Drug Abuse

First published in The International Journal of the Addictions, 17(1), 141-154, 1982.
Copyright © 1982 by Marcel Dekker, Inc.

by Patricia G. Erickson,* PhD

Addiction Research Foundation Toronto, Canada M5S 2S 1

*Address correspondence to the author at the Program Development Research Department, Addiction Research Foundation, Toronto, Canada, M5S 2S1.

Abstract

A sample of criminalized cannabis users provided information about their use of other illicit drugs and friends' attitudes toward various substances. The majority of those surveyed were regular, heavy users of cannabis, had friends who were similarly involved, and were more experienced with a variety of other illicit drugs than youthful groups from the larger population. In its perception of harmful effects of various substances, the offender sample held fairly conventional, high-risk views on opiates and amphetamines. Opinion was more divided over the psychedelics and cocaine. Cannabis was considered least harmful of all the other illicit drugs and alcohol. Those convicted of the offense of cannabis possession displayed the knowledgeable insider's perspective of a hierarchy of dangerousness for drugs that is at variance with their largely undifferentiated legal status.

Criminal law statutes may recognize few distinctions between categories of prohibited drugs, and pharmacologists may stress the fine nuance of effects related to strength and dose. From the consumer perspective, drug users themselves may differentiate among various substances according to personal and shared experiences with the drugs. Such perceptions by users have implications both for legal change and drug use prevention programs that rely on educative measures.

A number of surveys have established that rates of use vary enormously among the principal categories of illicit, non-medically-used drugs: cannabis, cocaine, opiates, hallucinogens, and amphetamines (e.g., Leon, 1977; Smart and Goodstadt, 1976). The social perceptions surrounding drug use, and the support gained or denied from peers, have been shown to be important factors in initiating and pursuing this illegal conduct (Becker, 1963; Lindesmith, 1965). As has often been demonstrated, drug use is a social as well as a physical activity (Goode, 1970; Orcutt, 1978; Zimmennan and Wieder, 1977).

Limited information about recreational illicit drug use and its social meaning has been available. As use levels of opiates, cocaine, and amphetamines are generally very low in broadly based population surveys, little additional information about consumption patterns in relation to attitudes has been obtained from this source. Similarly, many studies of drug users which have been drawn from clinical or incarcerated samples tend to focus on the features of a substance's abuse and user characteristics (e.g., Smart and Cox, 1972; Smart and Fejer, 1969; Whitehead and Brook, 1973). Since the sample of cannabis offenders described in the present study contained a high proportion of heavy, regular users of cannabis, it was expected that considerable exposure to other illicit drugs had also occurred (see Le Dain, 1973; Single and Kandel, 1978). Thus, the nature of this sample provided an opportunity to examine, in greater depth than has usually been possible, the use patterns, attitudes of users and peers, and perceptions of harmful effects displayed by experienced consumers of various illicit drugs as well as alcohol.

A group of 85 cannabis users in Metropolitan Toronto, who had been contacted at the time of a court appearance in 1974 for possession of cannabis, were reinterviewed 1 year later. Sinee the sample was selected initially on the criterion of no prior convictions for any criminal offense, and was otherwise representative of cannabis possession offenders, the official "criminality" of the subjects was restricted to the detection of their illicit cannabis use. (The representativeness of this group of cannabis offenders, with respect both to all those sentenced in Toronto during the sample selection period in 1974-1975 and to those described in studies elsewhere [e.g., Crow, 1973; Shafer Commission, 1972] is discussed fully in a recent book [Erickson, 1980].) Their background characteristics are summarized in Table 1. Levels of cannabis use by the sample were high both at time of trial and 1 year later (60% reporting use levds of twice a week or more). All interviews were conducted by a male or a female interviewer, both in their late 20s. Great care was taken to minimize any threat posed by the selfreporting of drug use activities (see Krohn et al., 1975).

In 1975 extensive information was collected on their current and past use of various illicit drugs besides cannabis, their own and peer attitudes to these drugs, and perceptions of harmful effects of use.

Table I

Background Characteristics of Cannabis Offenders (N = 85)

USE OF DRUGS (Table 2)

Subjects were asked if and how often each of eight categories of drugs shown in Table 2 had been used in the past 6 months on the average (Lanphier and Phillips, 1971a, 1971b, 197~c). Amphetamines or opiates administered by injection were distinguished from other ways of taking these drugs.

