Drug Abuse

5. Research Findings: Drug-Use Rituals, Sanctions, and Control

STUDIES OF THE PHARMACOLOGY AND CHEMISTRY OF MARIHUANA, THE PSYchedelics, and the opiates fill many volumes (see Grinspoon 1971, 1979; Kaplan 1970; and Goodman & Gilman 1975, for example). Fortunately, in order to understand the social-psychological relationship of each of these to personality (set) and to social setting, only a minimum of knowledge about their pharmacology is needed. Of greater importance is some knowledge of how these substances are used.

Marihuana

The common hemp plant, cannabis sativa, used for millennia to produce paper and rope, is the source of marihuana. The flowering tops, particularly from the female plant, produce an aromatic, sticky resin that contains the intoxicating properties. When the flowering tops themselves are gathered, the term marihuana is applied; when the resin alone is collected, the term hashish is applied. Interestingly enough, in contrast to most drugs, marihuana, in usual doses, cannot be classified pharmacologically as either a stimulant or a depressant, In heavier doses, it is more likely to act as a psychological depressant, even a sedative, but causes few of the physiologically depressing actions of such drugs as alcohol, barbiturates, benzodiazepines, and opiates, thus accounting for the low toxicity of cannabis. Although the action of marihuana is sometimes called psychedelic, the cannabis group is not chemically related to the psychedelics.

THC (delta-g-tetrahydrocannabinol) is considered the most active intoxicating ingredient, and the strength of any cannabis preparation is usually defined by its THC content. In fact, there are over zoo chemical constituents in the natural plant, some of which potentiate or inhibit the action of a particular plant strain, giving different strains not only different strengths but also individual qualities of response. In contrast to many drugs, cannabis is not water soluble but is soluble in fat, which explains the fact that it is retained in body fat for some days after use.

Marihuana use is not highly ritualized. It takes place in a wide variety of settings and circumstances, such as before going to a movie, during a party, while watching television, or during a walk in the woods. Users may sit alone at home, or they may join their friends. Controlled users do not usually get together specifically to take marihuana; they meet primarily to socialize, and if the drug is used, it is viewed as an adjunct to the occasion (Kaplan .1983; Trebach 1982; Weil & Rosen .1983).

The flexibility of marihuana rituals is partly explained by the pharmacology of the drug. Its effect, varying with the strength of the particular sample, is relatively mild and does not last long. My subjects, who were experienced users, found little difficulty in controlling the drug high, and usually they were able to function normally in that state if it became necessary to do so. This fact did not surprise me. As Becker (1963) had observed, because appreciation and control of the marihuana high are learned, the user eventually is able to function adequately while under its influence. Weil and I with Nelsen (1968) had expanded this finding by discovering that in a controlled setting experienced marihuana users were better able than naive users to control the high.

Flexibility in marihuana rituals can also be explained in terms of the drug's status. It is now widely accepted in our society that although marihuana is still a "bad" drug, it is "less bad" than heroin, LSD, or cocaine. This new attitude, coupled with the expanding use of marihuana, has created an environment in which rigid external controls in the form of rituals are no longer so necessary as they were in the 1960s. The more marked ritualization of the mid-1960s was described by research subjects who were twenty-five years old or over. They recalled with nostalgia and humor the dimly lit room, locked doors, music, candles, incense, people sitting in a circle on the floor, and one joint being passed ceremoniously around the circle. At the time of interview they regarded this earlier behavior as quaint and unnecessary. Nowadays, as the number of intermittent marihuana users in the United States has risen to some 3.1.9 million and the number who have tried the drug to 57 million (Miller & Associates 1983) marihuana use has lost much of its deviant character. Concurrently, social sanctions for controlled use have been strengthened and have become available throughout most of the using subculture.

Under these conditions considerable learning about controlled use can take place before actual use begins. Most American adolescents are well aware before choosing whether or not to use marihuana that the drug does not cause people to go crazy or fall apart. Our younger subjects (eighteen to twenty years old) had known of teachers in their high schools who used marihuana, and many of them had older siblings who used it. The same subjects had also acquired a knowledge of marihuana from friends, the underground press, popular music, or novels. Their first few experiences with the drug recapitulated many of the ritualistic elements of the early 1960s. These beginning sessions were rather formal affairs in which an experienced user introduced one or more newcomers to the drug, providing guidance, demonstrating how best to smoke the substance, and soothing the neophytes' fears. Very quickly, however, newcomers moved beyond these structured situations and began the process of adapting use to a variety of social settings. They had no difficulty in locating using friends with whom they also shared nondrug-centered interests.

The lack of highly specific rituals should not, therefore, be construed as evidence that controlled users are reckless in the way they use marihuana. Rather, the rituals that earlier served as rigid external controls have been replaced over the last decade by more general but still effective social sanctions. Through growing familiarity with every aspect of marihuana use, these sanctions, like those relating to alcohol use, have been internalized, and the rituals developed to support the sanctions no longer need to be followed so closely.

The research staff and I found it much more difficult to locate abusers than controlled users of marihuana. Our subjects described the drug as not particularly deleterious, easily controlled, and difficult though not impossible to abuse. Some expressed genuine disbelief when we asked if they had ever had any difficulty in maintaining controlled use. Still, they were not messianic about marihuana; they recognized its potential for abuse and offered guidelines for sensible use. As one subject said, "In spite of all the rationalizations about how good dope is, I don't see that I have to have a reason for getting high every time. Yet getting high consistently without a reason seems to be a reason to check things out with myself." Another subject commented that if one uses marihuana too much the quality of the high declines; when this happens, one should stop for a while and then adopt a pattern of less frequent use. Controlled users cited three reasons for not using too much marihuana at any one time: to avoid transient but unpleasant panic reactions or paranoia; to keep the high controllable so that other activities could be better enjoyed; and to avoid wasting the drug. Subjects generally subscribed to the ethic that they should not be high at work or at school. For example, Susan S., who worked as a housekeeper several days a week, explained that although she could clean when she was "stoned," she preferred to restrict her drug use to leisure time.

Although passing a joint around a group is no longer essential, it still serves on many occasions to assist the process of adjusting the intensity of the high. The time that elapses between inhalations permits the user to monitor his degree of intoxication. Several subjects stated that when using alone or with one or two other people, they stopped after several "tokes" to let the high catch up with them and then decided whether they wanted more. One subject commented that this was an especially sensible way to proceed when trying out a new batch of marihuana.

