual realizes that it isn't only undesirable (in his eyes) people who use it, but many poised, sophisticated ones as well, his defenses against using it have been weakened, possibly more than by any other single factor. "I didn't want to smoke it because that added you to a collection of people who were undesirable," said one nineteen-year-old ex-coed. "The times when I could have turned on, I didn't want to try it with the people I was with—they were depressing people to be around," added another young woman. The disillusionment came with the awareness that "people I respected smoked it. I gradually began to realize the fakery about it," in the words of a thirty-year-old executive. "People I like smoked it." "Friends I knew and respected smoked it and like it." "A guy I admired was smoking, and I asked him if I could smoke." This theme ran through our interviews. "At first I looked down on it—it's dope, it's habit forming, it leads to heroin, it's demoralizing. But once, when I was staying over at my cousin's house, I thought, if my cousin, whom I dig, is doing it—she's a great kid—it can't be too bad," a twenty-year-old clerk explained. "I was apprehensive, a little excited, scared, and ignorant, but I trusted the guy I was with," a twenty-nine-year-old commercial artist told me, describing his turn-on ten years ago.
It is necessary that the proselytizer be someone whom the potential initiate trusts; he is generally unwilling to put his fate in the hands of a stranger. If he accepts society's generally negative judgment of the drug, there must be some powerful contrary forces neutralizing that judgment before he will try marijuana. Peer influences are just such powerful forces. Society's evaluation, even if taken seriously, is a vague and impersonal influence. The testimony of one or several friends will weigh far more heavily in the balance than even parental disapproval. If an intimate friend vouches for the positive qualities of cannabis, the ground has been cleared for a potential convert.
More specifically, the relationship between the neophyte and his marijuana initiator is crucial. The lack of association in the naif's mind of marijuana with a specific unsavory "scene" is, of course, important, but it lacks the immediacy and impact of his feelings for those who actually hand him a glowing joint. Although sexual parallels should not be pushed too far, something of the same significance is imputed to one's first sex partner as to the person one has decided to be turned on by. With women, the conjunction is closer than for men, since women are usually turned on by men, whereas men are more often turned on by other men.
Looking at smokers through the eyes of the potential convert, it is clear that, on the whole, a high proportion are respectable. More than that, many are at the center of the youth culture—the most highly respected of the younger half of the population are known as users. Known users are generally brighter, more creative, socially active, and knowledgeable in those aspects of the youth culture that the young take most seriously. A young black man, president of his sophomore class at Andover, was quoted by The New York Times as saying, "No matter what parents instill in their sons, they lose a lot of it here. Everybody wants to be identified with the 'in' crowd, and the 'in' crowd is now on the left." He might have added that the left is into pot. It is not merely that marijuana is fashionable to youngsters today, its users are seen as role models; they are, in many ways, a reference group for slightly younger nonusers. It is from the using population that many of the dominant values of today's youth spring—in music and fashion, to mention two of the most obvious examples—and from whom standards of prestige and desirability flow. One of the appeals of the drug, and why its use has spread with such facility, is that endorsers and users are seen by their peers as socially acceptable and even highly desirable human beings. As Alan Sutter, one of the researchers on the Blumer study of drug use in the Oakland area, wrote: "Drug use, especially marijuana use, is a function of a socializing movement into a major stream of adolescent life." Another reason why marijuana spreads with such rapidity is that users project relatively unambiguously favorable endorsements. Not only are they interested in making converts to a degree unequal to that of any other drug culture, but they advertise their drug better. Their propaganda is more effective, because they present more of its favorable qualities and fewer of its negative traits. The chronic amphetamine user or the heroin addict are ambivalent about their drug of choice and rarely portray it in unambiguously positive terms. They are willing to admit its dangers, its damages to their body, the hazards of use. Asked if their drug of choice is harmless, the amphetamine and heroin users are unlikely to agree, while the pothead is likely to do so. An indication of the relativity in images of the various drugs, what they do to the body, and their users, may be gleaned from the jargon for users of these drugs. The term "head" implies no negative connotation; it is a purely descriptive term. Thus, a "pothead" is simply one who uses marijuana heavily. But the terms "fiend" and "freak" are predominantly negative. Freak and fiend are never used in reference to marijuana users, whereas they are frequently applied to methedrine and heroin users—"meth freak," "speed freak," "scag fiend," and so forth. A linguistic projection of these differential images does not prove our point, but it does lend it support.
The image of potential and present potsmokers as "wild thrill seekers" has no basis. Most of the users interviewed were cautious and apprehensive about trying marijuana, and would not have made the leap unless they had been convinced that it would not harm them. The lure of cannabis is not that it represents danger; it is almost the reverse. It represents no obstacle to the future user when he is led to believe that it is safe. He rarely tries it himself to determine whether it is safe, but accepts testimony about its safety from those whose judgment he trusts. If it were depicted by his intimates as a dangerous drug or a narcotic (as defined by law), the overwhelming majority would never have tried it.
Americans generally pride themselves on being objective, hardheaded, empirical, and tough-minded. This is the show-me country, where the challenge to prove it calls for scientific demonstration. "I'll try anything once" is an open-minded attitude toward experience. Yet, for some reason, these injunctions are highly selective; they apply to some spheres of experience and not to others. There are, presumably, many activities and experiences that need no testing and are rightfully condemned out of hand. But the younger generation is taking the pragmatism of the American civilization literally, at face value. If it applies to technology, to the business world, to foods and fads, then why not pot? "Don't knock it unless you've tried it," was a theme running throughout my interviews. The firsthand experience is respected by America's young, and he who condemns without having "been there" will be ignored. And the reason why the pull to the promarijuana side is especially powerful is that positive personal testimony is more common than negative personal testimony, negative testimony being largely nonexperiential. Physicians who give talks designed to discourage marijuana use are invariably asked by young audiences whether they have tried the drug they condemn. Although the reply—you don't have tohave a disease to recognize its symptoms—satisfies the middle-aged physician, it is insufficient for the experience-oriented high school or college student.
We are struck by the dominant role of at least five factors in this process:
- The initiate's perception of danger ( or the lack thereof ) in marijuana use
- His perception of its benefits
- His attitude toward users
- His closeness to marijuana's endorsers
- His closeness to the individual trying to turn him on*
* This discussion assumes that the potential user has been provided with an opportunity to try marijuana, this is, itself, a variable and not a constant. We are concentrating on the characteristics of the individual himself in this discussion.
Of course, these five variables are only theoretically independent —in actual cases, they interpenetrate and influence one another. For instance, the neophyte is more likely to believe that marijuana is harmless if he is told this by intimates—less likely if told the same thing by strangers; therefore, (1) and (2) are partly determined by (4) and (5). Each of these factors should be thought of as a variable that is neither necessary nor sufficient; the only absolutely necessary precondition for turning on is the presence of the pot. Thus, the individual can come into a turn-on situation with almost any conceivable attitude toward trying marijuana—although, obviously, if the turn-on is to be successful, certain kinds of attitudes on the potential convert's part are more likely than others. However, what is necessary is that certain combinations of these variables exist.
To understand how the process of a typical turn-on might work, let us play a game by assigning each factor an imaginary (probably unrealistic) weight of twenty, and each individual a score ranging from zero to twenty, depending on the degree of favorableness; in his case, each factor is for a turn-on. Let us further claim that a turn-on occurs when our candidate—who has just been given an opportunity to turn on—is assigned a total score of fifty. Let us look at the following actual cases:I had notions that marijuana was harmful, that I might commit suicide, that it was a real drug; pot wasn't separated from the other drugs in my mind. Then, I had a neighbor in Berkeley who was a pothead. He explained what it was like to me. He told me not to be frightened about it. He described the high as a very sensual experience. It was as if I was a virgin. He talked to me for about two months before I tried it.Twenty-two-year-old public school art teacher, femaleI knew almost nothing about pot. I had no attitude about it one way or another. I was in high school, and a friend took me to a bar, he made a connection—I didn't know it until after—and then we drove off. In the car, he asked if I wanted some. I asked him a few questions about it, and then I tried it.Twenty-seven-year-old graduate student in sociologyI didn't believe in it. I felt as if I was above it. I didn't need a thing like that. Others seemed to take it when they have problems, and not when they were happy.
It seemed to be a miserable type of drug. I was visiting friends who were marijuana smokers, who were talking about it constantly, but I didn't want to smoke, and everybody else did. They said at first that it was okay if I didn't smoke and everybody else did, but I felt awkward not smoking when everybody else was, and I felt pressured into it. They all tried to teach me how to do it.Twenty-two-year-old writer, femaleI can remember thinking, if I were offered marijuana, I would try it. I knew it wasn't dangerous. I was offered it coming back from skiing with somebody I'd just met. We were riding home in a car.Twenty-one-year-old advertising specialist, femaleI didn't want to go along with everyone else. It was the hip thing to do in my high school in the tenth grade. I just didn't want to be a part of the drug scene. I was against it, but I knew I would eventually try it. I felt as if I might really like it. I just didn't happen to like those kids I knew that smoked. One day, two of us were sitting in a coffee house, and a friend dropped in and said, let's try it. We went into the back, into the ladies' room, and smoked it.Eighteen-year-old college freshman, femaleI was sixteen years old, in the Air Force. Near the base, in a bar, a whore picked me up, and we went to her place. She turned me on. My attitudes were hostile concerning pot. I thought it was dope, I thought it was addicting. I took it because I'm a chump for a broad. Anything she suggested was okay.Twenty-eight-year-old carpenterI knew it would be groovy two years before I turned on. I didn't have any opportunities before then. I would have snatched them up if I had. I studied up on drugs before I took it. I knew what the hygiene course we had in high school was teaching were lies.Twenty-year-old bookstore clerkAt first, I thought, it's a terrible drug, and it leads to heroin. But my brother demolished all the fallacies. It sounded good. There was nothing wrong with it but I was still afraid of it. My brother turned me on.Nineteen-year-old clerk in a bookstore, femaleMy feelings about pot were nonexistent, though I was vaguely favorably disposed to it. I discounted the negative jazz as hoopla and propaganda; I couldn't see, after reading about it, any harm from it. I didn't accept the first few opportunities I had, because I didn't like the people I was with. Finally, I visited some friends, and they offered me some.Twenty-seven-year-old dishwasherBefore, I didn't want to—I didn't see any reason for it. I wasn't around people who smoked it. But at the job I have now, people at the office talked about it. I got interested. I mentioned to someone in the office I'd like to try it: Could you get me some? So, one night my husband and I had guests. No one had ever had the stuff before. Three of us turned on with the pot I got from the office. My husband didn't try it.Twenty-five-year-old assistant research analyst, market research firmI knew it was harmless, and I was curious about it. I was sitting in the park, and a guy came to me and asked if I wanted to buy some, and I bought a nickel bag, and went over to a friend's place, and we turned on.Nineteen-year-old college studentI was against the idea of marijuana. I was ignorant. I knew it was a drug, and I thought it was addictive. But my closest friend smoked—I was close friends with this guy for four years. He asked me several times to turn on and I said no. Finally, I decided, what the hell—give it a try.Twenty-four-year-old market research study directorMy older brother gave it to me. He told me not to turn on out of social pressure; I should be turned on by someone I trusted—himself. He got it for me, and then I went up to the attic and turned on alone. I came down and talked to my parents. Only my brother knew I was high. Before that, I didn't know people well enough, or trust them, to turn on.Twenty-five-year-old artist-performerI knew almost nothing about pot, but I was completely confident that nothing would happen, since my brother turned me on.Twenty-one-year-old unemployed college drop-outI felt safe with good friends, and I felt it would be all right.Twenty-year-old coder, female
Thus, someone who is extremely close to both the endorser and the individual turning him on (forty points), and who has an ambivalent attitude about users (ten points), sees no benefits in use (zero points), and is unsure about its safeness (ten points), is a potential candidate for being turned on, when the occasion arises. Another person who thinks of the stories about its dangers as myths, thinks that it would be fun, and has at least a moderately favorable image of smokers, is likely to be turned on, even by a stranger. One indication that our scheme reflects something of the actual situation is the fact that many marijuana users (46 percent of our respondents) report having refused opportunities to turn on prior to their eventual conversion because one or another circumstance at that time was not favorable. Any one of these factors could have been the reason, but the two most often mentioned were the fears about the drug's danger and a lack of closeness with the person or persons offering the opportunity to try it. With this scheme in mind as a very rough model, it is possible to see how someone could accept an offer to smoke even though he is still fearful of the drug's effects, although this is empirically infrequent.
It is relatively rare for the initiate to try to simulate prior drug experience, although it does occur. The majority going through the initiation ceremony are known to be novitiates by all present (70 percent of our interviewees), while occasionally some present at the turning on ceremony will know, while others do not (6 percent)— at a large party, for instance. It is not uncommon for the respondent to be unaware of what others know of his prior drug experience (15 percent), and sometimes none present at his turn-on knew that he was marijuana-naive (g percent). Typically, both initiate and initiator regard the turn-on as a highly significant event in the novice's roster of life experiences. It is a kind of milestone, a rite de passage; it is often seen as a part of "growing up" for many adolescents. Even when others are not in the know, the subject is nervous and excited at the prospect. Its importance in one's life is overshadowed only by (and is similar to) losing one's virginity. Although the following account is atypical because it is so extreme, it captures much of the flavor of the ritual-like nature of the characteristic turnon; I present the verbatim transcript of a portion of the interview of a twenty-three-year-old dramatics graduate student. (I am asking the questions.)Q: Do you remember how you got it for the first time?A significant element in the marijuana subculture's tribal lore is the technique involved in smoking the weed. For those who do not smoke tobacco cigarettes, the whole procedure might seem particularly strange. But even for those who do smoke, much of the tobacco cigarette agendum is inapplicable to smoking marijuana cigarettes; if pot is smoked exactly like an ordinary cigarette, the novice probably cannot become high—it is difficult enough in the beginning when done correctly—although it is possible with practice. The initiate, to become high, must inhale the marijuana smoke deeply into his lungs; take some air in with the smoke; hold it there for a few seconds; and let it out slowly. These procedures require observation and instruction. They are part of the technology of marijuana use that must be mastered. Although they do not compare in complexity with heroin technology, they are necessary for attaining the desired state of intoxication.
A: It was given to me. I smoked it with a friend of mine, and a friend of his, and another amiable person.
Q: Do you remember what the occasion was?
A: There was no occasion; the occasion was the turning on.
Q: You got together for the purpose of turning on?
Q: All the others present—did they know you were smoking for the first time?
A: Yes. And if the party was the celebration of anything, it was the celebration of a new person coming to turn on, and that was a big deal. And everyone was very nice, you know, and brought all sorts of great things to eat. And taste, and wild things, and put on a whole show, you know, it was agreat, marvelous experience: just absolutely marvelous.
Q: Did you get high?
A: Yes, I got very, very high. Had an enormously good time. The first time I got high, I think we were listening to jazz, and the notes became visual, and turned different colors, and became propellers. And jazz became kind of formalized in a great color and motion thing that I created from my own imagination—wonderful things like this happened. And the room was tilted slightly up, you know, turned on its side; it was like a rocket ship taking off for somewhere, you know, way out in the vastness of outer space.
By itself, without becoming high, marijuana smoking is not pleasurable. All users smoke marijuana to become high—in traditional language, "intoxicated." They see no point to smoking it for its own sake. There is no pleasure to be derived from inhaling the fumes of the burning marijuana plant (although the same could be said for the leaves of the tobacco plant), and there is, moreover, no ideology which claims that mere smoking, without intoxication, is pleasurable or good, or relaxing—or anything—as there is with regular tobacco cigarettes. (Pot, in addition, lacks the physiological compulsion-imperative built into nicotine.)
We may take it as an axiom that everywhere and at all times, marijuana is smoked in order to attain the high. It might seem surprising that at this point we encounter another learning process. No activity, bodily state, or condition is inherently pleasurable. Physiological manifestations of human sexuality, for instance, experienced by the completely untutored are apt to be interpreted as disturbing and puzzling, not necessarily pleasurable. We are prepared for and instructed in the pleasures of sex; sufficient negative tutoring will generally yield disgust and a desire for avoidance in the individual. Now, it should be mentioned that some bodily states have greater potential for being defined as pleasurable: sex, for instance, or the marijuana high. But the social-defining and learning process must be there. It seems a paradox to say that one must learn how to have fun, especially as the Freudians tell us that culture is primarily repressive, not liberative, but it is difficult to avoid such a conclusion.
The unprepared individual is unlikely to think of the marijuana intoxication as pleasurable. The pleasures or discomforts of the high are interpreted, defined, sifted by group definitions. One is, in a sense, programmed beforehand for the experience, for feeling a pleasurable response. Even as one is in the very process of becoming high and beginning to experience the effects of the drug, a dialectical relationship exists between the high and the user's moral and epistemological ambiance. Group definitions constantly interpret and reinterpret the experience, so that subsequent feelings and events are continually tailored to fit the expectations of the group. Although when a marijuana circle has a novice on its hands, the instruction is generally verbal and calculated, much of the learning process is preverbal. It need not be consciously didactic: one may be taught by example, tone of voice, movements, laughter, a state of apparent ecstasy. Merely by looking around him, the novice senses that this is a group preparing to have fun, this is the type of situation in which people enjoy themselves. Thus, even when turning on for the first time, the neophyte will rarely experience something which is wildly out of line with group expectations. If he does, the initiate is "talked out" of them. The statistically few events that do occur contrary to the group's expectations are noteworthy for their rarity.
Since users most generally think of marijuana use as normal, healthy, appealing, and sybaritic, the novitiate absorbs mostly favorable definitions and expectations of what he is about to experience. Interpretations concerning the high emanating from the group become assimilated into the beginner's moral outlook, and most commonly his experiences are a reflection of these definitions. If use were condemned by users who saw themselves acting out of "compulsive" and "sick" motives, and who thought of smoking in morbid, self-flagellating terms, not only would the novice be unlikely to try the drug, but even if he ever did, his high would be experienced as unpleasant, distasteful, repellent and even psychotomimetic. This is not generally the case because each new user is insulated from negative experiences with the high by favorable definitions; it is the "legacy" which the marijuana subculture passes down to succeeding generations.
Curiosity is the dominant emotion of the neophyte at the time of his turn-on; this is often mixed with excitement, apprehension, joy, or fear. It should be stated at the outset that I do not endorse the "forbidden fruit" argument. If marijuana use were not considered improper or immoral by the bulk of society, there is no doubt whatsoever that it would be more common. Social condemnation, particularly among one's peers, keeps down the condemned activity, although, obviously, the less significant the condemning individual or group is felt to be, the less effective the condemnation will be; it is even possible to find "negative reference groups." I would hold that one of the appeals of marijuana is not that it is abhorred by adult society; it does not represent rebellion or a rejection of adult values. Yet, its mystery, its underground character, the fact that it is clandestine and morally suspect—all lend an air of excitement and importance that would be absent otherwise. For the neophyte, the maintenance of a matter-of-fact attitude is almost impossible. A1though use is not greater because it is forbidden, its contraband nature, at least in the beginning, make it special and outside the orbit of the everyday. The excitement is manufactured: it is a social artifact. Inexperienced users perceive its socially imputed gravity through cues ranging from the voice tone of marijuana participants to the reactions of the police to the discovery of marijuana possession. The more contact the user has with the drug and other users, the less "special" use becomes.
Users often draw parallels with sex; being turned on is seen as equivalent to losing one's virginity. Feelings of the specialness of one's activities and uniqueness dissolve with the growing awareness that many seemingly respectable individuals also smoke marijuana: "After being turned on, I realized that many straight types smoke, too. It's sort of like when a virgin has just been deflowered; she realizes that others must also be nonvirgins, too, after having experienced it herself," said a twenty-two-year-old law school student, a weekly smoker. In fact, there is often a certain degree of disappointment in the experience. The experience has been billed as bizarre, beautiful, frightening, orgiastic, but either pro or con, the descriptions are invariably unusual. "At first I thought it would be the passageway into heaven," a young man of Catholic parentage told me, somewhat disenchanted that it wasn't. "I expected a fantastic change," said a twenty-three-year-old woman writer about her experience of being turned on in a cafe in Tangiers; "I was disappointed," she added. "I was scared shit," a student in pharmacy told me about an experience six years earlier.
