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• These experiments were carried out, with the help of Miss Judith Nelson, while we were guests at the laboratory of Dr Conan Kometsky and Dr Peter Knapp of Boston University Medical School.
WE have already reported the results"' of pilot human experiments with marijuana*. Those articles dealt principally with the subjects' responses to the drug itself and did not include many other observations made in the course of acquiring volunteer subjects, providing for their safety and assessing the long-range effects on them of their participation in the research. Interesting social and psychological similarities and differences were revealed among three groups of subjects: marijuana naïve persons (N), persons not naïve to marijuana (NN) and chronic marijuana users (C). We discuss these results here.
Obtaining Volunteers
In the experiment two groups of subjects were tested. The first consisted of nine male volunteers, at least 21 years old, who smoked tobacco cigarettes regularly but had never tried marijuana. The second group consisted of eight regular marijuana smokers (average frequency of use: once a day for several years), who were recruited by passing word among the staff of an underground newspaper that heavy marijuana users were needed for experiments with the drug. Nine men volunteered and were given appointments for screening interviews. These nine make up the C group in this discussion.
The nine naive subjects were selected from a pool of interviewees who were recruited by advertisements in college newspapers in the Boston area asking for volunteers for "psychological experiments". (There was no indication that the experiments concerned marijuana or other drugs.) All who responded to the advertisements were asked whether he drank or smoked tobacco. The non-smokers (of tobacco) were eliminated. We were unable to find enough marijuana naive smokers who smoked enough to inhale deeply and easily, and we resorted to more active methods of recruiting in areas where we thought marijuana use might be low, but we had no more success.
Eventually sixty-two prospective subjects, including the nine known chronic users of marijuana, were interviewed in depth by a psychoanalyst. Fifty-three had responded to our advertisements in college newspapers. Twenty-eight of these had used marijuana at least once and were therefore eliminated from the experiment; they make up our NN group. The other twenty-five were marijuana naive and make up the N group. Our sample is not representative of the general college population in Boston, but it is probably a fair sample of those in the college population of Massachusetts willing to answer an advertisement for an unspecified psychological experiment.
Interviews
All subjects were interviewed in the same way, although once a candidate was identified as a nonsmoker the interview tended to be shorter. The interviewer began by obtaining the subject's permission to ask somewhat personal questions, reassuring him that only group findings would be reported.
The interviewer asked about the general educational, geographical and social background of the subject and his family. The subject's emotional relationships with family and friends were discussed, along with medical history, including any psychiatric contact, actual or considered. There were general questions about use of cigarettes, alcohol and other drugs during a discussion of social habits, but detailed questions were held until near the end of the interview. The interviewer tried to determine the subject's economic, political and aesthetic attitudes and values, pausing for more specific questions in any area that interested the subject, caused him to become more reticent or seemed important in other ways for the further delineation of character structure.
The interviewer then questioned the subject in depth about drugs. If he admitted having tried any drug, he was asked exactly what he had taken, who had given it to him, whether he had given it to anyone else, what it had felt like and what he saw as the long-term effects of the drug use on his personality, attitudes and behaviour. If he had not taken any drug, he was asked whether he had had the opportunity to do so. He was also asked to discuss any knowledge of drug use he had obtained from friends or from the mass media, and to give his own overall attitudes toward drugs. Until the end of the interview, none of the subjects guessed that drug use was a principal focus. In the opinion of the interviewer, all the material we presented was offered freely and seemed reliable.
Information Elicited
The subjects ranged in age from 21 to 27, clustering around 23 to 24. Although we assigned them to the three groups—N, NN and C—the actual drug use of some of the NN group approached that of the Cs. All but two in each of the three groups were students in eight different institutions of higher learning in the Boston area. Of the rest, all but one (an N, diagnosed as a chronic schizophrenic, who will not be included in the tables to follow) were employed.
Drug histories of the different groups are quickly summarized. Two N subjects took occasional amphetamines without prescription during examination pressures; one took cortisone for medical reasons and one was pathologically sensitive to a variety of drugs. (The latter two were disqualified from the experiments.) Of the NN subjects, one had tried marijuana once, seven had taken it "a few times"; the rest used it regularly—weekly or even daily. Fifteen NN subjects had tried hashish, and four had used LSD (two once, one twice, and one six times). All the C group had tried hashish; four of them had taken LSD. One subject had taken LSD twice, mescaline twice, and methedrine, cocaine and heroin once each. Another had taken LSD three times and heroin once. Both of these had been overseas in
unusual circumstances when they had tried heroin several years before the interview, and neither had tried it again. All regular users in the NN group and all the C group said they had ready access to a variety of psychoactive drugs.