Many of the books and articles about marihuana that have been published in the past few years have warned the public, users, and potential users, about the dangers of the drug. Great stress has been put on the potential physical, social, and psychological harm that can follow use. Such writers as Peggy Mann (1978), Gabriel G. Nahas (1976), and Robert L. DuPont (1983) have increasingly returned to the position of the early 1960s, which barely differentiated use from misuse (Heller 1972; Kaplan 1970; Marijuana and Health 1982;

Report of the Liaison Task Panel 1978).

Implicit in these warnings is the sense that the users themselves do not appreciate the difficulties that can arise from their drug use. Occasionally, of course, this is true, as the following two interview excerpts show:

I: And let's say that you're on one of your sprees, will you use marihuana too or will you not?

R: Oh, yeah. Give me anything and I'll take it.

I: I see, so it doesn't really matter. Have there been occasions ...

R: If I'm loaded, if I'm doing both, I mean, you could give me anything . . . and like a dummy, I'd take it! You know?

There was every evidence that this young man's heedlessness about drug use was reflected in other areas of his life, and it was doubtful that any warning could have reached him.

Another subject exhibited the sporadic stopping and starting pattern that is also common among people who are having difficulty with alcohol:

I: Did you ever stop using it?

R: Yeah, but not for a very long period of time.

I: Why did you stop?

R: Well, sometimes it was inaccessible, and sometimes I just wanted to try and stop. No particular reason, just thought I'd prove to myself that I was not addicted to it or anything.

I: And for how long did your use stop?

R: I guess the most was one week.

I: And why did you go back?

R: Just because I felt like it.

Such an attitude, of course, reflected the user's lack of confidence in his ability to control drug use.

With these two exceptions our subjects were clearly aware of potential difficulties and were specific in their warnings about them:

R: There are some kids, adults too, that will just smoke to excess. And it can be an alternative life-style, practically. That isn't good, especially with kids in high school, when they might be doing things that are more constructive for themselves. They get involved in drugs, and all of a sudden it seems like the answer to all of their problems in the world. All their friends are smoking grass now, and I know in high schools there are a lot of problems with hard drugs. Hallucinogens, and downs, and things like that.

I: So you have genuine concerns about it?

R: Oh, yes, I think it definitely can be dangerous.

Similar sentiments were echoed in other interviews. Nevertheless, most of our subjects liked marihuana use so much that their recognition of its potential difficulties was balanced by more positive experiences with the drug.

Our interviews indicated that still greater confusion was likely to arise over the existence of effective sanctions. Frequently the sanctions that develop around illicit drug use are quirky and individualized, such as the following subject's sense that marihuana use was seasonal:

R: And also the springtime-I don't know-but people get high a lot. It's not that you smoke once a day or so-but you get high like several times a day-and you spend pretty much the [whole] springtime ...

I: Has that been a repeated pattern most springs?

R: Yeah.

I: What about the summer?

R: The summer people, in terms of drugs, are the ones who use it in their travels. I do hardly any drugs in the summer when I travel.

This woman's preference for spring over summer made sense to her if not to others, and it had functioned as a rule of use for her for five years.

But more frequently the sanctions that controlled use were not entirely conscious or the subject was not accustomed to articulating them. He only vaguely knew he had them:

I: And did you have any particular adverse reactions to it?

R: No, not adverse reactions. Because I still smoke now, if the situation is right. But I won't go out and buy it myself. It's a good social drug, I guess. Very.

I   He also considered his rules for use to be logical:

R: I don't think you have to have a reason for getting high every time, but just getting high consistently without a reason for it seems to me to be a reason to sort of check things out with yourself.

Here the explanation ended. But to the research team this subject's insistence on using the drug socially or on having a particular reason or occasion for use constituted the most compelling of sanctions.

Such sanctions do not develop out of nothing. Marihuana users, unlike alcohol users, are not exposed to enough early education about use to develop an awareness of their limits and to test them (Maloff et al. 1982; Harding & Zinberg 1977).

R: I was smoking every day, which I did at one time. I did that before, for a long time, because there was just so much available to me at one time that I did it, and that was very bad [laugh]. In fact, I was talking to my roommate today, before I came up here, and he said there was a time last year when he felt he was just in a fog. That's all it is, a fog. And when I think of that, I have to agree. If you smoke grass every day, even if it's late at night, you can't do that, even if it's social. Because, I don't know, it numbs the brain.

This experience, which was not unusual, indicated how users develop respect for the drug and come to recognize the need for controlling sanctions.

Because few of our marihuana-using subjects had drug-related problems at work, their work-related rules were simple:

I: Do you have any rules, rules for yourself, about using drugs?

R: I guess the only rule is that I won't get stoned if I feel that I'm going to be confronting a potentially hostile situation-not hostile, but a situation in which drug use might not work out. I wouldn't get stoned to go to work, But I feel that I can take care of myself when I'm on drugs. I don't worry about that too much.

I: Would you have gotten stoned for this interview?

R: I could have easily gotten stoned; it wouldn't have bothered me. It depends on the situation. I wouldn't like to smoke in the middle of the day if I have things to do. Or I wouldn't smoke in the middle of a class. Things like that.

This was a general attitude. Most experienced users believed that they could get stoned and function pretty well, just as most experienced alcohol users think that, under special circumstances, they can have a lunch-time drink and return to work; but they realize that it is a strain and generally undesirable. Many of our subjects were very specific in their caveats to new drug users:

I: If you were going to tell somebody who was going to try marihuana for the first time three important things to consider, what would they be?

R: Don't get carried away with it. Don't get into it as if it means anything other than it's just a drug, something to distort your brain; there's no deep meaning in drugs-that would be the second thing. And the third thing would be, be very careful about whom you initiate into drugs because you really have to realize that there are some people, especially young people-it can have a very devastating effect on them, if they get into it, if they think of it as something other than it isn't.

And some users were conscious of and extremely articulate about their own sanctions:

I: What does regular use look like?

R: Once or twice every two weeks or so. Maybe going sometimes a whole month without it, maybe taking two or three puffs, never smoking a whole joint, always sharing a joint with at least one other person.

I: Are there some times during the day or week when you're more inclined to use one drug or another?

R: Nope.