Aside from the expectation that the high would be much more spectacular, some of the disappointment stems from the fact that many initiates do not become high the first time that they smoke, or at least do not recognize it. Marijuana's effect is subtle, and is, as I have stated, quite dependent on the learning process. In Becker's words,... the new user may not get high and thus not form a conception of the drug as something which can be used for pleasure....
... being high consists of... the presence of symptoms caused by marijuana use and the recognition of these symptoms and their connection by the user with his use of the drug. It is not enough, that is, that the effects alone be present; alone, they do not automatically provide the experience of being high. The user must be able to point them out to himself and consciously connect them with having smoked marihuana before he can have this experience. Otherwise, no matter what actual effects are produced, he considers that the drug has had no effect on him.
It is possible that the drug sometimes does not take effect on an individual who has smoked once or even a dozen times. A small proportion of individuals seem almost incapable of attaining a high, at least using conventional smoking techniques. Whether this is physiological or psychological, it is impossible at this point to determine. Many of these individuals have been socialized into the subculture, know the proper techniques and what to expect from them, have seen others enjoying pot, and yet never seem to cross the threshold of becoming high. More commonly, however, the reason for the lack of attainment of the high is inexperience. Among our respondents, 41 percent said that they did not become high the first time and 13 percent said that they weren't sure whether or not they were high. The attainment of the high, however, usually comes with experience. Twelve percent of our respondents said that they became high on their second attempt, g percent on their third, 8 percent on their fourth, and so on. Only seven individuals in our sample claimed never to have been high, and all but one had tried only half a dozen times or fewer. The completely resistant individual, although he does exist, is a relative rarity. Of the various reasons offered for their lack of becoming high on the first attempt, the most common (twenty-seven individuals) was improper technique; fear and nervousness accounted for a dozen or so responses. Again, the sexual analogy seems relevant. Becoming high smoking marijuana is similar in many respects to the attainment of sexual orgasm, at least for the woman, in that:
- It is more likely to occur when emotion is part of the relationship the differential is greater, obviously, with sex than with pot.
- It often does not occur with the first attempt.
- With experience, its likelihood increases.
- Some individuals seem especially invulnerable to it ever occurring; they seem to resist it, possibly for fear of losing control, or, for some reason, their bodies seem peculiarly incapable of attaining that blissful state.
- Nervousness and fear reduce the likelihood.
- Simple technique has a great deal to do with its attainment.
- Some individuals (with sex, always women) wonder whether they have ever reached that state, since the line between attainment and "normalcy" is tenuous and the symptoms of attainment have to be learned.
- Its importance is exaggerated to such a degree that the neophyte will often be puzzled as to what all the fuss is about.
It is only after repeated interaction and involvement with the marijuana subculture that some of these initial disappointments begin to evaporate, just as the recently deflowered girl gradually learns that the delights of sex blossom with time and nurturance. There is a progressive accretion of sensitivity to the subtle and not so easily discerned marijuana high; it takes time to learn how to enjoy marijuana, to absorb the prevailing group definition on the drug's pleasures and virtues. By interacting repeatedly with more experienced users, the neophyte takes their definitions of what the drug does to his body and mind as his own and eventually comes to experience those effects.
Among individuals acquainted with marijuana over a period of time—individuals who have used it on many occasions, who have seen others high, and who have participated in a variety of activities high—the drug becomes demythologized. Much of the excitement and awe of the new adventure gradually drains out of its use. It becomes taken for granted. At this point the propagandists step in and inform us that a jaded palate inevitably generates the desire for increasingly greater thrills and kicks. No one has successfully explained why this should be so; for some reason it appeals to common sense. The truth is the drug need not retain that mixture of fear, awe, and excitement in use to retain its appeal. Experienced users become comfortable with the marijuana high, much as they might enjoy making love with a spouse of long duration. By losing much of its subterranean character, marijuana does not necessarily lose its appeal. In fact, whatever uncomfortable or even psychotomimetic effects the drug might have had earlier, with limited experience, become dissipated with increased use. In general, experienced users describe their high in more favorable terms than the inexperienced. (Although individuals who do experience discomfort in use tend to discontinue smoking.) Simultaneously, the experience becomes increasingly less and less "apart" from the everyday, less and less discontinuous with it, and increasingly a normal and taken-for-granted element in one's day to day existence.
Among the more experienced users, marijuana comes to be regarded as an ordinary item in one's life—it becomes "no big deal." In fact, users of long duration have a difficult time switching back and forth from their taken-for-granted attitude toward pot to society's fearful and punitive stance. Many users do not regard marijuana as a drug—i.e., in a special and distinct and harmful category—just as few liquor drinkers will claim to be users of any drug, so unaccustomed are they to thinking of their drug of choice as anything of particular note. During the research, I went into a psychedelic book store in New York's East Village and asked the salesman, wearing long hair, beads, and bells and sandals, if they had any books on drugs. "What kind of drugs?" he asked. When I said marijuana, he replied, "Marijuana's not a drug." This theme emerged in the interviews. A twenty-three-year-old woman, a daily smoker of marijuana, told me, "I can't think of marijuana as being a drug—it's just pleasurable."
N O T E S1. Howard S. Becker, "Becoming A Marihuana User," American Journal of Sociology 59 (November 1953): 235-243. (back)
2. In a study of the drug use of 432 "Yippies" in Chicago's Lincoln Park at the time of the 1968 Democratic National Convention, Zaks, Hughes, Jaffe, and Dolkart found that the most common reason claimed by the respondents for "starting on drugs" (i. e., for turning on)—marijuana was by far not only the most popular drug, but was most likely to have been the first drug used—was that he was turned on by friends; almost two-thirds of the sample (63 percent) gave that as their reason. (Cf. Table 6, p. 24.) Without an understanding of this process, this answer might seem a non sequitur. But the fact that a friend (whose judgment we trust) gives us an opportunity to try a drug has a great deal to do with whether we ever turn on or not. An additional fifth of the sample (22 percent) gave "association with users" as a reason for turning on. See Misha S. Zaks Patrick Hughes, Jerome Jaffe, and Marjorie B. Dolkart, "Young People in the Park Survey of Socio-Cultural and Drug Use Patterns of Yippies in Lincoln Park, Chicago Democratic Convention, 1968" (Presented at the American Orthopsychiatric Association, 46th Annual Meeting, New York, March 30, to April 2, 1969), unpublished manuscript, 28 pp. (back)
3. Herbert Blumer et al., The World of Youthful Drug Use (Berkeley: University of California, School of Criminology, January 1967). (back)
4. Alan G. Sutter, "Worlds of Drug Use on the Street Scene," in Donald R. Cressey and David A. Ward, eds., Delinquency, Crime, and Social Process (New York: Harper & Row, 1969), p. 827. (back)
5. John Kifner, "The Drug Scene: Many Students Now Regard Marijuana as a Part of Growing Up," The New York Times, January 1 l, 1968, p. 18. (back)
6. A recent film, Easy Rider, released in 1969, in which marijuana is smoked nearly throughout, depicted a turning-on scene which contained the neophyte's fears: that he would become hooked on marijuana and that it would lead to harder stuff. This was laughed at by his initiators. The initiate was provided with instructions on how to smoke the joint. According to an interview with the film's director, actual marijuana was used in the smoking scenes. Hopper said, in the Times interview, "This is my 17th grasssmoking year. Sure, print it, why not? You can also say that that was real pot we smoked in Easy Rider." See Tom Burke, "Will 'Easy' Do It for Dennis Hopper?" The New York Times, Sunday, July 20, 1969, D11, D16. (back)
7. The Zaks et al., study found that curiosity was the second most often cited reason for turning on; over a third of their sample (37 percent) said that the reason for starting on drugs was curiosity, o p. cit., Table 6, p. 24. (back)
8. Becker, Outsiders (New York: Free Press, 1963), pp. 48—49. (back)
Chapter 7 - The Effects of Marijuana
Introductory ConsiderationsAs with other aspects of the drug, describing the marijuana high has political implications. Both sides of the debate wish confirmation of their prejudices, and most facts presented will be distorted to fit them. The postulate, accepted on faith, not fact, that marijuana is a "crutch" and an "escape from reality," and that man ought to be able to live completely without recreational drugs naturally approaches the drug's effects in a negative way. Even if harmless, the effects, whatever they may be, aredefined as undesirable.
This aprioristic thinking dominates both sides of the dispute. The pro side engages in the same mental gymnastics by deciding beforehand that marijuana can do no harm. It is easy to say that what we need is less bias and more fact; more fundamental than facts themselves is the powerful tendency to read facts selectively. At least two processes operate here: the likelihood of accepting one or another fact as true depends on one's prior attitudes toward the drug; and facts may be interpreted to mean many things since what is a positive event to one person may be seen as supremely damaging to another. The description of being high by a user illustrates this axiom: "I felt omnipotent and completely free. I'm a free soul, a free person, and I often feel bigger and better than I am now." The marijuana defender would see this as strong evidence for marijuana's beneficial effects. The antimarijuana forces would interpret the description as evidence of the fact that the drug is used as an ego-booster by spineless personalities; a person should be able to "face life" without the aid of artificial props. The goodness or badness of the events themselves clearly depends on how they are viewed.
Descriptions of the marijuana high run the gamut from pernicious to beatific; one's conceptions of the drug's impact are highly structured by ideological considerations. In the 1930S, widely believed stories were circulated, detailing massacres, rapes, widespread insanity, debauchery, and feeblemindedness as inevitable consequences of the use of the insidious weed. One account, publicized nationwide, had a young man chopping his family to bits after a few puffs of marijuana. The blood has disappeared, but the controversy remains, and a novel element in the debate has been introduced. Whereas marijuana's adherents in the 1930S saw the drug's effects as being confined within a fairly limited scope, largely hedonistic and artistic in nature, today's smokers often extrapolate into philosophical and sociopolitical realms as well. Although it strains one's credulity to accept the notion that a marijuana "turnon" of contemporary political, military and business figures will result in "everlasting peace and brotherhood," this utopian fantasy is as much a fixture of the ideology of many of the drug's most committed propagandists as were the scare stories for the marijuana prohibitionists of the 1930S. Yet the question remains: What are the effects of marijuana?
This seemingly simple question is answerable only with major qualifications, specifications, and prefatory explanations. To pry into the subject, it might be fruitful to structure our thinking around a series of interlocking issues. To begin with, the question of dosage is crucial. Generally, other things being equal, the heavier the dosage of a given drug, the more extreme the effects, with some variations. Marijuana grown in different locations, under varying climatic and soil conditions, will differ in strength, which we explained earlier. Also, in general, hashish will produce more striking and noticeable effects than marijuana containing mostly leaves. It has been determined that the principle active chemical in marijuana is tetrahydrocannabinol (abbreviated THC). Thus, the most powerful effects may be obtained by administering the pure chemical to subjects. It is, therefore, meaningless to ask simply, "What is the effect of marijuana?" without specifying dosage.
A second qualification before detailing the effects of the drug involves prior marijuana experiences of the subject. A significant proportion of marijuana users did not become high the first time that they smoked the drug, as pointed out in our chapter on "Becoming a Marijuana User." In part, much of this may be attributed to improper and inefficient technique. However, even with the most careful instruction and technique, some fail to become intoxicated. But when the neophyte does attain a high, an interesting phenomenon occurs. The effect of the drug on the newly initiated marijuana smoker appears to be highly dramatic and almost baroque in its lavishness. His laughter approaches hysteria. Insights are greeted with elaborate appreciation. His coordination might rival a spastic's. The experienced marijuana smoker, on the other hand, learns to handle his intoxication so that the noticeability to an outsider is almost nonexistent. He compensates for the effects of the drug, so that his coordination is no different from "normal." This is a learning process, not attributable to the direct pharmacological properties of the drug (which, however, sets limits on the compensatability of the subject). It is simply a characteristic that experienced users share and neophytes lack. Yet it is an important qualifying element in the marijuana picture.
In addition, many of the effects of the drug vary with the attitudes, personality, expectations, fears, and mood of the user; this is generally referred to as "set." One experience might be euphoric and wholly pleasurable; another might be uncomfortable and frightening, for the same drug, the same dosage, and the same person. No one has adequate explanation for this variation. A1though the vast majority of all users report pleasant effects much of the time, a proportion will occasionally have an experience significantly different from the usual one. A very few users—who do not, for this reason, become regular users—report more or less consistently unpleasant experiences with the drug. Here, personality factors may be the controlling factor.
Some observers say that marijuana imposes behavior on the user, that the drug has effects that can be measured, that whatever happens to the human mind and body during a marijuana intoxication is a function of the drug so that the individual is said to be under its influence. To some degree, we have to admit that the drug is an "objective facticity." It is difficult to deny a certain degree of factorness of the drug's effect: the drug is not a zero or a cipher. There are neophytes who smoke oregano imagining their responses are due to the powers of marijuana. However, suggestibility has limits. Were all of the world's cannabis magically substituted for an inert substance that looked the same, it would become known at once. It would be foolish to deny that the drug has its effects. Now, this observation might seem blatantly obvious. Not so. Because the drug's pharmacology exists only as a potentiality, within which forms of behavior are possible as an "effect" of the drug. The effects of any drug are apprehended as subjective experience and experiencing a drug's effects must be learned. The subculture translates and anticipates the experience for the neophyte, powerfully shaping the experiences he is to have. The same bodily response will be subjectively apprehended in many different ways, and, in a sense the "effect" is different. The important dimension is not simply, "What does it do?" This cannot be answered until we know the answer to the question, "What does it mean?" What does it mean to the participant? How do the meanings of individuals relevant to him impinge on his conceptions of the experience? By itself, the simple physiological question is meaningless, since prior experiences and learning substantially alter what a drug does.
Another fundamental question connected with, and prior to, the effects of this drug is, "is the subject high?" The same quantity of marijuana administered to two subjects will produce a "bombed out of his mind" reaction in one and no response in the other. Although objective tests may be applied to determine this state, many users who report being high do not react very differently from their normal state. Many inexperienced users, of course, are not really sure whether they are high or not, and, as stated earlier, some users seem unusually resistant to becoming high. The point is, then, that whether the person is high or not is problematic, and if we want to know the impact of the drug, we must know this beforehand. The police make an issue of this point; they feel that if the promarijuana argument on the relative harmlessness of marijuana bears any authority at all, it is merely because the varieties of cannabis available in America are far weaker than varieties available elsewhere. The drug may be innocuous, but only because it is the very weakest varieties to which the American user is exposed. Were the drug legalized, we would be flooded with extremely potent varieties, causing some of the same kinds of debilitating and disastrous effects reported in the East:American-grown cannabis is likely to be a fraud on the hopeful hippie in that its cannabinol content, in certain seasons and places, may approach what would be near-beer to the boozer. This marihuana is almost harmless except for asphyxiation from air pollution. The hippie's kick is a psychic kick. Chemically speaking, the victim often is not smoking marihuana, but burning underbrush. He is not the victim of a drug, but is the sucker of a hoax. There is enough of this gyp going on to help support the notion that marihuana is innocuous.
(There is some cross-fertilization in regard to the language going on here; Donald Miller, Chief Counsel, Bureau of Narcotics and Dangerous drugs, in an article which justifies the present legal structure on marijuana, writes: "... many persons report they obtain no effects whatever when they use marihuana. They are not the victims of a drug, but merely have been deceived with a hoax. There is so much gyping going on that it helps support the notion that marihuana is innocuous. Chemically speaking, many ... 'triers' of marihuana really have... become partially asphyxiated from polluted air.")
The reader is seriously asked to believe that a great percentage of all marijuana users, even some experienced ones ("the hopeful hippie"), have never really been high, and that they are experiencing a placebo reaction. Actually, this point serves propaganda purposes: if anyone who has smoked marijuana has not been damaged in any way, he must not have gotten high. Thus protected, the antipot lobbyist is better able to defend the position that the drug is really dangerous. Actually, the position itself is something of a fraud. The placebo reaction occurs, of course, with no mean frequency, but the greater the amount of experience with the drug, the less likely it is that the subject has experienced either no reaction or nothing but a placebo reaction. In fact, the likelihood that a given person who has smoked marijuana more than, say, a dozen times, thinks that he has been high without actually experiencing what a truly experienced user would call a high, is practically nil. The experience has been described in such florid detail by so many more experienced users that he who has not attained it is eventually aware of it, and knows when he finally does attain it.
Throughout any discussion of the effects of marijuana, we must alert ourselves to the complexity of the equation. The simple question, 'What are the effects of marijuana?" is meaningless. The answer to this query would have to be a series of further questions: Under what circumstances? At what dosage level? Engaged in what kinds of activities? Given what kind of legal and moral climate regarding marijuana use? All of these factors influence the nature, quality, and degree of response to the drug.
Yet, at the same time, we must not exaggerate the variability of marijuana's effects. Responses are to some degree systematic. We do not wish to suggest that individuals react randomly to the drug. The police will often make this assertion, in support of the dangers of marijuana: "Medical experts agree on the complete unpredictability of the effect of marijuana on different individuals." The reason why this statement is nonsensical is that, of course, the effects of marijuana cannot be predicted with absolute certainty, though there will be a reasonably high degree of predictability. It is extremely important as to the kind of effect we wish to describe or predict. Some of the many effects of marijuana will be experienced by nearly all smokers who become high. Many other effects will be experienced by only a few users.
The Marijuana High: Experiments and DescriptionsOf the thousands of works describing the psychic and bodily effects of marijuana, the first to meet fairly strict standards of the application of scientific controls—that is, (1) standardized dosages were administered, (2) of actual marijuana (3) in a "double blind" situation, (4) with systematic measures used to study the effects, (5) to groups with varying degrees of experience with the drug (naive and experienced), (6) in a uniform environment—was published in December, 1968. (Also, significantly, the drug was administered to a nonincarcerated population.) All of the previous studies were lacking in some of these respects, or were primarily anecdotal, informal, literary, or were based on the literal descriptions of the high by smokers, without checking the accuracy of their descriptions.
Conducted in Boston by pharmacologist-physician Andrew Weil and psychiatrist, physician, and social psychologist, Norman Zinberg, this study established beyond question the generation of a few strictly biological effects of smoking marijuana and suggested the likelihood of others. It did, however, totally negate the possibility of some effects commonly associated with pot. The strictly physiological consequences of marijuana, the study found, were, first of all, highly limited, and second, extremely superficial in their impact. Most of the multifarious effects described in the literature are too ephemeral to be studied under rigid clinical controls, or simply turned out to be myths. The only positive effects which the Boston team could establish beyond dispute were a slight increase in the rate of heart beat, distinct reddening of the eyes, and probable dryness of the mouth.
This descriptive clinical study documented a few positive effects; it also demonstrated some negative ones as well. Not only is the public deluded into believing many myths about marijuana, but experienced marijuana smokers themselves accept a few. For instance, it is standard marijuana lore that, when high, one's pupils dilate. Yet careful measurement under the influence of the drug produced no such result; pupils remained the same size after administration. How could such a myth be believed by individuals with countless hours of experience in the presence of others while smoking marijuana? The Weil-Zinberg team suggests the answer: marijuana smokers customarily consume the drug under conditions of subdued light, which would, in the absence of marijuana, produce dilated pupils anyway. This finding strongly underscores the need for controlled experimentation, with each of the suspected causal factors being isolated successively to test their impact. It also addresses itself to the possibility of empirically false beliefs having widespread currency among even the most knowledgeable of individuals.