Questions about alcohol intake produced interesting information. For the NN subjects it seems that, when
marijuana use became regular, the use of alcohol, especially distilled spirits, declined proportionately or even more steeply (Fig. 1). In the C group, with one exception, no subjects drank alcohol except as part of the marijuana smoking ritual when they sipped cold beer or wine to relieve dryness of the mouth. In fact, three of the nine C subjects virtually never drank alcohol, and one other reported a definite distaste for drink even before he started using marijuana.
Questions about parental drug use elicited direct responses from eight Ns, eighteen NNs and five Cs. Three said that both parents were constantly on medication: tranquillizers, sedatives, insulin, antihistamines and digitalis were mentioned more than once. What impressed the interviewer were the promptness of reply and the extent of knowledge about parental medication, even by subjects who had been home infrequently in recent years.
In terms of socio-economic distribution of families, the N and NN groups differed hardly at all; nor was there any difference between the two in closeness of relation. ship with family, as rated by the subjects themselves on an arbitrary scale of 1 to 5. By contrast, the C group had more affluent backgrounds (Figs. 2 and 3), but this fact is probably a recruitment artefact: nineteen of the N subjects and eighteen of the NNs gave a desire to earn money as the reason for volunteering for the experiment, while only one of the C group gave that reason. The C subjects also had more prominent histories of family disturbance.
Ns and NNs corresponded almost exactly on courting behaviour and political attitudes. Most saw a girl about once or twice a week; three in each group were married. Most mentioned names like Rockefeller, R. Kennedy and McCarthy as presidential choices (interviews were held in the spring of 1968), opposed the war in Vietnam and sympathized with student demonstrators (Fig. 4). The chronic users differed here. Four were married (one of these already divorced), and two more had been living with the same girls for nearly two years. Seven of the nine described themselves as radical or becoming radical and refused to choose a desired candidate for president from existing politicians (Fig. 5).
Personality Structures
At the end of the interview, the interviewer tried to place the subject on a rough gradient of personality traits ranging from extreme compulsiveness to extreme hysteria. The entire gradient is considered to fall within the limits of "normal" character structures.
The profile of a classic compulsive personality includes a desire for control over his life situation and, particularly, over his emotions. The compulsive individual always tries to maintain an emotional distance from other people, and his attempts are quite noticeable in a psychiatric interview. He also tends to use precise language (even if the ideas are highly generalized) to avoid the underlying indecision and ambivalence that create his need for control. These characteristics reduce his susceptibility to suggestion and his awareness of his inner life but help him organize successfully his outer life, relationships and work.
At the other end of the spectrum, the hysterical personality has ready access to his emotions and tends to use imagery rather than facts to express himself. As a result his relationships with others are more direct and he has a greater immediate awareness of his emotional responses in life. But he obtains this contact with his inner self at the expense of organization, continuity in relationships and thought, and precision of expression. He is also more susceptible to suggestion than the compulsive person.
Most people are mixtures of these two basic personality types. We tried to place our subjects on this continuum because we predicted that, in experimental conditions, hysterical personalities would be more likely to experience the subjective effects of marijuana. In our sample the N group showed a general tendency towards compulsiveness; the NN group tended towards more hysterical traits, and regular users (at least once a week) within the NN group clearly fell towards that end of the scale. Most subjects in both groups fell within the limits of the scale (that is, within the spectrum of normal personalities). By contrast, five of the nine C subjects fell off the scale and one more was only questionably within it. We shall call these personality distortions aberrations, although four of the six seemed well stabilized in their chosen environments.
Experiments and Beyond
Ultimately nine subjects were selected from the N group and eight from the C group to participate in the exp-riment. All the N subjects were giveri high and low doses of marijuana and placebos in double-blind conditions. Our prediction about personality type and subjective response seemed to be correct at each end of the scale. Subject 4 (J. G.), who had been rated the most compulsive and said he wanted to prove that marijuana did nothing, called his high dose a placebo, while subject 3 (T. P.), who had been rated the most hysterical and said he had many friends who like to use marijuana, was the only N to experience a subjective high.
All nine N subjects who participated in the experiment were interviewed six months after the completion of testing to see how their participation had affected them. These interviews were briefer than the initial ones and had the slight disadvantage of taking place a few days after the American presidential election. Because the subjects had been asked initially about their political attitudes, they thought it appropriate to discuss their positions at some length. This was in fact the only dimension that showed a significant change. Two subjects reported shifts to more conservative positions, while four had become more radical. All were continuing on their career tracks, with no change in family relationships or use of alcohol; one was now engaged.