I: Mostly it's evenings?

R: Oh, yeah. I should say that I would be more inclined to drink in the evening related to dinner or socializing and use marihuana late in the evening.

I: Do you have any rules about using drugs? Things you check on before you use them?

R: Oh, yeah. With marihuana, I wouldn't use it unless I knew the person who was offering it to me.

I: You've had adverse reactions to marihuana? R: Yes.

I: Would you use marihuana if you were in a bad mood?

R: [Laugh] No, but maybe in an uptight mood.

I: If you were to tell a new drug user three important things about using, what would they be?

R: To use moderately, to make sure what you're using-you know, to know what you're using-and not to use it as a crutch. I: Are you more likely to use drugs in a particular place? R: Yes, I'm more likely to use it in a- home setting.

Such subjects had already learned why they needed sanctions. The question about what advise to give to a new user was valuable in that it often led them to articulate rules for safe use that they had not known they had.

Social' rituals, which develop to support sanctions for marihuana use as they do for alcohol use, include choosing a special place, a particular time, and a particular activity. The following excerpt describes the beginning of a ritual:

R: I was in one of these heavy roots-type bars, just sitting back and taking twenty minutes to drink a beer and listening to the Irish music. And then this old drunk started coming in and turning me on, you know, to drinks, and I sat down and started playing with this guy, playing chess with him. Because I was playing chess with him, he gave me a hit of hash, and that gave an opportunity for other people to take a hit and put it out and wait for a new move from there, so it was kind of a weird scene. But suddenly, I realized I had been in the bar for like five hours. All of a sudden, four games of chess and three weird conversations later it was one o'clock. And I had sort of a buzz. But I walked out, you know, walking straight; the only part I didn't like was sort of standing in a bar all night.

For years this man continued the ritual of playing chess when he was high.
Many of our subjects began marihuana use while listening to music. Some claimed that marihuana slowed down the time sense so that they could hear and experience music more explicitly and precisely, note by note, theme by theme.

R: I've noticed some people have mellowed a hell of a lot more than I have [as a result of using marihuana]. The mellowing out that I'm into-I listen to Cat Stevens and that type of music, you know-is that I really feel what the music is trying to say, both in the words and the instruments themselves. It's a really strange experience listening to music when I'm stoned. It's like the music goes right through me, or like I can feel the music entering my heart or something. It's like eating a piece of chocolate cake: you know how you feel and you taste what that chocolate cake is, you experience it. Well, it's the same with music. You get really close to it, it enters you and you become very close to it. Not like, well, now he's doing that riff and now that's a piano and a violin playing. You just feel the sound and the emotion in yourself and it carries you away with it. Sometimes I actually cry or laugh with the emotion of the music. Most of all it's very relaxing. And I feel like I get to know personally the guy who's doing the music. With Cat Stevens, I've noticed the changes in his attitudes through his music. A lot of people who sing his songs, even, are the types that once went through some hard times-they are sort of establishment in their kooky little ways. I've noticed a lot of people like that.

The enhanced sensations that many subjects experienced by mixing marihuana use with eating and sex led them to associate use with these special occasions.

Most of our subjects maintained one ritual or another, but these might change as their tastes or their social circumstances changed.

In some instances rituals were used when sanctions appeared to be slipping.

R: Yes, I was out there-well, as soon as I got out there I started getting high again [laugh]. This one relationship still was constrained, and I had to be pretty straight. At the time I was with her, my nervous system was such that when I got high, I still got a little bit uptight. When I first started getting high again, after having my central nervous system put together, it was beautiful. Everything was like when I first used to get stoned, so intense, no paranoia, and it was beautiful and exciting-the whole thing like that. And then I found myself in about two weeks really bitchy and irritable, and realized that I was smoking dope every day, and this was $1o-an-ounce shit. Then I stopped getting high for a couple of weeks and I told her, "Don't smoke more than twice a day, more than once a day; if you catch me doing it more than twice a day, let me know." And about a month later she came up to me and said, "Hey, you're doing this," and I started rationalizing, and I caught myself, realized what I was doing, and had to watch myself much more carefully.

This man's reliance on his girlfriend as an external control can legitimately be described as a kind of ritual, but one born of necessity rather than used to buttress a sanction and increase the pleasure of use. It shows an awareness of the need for rules. But in the judgment of the research team, whenever a ritual is used to replace a sanction, the potential for loss of control is great.

Psychedelics

Psychedelics include a wide range of substances that vary in both potency and duration of effect: LSD, mescaline, peyote, psilocybin, MDA, DMT, and a few others. Originally this class of drugs was called psychotomimetics or hallucinogens, because their effects, it was thought, imitated those of a psychosis or hallucination. For some years before the drug revolution of 1962, psychiatric residents at some installations routinely took doses of these substances so that by experiencing the time-limited effects they might become more empathic with patients who were experiencing the real thing. Indeed, there are a number of articles in scientific journals attesting to the success of such experimentation (Kafka 1964; Kafka & Gaarder 1964; Mogar & Savage 1954; Savage 1952). In time it became clear that the effects of these drugs were not psychotomimetic, and the term psychedelic, from the Greek 'mind manifesting,' came into general use. In nature there are hundreds of plants, barks, and vines with psychedelic properties that were discovered and used before the dawn of recorded history, often in religious rites. Chemically there are two broad classes of psychedelics: those based on an indole ring roughly related to the body's pineal hormone secretions, and those with a molecular structure closer to the adrenalin hormone and similar to amphetamines. Both groups have stimulant properties as well as the mind-manifesting intoxication. The best-known indole psychedelic, psilocybin, is contained in more than a dozen species of mushrooms (especially Psilocybe cubensis), but morning glory seeds contain a similar, though more toxic, substance. LSD (lysergic acid diethylamide), the drug many people believe to be responsible for the drug revolution and the most widely used of these substances, is a synthetic product developed in 1938 in the indole group which causes an intoxication lasting from ten to twelve hours. The buttons of the peyote cactus containing mescaline, long used in American Indian religious rites, are the best-known natural psychedelics in the adrenalinamphetamine group. For inexperienced users, ingesting these cactus buds causes nausea and vomiting. Numerous synthetics, such as STP (2,5 dimethoxy-4-methylamphetamine) and MDA (methyldioxyamphetamine), have been developed with similar chemical structures.