This research team also turned up a negative finding with regard to marijuana's impairment of various skill and coordination functions among experienced users, an area in which it was thought to have substantial impact. Marijuana, it is said, impairs the ability to perform manual tasks and manipulations. For instance, it is claimed that the widespread use of the drug represents a massive danger to society because of its obvious deterioration of driving ability, thus increasing the likelihood of fatalities on the road. "I ask the kids," a journalist intones, in a series of articles attempting to avert marijuana use in her readers, "If you have to fly someplace, which would you rather see your pilot take, a martini or smoke a marijuana cigarette?" Aside from the inaptness of the comparison (since very few drinkers can become intoxicated on one martini, while most marijuana smokers do become high on one "joint"), the striking thing about the verbal gauntlet is that the author assumes that the answer is a foregone conclusion. In fact, do we know the answer? Which is, as a result of actual tests, the safer and which is the more dangerous? Curiously, the assertion that it is far more dangerous to drive under the influence of marijuana has never been documented; it is assumed. After all, the role of alcohol in driving fatalities is only too well known; something like twenty-five thousand deaths every year from automobile accidents can more or less be directly attributed to the overindulgence of liquor. The reasoning is that if alcohol is dangerous, marijuana must, of necessity, be worse, because it is legally prohibited; moreover, the results of the two together can only be additive.
The only tests done on driving skills was completed a few months after the Boston experiments in the state of Washington. A team of researchers, including Alfred Crancer of the Washington State Department of Motor Vehicles, and James Dille, Chairman of University of Washington's Department of Pharmacology, conducted an experiment on simulated driving skills. (Tests on actual driving conditions are planned.) The various driving functions were accelerator, signal, brake, speedometer, steering, and total test score; a total of 405 checks were made throughout the course of the entire experiment, so that a subject's total number of errors could range, theoretically, from zero to 405. Subjects were experienced marijuana users who were also acquainted with the liquor intoxication. They were administered the test (1) high on marijuana—they smoked two joints, or 1.7 grams of marijuana (as a comparison, Weil and Zinberg's subjects were given half a gram as a low dosage and two grams as a high dosage); (2) intoxicated on alcohol (two drinks were administered, and a Breathalyzer reading taken); and (3) in a "normal" state of no intoxication. What were the results of this driving test? The overall findings were that marijuana did not impair motor skills, that there were almost no differences driving high on marijuana and normal. The total number of driving errors for the normal control conditions was 84.46; the total number of errors while driving high on marijuana was 84.49, a trivial difference, well within random fluctuation. (The only significant difference between the marijuana-high subjects and the same subjects "normally" was that high users, on the Crancer test, had to check their speedometers more.)
The same could not be said for alcohol. Being intoxicated on liquor significantly diminished one's ability to take the driving test without error. The total number of errors for the subjects under the influence of alcohol was 97.44. Crancer, the principal investigator in this experiment, concludes from it that the drunk driver is a distinctly greater threat than the high marijuana smoker. He is quoted, "I, personally, would rather drive in a car where the chauffeur is high on pot than drive in a car where the chauffeur is high on alcohol." However, it is difficult to extrapolate from thus test, done in an artificial setting, to actual road conditions; Crancer himself designed the test, and found an extremely close correlation between test scores and actual driving skills. But only real-life driving experiments will answer these points definitively; in any case, at the very least the Washington State driving tests certainly cast doubt on the fears of many propagandists that widespread marijuana use will result in an even greater slaughter on the nation's highways than prevails today. It is even conceivable that were pot substituted for alcohol in many drivers, the death toll would actually drop, not rise.
Certainly no one would argue that driving under the influence of marijuana is preferable to being without the influence of any drug. But Crancer speculated beyond the test-driving scores in saying that his "feelings and observations, and that's all they are—they are not scientific conclusions—lead me to believe that marijuana has a submissive effect on users." The effects of the drug subjectively exaggerate the sensation of speed, and the high driver often thinks that he is going much faster than he actually is. Some of my own informants report driving to the side of the road because they thought they were traveling at a frighteningly rapid speed, when, in fact, they were driving well under the speed limit. But it is difficult to see how marijuana could possibly improve driving performance. However, there is incomplete evidence that high on marijuana, drivers often drive more slowly than normally, out of fear. The proposition that the high driver is no worse than normal is definitely worth exploring; it is conceivable that further tests will reveal little or no deterioration in driving ability when high on marijuana. But the hypothesis that the marijuana high deteriorates motor skills far less than alcohol is, it may safely be said, firmly established. There is no doubt that, in the typical case, marijuana affects the ability to drive much less than alcohol.
The Crancer test results, by extension, would seem compatible with the Boston team's research. Various tests by Weil and Zinberg were administered to both inexperienced and experienced subjects under normal and marijuana-intoxicated conditions. These tests were "pursuit rotor" test, measuring muscular coordination and attention; the "continuous performance" test, measuring ability at sustained attention; and the "digit symbol substitution" test, measuring cognitive functioning. Most generally, the results consistently showed that among experienced marijuana smokers, no impairment whatsoever was discerned in the ability to perform cognitive and muscular tasks, whereas impairment was significant among inexperienced subjects. Experienced users were fully as able to perform motor skills and cognitive functions while under the influence of the drug as in a normal state. Although further research is needed in the kinds of motor skills in question, this finding powerfully illustrates the need to support one's prejudices with empirical facts. To justify marijuana's present legal status, it is necessary to use damaging "facts" about marijuana, such as its impairment of driving skills, even though they are imaginary in character. Recent research shows the argument that increased marijuana use would contribute considerably to automobile fatalities to be largely specious. Nonetheless, it will continue to be invoked for years to come, because of the need for such an argument. The belief that marijuana makes one a far more dangerous driver is believed, and will continue to be believed, even though the chances are great that it is scientifically false. Yet, scientifically false beliefs can exert a powerful hold on men's minds.
The Boston research points to the clear presence of almost complete compensation in the case of marijuana. The ability of the intoxicated marijuana user to compensate for his state in pursuing motor tasks is 100 percent. With alcohol, there is partial compensation. The alcoholic will be able to perform better than the drunk man once he has had a little experience with alcohol, but the experienced drinker, sober, always performs better than the experienced drinker, intoxicated. With marijuana, on the other hand, there seems to be complete compensation. However, the inexperienced user, with little or no experience with the drug's effects, will suffer a distinct loss in motor skills and coordination, and will be unable to compensate. (The Crancer driving tests, on the other hand, found no difference between inexperienced and experienced subjects; subjects who had never smoked marijuana before the test performed just as well when high on pot as the experienced users did.) It is a relevant question as to how quickly compensation takes place for both marijuana and alcohol. I suspect that after a very small number of experiences with marijuana—perhaps a half-dozen—full compensation takes place, whereas with alcohol, even partial compensation takes place only after long conditioning with its effects. The question of the dose-relatedness of marijuana's impact on coordination is relevant, although not fully answered. The Weil research team supplied its subjects with low and high dosages, the former two cigarettes of a quarter of a gram each, and the latter two cigarettes of one gram each. Not too surprisingly, with the inexperienced subjects, impairment was distinctly dose-related, i.e., the stronger the marijuana administered, the more of a negative impact the drug had on their coordination. However, with the experienced marijuana smokers, a higher dosage of the drug had no additional impact on their skills and coordination; they were able to perform equally well normally, slightly high, and very high.
Because of obvious possibilities for distortions, as with the pupil dilation myth, pharmacologists are uncomfortable leaving the sphere of the directly observable, the experimentally verifiable, the clearly empirically demonstrable. The sociologist, being somewhat more detached from the scientific tradition, is less careful about what he accepts as a "fact." He usually bases his data on reported statements, rather than direct observation. Now, this has both advantages and drawbacks. A competent pharmacologist, performing a carefully controlled experiment, is far more certain that what he says is true; it is less necessary to repeat the same experiment, but if it is repeated, he has more confidence than a sociologist that the results will be confirmed. Although a sociologist will more often be wrong than a scientist working within a firm experimental tradition, he will be able to cover a wider field. By including within his purview the verbal reports of the individuals whose behavior he is studying, he includes a range of data which may be highly significant, and which may tell us a great deal about human behavior. Since I am a sociologist, verbalized reports by my respondents forms a rich lode of information for me. Keeping in mind the realization of large possibilities for distortion, we should nonetheless be able to piece together a more complete picture of the effects of the drug than a pharmacologist is able to do, although one which is more open to question since it is less tightly tied down by unquestionable, demonstrable fact.
We should keep in mind the level of meaning at which we are aiming. With some phenomena, we may look at the marijuana smoker as a kind of scientist, reporting on the accuracy of an observation, which we can check. We have an independent means of measuring, for instance, reddening of the eyes. Aside from asking the user, we can simply look at his eyes. Then, we can check our observations, which we are sure are correct, against the descriptions of the marijuana user, which may be subject to error. If there is a discrepancy, as with pupil dilation, we should supply an explanation for the discrepancy. However, there are vast realms wherein the ultimate validating device is the experience of the user, where the subjective grasp of the experience is the experience, where external verification is not only impossible but meaningless. It is a level of meaning complete within itself. And it is here that we must part company with the more careful pharmacologist.
Psychologists tell us that there are two analytically distinct processes involved in sense perception. We have, first, the primary functions, whereby the sense organs are stimulated directly. Certain sounds are measurably louder than others and, other things being equal, the mind will apprehend the louder sound as being louder. However, the directly perceived sense must, in order to be actually felt, be transmitted to the brain. Thus, there exists a secondary function associated with sense perception, and that is how the brain receives the message. The mind might feel differently about one sound as another; perceptions, then, might also stem from secondary functions, or what a brain decides to do with the sense impression it receives. The mind can deal with similar sense impressions in very different ways, according to their subjective significance. It can, for instance, subjectively exaggerate the significance of a "quiet" sound, while minimizing that of a "loud" sound.
This distinction comes extravagantly into play with the psychoactive effects of marijuana. For the overwhelming majority of all of the effects described by marijuana smokers are those involved with subjective experience. The directly observable consequences of the drug are few, minimal in importance, and superficial in impact. Those effects which can only be gotten at by asking the user to describe them are extravagant, elaborate, and extremely significant. These effects are wholly subjective and beyond the reach of scientific tools and instruments. We are in the area of "thinking makes it so." The experience is defined in its totality by the subject himself. The mind assimilates and, in a sense, becomes the experience. The subject apprehends a reality, explores a subjective realm which reverberates in his own psyche, accepts the total reality of a given phenomenon without regard to external validation, and in a sense defines the configurations of the experience completely.
For this level of meaning we must, of course, ask the marijuana user what are the effects of the drug. We must rely on his descriptions of the high to know anything about the subjective lineaments of the experience. In our interview we included the question:
I want you in as much detail as you can, describe to me everything that happens to you when you get high the high and everything else. Try to describe it to a person who has never been high before; please include everything that you feel, think, perceive, etc., whatever it is.
Of our 204 respondents, seven said that they had never been high, and six said that they had, but claimed not to be able to describe it in any way, holding that its reality was too subjective and elusive for description. Our information, therefore, is based on the 191 individuals who said that they had been high and offered to describe their experience. It must be remembered that this was an open-ended question, with no attempt to structure the responses in any way. This has both virtues and flaws. On the one hand, we did not force any responses on the interviewees. On the other hand, their answers might, by their own admission, be incomplete; they did not necessarily think of all the effects of the drug in an artificial interview situation, to a stranger. However, we assume that the ones they mentioned will be most salient to them, a not unreasonable assumption, although one not in every instance correct. A structured question will also yield a far higher overall response rate. If we had asked our interviewees directly whether or not marijuana had an impact on, say, their conception of time, more than one-quarter would have agreed that it did. Every effect would have drawn greater agreement, but the rank-order of effects should be roughly the same with the two techniques. This contention is born out when our data are compared with studies wherein a direct closed-choice question is asked for each effect. For instance, in an informal study of seventy-four marijuana users in New York, 91 percent agreed that marijuana made them feel more relaxed, 85 percent said that being high makes music sound better, 66 percent said that the drug helps a person feel more sociable at a party, and 35 percent claimed that it helps a person understand himself better (62 percent disagreed with the last effect). The structured question, however, was unworkable for my study, due to the diversity of responses; we could not have offered every possible effect as an alternative, for we would have had no time for any other questions. If and only if we remember two methodological qualifications will our analysis of the responses be meaningful:
- The form of the study instrument—open-ended or forced choice—gives us results that are superficially different (the magnitude of the responses, for instance), but fundamentally the same (the order of the responses).
- Individuals who do not mention a given effect on our open-ended question are not thereby automatically agreeing that marijuana does not have that effect on them—they just did not think of it at that moment in that situation ( although we do have a certain amount of confidence that those who did not mention the effect were less likely to experience it than those who did mention it).
Overviewing the responses elicited, we see that there are over 200 totally distinct effects described. (We have presented only those which ten or more subjects mentioned; there are almost 150 effects each of which was mentioned by fewer than ten respondents.) Sixty-four of these were proffered by single individuals, completely idiosyncratic responses that could not in any way be classified with other responses which were somewhat similar. For instance, one individual said that she had the feeling of "being sucked into a vortex." Another reported more regular bowel movements while intoxicated. A third said that she could feel her brains dripping out of her ears. In addition to the sixty-four unique and therefore totally unclassifiable responses, there were twenty-eight where only two respondents agreed that marijuana had that effect on them. However valid these responses might be to the individual himself, they are not useable to us, since they are still quite idiosyncratic.
Although the diversity of the responses was in itself an interesting finding, the picture was not totally chaotic. Each individual offered an average of roughly ten different effects of the drug as a description of the high. Some of these effects were offered independently by a large percentage of the interviewees although, curiously, none attracted a majority; every effect described was given by a minority of the sample. That is, in spite of the huge diversity in the responses, some agreement prevailed.
Marijuana users seem to describe the effects of the drug in overwhelmingly favorable terms. Certainly the vast majority of the effects mentioned would be thought positive if the judge did not know that marijuana touched off the state in question. Let us suppose that we have been told that the list characterizes how some people react to a warm spring day; our sense would be that they think well of its effects. Thus, most of the characteristics of the marijuana high, as described by its users, would be looked at as beneficial. Yet with the knowledge that the triggering agent was marijuana, the judge reinterprets his favorable opinion and decides that the effect is in actuality insidious and damaging; the question then becomes a moral rather than a scientific one, with the judge being thrown back on his second line of defense—'Why should anyone need an artificial stimulus anyway; isn't reality sufficient?' But in spite of one's ideological stance, marijuana's effects remains to be described.
There is an abundance of striking contradictions in the effects described. The drug, it would appear, is associated with opposite effects on different individuals—and even on the same individual at different times. Yet these dualities are specifically located with certain effects and not others. Only one individual said that music sounded worse high, another that it sounded dimmer, and a third that it sounded strange; these responses are obviously negligible next to those who reported greater acuteness and appreciation of music while high. Yet many characteristics attracted mutually exclusive responses. Table 7-2 lists some of the more arresting paradoxes.
Effects of Marijuana: Responses by Users
N Percent More relaxed, peaceful, calmer; marijuana acts as a tranquilizer 88 46 senses in general are more sensitive, perceptive 69 36 Think deeper, have more profound thoughts 60 31 Laugh much more; everything seems funny 55 29 Exaggeration of mood; greater subjective impact, emotional significance 48 25 Time seems slowed down, stretched out, think more time has passed 44 23 Become more withdrawn, introverted, privatistic 42 22 Generally, feels nice, pleasant, enjoyable, fun, good, groovy 40 21 Mind wanders, free-associates, stream of consciousness 40 21 Feel dizzy, giddy, lightheaded 39 20 Become tired, lazy, lethargic, don't want to move 37 19 Feel light, airy, floating, elevated 35 18 Feel "happy" 35 18 Forget easily, have memory gaps, can't remember things 34 18 Feel freer, unrestrained, uninhibited 34 18 Stimulation of senses more enjoyable 34 18 Become hungry, want to eat more 32 17 Hear music better, musical ear sharper, more sensitive, accurate 32 17 Enjoy music more, greater pleasure from listening to music 30 16 Feel paranoid 28 15 Have hallucinations 28 15 Feel sleepy 26 14 Care less about everything, worry less, don't give a damn 25 13 Become erotically aroused, marijuana acts as an aphrodisiac 25 13 Mouth and throat feel dry 24 13 Concentrate better, become more involved in anything 24 13 Selective concentration: concentrate on one thing, shut out all else 23 12 Can communicate with others better 22 12 Euphoria, ecstasy, exhilaration 22 12 Sense of depersonalization: being cut off from myself 22 12 Food tastes better 20 10 Tend to fixate on trivial things 20 10 Feel secure, self-confident, get a sense of well-being 20 10 Able to understand others better, their meaning and being 20 10 The pleasure of touching is greater, touch more sensuous 19 10 Feel depressed 19 10 Tend to talk a lot more 19 10 Hear better, auditory sense more acute, hearing more sensitive 18 9 Colors appear to be brighter, more vivid 17 9 More uncoordinated, clumsier, motor skills impaired 17 9 Sex is more enjoyable 16 8 Become pensive, introspective, meditative 16 8 Senses become numb; marijuana acts as an anesthetizer 15 8 Body feels warm 15 8 Other people annoy me more, find fault in others 15 8 My vision is clearer, sight improved, see more, see more detail 15 8 Enjoy dancing more 14 7 Subconscious comes out; the real you emerges, one's truer self 14 7 Feel a sense of unity in the universe, a sense of oneness 14 7 Asthetic impulse greater, enjoy art works more 14 7 Feel more nervous 14 7 I feel thirsty 14 7 Skin feels tingly 14 7 Become outgoing, gregarious, convivial, extroverted 13 7 Eyes become hot, heavy, bloodshot, puffy 12 6 Body feels heavy 12 6 Sense of touch improved, more sensitive, can feel things sharply 12 6 Mind works more quickly, mind races 11 6 Experience synesthesia phenomena 11 6 Become more active, want to move around more 11 6 Feel a sense of unreality of everything around me 10 5
Many of these responses were highly conditional. The impact of marijuana seems to vary by mood and setting, as we mentioned, and our interviewees made it clear that the drug affected them in different ways at different times. For instance, nearly all of the descriptions including "feel depressed" as an effect of marijuana were pre faced by the qualification that only if I feel depressed beforehand does marijuana make me feel more depressed. The drug is often tagged with the power to heighten one's present mood, so that a prehigh mood of elation will yield to an even more exquisite feeling of elation, while a depression beforehand will become an even deeper depression.
Contradictions in Effects Described (percent)
More sensitive (36) vs. numb, de-sensitizer (8) Introverted (22) vs. extroverted (7) Emotion exaggerated (25) vs. care less about everything (13) Feel happy (18), things seem funny (29) vs. feel depressed (10) Mind wanders (21) vs. greater concentration (13) Feel paranoid (15) vs. feel more secure (10) More relaxed (46) vs. feel more nervous (7) Talk a lot (10) vs. difficulty talking (8) Time slowed down (23) vs. time speeded up (4) Feel light, floating (18) vs. feel heavy (6) Feel warm (8) vs. feel cold (3) Feel lethargic (19) vs. feel more active (6) Depersonalization (12) vs. your true self emerges (7) Touch more acute (6), fun (10) vs. numb, de-sensitizer (8) Mind more profound (31) vs. fixate on trivia (10) Selective concentration (12) vs. synesthesia (6)
We must bear in mind the fact that such an investigation can inherently yield only limited and selective information. However, this is also true of laboratory reports, which only display one facet of the drug crystal. Yet, piecing together several incomplete stories might very well give us a more comprehensive one. In asking the marijuana smoker the effects of the drug on himself, we tap only the subjective vein, a valuable but fragmentary source. This information should properly complement clinical findings, not contradict them. Thus, since we have asked for the effect of the drug on the person taking it, we have largely sidestepped the objective-subjective dilemma which is so often a source of confusion. We do not ask the smoker to be a scientist, reporting objectively on drug effects, but to re-create the drug experience itself, to convey the expressive character of the marijuana high.