They reported no significant changes in their attitudes toward marijuana. One had been at a party where a water pipe of marijuana was passed around; he had taken a few puffs with no effect. Another's friends, knowing of his participation in the experiment, had given him some of the drug as a birthday present. He said it was "not enough" for him to get high on, although a friend who smoked it with him and was a heavy user did get high. Another subject expressed a typical reaction when he said that he now has "no disinclination to try it again" but "no particular desire to seek it out". All nine subjects approved of the experiment and felt that more should be done to obtain knowledge about marijuana so that "kids won't get messed up" and the "law can be reviewed".
Who is Different ?
We noted in the previous section that there were no significant differences between our N and NN groups on a whole series of basic psychological dimensions; family relationships, social class, educational achievement, financial status, sexual behaviour, political position and personality structure. Because the two groups were recruited in the same way, the lack of difference requires close attention. It suggests that the use of marijuana in the present student population may not signify any other differentiation. If this suggestion is proved, it would probably mean that marijuana use is now so extensive and so accepted within this particular age group that it cuts across all other boundaries.
Our failure to find greater evidence of overt neurosis in the NN group does not support the contention that marijuana use per se represents a neurotic outlet. Neither have we any evidence that marijuana users who began after 1966 form a well-delineated campus subculture with common backgrounds or characteristics (permissive parents, hippies, radicals and so on). We found this lack of uniqueness of the NN group remarkable and would not have predicted it in advance. Even though the NNs were slightly more susceptible to suggestion and more inclined to have a hysterical personality this is of borderline clinical significance and requires confirmation.
The C group, however, deserves special attention because it is easily differentiable from the other two. First, they regarded their drug use as the most significant single factor in determining their pattern of life.
Their constancy of attachment to female partners is not only out of line with the rest of our sample but significant compared with their age group in the general population or with a selected group matched for family background and educational achievement. This finding stands out because Vaillant's study of heroin addictss implied that '70 per cent maintained relatively stable marriages of common law arrangements: a remarkable figure considering the generally erratic nature of their lives, and one that contrasts sharply with those for other deviant groups (22 per cent for criminal delinquents). Valliant uses the closeness to female partners in his argument that the heroin users he studied strove for closeness to a maternal figure and were unusually dependent.
Our C group has continued in school or chosen occupation, while Vaillant's group did not. But, as Fig. 5 shows, we did consider a significant portion of the Cs to be off our scale of usual personality structure. Supporting evidence for this rating was the extreme anxiousness and vague paranoia recorded during the interviews and persisting into the experiments. For example, the Cs had strong reactions against a blood sampling procedure. All of the Ns allowed blood to be drawn without incident, but three Cs complained of faintness, and two others wanted repeated reassurances that they would not be harmed. All nine commented repeatedly on that aspect of the experiment and gave strong indications that they did not want any tampering with their bodies.
In appearance the C group split about fifty-fifty with five recognizably hippy (long-haired and costumed) and four "clean-cut".
Two or three interviewees in both N and NN groups had unusual clothes, but none was as distinctive as the hippy members of the C group. There were signs of overt intellectual deterioration in the C interviewees, although several subjects talked with an unusual use of imagery and a general circumstantiality. Finally, their attitudes were quite negative toward society, which they saw as blindly conformist.
Hypotheses
We tried to explain these personality differences between the C and other groups by way of three hypotheses. (a) The C group was composed of persons who were more generally neurotic before they started using marijuana, and it was their need to express some personality distortion (excessive anxiety, paranoid tendency or excessive dependency) that pushed them into being chronic users of an illegal drug. (b) the Cs were "weaker", more suggestible persons who had succumbed to heavy marijuana use, and the drug itself caused the distortions now observed. (c) Choice of marijuana as a means of self-expression marks one as a deviant in the eyes of society and leads to fear of the police and other agents of the prevailing social order. Impact of these experiences on the C group produced the personality changes recorded in the interviews.
None of these hypotheses is satisfactory by itself. It is impossible to test the first without a prospective study. In retrospect, the Cs did not consider themselves unusually disturbed before marijuana use. They also did not see themselves as particularly susceptible to suggestion and rejected the idea that their involvement with marijuana had been unwitting. Many said their initial experience with the drug had been accidental or impulsive, but they considered the decision to use it regularly a rational one and under psychological control. Neither did they see themselves as "addictive personalities" who were hooked on intoxicants any more than most members of society. In fact, they tended to see themselves as freer and less interdependent than the rest of society.
Yet they did not reject the contention that their personalities had changed as a result of their use of marijuana. What the interviewer saw as greater circumstantiality, they saw as greater interest in abstraction or a use of the mind at a higher capacity. They evinced many doubts about the validity of Western thought, which they related to a greater interest in philosophy and —predictably—Eastern schools of thought.