The illicit status of these drugs creates a major problem for the average user in that he cannot be certain what is in the drug he buys. What he presumes to be mescaline may be LSD, or the mescaline may be adulterated with PCP, amphetamines, and other substances; therefore, he can only guess at the proper dosage. A few very knowledgeable users are in a better position. They have access to reputable sources, and some have their drugs tested by a chemist before use.

Unlike the marihuana high, the psychedelic high may last for six to eight hours, and it may differ substantially from one psychedelic to another (Zinberg 1974). It is an intensive though not uncontrollable experience, characterized by perceptual changes, sometimes of an illusory nature but distinguishable from genuine hallucinations. The risk of a bad trip, which is always present, is to some degree increased by the lack of quality control over the drug. For these and other reasons, within the drug subculture psychedelics are regarded as "real"-that is, dangerous-drugs. They neither have the widespread appeal of marihuana nor are they treated casually. Estimates of use are inexact, but it is frequently mentioned that between ten and twelve million people have tried psychedelics. Most of the rituals and social sanctions related to the psychedelics deal with making the specific drug experience as safe as possible for the user rather than with concerns about chemistry and frequency of use, as with the other drugs. Yet, as was the case with users of marihuana, we found it easier to locate users than abusers.

Psychedelic use is almost invariably a drug-centered group activity. Subjects talk about having others with them who can be relied upon to help them cope with a bad trip or with unforeseen events: "I have to do it with someone that I really know well, that I trust." Casual acquaintances are sometimes included in the group, but then the trip is commonly preceded by a discussion in which all the members try to get comfortable together, to determine who may need extra help or attention, and to establish ground rules. During this preliminary discussion, an experienced user may be assigned to act as a guide for an inexperienced or uneasy user. Group members may forbid anyone to wander away from the group without telling another member; otherwise someone might worry, and worrying is felt to be detrimental to a positive drug experience.

Subjects agree that planning the trip is an important matter, even when the participants have taken the drug together previously and feel quite close to one another. The need for structure varies, but pre-trip planning includes such issues as what foods or beverages to take along, what activities to engage in during the trip, whether thorazine or other drugs should be available in case of a bad trip, or whether talking people down is preferable to medicating them. This planning reaffirms the participants' sense of shared intentions and strengthens their ability to control the drug high.

Subjects are adamant about using psychedelics in a proper setting-"a good place." For many this means tripping in a relatively secluded spot in the country. In every case the space must be secure and comfortable. A city tripper said, "I'll take a walk outside, but it'll always be with the notion that I can come back to this sanctuary in the house, and so it's no threat." This subject and many others expressed some disdain for users who violated the principle that the drug experience should be confined to special settings. As one said, "I was living last year with a dude who's seventeen years old and is from the West Coast. He was telling me that when he was going to junior high school he would just drop acid in the morning and go to school, which completely weirded me out. He could just ride with any kind of horrible thing. Amazing!"

Another social sanction that subjects observe is the need to be internally prepared for psychedelic use. One subject described this as "making peace with the public reality: mentally putting your house, your affairs, in order; you know-what's the Zen thing--emptying out the teacup first." Others talk simply about needing to be in a "good mood" and needing "energy" to undertake the experience. Some subjects appear to ritualize this internal process by tidying up the space in which they are going to use the drug.

Beyond these conventions, which represent attempts to ensure a good trip and prevent a bad one, other rituals and social sanctions are directed toward inhibiting compulsive psychedelic use. Subjects repeatedly advocated using psychedelics no more than once every two weeks, and in practice their use was far less frequent than that. Less than once a month was the most typical using pattern, and over time, use consistently became even less frequent. Avoidance of compulsive use, however, is probably not so much the consequence of negative sanctions as it is the result of a combination of two other factors: the positive value that controlled users attach to the consciousness-altering properties of psychedelics, and the fact that tolerance to these consciousness-altering properties goes up very rapidly as use becomes more frequent. Our subjects who were interested in experiencing precisely these effects found that too frequent use of the drug was counterproductive.

Some psychedelic users who are not interested in the consciousness changing qualities of the drugs may become compulsive users. For them, it is the speedy, stimulating effects that are appealing-effects that are enhanced by larger, more frequent doses of the drug. Assuming, of course, that these compulsive users are actually using psychedelics and not amphetamines that have been wrongly labeled (a mistake that could not be made by a serious user), I would conjecture that such users are associated with groups in the subculture that either put a negative value on consciousness change or do not recognize it as a primary drug effect.

By comparing the testimony of older and younger subjects, my research staff was able to identify some of the shifts that have occurred over the years in psychedelic-using rituals and social sanctions. The older subjects, who had begun use in the mid-1960s, often shared a sense that psychedelics should be used for "personal growth" rather, than recreational purposes. They viewed tripping as an activity that was undertaken to accomplish a worthy goal-to learn more about oneself, to grow intellectually, or to transcend ordinary perceptual boundaries. By contrast, the younger subjects, who had been using psychedelics for only about five years, included among their reasons for use various goals that were plainly recreational. Younger subjects might trip for a rational purpose, but they seemed equally inclined to trip simply in order to enjoy the high state. Although I cannot yet account for these expanded goals, it is possible that they indicate a growing familiarity with the drugs and therefore less guilt feelings about their use. Perhaps when the older subjects began using psychedelics, they needed to assign some constructive purpose to tripping in order to justify their interest in this class of drugs, which was regarded as more dangerous and powerful then than it is now.

If the psychedelic-using population continues to grow, it is likely that recreational use will increase and, as with marihuana, will become less ritualized though not less controlled. It is unlikely, however, that psychedelic using rituals will ever achieve the same degree of flexibility and diversity as marihuana-using rituals. Probably periods of greater interest in psychedelic use will come and go every few years and social sanctions will be more or less available, depending on the resiliency of social learning; but because of the high-impact, long-duration drug effect and the related tendency to keep psychedelic use infrequent, there are both less need and less social opportunity for the process of internalization of social sanctions to take place. Thus the dependence on rituals (on external controls) will continue to limit the flexibility of psychedelic use.

Even those of our subjects who were satisfied with their drug experience felt the same extreme concerns about using psychedelics that had been evident among early users. To counteract these fears they took care to follow various rules for safe use and the rituals supporting them.

