Drug use was studied in a sample of 5 enlisted men on active duty. Twenty-seven percent of the subjects reported having used marijuana, amphetamines. LSD, or heroin. The authors conclude that their data may provide a more realistic estimate of the incidence of drug use than those of previous investigators because the sample is large, subject participation was complete (100 percent), and the sample represents a broad range of educational backgrounds and geographical areas.

 

MUCH ATTENTION has recently been focused on drug usage. Substantial evidence(1-5) exists concerning the chemical, psychopharmacological, and psychological parameters of drug use, but little is known(47) about the incidence and prevalence of current drug use. Peartman(7) said that drug incidence patterns of college students are "highly unclear at this time"; he believes that such knowledge is essential before meaningful data can be gathered. McGlothlin and West(4) have also commented on the dearth of empirical knowledge concerning marijuana and feel that available information is unobjective and biased. Recent articles in Newsweek(6) and in the Journal of the American Medical Association(8-11) voice similar sentiments.

 

Most of the sparse evidence available(4, 7, 12) regarding prevalence and incidence is concerned with drug abuse by high school and college students. Figures vary widely: Newsweek found estimates among school authorities ranging from five to 35 percent. In one of the few empirical studies available McGlothlin and Cohen(12) found that three percent of their subjects (121 graduate students) had used the stronger hallucinogens and 12 percent had taken marijuana or morning glory seeds. Perhaps the best empirical study is that of Pearlman(7), who surveyed 2,270 seniors in a large Eastern university. Of those approached, 55 percent (1,245 students) replied, and of these 6.3 percent admitted prior drug use. However, 70 percent of the students who had tried drugs had given them up by the time they became seniors. Marijuana was the drug used by about three-quarters of the subjects. Dickenson(13) reported a similar incidence among college students in his account of a Gallup poll. Of the college students interviewed, six percent admitted to marijuana use and less than one percent had used LSD.

 

Two studies of U.S. soldiers, conducted in Viet Nam, provide more information. Casper and associates(I4) found that 52.1 percent of a random sample consisting of 46 psychiatric patients and 32.6 percept of a sample of 46 dispensary patients reported the use of marijuana. A poll of 234 soldiers entering and 223 soldiers leaving Viet Nam revealed that 27.7 percent of the first group and 20.6 percent of the second group had used marijuana. In a similar study, Postel(15) found that 56 percent of a psychiatric sample and 35 percent of a sample comprised of surgery patients had used marijuana.

 

There are shortcomings in these studies, however. Three of them were limited to college students, a group that is not representative of the population in general. It is doubtful whether the samples used are even representative of the population of college students, since McGlothlin and Cohen(12) studied graduate students and 45 percent of Pearlman's subjects refused to participate(7). Dickenson's conclusions should be viewed with caution because the sample was nonrepresentative, and there were suggestions that the investigators wished to find a low incidence of drug use in an effort to "vindicate" our "young men and women"(13).

The present study is an attempt to define more carefully certain characteristics of drug usage as the problem exists in this country. Because of the appalling paucity of empirical knowledge, the investigation was exploratory in nature. The primary purpose was to determine drug incidence as expressed by the number of subjects admitting drug usage. A second goal was to determine the number of subjects using certain drugs (marijuana, amphetamine, LSD, and heroin) and the frequency,with which each drug is used. A final purpose was to investigate the possible relationship between marijuana and heroin use as it is expressed in the number of marijuana users who have also used heroin and vice versa.

 

Method

 

Subjects. The sample consisted of 5,482 enlisted men on active duty. Of these, 4,246 were in advanced individual training courses in cannoneering and had been in the Army approximately two to three months. These subjects had generally completed high school but few had college training. Of the remaining 1,246 men, 694 were in advanced individual training courses in fire direction control and the majority of them had college degrees; 434 were stockade prisoners with a mean education of tenth grade; and 108 subjects were in permanent units and had completed high school. The majority of the latter had returned from overseas duty. In summary, almost all of the 5,482 were high school graduates and many had college experience or were college graduates. The exception was the 434 stockade prisoners, whose educational achievement was low.

 

Questionnaire. The questionnaire consisted of one sheet of paper with a variety of questions and appropriate answer blanks. It had been subjected to several revisions to achieve simplicity. The relevant items for the present study consisted of age, drugs used (marijuana, LSD, amphetamines, heroin, and others), and number of times these had been taken.

 

Procedure. The questionnaire was given to 56 separate Army units, varying in size from 30 to 170 men. Stockade prisoners were given the questionnaire individually. The same mental hygiene specialist introduced the task to each unit by passing out the questionnaire forms and explaining that the procedure was part of a research project investigating drug usage. The subjects were assured of anonymity and a detailed explanation of how the questionnaire was to be answered was given. After completion, each subject folded his form and handed it to the specialist. Data were from January through April 1969.

 

Results

 

Drug use was reported by 1,497 subjects (27 percent of the sample). Of those admitting drug use, 1,243 (83 percent) had used marijuana, 395 (26 percent) had used LSD, 556 (37 percent) had used amphetamines, and 88 (five percent) had used heroin. Eighty-seven (six percent) of the subjects using marijuana had also used heroin, while 86 (97 percent) of the subjects using heroin had also used marijuana.