One-third of the responses to the open-ended question reported that their senses were more receptive, more sensitive. We straddle two realms here. Tests can be constructed to measure the ability of the subject to discern stimuli. But for the subjective impact of sense-stimulation, we have to abandon the laboratory approach, because it does not tell us anything; we must ask the subject himself. Most responses have this dual character. And the subjective meaning of phenomena and sense-impressions forms a vast and uncharted territory, with a logic and integrity of its own—yet one of immense significance.
Why should music be so often singled out as a locus wherein marijuana is said to have such a pronounced impact? There are, after all, five senses, thousands of sources of sound, an infinitude of possible changes in thinking, doing things, feeling; why music? There are at least three explanations:
- The physiological and psychological explanation. There actually is something about the effects of marijuana that relates specifically to music, to rhythm, movement, sound, and pitch.
- The culture explanation. Marijuana smokers happen to be people who enjoy music and merely project onto marijuana, which they also enjoy, the positive effects of any activity toward which they feel positively.
- The logistical and ecological explanation. It just happens that, given the personnel and the setting ( in one's living room for the most part ), it is highly likely that music is one of the activities in which marijuana users will be engaged while high.
There is no doubt that reasons (2) and (3) operate powerfully; the question is, do they account for all of the variance? Is there any pharmacological thrust at all?
A quarter of a century ago, an objective test of musical talent was done on incarcerated individuals, experienced with marijuana's effects, who had been administered parahexyl, a marijuana-like compound. The study found that the drug did not increase musical ability. The typical test result (except for rhythm) was to improve very slightly without the drug as a practice effect, and then to drop back to the original, pre-practice level when high. Although the magnitude of the differences was extremely small, this was a consistent pattern.
However, the Seashore test measures neither musical talent nor ability. What it does measure is the ability to discern differences in pitch, loudness, rhythm, time, and timbre in a laboratory setting. We have to guess as to the effect of the drug in an actual music-playing situation. In any case, this objective test has nothing to do with the subjective impact of music on the high listener. And in this realm, the evidence is overwhelming that marijuana stimulates a much more powerful identification, appreciation, and feeling for the music. The music means more when high, musical ability or not. "My most intense highs are when I listen to music," I was told by a twenty-seven-year-old mother. "I hear more. I hear five different levels at the same time. I can see the vibrations of the strings. I can identify exactly with what the composer was feeling and thinking when he composed the music. I am in the music, engulfed by it. It's happening through me." Another respondent, a twenty-year-old salesman, specifically mentioned the synaesthesia phenomenon as a catalyst for enjoying music more:Once, listening to Wagner, I had three visions. I was a Pegasus horse, flying through the air, with hundreds of smaller-type horses spanning out behind me, all co]ors, like a peacock. I was also a spirit, soaring through space. The third one was, I envisioned myself, I was crawling on the ground, watching flowers bloom and little animals crawling around. I've always enjoyed music more high than straight. Music has a visual correspondent.
In the interview, I asked a specific question on music (as well as sex and food): "What is music like when you are high?" If this question failed to elicit a meaningful response, I then asked the interviewee to compare the experience of listening to music high on marijuana with listening to it "straight." About 85 percent said they had actually listened to music while high, partly a testimony to the fact that music is a fixture in the marijuana mythology—everyone knows that listening to music while high is the thing to do—and partly a simple matter of the logistic fact that marijuana is smoked in one's living room. But is there a physiological component as well? Out of this music-listening contingent, 173 individuals, 10 percent felt that music was more or less the same, high or straight; it sounded no better and no worse. Two individuals thought that music sounded worse high, and preferred to listen to it while not under the influence of marijuana. All of the rest thought that music sounded better, that the high experience improved the listening experience.
Their reasons varied, however. As for the dominant and first mentioned reason for this, 40 percent said that their ability to become subjectively involved in the music, their emotional identification with it and appreciation of it, was heightened. They could "get into" the music better and became, in a sense, part of the music. About one quarter (23 percent) claimed that they could separate out the various instruments, sounds, and levels of sound, better appreciating the elaborate interweaving of sounds occurring in a musical composition. Some even likened listening high to having a built-in stereo set. The sounds actually seemed physically separated; one respondent felt that he could hear the notes of an organ bouncing off the ceiling, while the other sounds of the piece were off somewhere else in the room. Related to this perception was the sensation that they could hear one sound only, while all of the other sounds seemed subdued; there appeared to be some sort of ability to concentrate selectively on a single instrument, tune, sound, or level. Ten individuals, or 6 percent of the high music listeners, claimed that this was the first and most dominant characteristic of listening to music while smoking marijuana. Seventeen percent said merely that their hearing was more acute, that being high improved their listening ability. And 6 percent mentioned the synesthesia phenomenon, claiming that listening had a visual correspondent. They could see the music while listening to it.
Another of the more puzzling and intriguing products of the marijuana high that our interviews tapped remains its impact on the subject's perception of the passage of time. About a quarter of our respondents claimed that under the drug's influence they sensed much more time had passed than actually had. Time, in other words, seems to move extraordinarily slowly. Now, the positivistically inclined clinician will see this as a "distortion." It might, however, be more fruitful to look at time in a more relativistic sense. The division of the day into minutes and hours of standard length is only one of many possible ways of looking at the passage of time. Time also has a subjective element, a kind of organic flow. Under certain circumstances, a visceral grasp of time might coincide with a mechanistic one where, in laboratory terms, the subject will be able to judge time "correctly." Under other conditions, the two will be at variance with one another. Yet it is too narrow to view the mechanical measurement of time as its one true measurement; this may be expressed in many ways, for different purposes. The subject's "erroneous" estimation of time may have a powerful internal validity. We are reminded of Hans Castorp's words in Mann's Magic Mountain: "But after all, time isn't actual. When it seems long, then it is long; when it seems short, why, then it is short. But how long, or how short, it actually is, that nobody knows."
In the Boston experiments, three out of the nine inexperienced users overestimated the passage of time under the influence of a low dosage, while four did so with a high dosage. (No report was given for the experienced users, who may have learned to compensate for the time-altering effect of the drug.) In this case, our informal reports and the laboratory findings to some extent corroborate one another. It is impossible at this point to locate the source of this phenomenon, but it is possible that the exaggeration of mood described by my informants might have a good deal to do with it. Somehow, the drug is attributed with the power to crowd more "seeming" activity into a short period of time. Often nothing will appear to be happening to the outside observer, aside from a few individuals slowly smoking marijuana, staring into space and, occasionally, giggling at nothing in particular, yet each mind will be crowded with past or imagined events and emotions, and significance of massive proportions will be attributed to the scene, so that activity will be imagined where there is none. Each minute will be imputed with greater significance; a great deal will be thought to have occurred in a short space of time. More time will be conceived of as having taken place. Time, therefore, will be seen as being more drawn-out. One of our respondents, a twenty-six-year-old secretary, expressed it this way: "Time is different. You think it may take like five years to pick up a cigarette."
Marijuana's reported effect on memory is one of the more fascinating aspects of the drug's impact; almost one-fifth of the respondents said that, while high, they tended to forget simple things, that their memory seemed to be impaired by the drug. Psychologists divide memory into three zones, corresponding functionally to three areas of the brain; these are immediate, recent, and long-term memory. The marijuana smoker never forgets who he is, who his friends are, or where he is, but he may forget what he has been saying just ten seconds before. Weil and Zinberg pinpoint this speech impairment to marijuana's selective impact on the various memory functions in the brain:If this effect can be demonstrated, it is likely that it is, itself, a manifestation of a more general acute effect of marihuana on a specific mental function: namely, an interference with ultra-short (or immediate) memory. By immediate memory we mean memory over the past few seconds. To be more precise, the interference seems to be with retrieval of information while it is an immediate memory storage; once it passes into the next (recent-memory) storage, it again seems to be easily accessible to consciousness.[l7]
Whatever the physiological foundation of the effect, my informants commonly report it occurring. One user told me: "I can't remember what I said two seconds after I said it. I'm unaware of whether I actually said anything or not, even just after I've said it." In fact, most of the activities which involve forgetfulness while high take place when the subject is talking. This is an event which is both likely to occur and is relatively short-term. Thus the concentration on talking as a memory-impaired locus.
Let us consider hunger. It is an important component of the marijuana subculture that the drug makes you hungry. There seems, however, to be no physiological basis for the hunger. Some of the descriptions were so pungent that it is difficult to believe that some sort of physiological mechanism does not back them up: "I get a ravenous hunger high. When I start eating, my hunger is frightening. I could eat my finger if it got in the way." Hyperphagia, simply eating more, is common among high marijuana users, but the physiological basis for it is obscure. Yet it would be a mistake to throw out the observation, merely because it is not grounded in biochemical fact.
Pot's impact on taste was almost as influential. In fact, since there is no pharmacological reason for the hunger, it may perhaps be accounted for by the fact that the subject wishes to eat more be cause he knows that the food will taste much better. The idea of food suddenly seems much more attractive. Taste was reported as fabulously improved, almost a wild and orgasmic adventure. One of our respondents said that he rolled on the floor in ecstasy after eating some raspberries, so exquisite did they taste. Another respondent, a twenty-eight-year-old woman artist and art teacher, clearly delineated this distinction between the simple desire to eat more and a true, physiologically-based hunger, a hunger in the stomach rather than in the mind: "I love to eat when I'm high. I'm more interested in food. I don't think it's a matter of appetite; it's not hunger, it's mostly interest. Food tastes more interesting." Some of our most interesting and dramatic interview descriptions of the marijuana high were located in this impact on the subject's hunger and taste. The following account is presented by an eighteen-year-old college coed who was high for the first time two weeks before the interview. She smoked in her dormitory room with her roommate, who was a regular smoker:Throughout the whole thing, every time we'd go to the cupboard, we'd see this big bottle of Cremora, and we just had to find a use for it; it was like an obsession. And finally (laughs) we got some tuna fish, and we found a use for it. We mixed up the Cremora and water to make tuna fish stew—we didn't have any mayonnaise—and we used it like mayonnaise. And we thought it was delicious (laughs). And we kept making more, and we devoured it, and then we realized what we were eating. Except at the same time, we felt, I felt, natural, except, you know, this is, like, stupid, we're eating Cremora and tuna fish, and it's horrible, and everybody will think we're absolutely nuts. But meanwhile, it was delicious (laughs). And the whole time, I felt, like, the things I was doing might be silly, but they felt very natural.
Hunger and taste was another question which I singled out specifically; 150 respondents, or about 75 percent of the sample, said that they had eaten food while they were high. Of this 150, six said that there was no difference between eating high and eating straight, that marijuana had no effect on the nature of the eating experience. Eight percent said that the experience was worse in some way; they had less of an appetite, or the food tasted worse, and that they did not enjoy the experience of eating food when they were high. Thirty-eight percent said that the most dominant characteristic about being high and eating was that one's appetite was stimulated; one had a tremendous appetite while high. Thirty-one percent said that the food tasted more delicious high than ordinarily, that eating was a more enjoyable experience. Eleven percent said, merely, that they were more acutely aware of taste, that they could discern the various tastes more accurately while high. The remaining respondents said that they were more aware, above all, of the texture of the food while high, that the most important thing was that they suddenly desired unusual combinations of foods, that they wanted to eat weird foods they had never considered before, and that they had a special craving for sweet things.
We should also expect sexual activity to be closely intertwined with, and powerfully influenced by, smoking marijuana, and in this, our expectations are well supported. Three-quarters of our interviewees said that they had experienced sex while high on marijuana. We asked several specific questions on the difference between sex high on marijuana and sex normally.
First I asked, "Do you think being high on marijuana stimulates your sex interest, or not?" More than a third of the respondents said that marijuana had no effect on their sexual desire. Five percent said that marijuana had a negative effect, that it turned them off sexually. Thirteen percent said that the effect depends on their mood or on their sexual partner. In this group, a common response among the women was that marijuana acts as a sexual stimulant when they're with someone with whom they're already intimate, but when they smoke with a stranger, the prospect of sex becomes even more distasteful than ordinarily. For these women, marijuana seems to polarize sexual desire. But 44 percent, a strong plurality, replied that marijuana definitely increased their sexual desire.
Next, I asked, "Is your enjoyment of sex any different high?" The respondents were less divided on this question. An overwhelming majority, 68 percent, replied that marijuana increased their sexual enjoyment, that their orgasmic pleasure was heightened by the drug. Yet most scientists claim that in physiological terms marijuana lacks an aphrodisiac effect. If anything, it tends to reduce desire and to dull the sexual areas. Norman Taylor, a botanist, writes, "As to being a sex-excitant, marijuana appears to be just the opposite." Constantinos Miras, a Greek pharmacologist and one of the drug's severest critics, disclosed to a seminar at the UCLA Department of Pharmacology that marijuana actually impairs sexuality, and when administered to rats, their rate of "reproductive activity" declined go percent. If, physiologically, marijuana is neutral—or even negative—to sexuality, why are so many people sexually turned on by it? Why, after smoking the faddish banana, don't its users descend from a trial high to discover that it is neutral to sex desire and enjoyment?
Consider the mythology. Its use has traditionally been associated with the dramatic loss of sexual inhibition, and with what were thought to be the inevitable consequences: depravity, degradation, shame. Marijuana, according to an historic description, completely inflames the erotic impulses and leads to revolting sex crimes. For years, propaganda from the press assisted the Federal Bureau of Narcotics' campaign to nurture an evil image. An account written in the 1930s chronicles the degradation of a young girl lured into smoking:Her will power dropped away from her like a rent garment, leaving her a tractable, pliant creature, as exposed to chance suggestion as if her soul had been naked to the wind.
The unfortunate girl so discarded her inhibitions that she accepted proposals from strangers. When she came to her senses, she was so mortified that she committed suicide.
The sex-loaded invectives of the antimarijuana campaign may have been a tactical blunder. They seem to have attracted more recruits than they discouraged. Sociologists and psychologists stress the power of mood, expectation, social conditioning, setting, and myth in shaping the nature of the drug experience. And our mood, expectations, social conditioning, setting and myths have long associated marijuana with sex. We have learned to associate it with sensuousness and carnality, with hedonism and physical gratification. And so it stimulates those very reactions which are called debauchery by its critics and rapture by its adherents.
The human, unlike the caged rat, has a broad latitude in shaping the nature of his environment, even of his own body chemistry. Man's somatic responses are often influenced more by what he thinks than by biological and chemical imperatives; in fact, it can happen that what he thinks actually becomes his biological and chemical imperative. Thus the user's attitude toward marijuana may determine what happens to his body when he smokes it. It is only in the narrowest sense that the drug is not a sexual stimulant; that is, in the sense that it will not excite mindless, laboratory-located animal tissue. But many human marijuana users report an actual increase in sexual desire and sexual pleasure. Part of the reality may be analyzed as a "self-fulfilling prophecy." With marijuana's reputation, even a placebo could carry a sexual stimulus.
Women seem to respond more strongly than men to pot as an aphrodisiac. Exactly half the women said that the drug increased their sexual desire, as opposed to only 39 percent of the men. Two related explanations come to mind: (1) marijuana is an aphrodisiac for women because of its cultural association with sex: women are more likely to think themselves into becoming excited; and (2) women need an excuse to justify their desire. However, almost three-fourths (74 percent) of the men said that they enjoyed sex more high, but less than two-thirds (62 percent) of the women felt the same. The explanation for this discrepancy probably lies not in the properties of the drug, but in the characteristic sexual attitudes of men and women in our society. A woman is concerned with the ritual of sex and with what the textbooks refer to as "foreplay." For her, these aspects of the sexual act are often more meaningful than the immediate physical gratification it gives her. Because a woman is more preoccupied than a man with the path to sex, marijuana is more active for her during the overture. For a man, on the other hand, seduction (the overture) is often only instrumental. He is much more localized in both body and temperament; his concentration is on the orgasm. So more often he receives the most pleasure from marijuana during the act itself. But it should be noted that this is only a difference of relative emphasis: for both sexes, marijuana is more stimulating during the act itself than as an aphrodisiac.
The answers to my questions also indicated that both sexual stimulation and sexual enjoyment were directly correlated with frequency of smoking. The heavier smokers were the ones who most often answered "yes" to my two basic questions. I divided the sample into frequent users (at least three times a week) and infrequent users (less than once a week). Over half (52 percent) of the frequent users said that marijuana stimulates their sexual desire. Less than a third (30 percent) of the infrequent users agreed. Likewise, more than three-quarters (77 percent) of the frequent users claimed that marijuana increased their sexual enjoyment, while less than half (49 percent) of the infrequent users agreed.
Do the frequent users smoke more often because smoking makes them sexual, or does smoking make them sexual because they smoke more frequently? Do some people have minds and bodies that are naturally more receptive to the marijuana high, and therefore smoke more frequently? Or have those who smoke more already explored the psychic and bodily experiences available to them? Have they had more exposure to the sex-enhancing properties of the drug?
Another variable, of course, is strength of dosage: both the quality of the marijuana and the number of cigarettes smoked. But these are almost impossible to calculate. I don't know, and neither do my subjects, how potent their marijuana was. Most agree, however, that when they get very high, marijuana becomes soporific. After two or three "good" joints, the only erotic experience the pot head will have will be in his dreams.
To many marijuana users, the question of whether pot is a sexual excitant misses the point. Sex is just one example—though the example par excellence—of the kind of activity the drug enhances. But they were discriminate in their praise of the drug's power. Whereas it was recommended as an adjunct, collaborator, and stimulus to physical and sensual activity, it was found to be an impediment to cerebral activity. Only about a third of the sample had read anything during their high and, of these, about two-thirds said that reading was actually impaired by the high. Most material, particularly if it was logical, rational, traditional, and "linear," was rendered stuffy, incomprehensible, and impenetrable.
Marijuana seems to allow detours from the customary channels of experience and permit transcendence of some of our peculiar social inhibitions. The middle-class American is taught to be uncomfortable about his body and its gratification. The process of toilet training has made him uneasy about defecation. The taboos surrounding sex and sex education continue to cling to him. He has learned to respect the ritual surrounding food. He may not simply fill his stomach: he must not become too fat, nor stay too thin, nor eat at the wrong time or under inappropriate circumstances. He is warned against belching, flatulating, sweating. Every one of his bodily functions is stigmatized by prohibitions and restrictions. Marijuana may diffuse some of the rigid associations acquired from a culture ambivalent about bodily things. "Sex-evil," "sex-dirty," "sex-forbidden" is a class of linkages which, under the influence of the drug, is sometimes replaced by "sex-fun," "sex-nice." Consequently, users often claim that their involvement in sex is more total while high.
The attitude of play, of novel and unusual roles and activities, is also part of the sex-marijuana calculus. A twenty-year-old waitress said, "You do a lot of weird things in bed." A graduate student in psychology said, "I come up with new sex ideas." Alexander Trocchi, novelist and drug addict, puts it this way:Experts agree that marijuana has no aphrodisiac effect, and in this as in a large percentage of their judgments they are entirely wrong. If one is sexually bent, if it occurs to one that it would be pleasant to make love the judicious use of the drug will stimulate the desire and heighten the pleasure immeasurably, for it is perhaps the principal effect of marijuana to take one more intensely into whatever the experience. I should recommend its use in schools to make the pleasures of poetry, art and music available to pupils who... are... insensitive to symbolic expression. It provokes a more sensual (or aesthetic) kind of concentration, a detailed articulation of minute areas, an ability to adopt play postures. What can be more relevant in the act of love?
Marijuana cannot create a new mentality, a conscienceless, superego-free psyche. It does seem to endorse some of our more whimsical and carnal tendencies. The person who condemns marijuana because of its bestial and violent effects probably does so because in his subterranean self he actually regards sex itself as bestial and violent. The person who claims that marijuana's liberating effects will ultimately cause destruction and brutality probably has a destructive and brutal image of man's inner being. He who in his inner self condemns sex will, under the influence of marijuana, have basically antisexual experiences. Marijuana does not create anew, it only activates what is latent.