The social sanctions and rituals that surround the use of psychedelics are stronger, better articulated, and more carefully followed than those associated with either marihuana or the opiates. The sanctions that developed in the 1960s had two purposes: to establish control over excessive use (which early users did not realize was not likely to occur) and to establish control over the immediate experience, which was more demanding than any other drug experience. Interest in developing and following sanctions and rituals for reasonable psychedelic use was considerably more important than whether the rules were sensible. Keeping a day free after a trip was eminently sensible, while eating bee pollen was a highly romantic ritual; yet both sanctions indicated respect for the drug and a decision to try to use it safely in order to avoid destructive consequences.

The user of psychedelics shared some of the marihuana user's concerns about possible health hazards, such as chromosome breaks or a defective conception, but his fear of damage along social and psychological dimensions was much greater than the marihuana user's. With marihuana, it was usually the beginner who was anxious about such things, whereas experienced smokers, though they knew of a few genuine misusers (abusers), generally felt they had enough control over the drug to avoid social and psychological harm. With the psychedelics, experienced users recognized that trouble would follow unless the sanctions were observed; and even if care was taken, there were still worries:

R: Once it would be beautiful sunshine, but then the next time it would be like, you know, hiding in the corner like a rat. Your throat is dry, you can barely speak 'cause you're poisoned 'cause you took a heavy dose and-I had a few of those.

Fifty percent of our subjects reported at least one adverse reaction to the drug-usually a bad trip; and 22% knew someone else who had had an adverse reaction. As one user put it,

R: This guy that I really knew well, a graduate student who published this political magazine-he was a physicist, a graduate student, more into studies than I was, but I was in mathematics-he used to take some really incredible stuff. And so in 1962, I guess, I guess it was '61 or '6z, that winter, he went to Cambridge where they were doing the original Leary stuff, and he did a huge dose. I guess they didn't know in those days what was an appropriate dose, or something, and he went essentially psychotic.

Because of the power of psychedelic drugs to dislocate perceptions, it was recognized in the early 1960s that a beginning user might not know what was happening to him and therefore might need guidance.

R: It was important that the-whoever was the guide-should also have a light dose. And in two sessions I took psilocybin along with this person, and then in another session I was also operating as a kind of guide with two of my associates on the faculty of a theological school.

I: What did that entail, being a guide?

R: Well, I was just there as somebody who had had the experience. I was there to help them if they needed help.

The habit of having a guide was quickly translated into the social sanctions that someone tripping for the first time should always have an experienced user present.

R: In those days, everybody had a babysitter; you wouldn't do acid with

out a babysitter. Everybody had a babysitter then. That's the old days,

man, the great days.

I: What had you heard about it before you tried it?

R: Nothing, really, except like what my friend told me and stuff. I: What was that?

R: He hadn't done it either. But he just heard it from someone that heard it from someone that it was really fantastic. And you see all those lights and music. It's just fantastic, and you were just really planning for a trip. But now I just do it kind of whenever I want to. Then you planned all the environment, how you'd be. There was that big fear about freaking out.

I: Had your friends used it before?

R: A few of them had, yeah, but not regularly; it was like a special thing, you didn't wanna abuse it.

The guru or guide would soothe anxiety by telling the user: "It's OK. It is what is supposed to happen. Let it happen. Go with the flow." Some neophytes, anxious to use, found guides in odd places.

I: How old were you?

R: Sixteen.

I: Who showed you how to use it? R: I read a book [laugh]. I: Which book?

R: LSD by Hoffman and somebody else. I: And you really wanted to try it? R: Uh huh.

I: Who turned you on to it? R: A dealer that I met. I: Where did you try it?

R: By myself, in my bedroom. I: Did he tell you anything?

R: He said, "Have a good trip."

But even quite young, inexperienced people learned in a social way about this sanction without knowing how they had learned it, and they followed it carefully. Users also learned quickly how sensitive they could become to their own moods and surroundings in this alternate state of consciousness.

R: They told me to watch where I took it, that there were some places that one shouldn't take acid, like in resistance [to the draft during the Vietnam War] sanctuaries, or anything like that. Grass was cool, but acid's too strong. Watch where you get your acid because, like one experience I had wasn't real acid, and I had a really bad experience later with that. It was a headache. It was a physically bad experience. They told me to watch where I took it, watch where my head was at when I took it, and when I was taking it, I sort of already knew that.

An important factor limiting use was the difficulty most people had in arranging their highly organized lives to accommodate a drug "trip" that lasted a whole day and lingered on during the following day.

I: What is the next day like?

R: I like to have a day of recovery, usually I'm just tired. And not physiologically upset, but just, like, really tired out. I just don't want to have a lot of things to deal with. If I trip on Sunday and I have classes on Monday until three o'clock, I can't concentrate very well. I'm usually still tripping a little bit and I just can t attend to things very well. Sometimes the work in school is really important and I have to go to a meeting and really deal wit h something, and I can't really be-I have to be able to attend to it really well.

For most people, setting aside this much time required planning, and it was time that trippers either could not or did not wish to devote to mundane tasks (Bieberman 1967).

R: I'd use marihuana any time I felt comfortable to do so. And alcohol any time I felt comfortable to do so. I don't feel compelled to use either, really. And LSD or some kind of hallucinogen, I would like to use more if I had the space to do it. I don't feel I have the space now. I have to work every day. I have to keep certain things together. That's an expansive kind of drug. Sometime, I'd like to be able to just sit down and expand.

From these discoveries about place and time another sanction emerged not only among beginners but also among experienced users: "Only use at a good time, in a good place, with good people." Originally this sanction was offered as advice from one friend to another, but soon users far removed from the initial advisor accepted it as an important and valid way to avoid trouble.

R: I was, in some part of me, afraid of acid. I'd heard about bad trips and I never wanted to have one. So I tripped a few times, but I would never take a tab unless one of my friends had tried it first.

I: Tried it first?

R: Yes. They were real acid freaks; they were always tripping, but they knew that I didn't, and I trusted them to give me a tab that they found to be good or mild or whatever.

I: Is there anything else you would do?

R: I would never use it in the city, only in the country or in a park. I hate the city when I'm straight, too much noise, bad air, weird people. So I never wanted to intensify that experience. Also, when someone tripped, everyone else in the house would be informed beforehand, so they kept their behavior sort of, well, gentle and kind, I guess. No weird vibes, no head trips. And I would use on a weekend or when I didn't have to work so that I could come down and relax the next day because I always felt spaced out and tired. And I would trip on a pretty day with a friend. Never more than one person. Just one good friend I could relate to.