Alcohol was the most frequently used substance, with 90% of the sampl9 found in the "at least once a month" category. Next was cannabis, with 84% in the most frequent group. Opiates taken by injection were least used, with 7% reporting any use and only 1% reporting use within the last 6 months. Although nearly half the sample had experienced oral ingestion of amphetamines (487;) or opiates (41%), for most this use occurred in the more distant past. Of those who did report oral use of either speed or opiates in the past 6 months (9% and 5%, respectively), those using once a month or more did not exceed 2% of the sample. A similar pattern was displayed for amphetamine injections, with 21% reporting prior but not recent use and 7% acknowledging use in the past 6 months. After alcohol and cannabis, the drugs used most frequently in the preceding 6 months were psychedelics and cocaine. While 27% reported use of psychedelics at least once but less than once a month, and an additional 7% reported more frequent use, 52% acknowledged use at some time that did not extend into the most recent 6-month period. For cocaine, unlike any of the other drugs listed, the proportion of more current users (22%) was a close approximation of lapsed users (27%).

Drug use in the offender sample was higher than that recorded in a comparable sample not drawn from the courts (Leon, 1977). (The offender sample did contain females, students, and unemployed persons, unlike Leon's (1974) sample of male industrial workers age 26 or less. The comparisons that follow, while of limited validity, are intended to provide some context of drug use in the Toronto area at that time. In 1974 in Toronto, high school students reported use of these drugs in the past 6 months: 23% marijuana, 73% alcohol, 4% opiates, 3% speed, 4% LSD, and 6% other hallucinogens [Smart and Fejer, 1974].) While 92% were current cannabis users at follow-up, 26% of young nonoffenders reported some use of cannabis in the past 6 months. Less than 1% of this group reported use of speed, in either injected or oral form, and 3% indicated recent use of hallucinogens. Alcohol use patterns were more similar, with 82% current users. (Unfortunately, since use of opiates or cocaine was not solicited specifically in Leon's study, no comparisons are possible.) Thus the extent of some drug use in the offender sample is considerably higher than in a somewhat similar group, with regard to age and sex composition and geographical proximity, at about the same time period.

Table 2

Offender Sample's Self-Reported Use of Various Drugs
frequency of use in past 6 months on the average (%)

1. N = 85
2. Includes LSD, MDA, STP, PCP, THS, mescaline, and psilocybin.

PEER ATTITUDES TO DRUGS AS PERCEIVED BY THE SAMPLE (Tables 3 and 4)

It was of interest to learn the extent to which peers were supportive various forms of drug use. As would be expected, friends of the offend subjects tended also to be involved in cannabis use: 78% of the responder said that "almost all" of the people they spent their leisure time with us cannabis, another 8% said "about half" did, and the rest (14%) said that on "a few" or "none" were cannabis users. Again, not surprisingly, the more frequent the subjects' cannabis use, the greater the proportion of friends wi were reported also to be users.

Respondents were asked to select which statement best described tie attitude of their friends toward a number of illict drugs (Table 3). Compared the other illicit drugs, cannabis elicited a much higher number of responses the "mainly think it is or would be a good experience" category (61%)). Next

to cannabis, the most favorably viewed drug, according to the respondents' perceptions of their friends' beliefs, was cocaine (32%), while smaller proportions were considered to have this relatively positive attitude to psychedelics (16%), opiates (13%), and amphetamines (11%). In contrast, about half of those interviewed described their friends' attitude to each of these latter three drugs as "mainly think it dangerous to physical or mental health." A somewhat smaller proportion (30%) selected this negative description for cocaine, and 5% did so for cannabis. The option "not interested/not knowledgeable" was not selected as the best way to describe their friends' attitude to cannabis by any of the subjects, but this was chosen by 31% with respect to opiates, by 20% for cocaine, and by 18% for both psychedelics and amphetamines. Respondents perceived the items pertaining to fear of detection by authority figtsres as applying more often to cannabis than to the other drugs (34% for cannabis as ompared to a range from 10% to 18% for the others). The police were seen as a considerably greater threat than parents, teachers, or bosses for all categories of drugs. Friends' attitude to cannabis was also found to vary by level of use, wkh friends of heavier users thought to have a greater fear of detection by police than those of ligher users or nonusers (Table 4).

These fifidings show a very small minority of favorable opinion to some drugs (i.e., psychedelics, opiates, and amphetamines) perceived among friends of a quite knowledgeable and experienced group of drug users. The majority opinion was that these drugs are dangerous to health. In contrast, cannabis was generally viewed as a good experience, an attitude tempered by a fear of detection. Attitudes to cocaine fell somewhere between, with about the same proportion of peers reported to consider it "dangerous" as a "good experience.'

Table 3

Reported Attitude of Offender Sample's Friends to Various Illicit Drugs
percentage of respondents

1. N = 84 (excludes one respondent who did not express any opnion).

Table 4

Relationship between Friends' Attitudes to Cannabis as Reportedby Offender Sample and Respondents' Own Level of Cannabis Use

Level of cannabis use in past 6 months (1)

1. level of cannabis use: None = not at all; Light = once a week or less; Heavy = twice a week or more.
2. N = 84; one missing observation.