A young woman described it this way:A boy smoked it with me so that I'd enjoy the sex more, but it backfired! Every time he touched me, I'd get an electric shock, but if he would move away, I'd get very cold. At another time, it made me aware of the sex so that I'd become self-conscious of my sexual aggressiveness and realize that I wasn't worthy of sex. Often it would be like a psychodrama: I'd act out my problems, and become aware of what was bothering me—and become upset by it. I often became aware that I didn't want to have sex, and my body would freeze up. It brings out what your subconscious holds at the time...
Marijuana is much more than a mere chemical. The nature of its social reality, how it is defined, regarded, and treated, how its users shape their lives around it, will determine how it will treat them. A twenty-seven-year-old divorcée, was able to achieve orgasm only under the influence of marijuana. An eighteen-year-old coed chimed in, explaining how sex on marijuana was better, "Well, 'cuz, like you're all, you know, loose, free, and wild, and abandoned, and reckless and freaky. But, like, when I'm straight, I'm inhibited, you know, and cold, I guess, but when I'm, you know, on grass, I dig it." However, another girl experienced her only unpleasant sexual episodes when she was high. In the midst of being seduced, she saw little green men coming through the windows to attack her.
Another of the most popular of responses describing marijuana's effects dealt with laughter; there was widespread agreement that many more things seemed to be funny when high than normally. Even what we would consider quite ordinary in a normal state seemed extraordinarily droll, peculiar, incongruous, and even ludicrous. This is often pointed out by nonsmokers and critics as documentation of the distorting mechanism of the drug. The fact that someone laughs at something that is not really funny seems to prove pot's ability to take the user's mind out of reality, that the drug has the power to distort what is real, putting a "false conception" in its place. However, the user would say that the fact that something which appeared banal "straight" suddenly took on titanically comic proportions means that the experience itself was heightened—that the response was the experience; analyzing the reasons for the laughter destroys its validity and richness. Who is to say what is really funny and what is banal? (The user's reasoning parallels perfectly the symbolic-interactionist perspective's axiom, "The meaning is in the response.") If something is funny when high then it is funny—at that moment and under those circumstances. Whether something is funny or not is not a quality inherent in the thing, but in the field which is generated between the thing and the audience. The laughter evoked is the act of funniness.
In any case, this aspect of the extreme sense of amusement while high dominates our interviews and strikes the reader with dramatic force:The slightest little thing that's not right, it'll crack you up. You'd break your sides laughing. I was high in school once, and the teacher wrote a word on the board—this was in economics—and I forget what word it was, but to me it seemed funny. In fact, anything anybody does seems, like, it'll seem funny.Nineteen-year-old high school studentI get silly.... So all kinds of things, like, can crack you up, you know, that aren't really that funny, I guess, in regular life. But they can be really, really funny out of proportion. You can laugh for 20 minutes.Twenty-six-year-old secretaryA friend told a joke, and I couldn't even listen to it, and yet, I recall laughing at it, you know—I thought it was a riot, a very old joke which I probably heard before.Twenty-six-year-old social worker
Many of the responses reported can be summarized under the general category that Matza calls a "sensibility to banality." Many of the things we take for granted somehow are seen in a new light; the everyday is viewed with virginal eyes. Often the straight nonsmoker cannot understand the response of astonishment of a circle of marijuana smokers at a party at what appears to be nothing at all. Cries of "Oh, wow!" will greet the normal observer, and he will attribute them to mere stupidity or silliness. But what is actually going on is an appreciation of something that the detached nonuser has long ago taken for granted, something which to him seems quite devoid of any special meaning. According to Matza, and to most of our respondents, marijuana touches off this new look at the objects and events around us which we have ceased to wonder about.For something to become ordinary it must be taken for granted.... To take... for granted... is to render... empty of human meaning... it will not be an object for reflection.... Belief suspended, an aesthetic of the ordinary may appear. The unappreciable may be appreciated... the ordinary becomes extraordinary.
Many of the effects attributed to the drug and described by our informants fall within the orbit of the sensitization to the normally banal. We do not ordinarily reflect on the food we eat, unless it somehow seems extraordinary; marijuana is attributed with the power to make our commonest meals, meals we would never remark upon while "straight," seem uncommon and unbelievably delicious. Laughter is evoked by seeming banality. We are struck by the incongruity of the congruous, by the ludicrousness of the ordinarily serious, by the absurdity of the everyday. Paradoxes crowd in on us where we saw none before. A sense of wonderment animates the high, whether it be in sex, food, jokes, music, life in general, or, seemingly, nothing at all. (Everything is not reduced to the same basic level; there can be degrees of wonderment.) A twenty-three-year-old graduate drama student describes his sense of wonderment at snow:The way I'm using pot now is to try out everything new again. Like, there was a huge snow about a month ago and I went down to Riverside Park, completely stoned out of my mind. And the sky was full of snow, and the snow was eighteen inches deep in the park. And I went through the whole thing rediscovering snow, you know, sort of kicking my way through it and saying, "What's that, daddy?" You know, and sort of re-creating that experience of, you know, snow before snow meant slush and taxicabs, and blech, and inconvenience, and all of the other things that it means now. To go back and find the child-like snow. Pot is trying things out over again.
Of course, the effect need not involve such a conscious pursuit of the new in the guise of the banal. Most of our respondents felt the dramatization of the everyday without having to search for it, without even stepping outside their living room where they were sitting, smoking. Even the very act of smoking took on, sometimes, a new semblance. "When I'm high, I get hung up on little things that I wouldn't even notice straight," an eighteen-year-old coed told me. "Like, oh, wow, a cigarette. You start thinking about the cigarette and you think, you know, you're drawing in the smoke, and it's just going into your lungs, and you think about what's happening."
The issue of the generation of panic states, or psychotic episodes, by this drug marijuana is extremely thorny. There is no doubt that some individuals at some time while taking the drug have had some psychotomimetic experience. This is, however, a flabby, imprecise, and not very useful statement, for a number of reasons. First of all, it has never been established that these occurrences with marijuana are any more common than under any other exciting and possibly stressful situation, such as during a seduction, in an examination, or in athletic competition. There is no clear indication that the effects described as adverse effects of marijuana are due directly to the drug or to an unusual and novel situation, to social pressures and expectations—worrying about not becoming high, for example, or becoming too high, about having a good time—or possibly fears about the drug, about being arrested. One thing is clear, at least from anecdotal material: the factors of "set" and "setting" described earlier make a great deal of difference in the generation of "adverse reactions" to the drug, in fact, in the effects in general which the drug has.
A healthy psyche, taking the drug in a supportive, familiar and enjoyable environment, is highly unlikely to experience a psychosis-like episode. The presence of stress, hostility, strangeness, and a past with psychiatric difficulties, all make it more likely. As with virtually any psychoactive drug, marijuana can induce acute anxiety with some feelings of panic in the user. This type of reaction is uncommon and is often related to an improper set or attitude by the user, or pre-existing personality problems. The perceptual alterations produced by moderately high doses of marijuana occasionally produce a feeling of depersonalization in the user, and his fear that this effect may last produces fear and anxiety. Individuals who are insecure or threatened by circumstances surrounding the drug experience, such as arrest, are more prone to this type of reaction. Prolonged reactions have been reported, but almost always are related to high dose use in individuals with unstable predrug personalities or individuals who have had experiences with more potent psychoactive drugs such as LSD.I have seen three cases of marijuana-induced psychoses... a]l ... were using marijuana for the first time in "far out" environments. All had extreme paranoid reactions characterized by fear of arrest and discovery...
The... psychotic reactions represented the users' attitude toward experimenting with an illegal drug and their rigid personality structure rather than an indictment of the pharmacological properties of marijuana, and demonstrates only that "upright" Americans committed to the current dominant value system should not experiment with illegal drugs even though they might be quite capable of handling accepted intoxicants such as alcohol. Were the illegality of the drugs reversed, then their experiences would also be reversed.
Clearly, a factor making for variability in potentiality for adverse reactions is the setting. The user may find himself in surroundings which are unpleasant to him, in the company of strangers or others whom he does not like, or in danger of some kind. These circumstances will influence his response to the drug. The fact that he is on the street, in public, or in his own house or apartment, will influence what he feels, sees, and does. Marijuana smokers often report paranoia as one of the effects of the drug on their psychic state while high. Many, however, qualify this with the reservation that it is only because of the legal climate, because of the drug's illegality, their fears of being arrested, the fact that a friend may have been arrested, that this mood is engendered. In other words, part of the setting of all users is the fact that the outside world punishes the act, and this realization is often woven into the experience itself, in the form of fear. Yet to say that this effect is a direct product of the drug, and not the legal setting in which the user consumes the drug, is to distort the reality of the situation. As Kenneth Keniston said in a drug symposium, given February 28, 1969 at the "New Worlds" Drug Symposium, at the State University of New York at Buffalo, "The only thing that we know for sure about marijuana is that you can get arrested." The smoker knows this, and sometimes responds, while high, accordingly. Those who charge the drug with generating panic states are often the very same ones who themselves produce them. Allen Ginsberg attributes his sometimes-feeling of paranoia to the prevailing legal climate:I myself experience... paranoia when I smoke marijuana and for that reason smoke it in America more rarely than I did in countries where it is legal. I noticed a profound difference of effect. The anxiety was directly traceable to fear of being apprehended and treated as a deviant criminal and put through the hassle of social disapproval, ignominious Kafkian tremblings in vast court buildings coming to be judged, the helplessness of being overwhelmed by force or threat of deadly force and put in brick and iron cell.
From my own experience and the experience of others I have concluded that most of the horrific effects and disorders described as characteristic of marijuana "intoxication" by the US Federal Treasury Department's Bureau of Narcotics are, quite the reverse, precisely traceable back to the effects on consciousness not of the narcotic but of the law and threatening activities of the US Federal Treasury Department... Bureau of Narcotics itself.
Another difficulty with the contention that marijuana is psychotomimetic is that it is never clearly defined what constitutes a psychotic episode. Thus, at one end of the spectrum of adverse reactions, we might find various vague and superficial sequelae, such as nervousness after drinking coffee, which are easily dispelled. It is possible to place any effect on the Procrustian bed of value judgments; hysterical laughter, for instance: "I laughed for hours at 'Please pass the potato chips.'" Certainly laughing for hours at such a straightforward request is not normal. Yet the respondent reported the event in positive terms; a clinician might see it in a different light.
In fact, the conceptual difficulties which plague the advocates of the psychotomimetic position are even more fundamental than this. The charge is not simply that cannabis generates psychosis-like states. It is that being high on marijuana is a psychosis-like state. The very nature of the experience is abnormal, according to many medical observers. For instance, the Lexington studies' assertion that cannabis has psychotomimetic properties relies on a questionnaire, a battery of questions which purport to measure the degree to which the subject is suffering a psychosis-like state. Yet, when the items in the questionnaire are examined, they contain almost nothing that would qualify as a true clinical psychosis, or anything like it. The general psychotomimetic questions include: "Is your skin sensitive?" "Are you happy?" "Are colors brighter?" "Time passes slowly." "Are you having a lot of thoughts?" "Do you feel silly?" "Is your hearing keener?" The statements specifically related to marijuana (actually THC) include: "My thoughts seem to come and go." "My appetite is increased." "I notice things around me which I have not noticed before."
In other words, what is labeled a psychotomimetic experience is nothing more than the characteristics associated with the marijuana high. The fact that any of these items were actually used to measure a state labeled a psychosis is nothing more than a display of the researchers' prejudices, a display of an archaic epistemological ethnocentrism which rejects any and all experience which does not fit the narrow positivistic mold. This form of reasoning clearly illustrates the interpenetration of science and ideology—ideology parading as science. The marijuana experience is, of course, different from "normal." Marijuana is a psychoactive drug; it influences the mind, influences perceptions. This is, in fact, precisely one of the main reasons why it has the appeal it has to some. Some people may like this state, and others may not. But is it madness? How frail are the facts in the path of the mighty concept!
Thus, the attribution to marijuana of psychotomimetic properties is an ideological and political act. It involves a definitional process of deciding that certain psychic manifestations subsequent to smoking marijuana in fact (1) may properly be characterized as psychotomimetic in nature; (2) are generated by the drug; and (3) are not typical of, or generated by, substances of which society approves. There is a tacit assumption in descriptions of adverse reactions to pot that the laws prohibiting this substance are legitimate, and that one of the reasons why it is outlawed (and should continue to be outlawed) is that it is capable of producing a psychotic episode. Yet there is a mirror process at work; not only must we ascribe to marijuana a causal nexus with temporary psychoses, we must also ignore the role of other substances equally as capable of producing the same or even more extreme states. It was found, as a parallel example, that numerous household substances had the same chromosome-breaking properties as LSD—aspirin, nicotine, caffeine, tranquilizers, and so forth. The fact that no hue and cry was raised concerning these findings demonstrates the political character of the controversy.
The firmer root which a marijuana subculture would take in American society as a result of its legality is another change that must be considered. Many of the values that marijuana users pass on to neophytes are a contextual feature of its underground status. Elements of paranoia (for instance, fear that one's phone is being tapped by the police, apprehensiveness that someone who wants to do harm is following when one is high on the street) are part of the culture and are only partially a matter of personality configurations. The cultural beliefs evolving subsequent to legalization would not include these elements of paranoia, at least in the same degree.
As Becker has pointed out, the more solid and fully developed that a psychedelic drug culture is, the more it cushions the subject from untoward or psychotic reactions by giving them an approved and fully explained status. Where the high neophyte—or the individual who is not part of a drug culture, or is taking a drug for which there has developed as yet no subculture—senses reactions which he did not expect, or which his companions did not expect, they rely on the interpretation which a positivist society passes on to them about anything novel or strange or fantastic: he's crazy. If he says, "I'm Jesus," or "I just saw infinity," or "I want to make love to this flower," where no subculture which has handled such eccentricities exists, the conclusion is obvious: he's crazy. And the message flashes back to the subject; eventually this becomes: I'm crazy! With this lack of cultural and interpersonal support, the individual, high on a strange drug, loosened from his traditional moorings, heavily influenced by the interpretations of his behavior by his equally naive companions, comes to look on his behavior and himself as insane. In this situation, psychotic episodes are highly likely. But if his statement "I'm Jesus" is met with "Groovy, baby; just groove on it," a psychotic self-image is not likely to be engendered. The fully developed drug subculture acts as interpretative "decompression chamber" for bizarre feeling and behavior, which are alien to a rational civilization. By finding such feelings and behavior acceptable, even admirable, by setting them into a more or less commonplace universal and to-be-expected context, and by providing some sort of explanation for their occurrence, they are experienced by the individual as a normal part of his drug adventure, an inevitable unfolding of his destiny and psyche. According to this thesis, with an elaborate and ramified drug subculture, few users of the drug will experience psychotic reactions as a result of such a definition by their peers; in fact, few psychotic reactions will occur at all.
It is Becker's thesis that this process has in fact happened with marijuana historically. Prior to the development of a society of marijuana users with a distinct view of the world, and especially with its own version of the effects of the drug, panic reactions were common; nowadays they are rare. Extending Becker's argument one step further, we would predict that they would be even rarer in the absence of legal sanctions against its possession. The paranoid elements would fall away. There would be less of a need to set oneself off from the nonsmokers—the squares—since there would be less need to play at being straight when one is high. The "bad vibrations" which marijuana users often feel from uncertain situations and individuals—often nonsmokers—would lose much of their force. And a richer and firmer and more supportive subculture would protect the high user from any potentially untoward reactions, from incipient feelings which, in the absence of a justification, might bring on panic.
In the approximately two and a half thousand man-hours of observing marijuana smoking taking place, I did not encounter any response that could qualify as a psychotic episode, even by the most generous definition. The closest manifestation of such a state was when a girl left a party because she felt uncomfortable. However, the descriptions of the marijuana high brought out a small amount of material; two girls experienced more or less consistent adverse and even psychotomimetic episodes while under marijuana's influence. And reactions which would be judged adverse by anyone were sprinkled throughout the descriptions of the high. Some were more commonly reported than others; as we saw, 15 percent of the whole sample said that they sometimes felt paranoid while smoking, a not unreasonable reaction given the present legal setting. However, considering the number of respondents and the frequency with which they had been high, acute panic states while under the influence of the drug seemed to be extremely rare.
This generalization is corroborated by research done in a San Francisco clinic associated with a heavily drug-oriented hippie population. Summarizing his observations in the clinic, David E. Smith, a toxicologist, writes:In fifteen months of operation the Haight-Ashbury Clinic has seen approximately 30,000 patients.... Our research indicated that at least 95 percent of the patients had used marijuana one or more times, and yet no case of primary psychosis was seen. There is no question that such an acute effect is theoretically possible, but its occurrence is very rare.
We would expect that powerful differences in the nature of their answers should obtain among different kinds of marijuana smokers. For instance, do men and women react to the drug, or report acting to the drug, in the same way, or are there systematic differences between the sexes? Curiously, our data suggest small and not very enlightening differences between men and women in their descriptions of the marijuana high. They both give the same average number of characteristics describing the high—about ten per person. And for each effect, the proportion of men and women who proffered it is about 54/46—the ratio of men to women respondents answering this question. The only pattern that significantly departs from this is in the realm of adverse reactions. Although for both men and women the effects which the subject and an outside observer of any ideological persuasion would describe as pleasant heavily outweigh the unpleasant, women seem to be more likely to mention unpleasant characteristics in their description of the high.
This pattern holds true, for instance, with feeling paranoid; less than 10 percent of the men included paranoia as one description of their drug experience, while this was true of 21 percent of the women. Women were also more likely to report sometimes feeling depressed (6 percent for men, 15 percent for women), introverted (16 percent vs. 30 percent), or a sense of depersonalization, being cut off from themselves (8 percent vs. 16 percent). In short, women seemed to dominate the negative responses.
Differential involvement with the drug might also be expected to yield differential responses. Strangely, the heavy marijuana smoker (who used the drug at least three times per week) gave the same number of average characteristics describing the high as did the more infrequent user (smoking less than once per week). Adverse reactions were slightly higher for the infrequent user, but the differences were small, although consistent. Contrariwise, the more the respondent smoked, the greater was his attribution of favorable characteristics to the marijuana high.
Aside from three effects—the feeling that everything seems funnier while high, the sense that time is moving slowly, and the impairment of memory, as well as the sex findings which we mentioned—no strong differences of any kind emerged from the interviews outside of the pleasant-unpleasant orbit. In these three, the less frequent smoker gave them more emphasis as a valid description of the high; yet for even these, the differences were never over l0 or 12 percent. What is so striking about these descriptions, then, is the relative consistency of descriptions, the sameness in the qualities chosen to describe the marijuana experience; the variations are always minimal in comparison with the uniformity.
It is possible that our differentiation between the less than weekly smokers and those who used the drug at least three times per week is not sufficiently sharp to capture differences among levels of use. As mentioned above, compensation with marijuana probably develops fairly quickly and easily. Thus, most of our less than weekly smokers were experienced users: they had had sufficient experience with the subjective effects of the drug as to be aware of how to control the high. Thus, the most striking point of difference in the descriptions of the drug's effects would lie between the complete neophyte, who had just been turned on and had experienced the drug's effects once or twice, and the experienced user, who had been high more than a few times. Our differentiation, at any rate, did not yield any interesting contrasts in level of use.
It is often asserted that "nothing is known" about the effects of marijuana, and it is, for this reason alone, a dangerous drug. In the narrow sense that even supposed experts disagree fundamentally about most of the basic issues, this is true. But a great deal of evidence has been collected, and if read critically, a reasonably consistent picture emerges. The one thing that we do know about the effects of marijuana is that many of the components of the classic diatribes from an earlier age turn out to be hoaxes. It is peculiar that "nothing is known" should become a rallying antimarijuana argument today, since what was asserted previously was that we do, indeed, know the effects of marijuana—and they are all bad. However, what is not known, above all, are the effects of long-term usage, particularly long-term heavy usage. And unfortunately, even the most tentative and exploratory answer to this question lies quite distant in the future.