R: I'm very much accustomed to getting into a situation that's as unthreatening as possible. Usually it's, you know, the room's kind of tidied up, I know exactly who's going to be around, everything is pretty much in order. I mean, I'll take a walk outside, but it'll always be with the notion that I can come back to this kind of sanctuary for myself in the house, so it's no threat.

I: How about the other people in the house?

R: If people in the house know that other people are tripping, I think that the effort that's made is to act as normal as possible. I think that's really necessary. I know that I feel really condescended to if people behave differently.

Psychedelic drug users illustrated more clearly than either marihuana or opiate users the interplay between sanctions and rituals.

R: OK. Now, I make sure set and setting are right. I have to do it in a really good environment, dig some of the people and the vibrations there, so I have to do it, maybe, with someone that I really know well, that I really trust, and there are some people like that. I have to do it where I have the freedom to, like, walk around outside, somewhere in the country, or something, and dig on trees or whatever, and I have to have my head in the right place, so that I'm not really angry or upset or anything like that.

These rules or sanctions were supported by individual quirky rituals involving seasons of the year, physical activity or lack of it, the state of the surroundings, and what to do when going up or coming down.

R: When you get ready for an LSD trip, there's a lot of preparation involved. It was in early, well, late springtime and, let's see, there were five us who dropped-we're still close friends. We took very small amounts of LSD, very small, because I'd never done it before, and everyone else had, but we wanted to. We thought if we all took the same amount, we would be on the same wavelength, and we sat down and listened to music the first part of the trip. And I did it. Nothing really happened to me for about two hours. I didn't know what to expect, and we started talking about all kinds of things-what we should expect, how to come down, and stuff. You know, it was just basically bullshit, giggling and stuff, a lot of nervousness. I was pretty nervous, and then it came on, and it was a very mild trip, as far as my trips have gone. I didn't get into any astral phenomena. I talked to my friends about what to do. It was getting late and we went out into some woods where there were no people around.

I: Were you out in Gloucester?

R: Yeah. At a friend's house. And we went into some woods and the trees looked more beautiful, and we watched the sunset. It was a really beautiful experience. I didn't really have anything religious; it was just really beautiful.

All of our subjects recognized the primary importance of social sanctions and rituals. All of them stated, in fact, that in order to contain comfortably the long-lasting effects of the drug, they followed several rules for use (mean number of rules = 3.2, S. D. = 1.665, range = 0-6). For the group as a whole these rules included: plans for use (61% of the sample), never use with strangers (44%), never use in a strange place (39%), never use alone (39%), do not let significant others know of use (22%), make special schedules for use (28%), clean the surroundings before use (ii%), have rules about obtaining the drug (11%), keep a drug budget (11%), and various other specific rules (50%).

Opiates

Pharmacologically all narcotic drugs are depressants. Indeed, the term "narcotic" is rooted in the Greek word meaning 'stupor'. In legal terminology, the term narcotic has come to include many classes of drugs, but in fact, the term refers only to drugs derived from opium and synthetic variations of opium derivatives. It is important to remember that broad pharmacological classifications, such as depressants, tell us little about the individual actions of particular drugs, especially about their subjective effects. Thus the user experiences opiate derivatives far differently from other depressants such as alcohol or barbiturates, just as the subjective experience of the stimulant cocaine has little in common with the stimulation of psychedelics, although both are antistuporous.

The potency of opium as an analgesic and intoxicant when eaten or smoked goes back to prehistory and was known to ancient Greeks, Chinese, and Egyptians. If the pods of the opium poppy are cut just before they ripen, they ooze a milky-white substance which when dried turns brown and gummy, and that crude opium contains more than twenty-five ingredients. One ingredient, morphine (from Morpheus, the Greek god of sleep), was isolated in 1803. That event, followed by the invention of the hypodermic syringe in 1853, ushered in the era of modern analgesia and, of course, with it, modern addiction. Heroin is simply diacetyl morphine, a more potent product, developed in 1898. Codeine and Dilaudid are two other well-known opium derivatives. Demerol and methadone are the best-known synthetics, although a new generation of synthetics has become popular recently in such products as Percodan and Darvon.

More than any other illicit drug, the opiates have been the object of public condemnation. Popular convictions about the evils of opiates and particularly of heroin extend deep into the drug subculture itself. Many of the marihuana and psychedelic users we interviewed did not even recognize the possibility of controlled opiate use, even though they had identified and dispelled many of the larger culture's myths about their own drugs. (It is possible, of course, that standing with the larger culture against opiate use may help marihuana and psychedelic users to view their own drug use as comparatively "good.") Perhaps because of this general attitude of condemnation, we found it harder to locate controlled opiate users than abusers, just the reverse of the situation with the other two groups of drug-takers.

The controlled opiate users in our study-most of whom used heroin but some of whom used Dilaudid, codeine, and other pharmaceutical opiates, all on an occasional basis-were painfully aware that they were perceived as deviant. They tended to keep their use a closely guarded secret from everyone except one or two dealers and their opiate-using friends. During our study project, a woman who for several years had been a reasonably close friend of one of the researchers felt free for the first time to "confess" to him that she had been a controlled heroin user ever since she had known him.

The relationship of controlled opiate users to addicts, or compulsive opiate users, is as dangerous. and difficult as it is necessary. One way in which controlled users can assert their normalcy is to spurn and condemn junkies, but often they must rely on junkies to obtain their drugs; and a few controlled users show impressive ingenuity in finding drug sources (Zinberg & Jacobson 1975). Addicts, for their part, do not understand and often feel threatened by the controlled user's "peculiar" relation to opiates. Hence, on the one hand, controlled users get poor-quality opiates at great cost from junkies, and on the other hand, they are repeatedly and seductively invited to become full-fledged members of the junkie subculture. The controlled user's constant dilemma is how to become friendly enough with an addict to establish a reliable contact for quality opiates, but not so friendly that his refusal to participate in the addict's subculture might offend the latter and lead him to cut off the supply.

Beset by danger on all sides, controlled users huddle together in small isolated groups that develop idiosyncratic, rigid rituals and social sanctions. These groups are fragile and drug-centered because it is difficult to find controlled users who would make compatible friends-the inverse of the situation with marihuana users.