PERCEPTION OF HARMFUL EFFECTS BY RESPONDENTS

(Tables 5-8)

Cannabis offenders were asked to choose, from a list of statements pertaining to relative harmful and good effects, the one which best described theit attitude to a particular drug (Table 5). Respondents who had never tried a given drug were also asked if they would, given the opportunity, and to provide their reasons (Table 6). Perceptions were also differentiated according to experience with the various drugs (Tables 7 and 8). First we examine their views on the drugs that were considered the most dangerous (opiates and amphetamines), then those that were the subject of more ambivalent feelings (cocaine, psychedelics), and fmally, alcohol and cannabis, seen as least harmful.

Opiates and Amphetamines

As shown in Table 5, over 90% place both drugs in one of the three "dangerous" or "harmful" categories, and more than half of these respondents acknowledge "few or any" good effects of the drugs. Those who do are mote than four times as likely to view the dangers of amphetamines, and twice as likely to view those of opiates, as outweighing the good effects than vice versa. The small balance of the sample tended to choose the "lack of knowledge" response rather than perceive the drugs as harmless. These impressions of high dangerousness are reinforced by the data in Table 6. The proportion of never-users in the sample who would try the drug if the opportunity arose is lowest for injecting amphetamines (7%), followed by injecting opiates and oral amphetamines (11% each). A considerably higher proportion (39%) was willing to try opiates orally, usually in reference to the smoking of opium.

The injecting of opiates or speed was seen as the least attractive form of drug use. Reasons for unwillingness to try these drugs ranged from the fairly straightforward fear of addiction to the elaboration of the observed deleterious effects on others. The fear of legal consequences was never cited as the principal reason for not trying these drugs, and in o~y a very few cases was it even mentioned as a supplementary reason. The fear of adverse physical and mental consequences combined with a general disinterest was predominant.

Respondents who had injected speed or opiates were also inclined to view them as very dangerous and debilitating. Those few who had experimented with heroin usually described the experience a~ unpleasant. Some subjects also mentioned a concern with mental effects of speed use. Thus the views of one group, gained from direct experience, and the attitudes of their never-using counterparts, display a marked congruence in rating amphetamines and opiates as dangerous drugs. The self-descriptions of the ever-users tend to mirror the perceptions of those who had only observed the effects in others. As Table 7 shows, ever-users were quite similar to nonusers in their assessment of dangerousness of injecting speed and opiates

Table 5

OffenderSample's Attitude to Various Drugs
percentage of respondents

1. presented in Le dain Commission national Survey's (Lanphier and phillips, 1971a, 1971b, 1971c)
2. total N of 85 excludes "don't know" or "no opnion" responses: one for each of amphetamines, opiates, and cannabis; two for psychedelics; three for alcohol; and four for cocaine.

Table 6

Proportion of Those in Offender Sample Who Have Not Tried Particular Drugs but Who Would, Given the Opportunity

Cocaine

Less consistency of perceived risk was shown for cocaine. While 80% of subjects placed it in the "dangerous" or "harmful" categories of Table 5, fewer than half of these said it has no or few redeeming effects. Whether they considered it dangerous or not, 26% considered its good effects to outweigh its bad effects, while 28% would reverse the emphasis. The proportion of never-users who stated their willingness to try cocaine was strikingly high, 40%, when compared to 7% and 11% for injecting speed and opiates, respectively (Table 6). This "willing" group was characterized by a curiosity to try a relatively new drug they had beard a lot about. Concern with physical effects was related by them to heavy use, which was deemed unlikely because of the high cost of cocaine. Those who would reject experimentation wilt cocaine seemed either to class it with the opiates and amphetamines they would also refuse, or to view it with some suspicion of irs addictive potential. Most of those who reported trying cocaine indicated generally pleasurable rather than adverse effects. Thus the sample's attitude to cocaine, while quite varied, is seen to be on the cautious side. In Table 7 about half of both ever-users and nonusers perceived cocaine as dangerous, but 3% of never-users and 22% of users saw it as good or harmless.

Table 7

Relationship between Offender Sample's Attitude Toward and Use of Various Illicit Drugs

1. categories combined from those listed in table 5 (1 + 2, 3, 4 + 5, 6)

Table 8

Relationship between Offender Sample's Attitudes to Cannabis and Their Level of Use (1)

level of cannabis use in past 6 months (2)

^1. Although percentages in this table (and in Tables 3, 4, 5, and 7) are based on use level (vertically), they could just as well have been displayed on attitude (horizontally), since no assumptions of causal priority are being made. The Ns for each cell are included to show the distribution in both directions.
2. Level of cannabis use: None = not at an; Light = once a week or less;Heavy = twice a week or more.
3. N = 84; excludes one missing observation.