N O T E S1. If one were to do a social history of marijuana use, it would be necessary to grapple with the question of the events so hysterically described. There are several possibilities: (1) events were fabricated, utterly and totally, by the Federal Bureau of Narcotics, to initiate and justify the statute outlawing marijuana possession; (2) marijuana use was unconsciously "read" into events that actually took place; some murders, for instance, may have taken place by someone who smoked marijuana, may have smoked marijuana, would have been the kind of person who could have smoked marijuana etc.; (3) the events actually occurred, but were due to the unfamiliarity of the populace with a new drug, and disappeared with the accretion of a subculture of users who have learned, and who initiate the neophyte into learning, what to expect of the drug, how to handle its effects, what to do in case of unusual events or panic. For an imaginative presentation of the third argument, and its extension to LSD use in the early and middle 19605, see Howard S. Becker, "History, Culture and Subjective Experiences," Journal of Health and Social Behavior 8 (September 1967): 163-176 (back)
2. In regard to the "peace" component of this equation, it must be remembered that an extraordinarily high proportion of the American soldiers in Vietnam (and the Viet Cong as well, according to returning veterans' stories) have smoked marijuana; some estimates put the figure at 60 percent. (back)
3. Two complications muddy this simple statement: (1) the excitement of smoking marijuana for the first time—the idea of smoking—often produces many symptoms which are similar to an actual high, for instance, an increase in the heartbeat rate; (2) many initiates do not recognize the actual effects, thinking them to be much more extreme than they are, and may be high without realizing it. (back)
4. Malachi L. Harney, "Discussion on Marihuana: Moderator's Remarks," in the International Narcotic Enforcement Officers Association, Eighth Annual Conference Report (Louisville, Ky., October 22-26, 1967), p. 50. (back)
5. Donald E. Miller, "Marihuana: The Law and its Enforcement," Suffolk University Law Review 3 (Fall 1968): 83. (back)
6. Harry J. Anslinger and W. G. Tompkins, The Traffic in Narcotics (New York: Funk and Wagnalls, 1953), p. 21. (back)
7. Although researchers often complain of the unstandardizability of the natural marijuana, it is, nonetheless, the substance actually used illicitly, so that synthetic products will produce misleading results. (back)
8. Andrew T. Weil, Norman E. Zinberg, and Judith M. Nelson, "Clinical and Psychological Effects of Marihuana in Man," Science 162, no. 3859 (December 13, 1968): 1234-1242. (back)
9. An earlier research study, Harris Isbell et al., "Effects of (-) A 9 Trans-Tetrahydrocannabinol in Man," Psychopharmacologia 11 (1967): 185, also turned up the negative finding on dilation of the pupils. (back)
10. Donald B. Louria, Nightmare Drugs (New York: Pocket Books, 1966), p. 36, and The Drug Scene (New York: McGraw-Hill, 1968), pp. 107-108; Edward R. Bloomquist, Marijuana (Beverly Hills, Calif.: The Glencoe Press, 1968), pp. 1gS-1g8; Pablo Osvaldo Wolff, Marihuana in Latin America (Washington, D.C.: Linacre Press, 1949), p. 31; United Nations Document E/CN 7/481, "Effects of the Use and Abuse of Narcotic Drugs on Accidents in General and on Road Accidents in Particular," September 14, 1965. Louria correctly writes that "there are no statistical data linking marijuana to automobile accidents." Cf. Drug Scene, p. 107. This does not appear to dim the fervor of Louria's argument, however. (back)
11. Myra MacPherson, "Parents Need Facts on Pot," The Washington Post, July 10, 1969, p. K3. The stated purpose of the article is something of an admission of defeat of the antipot argument. The marijuana-using youngster is well equipped to demolish the other side's arguments with facts of his own, which, in its inexperience and ignorance, the older generation is often unable to refute. The MacPherson article, then, attempted to fill this void. Needless to say, what was provided was not facts, but propaganda—as is true of the facts wielded by the opposition. (back)
12. Alfred Crancer, Jr., James M. Dille, Jack C. Delay, Jean E. Wallace, and Martin D. Haykin, "Comparison of the Effects of Marihuana and Alcohol on Simulated Driving Performance," Science 164, no. 3881 (May 16, 1969): 851-8S4. Significantly, The Journal of the American Medical Association rejected publication of this important research report. (back)
13. Lloyd Shearer, "Marijuana vs. Alcohol," Parade, July 6, 1969. (back)
14. Shearer, op. cit. (back)
15. See Richard Brotman and Frederic Suffet, "Marijuana Users' Views of Marijuana Use" (Paper presented to the American Psychopathological Association, February 1969), p. 10. (back)
16. C. Knight Aldrich, "The Effect of a Synthetic Marihuana-Like Compound on Musical Talent as Measured by the Seashore Test," Public Health Reports 59 (March 31, 1944): 431-433 (back)
17. Andrew T. Weil and Norman E. Zinberg, "Acute Effects of Marihuana on Speech," Nature 22 (May 3, 1969): 437. (back)
18. Norman Taylor, "The Pleasant Assassin: The Story of Marihuana," Narcotics: Nature's Dangerous Gifts (New York: Delta, 1963), p. 21. (back)
19. Constandinos J. Miras, "Report of UCLA Seminar," in Kenneth Eells, ed., Pot (Pasadena: California Institute of Technology, October 1968), pp. 69-77. (back)
20. Lionel Calhoun Moise, "Marijuana: Sex-Crazing Drug Menace," Physical Culture 77(1937): 19. (back)
21. Alexander Trocchi, Cain's Book (New York: Grove Press, 1961), p. 123. (back)
22. David Matza, Becoming Deviant (Englewood Cliffs, N.J.: Prentice-Hall, 1969), p. 136 et seq. (back)
23. Matza, op. cit., pp. 138, 139. (back)
24. David E. Smith, "Acute and Chronic Toxicity of Marijuana," Journal of Psychedelic Drugs 2, no. 1 (Fall 1968): 41. (back)
25. Allen Ginsberg,"The Great Marijuana Hoax," Atlantic Monthly, November 1966, pp. 108, 109. (back)
26. Isbell et al., op. cit., and Harris Isbell and D. R. Jasinski, "A Comparison of LSD25 with (-)delta-9 Trans-Tetrahydrocannabinol (THC) and Attempted Cross Tolerance between LSD and THC," Psychopharmacologia 14 (1969), 115-123. The items of the questionnaire are not included in the published articles, but are available from the senior author on request. One piece of clinical evidence on the psychotomimetic properties of THC was offered in passing: two subjects withdrew from the experiments because of their experience with psychotic reactions. It need hardly be stressed that these experiments have an extremely limited applicability to marijuana use. Pure THC is considerably more potent than the cannabis substances typically consumed, so that the reactions of subjects will be considerably different for the two substances. In addition, different reactions can be expected in a laboratory as opposed to one's own living room. (back)
27. Howard S. Becker, "History, Culture and Subjective Experience: An Exploration of the Social Bases of Drug-Induced Experiences," Journal of Health and Social Behavior 8 (September 1967): 163-176. (back)
28. Smith, op. cit., p. 41. (back)
Chapter 8 - Multiple Drug Use Among Marijuana Smokers
The PremiseThe antimarijuana argument most widely encountered and taken seriously is that marijuana is a "threshold" drug; its use, it is said, "precipitates," "predisposes," or "potentiates" the user to the more potent and dangerous drugs, particularly heroin. It is the empirical and logical basis of this argument that we will now examine.
It is interesting that the Federal Bureau of Narcotics did not take this argument seriously during the period of the richest and most virulent diatribes against the drug. In 1937, the year of the passage of the Marihuana Tax Act, Harry Anslinger, in testimony before a congressional committee, said that the marijuana user specifically didnot progress to heroin: "I have not heard of a case of that kind.... The marihuana addict does not go in that direction." With the post-World War II wave of heroin use and addiction, the connection was suddenly perceived by Anslinger. No studies were done in the interim which demonstrated the connection, or even hinted at it. (Some observers claim that the shift in the association, if it has occurred, is evidence that it is the laws and the law enforcement officers which have created the marijuana-heroin link.) In any case, beginning in the late 1940S and early 1950S, asserting the marijuana-heroin link was part of official FBN policy.
Other observers in the 1930s, however, were affirming the association that Anslinger denied. In fact, an even more elaborate association was constructed for marijuana. One of the most widely circulated and widely quoted works of the 1930s, On the Trail of Marihuana: The Weed of Madness, written by Earle Albert Rowell and Robert Rowell, asserted that cigarettes lead to marijuana, and marijuana, eventually, to heroin.
This argument emphasizes progressive moral decay as the dynamic thrust generating this movement from one drug to another, a kind of "greased toboggan to hell" approach to activities that society condemns. In a sense, one sin begets another greater sin. By getting away with one sinful activity, one is emboldened to try a more serious one. The only way of avoiding this descent into total corruption is to avoid all contact with evil. Since cigarette smoking is clearly an evil activity, one can avoid being sucked into the maws of marijuana use—and subsequently, narcotics addiction—by never smoking at all:Marijuana is especially dangerous because it comes in cigarette form. The great tobacco companies have prepared the way for the Devil's parade of death; they have popularized the use of cigarettes ... until today in America, men, women, boys and girls think nothing of lighting up their choice tobaccos.... It is easy now, for a young man or woman planted by the peddler, to pass out this new cigarette and American youth, always looking for adventure, will fall an easy prey. The step from Marijuana to... morphine is a short one.
Today's observers would consider this portrait absurd, even amusing. As pointed out in the chapters on selling marijuana and on becoming a marijuana user, the neophyte is turned on and supplied by friends; the peddler does not supply cigarettes to get his customers hooked on narcotics. The percentage who go from tobacco cigarettes to marijuana and from marijuana to heroin is minuscule so that no peddler could possibly afford to spend the necessary time to recruit customers.
In spite of its late entry into the pot-to-heroin debate, the FBN (now the Bureau of Narcotics and Dangerous Drugs, a subunit of the Justice Department) is presently the most vigorous proponent of the progression theory (although the Bureau, now under John Ingersoll, may eventually represent a departure from its earlier stand of the Anslinger-Giordano years).... it cannot be too strongly emphasized that the smoking of the marihuana cigarette is a dangerous first step on the road which usually leads to enslavement by heroin....
Ordinarily, a person is tempted first with marihuana cigarettes. He may not even know they are dope. Then, someone already addicted makes it easy to try some heroin. Most teenage addicts started by smoking marihuana cigarettes. Never let anyone persuade you to smoke even one marihuana cigarette. It is pure poison.
One particularly grave danger of habitual marihuana use is that there is often a clear pattern of gradation from marihuana to the stronger addictive opiates.
Often antidrug and narcotics associations, as well as educational and parents' organizations, will sponsor lectures by ex-addicts who describe the horrors of addiction, along with the inevitability of the transition from smoking pot to leading the life of a junkie. One of the most dramatic and effective of such talks, at Miami Beach, is excerpted below:I am a drug addict.... For twenty-three years of my life I was a junkie. I spent seventeen years... in jails....
I come from a very nice Jewish family, a middle-to-upper income family. I was the baby and they loved me. They educated me; I got a degree in anthropology at the University of Wisconsin.
And what did I do to them? I have had forty-seven arrests. For using narcotics. Felonious possession of narcotics. Selling narcotics. For being a whore. For being the madam of a whorehouse. For running a con game.
I'm not a thief..., but when you have a $185-a-day habit of cocaine and heroin, no legitimate job can support it.
Look at me.... I'm a fifty-year-old hippie. Every vein is collapsed. I must carry my stigma all my life, a card that warns the doctor he must never try to give me a shot of anything, that only the vein in my neck can be used to take blood out if necessary....
I was finishing six months as an habitual user in New York. I gave an "honest" cop $10 to slip a letter out to my connection, Porkchop, in East Harlem. I told Porkchop to meet me when I got out, to have a fix ready, I couldn't go out on the street without it.
He was waiting for me. I went into a phone booth and right through my clothing I gave myself a shot. Just then a police matron came in to make a call, and she busted me. Another six months—a year, back to back. And I started to get scared.
I was forty-six years old. I couldn't go out and hustle. There are twenty-year-olds doing that. I couldn't shoplift; my mug is known in every store
from Klein's to De Pinna. I was a five-time loser, I could get fifteen to thirty years. I didn't get smart. I got scared....
Here I am. I loused up a complete lifetime. I'm starting a new life and I'm forty-nine.
The revelation of this talk was not simply that someone could become a junkie and live a life of degradation and infamy; it was that pot was the front door to this downfall. "All I did was start with pot," the ex-addict explained. "At the university I fell in love and married a musician.... My husband smoked pot, and what my love did, I did." When asked by a sophisticated student about the "statistics on marijuana leading to drug addiction," she replied:Will you believe me if I tell you that I know junkies after twenty-three years of living in the gutter with them? Will you believe me when I tell you that I don't know any junkie that started on horse, that they all started on pot?
I don't know statistics, but I know a thousand junkies, and I tell you that they all started on marijuana. Using drugs is sheer stupidity....
The question before us, then, is what do the studies on multiple drug use tell us about the likelihood of "progressing" from marijuana to more potent drugs, such as heroin?
Multiple Drug Use among 200 Marijuana SmokersIn my questionnaire, I asked interviewees what drugs other than marijuana they had taken at least once to become high. With two specific drugs, heroin and LSD, I also asked how often they had ever taken them. I excluded those drugs taken for strictly utilitarian purposes, such as amphetamine pills taken for dietary reasons or for studying. Needless to say, the fact that a given individual, or a certain percentage of the sample, ever took one or another drug at least once does not imply continued or even occasional usage of that drug. In fact, most individuals who try any given drug to become high do so a small number of times; the majority of all drug users are experimenters, and the regular users, although numerous for many drugs, are usually in the minority.
About the same time I was interviewing respondents, The East Village Other conducted the survey on drug use cited in Chapter 2, which made inquiries about the age of first turning on, arrests for drugs, feelings of paranoia, selling marijuana, and so forth. One question asked the respondent to enumerate all the drugs he had taken at least once. While this study, like my own, had problems of interpretation, I will examine parallels between the two studies, showing that, although the percentage using nearly every drug is higher for the EVO respondents, the rank-order (i.e. degree of popularity) of the drug used was surprisingly similar.
Multiple Drug Use Among Marijuana Smokers:
Goode EVO LSD 49 77 LSD Amphetamine 43 70 Methedrine 55 "Diet pills" 4 Darvon DMT or DET 26 50 DMT 14 DET Barbiturate or tranquilizer 24 18 Barbiturate or tranquilizer Opium 20 11 Opium or morphine Cocaine 19 31 Cocaine Peyote or mescaline 19 41 Peyote Heroin 13 21 Heroin Amyl nitrite 8 8 8 Codeine 5 5 Codeine 4 Cough medicine Morning-glory seeds 5 10 Morning-glory seeds Psilocybin 4 12 Psilocybin Romilar 3
Among the 204 respondents, the use of drugs in addition to marijuana was more characteristic than it was exceptional. About two-thirds of the respondents (68 percent) had taken at least one drug other than marijuana or hashish once or more. (Some of the interviewees, I found out later, did not distinguish between marijuana and hashish.) The median number of drugs taken by the interviewees was two and the mean was 3.4. More important than the sheer number of drugs taken is both the kind of drug taken, as well as the frequency. In spite of the commonly stated belief that involvement with marijuana will lead to the use, and eventual addiction to heroin, this potentially dangerous narcotic was used by only a small minority of the sample. Twenty-seven respondents, or 13 percent of the sample, had used heroin at least once, with extremely limited use predominating.
The picture that LSD presents is different in the extent of its use among marijuana smokers, but similar in the characteristic infrequency. Half had taken the drug at least once and of these, a quarter, or 12 percent of the whole sample, tried LSD only once; nineteen took it twice. Only fourteen respondents took the drug twenty-five times or more, and of these, four had taken it one hundred or more times. Thus, LSD typically is not a drug of frequent use. It is most often taken for curiosity, exploring unusual psychic states, affirming one's status in, and experiencing some of the bases of, a distinctive subculture. Probably more than any other drug in use, the drop-off after the first drug experience is precipitous. There was usually little desire to continue use. Of course, the frequent LSD user may be found (Timothy Leary has claimed to have taken more than 400 "trips"), but relatively rarely. And, of course, fear of chromosome damage temporarily brought the widespread use of LSD almost to a halt, sometime after the interviews, by the fall of 1967. However, after the initial scare, many drug users gradually discounted the findings on the damage to the chromosomes, partly as a result of contrary propaganda, and the extent of LSD usage climbed back up to its former level, accompanied by the use of other psychedelics, such as mescaline.
Since our sample is not representative, we have no idea whether the percentage taking each of these drugs can be applied to the larger marijuana-using population; it is a safe guess that our respondents are much more heavily involved with other drugs than is the average group of cannabis smokers, including everyone who has sampled the drug at least once up to the daily smoker. What we want to know are the factors that are related to multiple-drug use; what is there in the social life of some users that contributes to the use of drugs other than marijuana? What is it that helps a marijuana user go on to other drugs?
We found that the most potent variable, by far, in determining a user's use of drugs other than marijuana was how much he smoked marijuana. For instance, nearly all of the daily smokers had tried at least three drugs other than cannabis (92 percent), while almost none of the less than monthly smokers did so (g percent). Each of the categories of use in between formed a step-wise pattern of multiple-drug use; there was a perfect relationship between how much the person smoked marijuana and the likelihood of trying other drugs. (This relationship is presented in Table 8-2).
In fact, the concatenance of many factors relating to marijuana use, conceptions of identity, and marijuana-related activity, was remarkable. The more that the respondent used marijuana, the greater the likelihood of conceiving of others in marijuana-relevant terms, conceiving oneself in terms of being a marijuana user, and of desiring that others around oneself smoke marijuana.
Frequency of Marijuana Use and Involvement with
Drug Activities (percent)
Marijuana Use Ever Tried at
Least Three Drugs
Aside from Marijuana
Ever Took LSD
at Least Once
Daily 92 82 92 96 3 to 6 times per week 69 71 80 93 1 or 2 times per week 29 49 40 84 1 to 4 times monthly 19 25 14 67 Less than monthly 9 22 11 29
With extended, frequent use and its invariable concomitant, subcultural association, attitudinal shifts generally take place relative to drug use and drug-associated identities. The more that one smokes, the greater the likelihood that he will see himself as a marijuana smoker and the higher that drug-connected identities will rank on his "who am I?" responses. The more that one will look for drug cues in others, the more he will think of others in drug-associated terms; also the more one will think it necessary that others with whom he associates smoke. The more that one smokes, the greater the salience that marijuana has in his life. (The evidence for this assertion is presented in Table 8-3.)
It is impossible at this point to draw causal arrows. We must rather, think of the relationship between our variables in dialectical terms. One variable, the amount of marijuana smoked, influences a person's conception of himself as a smoker which, in turn, also influences how much he smokes. The simple cause and effect model is inadequate here. All of the factors form a kind of configuration. The amount a person smokes is easily quantifiable, but it is itself a partial consequence of other factors. To attempt to separate a strand does violence to the whole.
Salience of Marijuana by Amount of Use
Percent saying "yes" to the following questions:
"When you meet a person for the first time, is the fact that he smokes marijuana one of the first
half-dozen things you think about?"
"Is it preferable that your friends smoke marijuana, or not?"
"Do you think that you would turn on your younger brother or sister, if you had one?"