Many of the rituals of controlled opiate users are hard to distinguish from those of compulsive users. In both groups, people squabble over who gets off first, belts are used as ties, eyedroppers are used instead of syringes, and booting is common. The main reason for this ritual-sharing is that in the absence of a highly visible, communicative population of controlled users with its own discrete rituals the addict subculture is the only readily available source of expertise about the drug. But there are also two other reasons for this phenomenon. First, although the life-style of the addict is repugnant to most controlled trolled users, they sometimes find the addict's bold, outlaw stance attractive; hence, partaking of the addict's ritual may be an expression of wistful identification. Second, some controlled users (including several of our subjects) started out as addicts, and they retain and share with others their former compulsive drug-using rituals, of which booting is probably the best example.

Several controlled users have added new elements to the addict ritual. One subject, for example, shifted the emphasis away from "getting of by tacking on middle-class amenities. He played the good host by serving wine and food to his user guests (without any of the nausea that is commonly accepted as accompanying opiate use), and all spent the evening together in conversation. Another user protected herself from a possible overdose by shooting a little of the drug, waiting to gauge its effect, and then shooting the remainder. By and large, however, controlled users' rituals are not clearly distinguishable from those of compulsive users, especially in the details of administering the drug.

By contrast, the social sanctions surrounding controlled use are distinctive. Most of the rules for opiate use to which controlled users adhere are summarized by the maxim, "Don't become dependent," because they realize that it would be relatively easy to become addicted. For example, our exaddict subjects had firm rules about frequency of use. One such subject was a woman who had used heroin on an average of three or four times a month for more than four years. Occasionally, when her commitments to work and to her child permitted, she would go on a using spree that lasted about a week. Even on such a vacation, however, she would not use heroin more frequently than every other day. In general, subjects limited their opiate use far more than was necessary to avoid addiction. One subject had confined his use of heroin to weekends for the past five years. Another had limited her regular use over an eighteen-month period to twice a month, except on special occasions such as birthdays and New Year's. Then, troubled by her tolerance of some of the drug's effects, she deliberately cut back to only once a month. She ignored the possibility that instead of growing tolerance on her part, the problem might have been the variability in the potency of the drug she had used on the two occasions when it had happened. There was some question of whether she had really developed tolerance or whether she had simply bought some low-potency heroin.

These and other examples indicate that although many controlled users feel that heroin can be used moderately, they regard it as more rapidly addicting than is warranted by the pharmacology of the drug. This attitude, of course, is understandable in view of the prevailing myths about heroin's power as well as the exposure of controlled users to addicts who have succumbed to the drug.
Controlled subjects observed common sanctions against behaving like or becoming overly involved with junkies and compulsive users. One user might
chastise another for manifesting irresponsible, junkie-like behavior or being unable to control the drug's effects. A user of codeine-based cough syrup and of Doriden indicated that despite the somnolence induced by these drugs, people who used them were expected to act responsibly: "One cigarette burn and you're thrown out." Being cheated by dealers was a fact of life, but a controlled user who cheated his or her fellow users was punished by being called a junkie. Controlled users frowned upon spending too much money on heroin because it suggested the junkie's lack of control: "Just 'cause I had the money didn't necessarily mean I would cop. Of course, I wouldn't steal to get the money to cop; there's no need for it 'cause I don't have a habit."

Shooting up like a junkie was acceptable, but shooting up with junkies was not, because it symbolized a loss of control. A couple who had regular access to opiates through the wife's addicted sister and brother-in-law stopped relying on them for opiates because of the social pressure to use the drug with them. Instead the couple would borrow a car and drive several miles to a copping site in another city where they knew they could obtain heroin from street dealers.

This sort of behavior is not unique. It is indicative of the care with which controlled opiate users observe their social sanctions and, in sharp contrast to compulsive users, of their insistence on privacy. It is this insistence rather than their rarity that has raised so many questions about their existence (see appendix C).

The interview excerpts cited in chapter 4 on the effects of opiate use reveal more than the users' awareness of how the drug influenced their lives and psyches. These excerpts also indicate the existence of social sanctions and rituals that served to control use. For example, each response concerning special-occasion use shows the subject's recognition of a sanction that might be paraphrased as follows: "I do not take opiates at any old time, like an addict, but only or chiefly on special occasions." Even a user's constant fear of associating with junkies or of becoming addicted implies a sanction against uncontrolled use. In effect, our controlled subjects were able to construct a hierarchy of values-a list of activities that were important to them-and then to assign to opiate use a ranking somewhere within that hierarchy. Unlike compulsive users, they did not put opiates at the top of the list.

I: In your mind, at what point does an occasional user become an addict? R: At that point when he decides he doesn't give a damn, you know. I: Could you ever be an addict?

R: No.

Junkies invariably put opiate use at the top of their hierarchy, as the next subject, an ex-addict, pointed out.

R: Well, I've used a lot every day in the past. At different times. I mean, I've been strung out at different times.

I: How do you use it now?

R: Well, chipping. I don't know what you mean by that, but chipping in my sense means that you have a little jones [habit]. But using it occasionally means something different to me.

I: What difference is there in your mind between someone who is an occasional user and someone who uses a lot? Is there any?

R: Well, of course there's a difference. When you're strung out, you can't work. I couldn't work. I ended up quitting my job 'cause getting really strung out, getting the dope is a full-time job. But when I was using .occasionally, I lived like a normal life, I went to work every day. I decide when to use, who to use with, and what will go on when I use. I have lots of rules about all that, and now I follow them. I think that's quite a big difference from people who use a lot. Tomorrow maybe I'll go to work, or maybe I'll call in. I really haven't made up my mind. If I was strung out right now, I'd be in town tonight copping for a fix tomorrow morning. Or trying to make money. I think that's obvious. Being a junkie's a full-time job. And it's a hard one.

Compulsive users may also have certain sanctions and rituals; but theirs are not so well developed and reinforced or so consistently applied. Booting, mentioned earlier, is one example. Still more important, compulsive users are likely to adhere to and articulate rules that operate to support compulsivity rather than control it. One compulsive user, with great difficulty, would save some heroin so that he could begin each day by getting off.

All of our controlled users were obliged to abide by definite sanctions and rituals in order to keep their drug use under control. Usually they perceived and described their rules and ceremonies simply as safety precautions, that is, as the "correct" way of doing things.