Psychedelics (Hallucinogens)

Respondents' opinion of psychedelic drugs-defined to indude all the hallucinogens, or "chemicals"-was also mixed. Since 86% of the subjects reported some priot use of any psychedelic, their views were mote likely to be based on direct personal experience than was so for opiates, amphetamines, or cocaine. Almost three-quarters (73%) chose the "dangerous" or "harmful" descriptions of this drug grouping in Table 5. Psychedelics' bad effects were seen as far outweighing the good effects. However, one in five sample members (21%) made no evaluation on the grounds that "not enough is known" (compared to 5-7% for the drugs previously discussed). Only 6% considered psychedelics "good" or "fairly harmless" drugs. Data in Table 6 indicate that 17% of the never-users would be willing to try them, considerably less than the 40% who would try cocaine. Those who would not, emphasized fear of physical or mental, rather than legal, consequences. Many of the experienced users commented that some psychedelics had become very tisky because they were unpure. It was not uncommon for subjects to reject I£D or MDA and still be willing to engage in other forms of psychedelic use such as mescaline.

The respondents displayed quite ambivalent feelings about psyched~ics, seeing them as carrying high tisks but also to have qualified benefits depending on the particular substance, its purity, and how it was used. Compared to cocaine, the perceived dangers tend to be more unpredictaNe. Sometime-users were more likely to withhold judgment than never-users, but perceptions of dangerousness were similar (Table 7).

Cannabis and Alcohol

The last topic is a consideration of the subjects' opinion on the relative harm of cannabis, and also of alcohol. As Table 5 shows, the respondents overwhelmingly endorsed cannabis as a desirable and relatively benign drug. Three-quarters viewed its harmful potential as very low. Only 7% perceived it as dangerous, and none saw its good effects as outweighed by its dangers. Their greatest fear was of arrest. A fairly large proportion (17%) took the position than not enough was known to judge it. Attitude to cannabis varied with use level (Table 8), with the most positive views held by the heaviest users. In contrast, very few wirhbeld an opinion on alcohol, and respondents tended to judge it as more dangerous than cannabis but less harmful than the other drugs. Half as many (32%) saw alcohol as a "good" or "fairly harmful" drug, as placed it in the "dangerous" or "fairly harmful" categories (65%) (Table 5).

This finding is further illustrated by the responses to a question specifically relating the perceived harm of marijuana to that of alcohol. While 2% considered marijuana more dangerous than alcohol, and 11% viewed them as about the same, the large majority (87%) perceived alcohol as more dangerous than marijuana. The elaborated comments suggested that the greater perceived dangerousness of alcohol was seen in relation to its effect on driving, violent behavior, and health in general-not an unrealistic assessment. These findings may be compared to those of Leon (1974, p.⁴⁴), in which 37% perceived alcohol as more harmful than marijuana.

This discussion of the cannabis offenders' perceptions of health effects of various substances has indicated, first, that the nature and extent of risks identified varied greatly by drug; second, that cannabis was viewed as relatively much less harmful than the other illicit drugs and alcohol; and third, that heavy cannabis users were generally unconvinced about its possible adverse health effects.

CONCLUSION

Convicted cannabis users, because of their tendency to have relatively heavy levels of cannabis use and exposure to other illicit substances, were found to be -informed commentators on their own and peer attitudes to drugs. Their views, while not typical of those surveyed in cross-sectional studies of youthful or adult populations, probably provide a more representative view of the experienced

"insider's" perspective on illicit drug use (see Johnston, 1980). The offender subjects' perceptions, and those reported fot their peers, showed a marked ability to discriminate among various drugs. They tended to consider cannabis as the most benign drug; the opiates, amphetamines, and hallucinogens as the most dangerous; and to place alcohol and cocaine somewhere in between. Feat of health consequences was much more pronounced than fear of arrest for all illicit drugs other than cannabis. Since regular, heavy cannabis use requires contact with a steady source of supply, and thus the establishment of links with the illicit drug market, the concern for adverse physical or mental effects would seem to be a much more important disincentive than lack of opportunity for this group. Except for cannabis, greater exposure to drugs seemed to enhance an appreciation of their health hazards.

The experienced drug user's perception of variation in harmful health effects-what might be termed a hierarchy of dangerousness-offers a sharp contrast to the lack of refinement shown by most current drug prohibition laws. The argument for more rational drug scheduling would appear to have some basis in the social reality of the drug use milieu. Moreover, these findings point to the potential value of preventative programs that focus on credible information about health risks. Educational strategies rather than legal threats would likely be more effective for those already exposed to the opportunity for illicit drug use. Cannabis, because of its widespread use and minimal health risks (as perceived by users), poses particular problems. Further, longterm research is needed to ascertain whether growing evidence of potential adverse health effects (NIDA, 1980) will bring cannabis the disrepute attached to other illicit drugs or the relative acceptability accorded to alcohol.

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