Marijuana Use First Half-dozen
Daily 81 56 88 3 to 6 times per week 69 53 73 1 or 2 times per week 45 37 65 1 to 4 times monthly 39 33 57 Less than monthly 16 31 41
Moreover, the more an individual smokes marijuana, the greater is the likelihood that he will also be involved in drug-related activities which further strengthen his social ties to the drug-using group. For instance, the more he smokes, the greater the chances of his having bought and/or sold marijuana. The more he smokes, the greater the need to purchase marijuana; the more he smokes, the greater is the chance of being able to take advantage of the economy in large purchases, and the greater the likelihood of having a surplus to sell; the more he smokes, the more he associates with others who smoke, especially heavily, and thus the more centrally located he is in the marijuana distribution system, and the more knowledge he has about buying and selling.
But the arrows move in both directions. The more he buys and sells, the greater the number and the intensity of his personal acquaintances in the marijuana network, and the more reinforced will be his marijuana-related activities, including smoking; the more that he buys and sells, the more marijuana there will be around— the greater the likelihood of his keeping a supply—to smoke, and the greater the likelihood of having marijuana to offer to friends when they visit. Simultaneously, both use and sale can be seen as indices of the degree of involvement in the marijuana subcommunity (see Table 8-4).
The greater the proportion of one's friends who are regular marijuana smokers, the greater is the likelihood that one has taken drugs other than marijuana, and the more extensive one's experience with other drugs is likely to be. Likewise, buying and selling push the individual into social relations that alter his conception of himself regarding drug use and provide opportunities for involvement with other kinds of drugs. The fact that the individual has bought and sold marijuana means that he has had contact with other individuals who are likely to be heavily involved in drug use and who define drug use in favorable terms. This clearly means that other drugs are more available to him (friendships and drug use are empirically related in Tables 8-5 and 8-6).
Nonmarijuana Drug Use by Buying and Selling Marijuana
N Bought Marijuana Yes 27 27 49 147 No 49 37 14 57 Sold Marijuana Yes 13 22 64 89 No 45 35 20 115
Heavy marijuana use, then, implicates the individual in intense and extensive social interaction with other marijuana users, involves him with numerous marijuana users and in numerous marijuana related activities, alters the role of marijuana as a relevant criterion in his conceptions of others, and changes his conception of himself as a drug user. Moreover, it increases the likelihood of his taking drugs, in addition to marijuana, of which the subculture approves
Nonmarijuana Drug Use by Marijuana-Smoking Friends
Percent of Friends
Who Are Regular
Taken One or
Two Other Drugs
Taken Three or
More Other Drugs
N 60-100% 16 25 59 73 30-59% 23 30 46 56 0-29% 53 32 15 72
Taking LSD by Marijuana-
Percent N 60-100% 64 73 30-59% 57 56 0-29% 26 72
The higher the proportion of friends who were also regular marijuana smokers, the greater were the individual's chances of taking LSD. The fact that he bought or sold marijuana also increased his chances of having taken LSD. It can be seen in Table 8-7 that since marijuana selling is a more intense commitment than mere buying—selling takes one further into the core of the drug-using subculture, particularly the psychedelic drug community—it serves as a more effective predictor in differentiating whether a person will have taken LSD. (Thirteen percent more of the sellers of marijuana have taken LSD than the buyers, and 7 percent fewer of the nonbuyers have taken it than the nonsellers.)
For every drug that we computed, the daily marijuana smoker was far more likely to have tried it than was the less than monthly marijuana smoker. For instance, only a tiny proportion of the least involved smokers (4 percent) had tried heroin at least once, while slightly over a third of the daily smokers had A quarter of the less than monthly smokers had taken one of the amphetamines to get high, while four-fifths of the daily smokers had. So the greater the amount of marijuana use, the greater the chance of having taken nearly any drug. Intense and continuing involvement with marijuana use implies involvement in a drug-using subculture. But it must be recognized that this is a highly conditional statement, it refers specifically to heavy use and intense involvement. At the lowest levels of use, the use of drugs considered dangerous is highly unlikely.
Taking LSD by Buying and
LSD Yes No N Bought Marijuana Yes 59 41 147 No 23 77 57 LSD Yes No N Sold Marijuana Yes 72 28 69 No 30 70 115
By smoking marijuana, one does not automatically hurl oneself into an LSD miasma. But by smoking marijuana regularly, one makes friends who also smoke. By making friends who smoke, one's attitudes about not only marijuana use, but also the use of the hallucinogens may change as well. The more that one smokes, the more likely it is that one will make friends who approve of LSD use, and who offer opportunities for the use of the LSD-type drugs. We must think of this process in dynamic, as well as in dimensionalist, terms. This is a time-bound process. And it is a process that is a matter of degree. A single puff of marijuana will do practically nothing in the way of "potentiating" one to LSD use. But daily use over the process of several months, within a milieu of heavy marijuana use, with friends who smoke regularly—the greater the number of friends, and the more intimate the relationship—the greater is the likelihood that this will occur.
Logic and Fact in Multiple Drug Use StudiesUnfortunately, no adequate cross-section of marijuana users has ever been studied. Every work done in this area, including my own, suffers from sampling bias. What holds up for one segment of marijuana users may have no relevance for another Probably no study reveals this problem more than a recent paper from the New York State Narcotic Addiction Control Commission, by Glaser, Inciardi, and Babst. A five and ten year follow-up study was conducted of about 700 males who were, in 1957 and 1962, referred to the New York City Youth Council Bureau, "an agency established for handling juvenile and youthful persons alleged to be delinquent or criminal and not deemed sufficiently advanced in their misbehavior to be adjudicated and committed by the courts" for the following three offenses: marijuana use, heroin use, and nondrug offenses.
The study then checked the appearance of the names of the members of its sample in the Narcotics Register, "the most complete file of its type available anywhere in the United States." Which of these three categories of juvenile offenders was most likely to turn up in the heroin files later? The data appeared to confirm the progression hypothesis: "... while half of the male adolescent heroin users had a heroin record five or ten years later, about forty percent of the marijuana users also acquired a heroin record in this follow-up period.... marijuana use is almost as portentous of adult heroin use as is actual use of heroin as an adolescent." The authors strongly qualify the report's findings in their conclusions; they are in no way guilty of an attempt at an overextension of the applicability of their results. Of the four groups which the authors point out as most likely to use marijuana—the slum dweller, the bohemian, the college student, and the high school student—it is only among the first (and last) of these that the study's data was likely to be drawn. And it is in this group that the transition to heroin is most likely. In the other three groups, the use of heroin is certainly far lower than for the urban slum dweller, so that had the study covered all of the marijuana-using groups, the likelihood of later heroin use, and therefore of the transition taking place, would have been much smaller.
In fact, the findings are even more narrowly applicable than that. The marijuana smoker whose use is so conspicuous as to come to the attention of the authorities in no way represents users as a whole. To come to the attention of any agency of law enforcement is to be a part of a highly special and unrepresentative kind of social group. Such users are far more likely to be more highly involved with the drug, to be implicated in some of the more heavily sanctioned marijuana-related activities, such as selling, and to be incautious.*
The Blumer study emphasizes the importance of the cool style in one sector of marijuana users. This kind of user is inclined to denigrate the delinquency-oriented rowdy, who is both more likely to become arrested and to move to later addiction. The cool user is likely to do neither of these. It is almost a certainty that among this conspicuous group, progression to later heroin use is far more likely than among users as a whole.
The adolescents included in the NACC study are far from representative because they generally reflect the very highest levels of use. And it is among these levels of use that later heroin involvement is most likely. It is not unreasonable to assume that less and more cautious use, lower involvement in the marijuana subculture, and participation in a greater variety of social groups, will be far less likely to precipitate heroin use and addiction. In fact, the Narcotics Addiction Control Commission has probably selected the segment of users which has the very highest likelihood of later heroin use. The progression hypothesis holds up best in the very group where the commission gathered data.
Lower-class adolescent slum dwellers are far more likely to come to the attention of formal legal agencies of social control than the middle-class suburban teenager. For the latter, informal, nonrecord, nonarrest implementation is more likely than for the former, if caught. Again, it is a certainty that this progression to heroin is most likely among the slum dwellers, which the authors themselves state, and least likely at the top of the class structure, which is distinctly underrepresented in official records. The process of officially recording an individual's illegal behavior is highly contingent on social class, neighborhood, race, and education, among other contingencies. Official notice, in fact, is immersed in the very process the authors are trying to explain. The problem is not with differentials of law enforcement involvement, as the authors imply (i.e., with the New York Youth Council files as opposed to incarcerated drug users), but with involvement with the law at all as opposed to no involvement. In my study only seven respondents were arrested on marijuana charges, and none was incarcerated. To reason from this handful of cases concerning the characteristics of the 200 users in my sample would have led to erroneous conclusions.
The Narcotics Addiction Control Commission survey at least implied that its validity was stronger in some groups and weaker in others. Another study often cited by law enforcement officers to support their pot-to-heroin claim was conducted among the admissions to the Lexington and Fort Worth addiction centers' inmates in 1965. Of the addicts studied, 70 percent had used marijuana prior to their addiction, that is, had progressed to the narcotics from cannabis. This is quoted as definitive proof that the stepping-stone hypothesis is valid. Giordano, for instance, quotes the Lexington study to support his antipot propaganda. Haslip, too, uses the Ball Lexington research report as support for the progression thesis. Further, both pieces claim that the addict survey documents the pharmacological "effects" explanation for the transition to heroin.
What does the Ball article really say? Actually, its argument and presentation of fact is much more subtle than the law officers admit. The findings do not support the pharmacological explanation: they refute it. And they do not even document the progression theory; they qualify it. The main point of the Ball-Chambers-Ball article was not that 70 percent of all addicts once used pot. It is that where there is an illicit drug-using subculture, marijuana and heroin will be found as mutual components, making the link more likely; where there is no illicit drug subculture, the progression is unlikely, because there is no group to sustain the transmission. It is the subculture that makes for the pot-to-heroin connection, not the drug itself. The central concept in the Ball piece is "differential association—becoming part of a drug-taking group." Needless to say, the propagandists hold the article to support their own "effects" argument; the findings actually refute this contention. (Actually, in his conclusions, Ball also mentions the effects-reason as one of the various possible explanations for the link: "marijuana is taken for its euphoric effects.")
However, another caveat is necessary. The Lexington study, like most studies of drug progressions, was made up entirely of addicts, incarcerated ones at that. It was not done with a cross-section of marijuana users. Therefore, we have no idea of how typical their experience with drugs was. The relevant statistic should not be a retrospective percentage of narcotic addicts who have ever used pot, but a percentage of the total universe of all those who have ever used marijuana who also ever became addicted to heroin. The whole reasoning process in studies of addicts is backwards. By all indications, the percentage of marijuana users who ever become narcotics addicts is quite small; the relevant question here is whether this minuscule minority forms a larger percentage than the total universe of those who have never smoked marijuana.
Out of this seemingly innocent source, gallons of ink have gushed forth in fatuous debate. The progressionists claim that the percentage of addicts who have ever tried marijuana—70 percent in the Ball study, as high as over go percent in others—indicates that pot leads to heroin. The pro-pot propagandists claim that this figure is meaningless, because l00 percent of all addicts drank milk, so that milk is more predictive of later heroin use than marijuana. The antiprogression position is correct on one level, but erroneous on another. In theory, it is always improper to cite the percentage of addicts who ever used marijuana to demonstrate the validity of the stepping-stone hypothesis, because other progressions (milk to heroin) are even stronger. But empirically, we have to assume that the percentage of addicts who have ever used marijuana is higher than for the population at large. Since the percentage of addicts and nonaddicts who once used milk—l00 percent—is the same, this factor provides no differentiating power. But the addict-retrospective argument is also improper, because (1) we do not know whether the percentage of addicts who once used pot is any different for addicts and nonaddicts (we have to assume it, though it is probably a correct assumption); (2) we do not know how much more the addict figure is; (3) and we do not know why it should be more. So the Lexington data does not really tell us very much about drug progression until we have more data, most particularly, a representative sample of the total universe of all marijuana smokers, not merely the ones who became narcotics addicts.
The theories explaining the progression from pot to heroin (assuming that it exists) boil down to two: the psychological-pharmacological, and the social. The former is espoused by the police; the latter, by nearly everyone else. The psychological-pharmacological interpretation holds that there is an actual property of achieving the high that impels the user from marijuana to heroin; basically it is the effect of the drug which dictates the link. The user, who is "kicks" or "thrill" oriented (otherwise he wouldn't smoke marijuana), seeks an increasingly bigger thrill. Gradually the excitement of marijuana begins to pale; he ceases to achieve the charge he first got; and he searches around for a greater kick. This, as we know, is heroin, the "boss kick," the ultimate high. As Giordano has informed us, "Those seeking personal well-being and exhilaration through the stimuli of drugs ultimately discover that the opiates have more to offer."
This combination psychological and pharmacological, or "effects," conception of the reason for the progression is that "the use of marihuana develops [in the user] a taste for drug intoxication which, in turn, leads many people to the use of more potent drugs— even heroin." One problem with this view centers around the imputation of causality. Admitting that marijuana fails to provide the kick provided by heroin is in reality saying that marijuana is discarded for heroin. It is not that marijuana leads to heroin, according to this hypothesis, but that marijuana fails to lead to heroin. Marijuana is not a path, but a dead end: it even slowed down the search for the ultimate kick. If it hadn't been for marijuana, the user would have found heroin sooner. Obviously, we need a different explanation.
Another problem with this conception involves the mechanism by which heroin is perceived as delivering the thrill claimed for it. The effects of a drug are not uniformly grasped by all who happen to come into contact with it; a drug has to be socially defined as delivering a boss kick. The lack of this social dimension weakens the simple effects argument. Were the social dimension taken into account, it would destroy the argument altogether, because the social perceptions of the various drugs vary considerably by user.
One of the problems with a theory that tends to equate all drugs as existing in the same social and phenomenological category is that those who use drugs illicitly do not perceive them as similar. Some classes of drugs will be thought of as opposites. The effects of the various drugs are extremely different, and their social definitions are even more heterogeneous. Drug users often make the distinction between "head" or "mind" drugs and "body" drugs. Head drugs include LSD, DMT, and DET, mescaline and peyote, and usually hashish and marijuana; these are referred to by drug propagandists, such as Timothy Leary, as the "psychedelics," a term coined by the physician Humphrey Osmond, and taken from the Greek, meaning "the mind is made manifest." The clinical professions often call these drugs "hallucinogens" or "psychotomimetics." (However, they rarely produce hallucinations, and they very rarely mimic a madness-like state, although this is dependent on one's definition of madness.) The body drugs encompass a wide range of substances: the amphetamines, cocaine, the barbiturates, the narcotics (including heroin), and alcohol. One of our respondents, a thirty-two-year-old actor, and a daily smoker of marijuana, spells out the differences between body and mind drugs by citing the irrelevance of heroin to the psychedelicist:Heroin is a drag, I think, for anybody who is into mind drugs, because it's like being very, very drunk, and it tends to take one out of everything, as I think, as Cocteau said, it's just like getting off the express train that's going to death, and just sort of being nowhere for a while. The only pleasant aspect of heroin is the peculiar sensation of consciousness and unconsciousness at the same time, so that you can actually perceive what it's like to be asleep because part of your brain is still awake, digging it, digging the groovy feeling of being asleep. But other than that, I don't have anything to recommend it.
Cocaine, of course, and the other stimulants are what I call body drugs which tend to accelerate your behavior, but which don't give you, particularly, any insights.
The miraculous thing about the psychedelics is that things just pop into your mind, and if you can just listen to what you're saying inside there, you can learn a lot. It seems to me that one of the great things about LSD is that any insights you happen to get behind it are reinforced at the same moment by an emotional response that is so total that you tend to accept the insight because you believe it intellectually and emotionally at the same time, and it stays with you later.
The single similarity between marijuana and heroin is that both seem to give, or are reported as giving, a kind of relaxing euphoria, a sense of floating well-being. Beyond that, their effects are almost diametrically opposed and are categorized as such. Marijuana seems to generate a speeded-up, irrational, and seemingly disconnected thought, while heroin slows down, dulls, and deadens the mental processes. Marijuana smokers are far more sensually inclined than heroin addicts; marijuana is closely linked with sex, with orgiastic eating practices, and with an appreciation of loud, vigorous and frenetic hard rock music, while heroin tends to produce a lack of interest in sex—even impotence—and food (junkies often eat just enough to keep themselves alive).
We are not claiming that the effects of one drug have nothing to do with whether a user will later use another drug whose effects are similar. But what we are saying is that if the effects-hypothesis holds up at all, it cannot explain the marijuana-heroin link. If anything, it casts doubt on it. A sociologist might say that it is possible for a subculture to define the effects as similar, and users will think that they are similar, isolate similar characteristics such as the feeling of euphoria, but then we have to move to an altogether new level of explanation, which the proponents of the pharmacological theory of the escalation are unwilling to do.
The social theory of the progressive drug use underplays the pharmacological characteristics of the two drugs. It is not so much that getting high pushes the drug user from marijuana to heroin, as Henry Brill claims: "... the association is not a direct pharmacological association, which means that if you take marijuana ipso facto youbecome physically vulnerable to the opiate. It isn't that way." Furthermore, "there is no pharmacological relation between the two drugs in the laboratory, but it is far from certain that there is no association in the street." Rather, it is that a specific social group defines both as acceptable and pleasurable, offering opportunities for members to use both. As the New York State Narcotics Control Commission data show, it is entirely possible that in slum and ghetto milieu, marijuana use leads to, or, in a very broad sense, potentiates, heroin use. But it is not marijuana, specifically, that provides the impelling force. Marijuana and heroin use in the slum are mutual components in a subculture. Marijuana is experienced sooner in the encounter with this subculture; it is on the periphery of this quasi-criminal subculture. Yet the involvement with marijuana is obviously a matter of degree. Taking a few puffs of a marijuana cigarette during a school lunch period may not implicate one in any heroin-linked activities or associations. But daily use has a far higher chance of doing just that. In the ghetto milieu, progressive involvement with marijuana is likely to precipitate encounters with heroin users. The more that one uses marijuana in the lower-class slum, the greater is the likelihood that one will later use heroin; the two exist in the same subcultural context. Interactions, friendships, associations, which are carried out as a result of marijuana use are likely to precipitate heroin-using involvements, particularly if they are frequent and intimate. In this sense, and in this sense only, marijuana use leads to heroin use.
One subcase of this line of reasoning is the "supplier" theory of drug progression. By smoking marijuana, one is to some degree forced to interact with the criminal underworld. The seller of marijuana is also invariably a narcotics supplier, or so the theory has it. By buying marijuana, one often interacts with, forms friendships with, comes to respect the opinions of, the seller of the drug, who is generally older, more experienced and sophisticated, involved in a daring and dangerous life, and is respected and eagerly sought after by many members of one subcommunity. This interaction can be seen as having a hook attached to it: the seller does not make as much profit from the bulky, low-priced, sporadically used marijuana as he would selling heroin, so that he is, therefore, anxious to have his customers use the more profitable drug. The neophyte drug user gradually acquires the seller's favorable definition of, and accepts opportunities for, heroin use.
In large part, the association of the two drugs is seen as an unintended consequence of their mutual illegality. If marijuana were readily available, it would not be necessary to go to the underworld drug supplier, and the impelling thrust behind this relationship would be removed. This argument holds that the agent most responsible for the progression from marijuana to heroin is the police, that is, law enforcement agencies from the Federal Bureau of Narcotics to the local authorities. It is the fact that marijuana users, are, willy-nilly, involved in criminal activity and in criminal associations that makes for this drug progression.The fact that those who use marijuana, a nonaddicting stimulant, are also required to see themselves as furtive criminals could in some part also account for the presumed tendency of the majority of, if not all, drug addicts to start out by using marijuana. It is a reasonable hypothesis that the movement from the nonaddicting drugs or stimulants to the addictive is made more natural because both are forced to belong to the same marginal, quasi-criminal culture.
