Appendix A

Some Basic Problems in Drug Addiction and Suggestions for Research*

by MORRIS PLOSCOWE

VII. SOCIAL FACTORS IN ADDICTION

Psychopaths, psychopathic diathetics, psychoneurotics, emotionally disturbed persons, etc. would not use narcotics as a solution for their personal problems, unless such drugs were available. If such individuals happen to live in the slum areas of our cities, this offers no problem, for one of the facts of life in connection with narcotics is that illicit drugs can be purchased most readily in the slum neighborhoods of our large cities. Police officers from many different cities testified before the Congressional Committees that most drug arrests and violations of the drug laws occurred in certain limited areas of their cities, usually the areas of greatest social disorganization. In these neighborhoods live the most economically deprived groups of our population; the racial and religious minorities, and the recent immigrants into the cities. These are the areas of poor and squalid housing, of overcrowding, of a shifting disorganized family life. They are the areas with the largest number of relief cases; the highest rates of juvenile delinquency, adolescent and adult crime. They are also areas with high rates of mental disturbance and psychological bnormality.49 It is these disorganized slum neighborhoods, whether they exist in New York, Chicago, Los Angeles, Detroit or Washington, D. C., which develop a special cultural climate which is favorable to drug use and experimentation particularly by juveniles and adolescents. Two major studies in recent years (The N. Y. U. Study and the Chicago Study) were concerned with an analysis of the factors in such neighborhoods which were conducive to a high degree of drug use. The Chicago Study pointed out that the social environment for young males in these areas comes to be dominated by a "street corner society" and that such societies flourish in communities where the traditional influences and controls over youth tend to be weak and uncertain. The central feature of this society or culture is the support that it gives to behavior which is inconsistent with the norms of conventional society and often openly hostile to many of its expectations. This orientation on the part of the street boys is expressed in a variety of ways, particularly by delinquency and crime "and in the search for and exploitation of kicks." Success in the exploitation of "kicks" entails willingness to experiment with new drugs whose effects and properties are not precisely known to the user. However, the street corner groups appear to vary in the degree to which they court the double interest in delinquency and "kicks." There are, as an N. Y. U. study pointed out, street gangs with a high degree of narcotic use, a low degree of narcotic use and gangs which do not permit their members to use narcotics at all. Nevertheless, as the Chicago study notes, the introduction of heroin to street groups in Chicago, "...was facilitated by an established and pre-existing interest in the use of stimulants and intoxicants and by the tendency to experiment freely with new drugs."50 Heroin was "pushed" vigorously by the frenetic search of the street corner boy for newer, stranger and more status giving intoxicants, and after heroin use had been defined as "desirable and valuable by intimate associates whose views are meaningful to the potential user." The New York University studies came to similar conclusions : "We have learned that the social pattern of using narcotics is highly concentrated in the most deprived areas of the city; that it is associated with the type of delinquency that produces ready cash; that the pattern of using drugs spreads within the peer-group and apparently is meaningful in the context of the social reality in which the boys live; that the users (and nonusing delinquents) live in a special defiant and escapist subculture side by side with the other subculture of 'squares' who want to life themselves out of their depriving environment."51 Obviously not all the boys who participate in the activities of street corner society or of street gangs wind up as habitual or professional criminals or drug addicts. The wider, conventional society exercises its pressures for conformity even against the members of the delinquent and deviant sub-culture. As the boys grow older, the youthful preoccupations with delinquency, kicks, hell-raising, gang fights, etc., give way for many of the boys to a concern about the future, a steady girl, a job, a home, etc. The problem of who will and who will not become a professional criminal or a drug addict is dependent upon the personality of the individual boy. This is noted by both the Chicago and the N. Y. U. studies: "... Most likely to become extreme delinquents or drug users are those who by virtue of their personal histories are least responsive to the expectations of conventional society. Thus, the problem of differences between those who do and those who do not become drug addicts in the world of the street boy may be regarded as a problem of the difference in life history among individuals, with each life history constituting a unique equation of forces."52

"But as the group grows older, two things happen. Sport, hell-raising and gang fights become 'kid stuff' and are given up. In the normal course of events, the youthful preoccupations are replaced by more individual concerns about work, future, a 'steady' girl and the like. If most of the gang members are sufficiently healthy to face these new personal needs and societal demands and engage in the new activities appropriate for their age, the availability of drugs will not attract their interest. But for those gang members who are too disturbed emotionally to face the future as adults, the passing of adolescent hell-raising leaves emptiness, boredom, apathy and restless anxiety. In a gang where there are many such disturbed members, experimentation with drugs for 'kicks' will soon lead to frequent and, later, habitual use; cliques of users will grow quickly. Enmeshed in the patterns of activities revolving around the purchase, sale and use of drugs and the delinquent efforts to get money to meet the exorbitant cost of heroin, the young users can comfortably forget about girls, careers, status and recognition in the society at large. Their sexual drive is diminished, they maintain a sense of belonging in the limited world of the addict, they remain children forever. They may give up all sense of personal responsibility for their lives and conveniently project the blame for their shiftless existence on the 'habit'."53 It is obvious that in the production of a drug addict, just as in the production of a delinquent or a criminal, there is an interaction of personality and environmental factors. But there is also a shaping of personality by environmental factors, cultural attitudes, and interpersonal relationships. Nowhere is this more true than in the intimate confines of family life. The N. Y. U. group compared the family background of 30 White, Negro, and Puerto Rican families with a non addict boy and 30 such families with a boy who was an addict. All the families lived in a high drug use neighborhood. Almost all of the 30 addicts came from families where there was a disturbed relationship between the parents as evidenced by separation, divorce, overt hostility or lack of warmth and mutual interest.

The addicts experienced much more frequently than the controls, "... cool or hostile parent figures, weak parent-child relationships, lack of clarity as to the way in which disciplinary policies were established and vague or inconsistent parental standards for the boy."54 As a result of these findings, this study came to the conclusion: " ... that the pathologic personality characteristics of the juvenile heroin addict are consistent outgrowths of the disturbed pattern of family relationships to which he has been exposed."55