In the past decade this society has witnessed a great increase in illicit drug use. This increase in drug use has not brought a concommittant increase in our knowledge about drugs. Instead many myths, fears, and beliefs exist which are often grounded in superstition rather than in fact. One common belief is that the use of marihuana leads to experimentation with more powerful drugs, which leads to addiction to heroin or morphine. This view is best summed up by Donald Miller, Chief Counsel, US Bureau of Narcotics, who states "One particular danger in marihuana use is that there is often a clear pattern of graduation from marihuana to stronger addictive opiates." ":" The evidence presented by Miller in support of this contention consists of several studies in which a majority of heroin addicts were shown to have begun their drug experience with marihuana. While Miller acknowledges that "not all persons who have ever smoked a marihuana cigarette have gone on to the use of heroin," P 143' he fails to provide any data indicating how many marihuana users actually do progress to narcotic drugs.

 

Data relevant to the question of the association of marihuana use and the use of other drugs was recently gathered from interviews carried out with experienced marihuana users. The interviews were carried out as part of a screening procedure in gathering subjects for an ongoing marihuana research project. One hundred and six adult males were interviewed and questioned about their experience with various street and pharmaceutical drugs as well as their frequency of use. Initial contact was made through a newspaper advertisement so that our sample represents a "normal" or at least a nonpatient group whose common denominator is their illicit use of marihuana. A possible minor bias in formation of the sample is the subjects' attitudes toward risk taking. Whether men who respond to an ambiguous advertisement in a university newspaper offering up to $20 for subjects for psychological research are more likely to use drugs than men who do not respond to an advertisement is an open question. The average age of this group was 24.5, ranging from 21 to 41 years old. The majority were students (60%) but the sample included men who were working (23%) and some who were either unemployed or "dropped out" (17%). Frequency of marihuana use varied greatly, but typical use was about three times per week. Some subjects had discontinued use of the drug and others were now smoking marihuana several times a day. Many mentioned they were more likely to use the drug during summer when they had fewer obligations to school or jobs.

 

A majority of our subjects reported experience with other psychedelic drugs. When asked about lysergic acid diethylamide (LSD) and mescaline, 74% of our sample indicated that they had taken one or both drugs. Ex-

perience with these drugs varies greatly from one "trip" to hundreds. While the number of subjects who sampled the two drugs is roughly equal, it appears that the experimental user is more likely to experiment with mescaline while the more extensive user is more likely to have tried LSD. An interesting sidelight is the frank statement by many of our subjects that their use of mescaline was somewhat uncertain since they are not sure that what they bought as mescaline was in fact really mescaline. The data reveal that 6% of the subjects interviewed have experimented with either heroin or morphine and that frequency of experimentation was once or twice. A considerably larger proportion of subjects (27%) revealed they had experimented with smoking opium. The extent of use was generally ten times or less. All 106 subjects deny having developed either a physical or ps-jrchological dependency to the opiate drugs. These data are summarized in the Table.

In comparing these data with those of a study conducted in 1966-1967 by Blum and associates,' some marked differences emerge. Blum et al found that only 24% of marihuana users in their sample had experimented with other hallucinogenic drugs. This is a significantly smaller proportion than was found in the current study. To what extent these differences represent a change in patterns of drug use that occurred over a three- to four-year expanse of time, or to what extent these differences represent sample discrepancies, is of course a prime question. However, the difference in use is remarkably large and may represent both sample differences and an increased acceptance toward the use of psychedelics.

 

Blum did not provide a separate category for opium use, and only 6% of his sample reported the use of any opiate drugs. In contrast, 27% of our subjects experimented with opium, while only 6% experimented with heroin and morphine. These figures may represent a growing acceptance of the use of opium within the group of psychedelic drug users, who still maintain a very low rate of heroin use.

 

With respect to pharmaceutical drugs our data were quite comparable with the 1966-67 study. Sixty percent of our subjects reported the use of amphetamines (Blum reported 50% of his marihuana users had used amphetamines). The subjects in this study most frequently used amphetamines to facilitate cramming for examinations and to meet a deadline rather than for "recreation" uses. Forty-seven percent of our subjects have taken tranquilizers and 44% have taken barbiturates. The majority of these subjects claim to have used these drugs for medical reasons, although some of our subjects reported taking barbiturates for experimental purposes. A total of 9% of our sample has experimented with tranquilizers, and 13% with barbiturates. The majority of subjects have had pain medication prescribed. The experimental use of this class of drug was again only 6%.

 

The use of barbiturates is quite similar to that reported by Blum for a student population's experience with sedatives. Our sample's use of tranquilizers is significantly higher than that reported by Blum for student marihuana smokers. This may represent a change in the marihuana-smoking population's attitude or physician's attitude toward tranquilizer use or both, or it may represent increased psychological discomfort in our sample. Available data do not allow selection of any one hypothesis. The surprisingly high rate of experience with pain medication may reflect the experience of young adults with physicians. The medical use of this class of drugs was for a gamut of injuries and illnesses ranging from fractures, dental procedures, minor operative procedures, to renal colic.

 

Reviewing these findings, it appears that one of the greatest fears of marihuana use, that of graduation to addicting narcotic drugs, has not materialized. If our sample is at all representative of the drug culture, and indeed most of these men have been using marihuana over a period of years and are as immersed in the drug culture now as they are likely to be, the progression from marihuana to heroin addiction appears to he an improbable occurrence. Indeed, some question arises as to whether marihuana use may not be self-limiting since a good number of our subjects claim to be using marihuana less now than they have in the past. They usually explain their decreased marihuana use on the basis of a variety of personal reasons.

 

It appears that if one is a regular user of marihuana, one is likely to go on and at least experiment with other more powerful psychedelic drugs. The rate of experimentation with hallucinogenic drugs seems to have increased greatly since Blum's report of 1966-1967. However, the use of heroin appears to be about the same. These findings may reflect increased acceptance of hallucinogenic drugs, ie, as more people have experience with the drugs, the amount of risk inherent in drug use seems to be seen as less. Becker' (1967) has hypothesized a socialization process by which drugs enter into a culture. These data, which suggest increased acceptance of psychedelic drugs, seem to support Becker's hypothesis. One wonders whether the marked increase in the use of opium represents a local phenomenon or the beginning of a redefinition of opium from a narcotic to a psychedelic drug, and hence greater acceptance within this group. Even with the increase in the use of opium, the plight of the heroin addict appears to be common knowledge, and heroin still seems to have the status of a "dangerous drug" even within the drug culture.

 

This research was supported by National Institute of Mental Health grant 1 R01,2)4H19015- 01.

 

References

 

1. Miller DE: Narcotic drug and marijuana controls, in Hollander C (ed): Collection of Background Papers on Student Drug Involvement. Washington DC, US National Student Association, 1967, pp 135-146.

2. Blum R and associates: Students and Drugs. San Francisco, Jossey Bass Inc, 1969, vol 2.

3. Becker HS: History, culture and subjective experience: An exploration of the social bases of drug-induced experiences, in Hollander C (ed): Collection of Background Papers on Student Drug Involvement. Washington DC, US National Student Association, 1967, pp 69-86.