 

Table 1 shows the frequency of use for marijuana, LSD, amphetamines, and heroin. Two-cell chi squares were computed to determine the significance of the observed differences in frequency of use. For purposes of comparison, frequency of use was classified as less than ten times or ten or more times for marijuana and amphetamines, and less than five times or five or more times for LSD and heroin. Seven hundred sixty-five (61 percent) of those using marijuana had taken it ten or more times (p < .001). Three hundred fifty-six (64 percent) of those using amphetamine had taken it ten or more times (p <.001). Differences between frequency of LSD and heroin use (as classified into less than five or five or more times) were not significant.

 

Conclusions

 

Most clinicians have the opportunity to observe only those individuals who seek their help. Drug users, unless they are experiencing some difficulty or are apprehended by the law enforcement agencies, do not come to the clinician's attention. The clinician who wishes to gather reliable data on drug use must therefore seek out the population he wishes to study. This presents a problem, however, inasmuch as it is difficult to gather a sufficient representative sample. It has been attempted in the past with college students(7, 12), but the generality of the results is restricted by several factors.

 

The present study involved a very large number of subjects, with 100 percent participation, and included subjects from various educational backgrounds and geographical areas. Of great importance is the fact that nearly all of the subjects were functioning at an adequate physical and social level (with the exception of the 434 stockade prisoners). The generality of the present results may therefore be superior to that of the previous studies.

 

The most important conclusion drawn from the data of this study involves total drug incidence. The obtained incidence figure of 27 percent (1,497 of the total number of 5,482 subjects) is much larger than that suggested by most previous studies. Further breakdown showed the lowest incidence of drug use in subjects with higher educational attainment. This leads one to question the popular assumption that there is a connection between drugs and higher education.

 

Also striking is the pronounced degree to which marijuana is the drug of choice. More than one in four of the subjects had used drugs, and the great majority of these had used marijuana. Furthermore, a large number of the subjects had used drugs on a fairly continuous basis. For many of the subjects drug usage was not restricted to a few experimental trials motivated by curiosity. Sixtyone percent of the marijuana users had used the drug more than ten times and 30 percent had used it over 100 times. Similar frequencies of use were obtained for those who had used amphetamines. The obvious conclusion is that a great many people continue drug usage over a long period of time. The inevitable implication is that marijuana and amphetamines may tend to habituation to a greater degree than has been suggested by previous research. The probability is greater than chance (p <.001) that the young man who "tries marijuana" will continue to use the drug ten or more times.

 

Previous or present use of drugs does not appear to markedly affect the indiliidual's physical dexterity. With the exception of those in the stockade, all subjects were engaged in strenuous and exacting activity for eight-week periods and were completing training requirements satisfactorily. This would tend to support the conclusion of Weil and associates that chronic users, after smoking marijuana, performed on some tests as well as or better than they did before taking the drug( 16).

 

It should be noted that, although initial experiences with marijuana tend to lead to continued use, marijuana usage does not lead most individuals into experimentation with heroin. The belief that marijuana use is dangerous because it predisposes toward heroin is fallacious, although it is true that nearly all of the heroin users in the present study had also used marijuana.

 

The subjects in the stockade, while showing a higher percentage of drag use than their nonstockade counterparts, were not incarcerated for drug use but mainly for being absent without leave. Drug use or alcohol may have contributed to this but was not the primary cause of their incarceration.

 

Both previous literature and this study suggest many avenues for future research. Little is known regarding patterns of initial drug experience and the factors that lead to drug experimentation. Even less is known about the factors that lead some individuals to continue drug usage and others to stop after a few experimental trials. We hope the results of this study will provide a sound empirical foundation upon which more sophisticated research can be based.

 

REFERENCES

 

1. Janowitz JF: There's no hiding place down there. Amer J Orthopsychiat 27:296, 1967

2. Louria DB: Cool talk about hot drugs. New York Times Magazine, August 6, 1967, pp 44-46, 51-56

3. Mamie LN: "Consciousness-limiting" side effect of "consciousness expanding" drugs. Amer J Orthopsychiat 37:296-297, 1967

4. McGlothlin WH, West LE The marihuana problem: an overview. Amer J Psychiat 125:370-378, 1968

5. Oursler WC: Marijuana: The Facts, the Truth. New York, PS Erikson, 1968

6. The drug generation: growing younger. Newsweek, Apri121, 1969, pp 107-110

7. Pearlman S: Drug use and experience in an urban college population. Amer J Orthopsychiat 37:297. 299, 1967

8. American Medical Association, Council on Mental Health: Dependence on amphetamines and other stimulant drugs. JAMA 197:1023-1027, 1966

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10. American Medical Association, Council on Mental Health: Dependence on LSD and other hallucinogenic drugs. JA MA 202:47-50, 1967

11. American Medical Association, Council on Mental Health: Marijuana and society. JA MA 204:1181- 1182, 1968

12. McGlothlin WH, Cohen S: The use of hallucinogenic drugs among college students. Amer .1 Psychiat 122: 572-574, 1965

13. Dickenson F: Drugs on campus: a Gallup poll. New York Times Magazine, August 6, 1967, pp 114-115

14. Casper E, Janecek J, Martinelli H: Marijuana in Vietnam. USARV Medical Bulletin 40:60-72, 1968

15. Pastel WB: Marijuana use in Vietnam: a preliminary report. USARV Medical Bulletin 40:56-69, 1968

16. Weil AT, Zinberg NF, Nelson JM: Clinical and psychological effects of marijuana in man. Science 162:1234-1242,1968