If the social theory of drug progression has any validity, then further thought yields the realization that marijuana has relatively little to do with the actual mechanics of the link. We must make a clear distinction between a simple association or correlation and actual cause. We are a long way from the description of a fact (marijuana and heroin exist, in some drug-using groups, in mutual association) to the attribution of causality (marijuana use causes heroin addiction). In this case, both marijuana use and heroin use are part of the same basic syndrome, only in one specific social environment. In other words, marijuana use does not cause heroin addiction, but both are caused by a third outside condition. The automatic attribution of causality here is classified as a post hoc, ergo propter hoc fallacy. Something that happens in association with, and after, something else is not necessarily caused by that earlier event. The link may exist elsewhere; in this case, the social environment. The simple-minded impute causality to time-ordered association. The sophisticated withhold such judgments. Naturally, this whole argument is dependent on the empirical fact of the mutuality of marijuana and heroin in "quasi-criminal" contexts which vary considerably from one group, class, and community to another.
A recent work on multiple drug use among college students shows the relative absence of the opiates on campus. According to Richard Blum, the total number who used any of the opiates in each of the schools was always under five, or about 1 percent of his five campus samples. (Actually, most of those who had tried one of the opiates had tried opium, not heroin, which is far weaker in effect and very, very infrequently leads to addiction in America, although obviously, quite often in the Orient.) The marijuana use ranged from about a third of the students to a tenth, depending on the campus. The degree of the use of marijuana, as opposed to any opiate, including heroin, on the college campus, is of a wholly different magnitude. Even if heroin use on the college campus in the past two years has doubled or tripled, the numbers are still minuscule.
Does marijuana precipitate or lead to heroin on the college campus? Obviously not, if the heroin users are microscopic in number. Actually, this notion cannot be dismissed so lightly; it deserves some exploration. Even though the opiate users may be insignificant in number, it is entirely possible that the marijuana user is more likely to use one of the opiates than the person who does not use marijuana. Blum correlated figures for the use of each of the various drugs. These figures show that users of any given drug are more likely to use (or to have tried) any other drug. However, for each drug, the degree of increasing the likelihood varies from one drug to another. The users of LSD, say, are more likely to have taken at least one of the tranquilizers or barbiturates to get high than those who have never tried LSD; however, the difference between the two figures is small. On the other hand, using heroin considerably increases the chances of having taken, say, dolophine or dilaudid. Rather than looking to see whether there is a simple increase over the nonuser, it is more profitable to look at differences among various categories of drug users, as well as the degree of increase.
On the surface, this evidence will appear to support the antimarijuana, progression hypothesis. In a very narrow statistical sense, marijuana does lead to heroin, even on the college campus. Of course, most pot users never even try any of the opiates, but at the very least, having smoked pot increases one's chances of ever trying (and possibly becoming deeply involved with) the addicting drugs. Or so it would seem. Blum's data, however, are more complex than that. The correlation between marijuana and the opiates is not substantial; however, it is statistically significant. But the correlation between tobacco and marijuana, and alcohol and marijuana, is as large, and even larger than, the marijuana-opiates correlation.
This means that if the argument that marijuana leads to the opiates is meaningful, so is the claim that alcohol or cigarettes lead to the use of marijuana. Alcohol and cigarettes lead to marijuana in the same degree that marijuana leads to the opiates. If the former argument is absurd, then so is the latter. They make the same degree of empirical sense. These data, however valid, will be of no interest to the propagandists. The cliché that marijuana leads to heroin will be repeated without realizing that the argument that cigarettes lead to marijuana is equally valid and equally absurd. Thus, although alcohol and marijuana are often seen as competitors and are to some degree mutually exclusive, in fact, drinkers are more likely to smoke (at least, to try) marijuana than nondrinkers are. The few very heavy drinkers are unlikely to use pot regularly and if these near-alcoholics begin using marijuana, their alcoholic consumption typically drops. But on the gross overall levels, drinking liquor increases one's chances of trying marijuana. Individuals who drink more than occasionally have a much higher likelihood of ever trying marijuana than those who drink only occasionally. The Simon-Gagnon college youth survey cited in Chapter 2 uncovered the dense and close relationship between the consumption of these two intoxicants. Only 4 percent of the male and 2 percent of the female nondrinkers had ever tried marijuana, but 22 percent of the male and 13 percent of the female moderate-or-more drinkers had done so. Moreover, only 6 percent of the men and 7 percent of the women nondrinkers who had never smoked marijuana said that they might like to try; while of the moderate or more drinkers, almost a third said they would like to try.
tobacco-marijuana correlation: r =.31 alcohol-marijuana correlation: r =.22 marijuana-opiates correlation: r =.24
In a statewide representative study of the high school students in the state of Michigan conducted in 1968, a powerful relationship between drinking alcohol and smoking marijuana was found. Only 2 percent of the students who said that they did not drink claimed ever to have smoked marijuana. The figure was nearly ten times higher, 17 percent, for the youths who drank alcohol. And almost 20 percent of these high school students who drank said that if they were offered pot in a congenial setting by a friend, they would accept; only 3 percent of the nondrinkers said that they would. On the other hand, only 8 percent of the drinkers said that if offered, they would tell officials about the offer, but a quarter of the nondrinkers would inform the police or a high school official representative. About twice the percentage of drinkers as nondrinkers thought that marijuana was basically harmless or beneficial. High school and college students who drink alcoholic beverages are clearly far more likely to progress to the use of marijuana than their peers who do not drink liquor.
This means that the claim that heroin addicts started with marijuana turns out to be false. The drug that nearly all addicts started with is, of course, alcohol, and not marijuana. The adolescent's first experiences with a psychoactive drug are invariably with alcohol, and not marijuana. And the alcohol-drinking adolescent is statistically more likely to "go on" to use marijuana, just as the marijuana smoker is statistically more likely to go on to use heroin—or any other drug—than the adolescent who never drinks alcohol or smokes pot. Obviously, much of the causality in the relationship must be laid at the doorstep of experiences tracing back before the young adult's first marijuana experience.
In other words, it is not only the friendships and associations that the young marijuana user makes in the process of smoking pot which makes it more likely that he will experiment with more powerful drugs. It is also necessary to explore early family experiences. I do not refer to the classic psychoanalytic variables, but to cultural and style of life variables. Parents who drink are more likely to raise children who have a more tolerant attitude toward drugs in general, and who have a higher chance of experimenting with drugs. The example of parents is a powerful factor in unwittingly generating the adolescent's deviant behavior. Parents who drink and smoke react hostilely to their children's drug use without realizing that they had a hand in it.
Some Recent TrendsMany journalists think that since about 1967 heroin is increasingly used in social groups which had shunned it previously. College students, suburban residents, white middle-class youths of all kinds are beginning to experiment with heroin and the other narcotics, some eventually becoming addicted. A newspaper story announces, "Heroin Invades Middle Class." Another intones, "Use of Heroin Said to Grow in Colleges."
No serious observer doubts that the use of heroin has increased in the past few years, and, moreover, is now used in social and economic groups which previously had shunned it altogether. College and even high school students with upper-middle-class backgrounds seem to be experimenting with, and even becoming addicted to, heroin in numbers which were totally unknown in 1967 or 1968. The suburban addict has become a reality. And of course, addiction to heroin seems to be rising among all groups, not merely the affluent, and especially among teenagers. (It is unfortunate that widespread public attention to this problem did not come about until it became a problem among white middle-class youth, and not when it was mainly concentrated in the slums.) For instance, teenage deaths from heroin overdosages in New York City have risen about five times since 1965. Arrests on "opiates" charges in California tripled between 1967 and 1968 for juveniles (see Table 8-8 for these figures.) Schools in which heroin use was previously unknown find themselves with noticeable numbers of users; schools in which heroin use was rare but noticeable now have a thriving colony of users.
Drug Arrests in California, 1960 to 1968 [a]
ADULTS JUVENILES Marijuana Opiates [b] Dangerous
Marijuana Opiates [b] Dangerous
1960 4,245 9,135 3,533 910 160 515 1961 3,386 8,171 4,530 408 136 709 1962 3,433 5,939 5,865 310 83 906 1963 4,883 5,962 4,768 635 92 675 1964 6,323 7,597 4,577 1,237 104 639 1965 8,383 6,104 5,930 1,619 60 951 1966 14,209 6,364 6,064 4,034 118 1,007 1967 26,527 8,197 9,558 10,987 272 2,809 1968 33,573 10,411 13,459 16,754 838 8,240[a] Does not include the category "other offenses."There is, then, no question that this process is taking place. But there is some question as to its extent. It is an easy matter to exaggerate the depth of a problem and to declare that a previously absent problem is reaching epidemic proportions. The question of whether a given condition should exist at all is completely separate from the issue of how widespread it is. It is necessary to place the problem in perspective. First of all, recall from earlier chapters that a minority of America's youth has tried marijuana once—about a quarter of college youth, and fewer younger adolescents and young adults who do not attend college. And the marijuana experimenters who progress to use marijuana regularly are only a small minority of this small minority. Further, the regular marijuana users who progress to heroin are still a smaller proportion of this tiny segment. Actual addiction is less likely still. Of course, in some milieu, such as in and near large cities, especially New York, far more adolescents will take heroin than in rural areas; but even in New York, it is a minority phenomenon.
[b] Not all "opiate" arrests are on the basis of heroin charges, although most are. In 1968, the California Bureau of Criminal Statistics combined the categories "heroin and other narcotics" and "narcotic addict or user" into the single category "opiates." Thus, for the previous years, I have combined these two categories to make them consistent with the 1968 designation.
[c] The main drugs included in the category "dangerous drugs" are the amphetamines and LSD: however, LSD was not added to the "dangerous drugs" category until 1965.
In early 1970, I conducted a brief study of drug use among the students of a deviance and delinquency class in a large suburban university. Some tentative generalizations relevant to multiple drug use may be made, using this study. About a quarter of the over 500 students in the sample had not tried any drug, including marijuana, even once, to get high. (Medical uses were not considered.) About a third had tried marijuana at least once, but had not used any other drugs. Thus, slightly under half had smoked marijuana and, in addition, had used some other drug at least once: they were multiple drug users. Ranking the drugs according to what proportion of the students in the sample had ever used them produces a rank-order almost identical to my 1967 New York marijuana smokers study, cited in the beginning of this chapter, and the EV0 study, also done in New York in 1967. The drugs most often used are the amphetamines and the psychedelics; one of the drugsleast often used, aside from a variety of miscellaneous drugs, is heroin. Heroin does not appear among the first half-dozen drugs most often used among young adults. About a third of the students had taken at least one of the amphetamines at least once (although for exactly what purposes I was not able to determine due to the questionnaire's brevity—many used pills to study for examinations at night). The next most popular drug was mescaline; slightly fewer than a third had taken mescaline at least once. About a quarter of the sample had taken LSD. The next most frequent drugs used were the barbiturates and tranquilizers—about half as many as had tried LSD took "downs" at least once. The remaining drugs, in order of the number of students who had taken them, were: opium, cocaine, methedrine, and DMT. Heroin was sampled by about 5 percent of the students. Of these, about six students admitted to regular use (more than a dozen times); this is about 1 percent of the sample.
An exploratory study such as this cannot be regarded as precise or infallible; it is, for instance, possible for students to avoid admitting to drug use, even in an anonymous questionnaire distributed to a class of 500 students. (Some students hinted at exaggeration rather than understatement.) And the students in this particular class may not represent the entire university, and the experiences of this university may not be duplicated at other ones, and so on. But as a scrap of evidence, it may be useful to help piece together the whole picture. But bringing evidence to bear on the heroin question is not in any way an effort to minimize the problem. The use of this dangerous narcotic is engaging a larger and larger number of our youth today. The situation that exists in 1970 may not be valid in 1975. At the same time, it is necessary to examine the facts. And the facts indicate that there appears to be no cause for the cry epidemic. It is possible that in some neighborhoods or schools the problem is that extensive. But looking at the broader picture, such a situation has not materialized. A rational and sober assault on the heroin problem is called for, and not sensational cries of a mythical epidemic.
Although it in no way minimizes the heroin issue, a related point has tended to become lost in the public outcry against heroin. The heavy use of methedrine ("meth" or "speed") is actually far more dangerous than heroin addiction. The physically debilitating longterm effects of heroin—overdosing aside—are relatively trivial.**Methedrine, on the other hand, is debilitating and toxic. The nervous system is progressively destroyed by heavy continued dosages of this drug. Moreover, the use of this drug is extremely widespread; although exact figures are impossible to obtain, there may be more chronic users of methedrine than heroin addicts. This does not even count the millions of housewives, truckdrivers, and businessmen, who use smaller doses of the amphetamines over long periods of time. Although there has been some recent attention paid to the amphetamine and methedrine problem, the public is generally completely ignorant about the degree of its seriousness, as well as its extent of use. As long as marijuana continues to be socially defined as a serious social problem, it is unlikely that any progress will be made toward a solution of the problem of the use of really potent drugs. There is no indication that any such awareness is emerging, so that American society will continue to have its heroin and methedrine problems for some time to come.
* In the chapter on "Marijuana and the Law," we show that the large majority of arrests that occur are a result of accidental patrol enforcement. The statement on the incaution of arrested users does not contradict this fact. It is the incautious user who is most likely to be in situations where the police may accidentally discover his possession, use, and sale. (back)
For a description of these various styles of drug use, see Herbert Blumer, Alan Sutter Samir Ahmed, and Roger Smith, The World of Youthful Drug Use (Berkeley: School of Criminology, University of California, January 1967), pp. 13-47.
** This point illustrates the fact that addiction, in and of itself, is not an adequate measure of the degree of harm of a drug. Methedrine, which is not addicting technically, is more dangerous than heroin, which is. (back)
N O T E S1. Elmer James Rollings, "Marihuana—the Weed of Woe" (Wichita, Kan.: Defender Tract Club, n.d. [circa 1938]). (back)
2. Federal Bureau of Narcotics, "Living Death: The Truth about Drug Addiction" (Washington: U.S. Government Printing Office, 1965). (back)
3. Gene R. Haslip, "Current Issues in the Prevention and Control of Marihuana Abuse" (Paper presented to the First National Conference on Student Drug Involvement sponsored by the United States National Student Association at the University of Maryland, August 16, 1967). See also, Henry L. Giordano, "The Prevention of Drug Abuse," Humanist, March-April 1968, pp. 20-23. Word for word, Giordano duplicates Haslip's sentence on drug progression. (back)
4. Theo Wilson, "I am a Drug Addict: An Autobiography," New York Daily News, February 14, 1968, p. C6. (back)
5. See The East Village Other, January l-15, p. 6. Consider only the following possibilities of sampling bias: EVO readers do not represent marijuana smokers in general; EVO readers do not represent even New York area marijuana smokers, the EVO reader who is sufficiently motivated to fill out the questionnaire doesn't represent all EVO readers; all EVO purchasers do not represent all EVO readers, some EVO readers (none of which sent in the questionnaire) do not use drugs; and so forth. We use this survey only as rough corroborative evidence. (back)
6. Daniel Glaser, Tames A. Inciardi, and Dean V. Babst, "Later Heroin Use by Marijuana-Using, Heroin-Using, and Non-Drug-Using Adolescent Offenders in New York City," The International Journal of the Addictions 4 (Tune 1969): 145-155. (back)
7. John C. Ball, Carl D. Chambers, and Marion .T Ball. "The Association of Marihuana Smoking with Opiate Addiction in the United States," Journal of Criminal Law, Criminology, and Police Science 59 (June 1968): 171-182. (back)
8. The best description of social definitions of heroin as the ultimate kick may still be found in "Cats. Kicks and Color," by Harold Finestone, in the anthology edited by Howard S. Becker, The Other Side (New York: The Free Press, 1964), pp. 281-297. (back)
9. Giordano, op. cit., p. 21. (back)
10. Henry L. Giordano, "Marihuana—A Calling Card to Addiction," FBI Law Enforcement Bulletin 37, no. 1l (November 1968): 5. See also Giordano, "The Dangers of Marihuana, Facts You Should Know" (Washington: U.S. Government Printing Office, 68). (back)
11. I am grateful to Professor John Kaplan for this insight. See his Marijuana: The New Prohibition, forthcoming. (back)
12. Jean Cocteau, French artist, writer, and filmmaker, 1891-1963, was addicted to opium in the 19205; he wrote a book about his experiences, translated into English as Opium: Diary of a Cure (New York: Grove Press, 1958). The bodily effects of opium are superficially similar to heroin in some respects, although considerably weaker. Heroin is, of course, a derivative of opium. (back)
13. Henry Brill, "Drugs and Drug Users: Some Perspectives," in New York State Narcotic Addiction Control Commission, Drugs on the Campus: An Assessment(The Saratoga Springs Conference on Colleges and Universities of New York State, Saratoga Springs, N.Y., October 25-27, 1967), p. 59. (back)
14. Brill, "Why Not Pot Now? Some Questions and Answers," Psychiatric Opinion 5, no. 5 (October 1968): 18. (back)
15. For an example of this line of reasoning, see Alfred R. Lindesmith and John H. Gagnon, "Anomie and Drug Addiction," in Marshall B. Clinard, ed., Anomie and Deviant Behavior (New York: The Free Press, 1964), pp. 171-174. (back)
16. Kenneth B. Clark, Dark Ghetto (New York: Harper & Row, 1965), p. 90. (back)
17. Richard H. Blum et al., Students and Drugs (San Francisco: Jossey-Bass, 1969), pp. 101-109. (back)
18. I am making the empirically valid assumption that the first instance of alcohol and cigarette use generally precedes rather than follows the use of marijuana, and that the use of marijuana precedes the initial use of the opiates. (back)
19. William Simon and John H. Gagnon, The End of Adolescence (New York: Harper & Row, 1970). (back)
20. Richard A. Bogg, Roy G. Smith, and Susan Russell, Drugs and Michigan High School Students (Lansing: Michigan House of Representatives, Special Committee on Narcotics, December 9, 1968). The figures I present were not calculated in this study. Mr. Bogg kindly lent me a copy of the IBM cards which stored this study's data, and I calculated the percentages myself. I would like to thank Mr. Bogg for his generosity. (back)
21. See the study by the Addiction Research Foundation of Toronto, Canada, A Preliminary Report on the Attitudes and Behaviour of Toronto Students in Relation to Drugs (Toronto. Addiction Research Foundation, January 1969), p. 66 and Tables 18 and 19. Recently Mayor Lindsay of New York City claimed that television was one of the causes of tolerance in attitudes toward drugs among today's youth, and partly responsible for drug use. Actually, as the Toronto study shows, drug users are more skeptical toward the mass media as a source of information about drugs than nonusers are. See pp. 56-57 and Table 45. (back)
22. Philip D. Carter, "Heroin Invades the World of the White Middle Class," The Washington Post, February 16, 1969, pp. A1, A8.(back)
23. Peter Kihss, "Use of Heroin Said to Grow in Colleges, but Number of Addicts is Still Small," The New York Times, March 1l, 1969, p.35. (back)
24. State of California Department of Justice, Bureau of Criminal Statistics, Drug Arrests and Dispositions in California: 1968 (Sacramento: State of California, 1969), 1968 Drug Arrests in California: Advance Report (Sacramento: State of California, April 1969), and Drug Arrests and Dispositions in California: 1967 (Sacramento: State of California, 1968).
The same trends are noticeable in Great Britain. The number of cannabis offences and heroin addicts seem to be increasing almost identically. See Nicholas Wade, "Pot and Heroin," New Society, January 23, 1969, p. 117. (back)
25. For a frightening, although sensationalistic, journalistic account of the lives of several chronic amphetamine users, see Gail Sheehy, "The Amphetamine Explosion," New York, July 21, 1969, pp. 26-42. Earlier journalistic articles include John Kifner, "Methedrine Use Is Growing," The New York Times, October 17, 1967, pp. 1, 40, and Don McNeill, "The A-Heads: An Amphetamine Apple in Psychedelic Eden," The Village Voice, February 2, 1967, pp. 11, 31. Blumer's study also contains some material on the use of the amphetamines. (back)