By implication, the Cs themselves preferred the third hypothesis and saw it as a factor in their early decisions to marry. They were uniformly hitter ahout society's attitude toward marijuana use and said this feeling affected their lives. Many reported that being defined as a deviant and law-breaker for something they could not accept as criminal had driven them into increasingly negative attitudes toward the larger society. Three subjects were especially articulate in tracing the shift of their values that led them to seek out individuals and groups who shared their positions and who used marijuana as frequently.
This argument, however, does not explain why the NN group had not reacted this way and had not allowed their drug use to become as dominant in their lives. A possible factor is that, although 60 per cent of the NN subjects were regular users, all began use after 1966 while all the Cs began use before 1965. The social atmosphere at the time the NNs began to use marijuana accepted the use more thoroughly, contemporaries were less likely to differentiate people as special (rebels or heroes) simply because of the drug use. Further, the NNs—even those whose use of marijuana approached that of the Cs—did not think of themselves primarily as members of a drug subculture.
Other Drugs and Alcohol
A negative finding that deserves some attention (and was a surprise to us) was the low frequency of use of drugs other than cannabis* in the NN and C groups. At first glance, the fact that almost 50 per cent of Cs had tried LSD and 20 per cent heroin may not seem low. But when one considers the ready availability of drugs to all members of this group, one must look further. In fact, if a single experiment with a drug ("one taste")4 is disregarded, then only 20 per cent have used any drug other than cannabis. And in those two cases (LSD and mescaline twice, and LSD three times) the use of these drugs was seen as a careful intellectual or philosophical exercise and was repeated ostensibly only for that purpose. In no case is there any evidence for any form of craving for further drug experience, although four Cs stated that at some future time they would like to try LSD (two again and two for the first time).
The figures for the NN group are even more remarkable. Of twenty quite regular cannabis users, only one (LSD six times) had used any other drug frequently. This finding bears on the question whether use of marijuana leads to the use of other drugs. With the exception of one NN subject who said he needed LSD "to further the enlightenment begun by marijuana", none of the subjects was moved by his cannabis experiences to the regular use of other drugs. We found no dissatisfaction with cannabis use that called for other drugs, and no subject expressed any fears of dependency on marijuana.
Lack of political activism among NNs is worth mentioning because it contrasts with findings of other interviews5'6 which show a high frequency of marijuana use among activists. Generally speaking, these writers suggest that the activism had been equated with rebelliousness, and this was not one of our findings. Greater use of drugs among NN parents, however, supports the possibility that illicit drug use can represent a rebellion/submission reaction to parents. In the US a young man can imitate and thus establish closeness with his elders by experimenting with drugs, but by taking the drug marijuana he can at the same time declare his independence and rebellion. There is some evidence for this possibility in our interviews, as exemplified by these statements: "My father would die if I told him I got the same tranquillizing effects from pot that he gets from his pills". And: "The first time I got. high was. in Cincinnati [pa, re nt home], and I remember thinking that maybe Mom gets a kick out of all that junk she takes [antihistamines]".
Finally, it seems that idcoli.)1 intake decreases as marijuana use becomes regular. Because only one of the NN and none of the C subjects regarded themselves as heavy drinkers before using cannabis, it is not possible to infer that the same effect would be seen with regular drinkers of alcohol. But, in the case of the moderate use of alcohol associated with late adolescence and the early twenties, marijuana smoking seems to be a functional equivalent, not simply a further drug habit (contrast alcohol and nicotine, according to J. F. E. Shick, D. E. Smith and F. H. Meyers). The fact that many Cs were antipathetic to alcohol even before their initial exposure to marijuana requires further 'study. We found that the surest indication of marijuana naivety is being a non-smoker. Possibly, a history of initial and persistent dislike of alcoholic effect will turn out to be correlated with subsequent chronic marijuana use.
" In differentiating between hashish and marijuana, the suhiects confused power with potency—a common error. Hashish, as found in the US, is sometimes (by no means always) more potent than potent marijuana, but its effects are qualitatively the same when an equivalent dosage is taken.
Weil, A. T., Zitiberg, N. E., and Nelson, J 31., Science,162, 1234 (1968). ' Weil, A. T., and Zinberg, N. E., Nature,222, 434 (1969). ' Vailthnt, G. E., Amer. J. Paychiat.,122, 727 (1966).
Kenniston, K., The American Scholar, Spring 1968.
Farnsworth, D., West Virginia Med. J., 433 (December 1963).
Halleck, S., Proc. Ann. Meeting, Amer. Psychiat. Assoc. (1967).
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