R: I wouldn't do it daily. I didn't let myself do it daily for a period of time.

They did not want to become addicted, and they were keenly aware of that possibility.

R: I'd do it every day for four or five days and then I wouldn't do anything. I wouldn't do anything for about a week, try not to do anything for about a week. Because I was really wary about getting strung out.

I: Would you do it once a day then?

R: Yeah, once a day, sometimes twice a day, if I had enough money to do it. But sometimes I'd pick up like three bags at a time or something like that, and I'd do one and a half one time and then later on that day I'd do another half, or I'd do like two bags and then save the cotton and do the other bag. That sort of thing. But sometimes I didn't do it for a week or two weeks or something like that. Not at all.

I: In order to not get strung out?

R: Yeah. Because I just feel that-I knew that I was close and I could very easily. And there's a real psychological thing to it, you know. It's a real psychological trip. It really is.

Such subjects recognized external responsibilities and used them to keep themselves in line. They were not always aware, however, that the ability to do this differentiated them from addicts.

I: Were you ever an addict?

R: No.

I: If not, how did you avoid becoming an addict?

R: Well, I have responsibilities, you know, and I keep my use down. If I

wasn't married and I didn't have my son or my business, then I think

my chances of becoming an addict would be very strong. I: Have you ever felt that you were getting a habit? R: No.

Even if the following subject was fooling herself about the extent of her interest in opiate use, she was still stating the sanction that such use should not be at the top of her hierarchy.

I: How important is using drugs to you and your friends?

R: Well, it's one of those things that if it's appropriate and it works, it happens. If it's not, it doesn't. I don't really care that much. I doesn't make that much difference to me.

The controlled users' statements repeatedly indicated a rule that they would only go so far or do only so much to get the drug.

R: Some friends up there from Roxbury, the South End, that's how I made my connection.

L I see. So it was kind of-it was chance, until you got a connection.

yeah. If it was there I would have used it before, but I don't know, I'm not into the bag of chasing things down. If I had to hassle or something, forget it.

The decision as to what was too much opiate use was more conscious and specific with some users than with others.

R: So I just sort of said to myself, "OK, man, you're going to have to make a decision. You're at the point where obviously you're enjoying doing it, you know, but is it more than that? If it is more than that, are you going to continue like this, because if you are, you're going to have to go out and start hustling. You're going to have to find a new source of

income because you're not going to make it this way. Or you're going to have to cut down." And when I thought of the change in life style that would be necessary, it just didn't appeal to me at all. I enjoy gettin' high, but I don't want to make it my life.

Money was often cited as a controlling factor:

R: I have one rule that I never, never break. I never spend more than $25 a week on dope.

But the research team was astonished to find how many people could get money for drugs if they moved drug use higher in their scale of values.

I: You said you had controls on yourself to make sure you don't get strung out. What are they?

R: Usually the cost of it is enough to control me because I start thinking about how much money I'm wasting. You know, I'll add up how much money I spend in the month. If it's more than $100 and at the time I'm broke, then I'll just stop for a while and say, "God, what am I doing?" [laugh].

Subjects frequently stated their sanctions as if they were purely expressions of their own personalities.

I: Could you be an addict?

R: No, I don't-because of the experience and everything else, I don't think I could be. I really don't. I couldn't-what is it-I couldn't throw myself into anything that much. Whether it were a good thing, a love affair, or a drug addiction. I don't think I could just put that much energy into any one thing.

But invariably such statements actually expressed sanctions against addiction.

I: What kind of user do you consider yourself?

R: I'm slowin' down a helluva lot. I think I'm becoming more mature. It's like smoking cigarettes. The two cigarettes I just smoked were the only two all day and I enjoyed them, you know, whereas if I had gotten up this morning and smoked up until now, I'd constantly be aware if I was. smoking a cigarette, even if I was talkin' to you. I'd sort of feel it burning, you know, in my head and in my hand. And that shows me that my mind is getting older and is learning more, and I'm knowing myself better. I'm slowing down to learn more, to treat myself better. So I don't know-moderate use now is becoming more important. I never want to be a junkie.

And the familiar themes of staying away from junkies and from addiction could also be stated explicitly.

I: What advice would you give a new user?

R: I'd tell them not to hang out with, you know, superfly junkies, you know, pseudo-superfly junkies, and get into that whole scene. Like, don't let it be a jumping-off point for-I'm speaking in terms of, maybe, liberation. You know, so many people say opiates are-keep the people down in the ghetto. Keep the minds asphyxiated. And that's not true. In my case, it's not true. So don't let it become your master. There's some weird saying about that.

Some subjects gave their own special reasons for wanting to establish sanctions about frequency of use.

R: I was only doing it once every week or once every two weeks. The first time I went out and got high, my wife and I could function, but if I get high the second day, it really wipes me out, I'm really dragged out. If I get high on Friday and don't get high on Saturday, I'll remember what I did Friday, but if I get high on Friday and get high on Saturday, when I do come around and straighten out, I really don't know what I did on Friday. That was a major concern of mine, not knowing what I'd done.

In describing how they viewed use, our controlled subjects often sounded as if they were speaking about a more conventional experience, such as alcohol use, rather than about the esoteric experience of using heroin.

I: If you were to tell a new drug user three important things about using, what would they be?

R: I would say that the first thing, the cardinal rule about using drugs, about using anything in life, is to do it in moderation. That's the first thing. Do it in moderation. Now, there are certain nuances of using drugs that I can tell them. There are certain things, little things, that I could explain to them, but basically it's to use it in moderation. I'm not going to say, don't use it, or use it. I'm just going to say, if you're going to use it, use it in moderation. That way you'll never get burned. You're always one step ahead of your dope use.

The following excerpt emphasized that the drug was often used in social interaction:

R: I enjoyed the whole idea of being with people, you know. And getting the drug ready and shooting up.

A general principle or sanction underlying this behavior was the attempt by our subjects to choose using companions whom they knew well.

R: Well, there've been times when I've used heroin around other people that had been using heroin whom I didn't know, and I was sort of apprehensive about it. At first, I don't know, there's something that happens-there's something that's a little apprehensive in the first place about getting off. I prefer to either do it by myself usually, or with that girl.

I: Let's call her Mary.

R: Mary-with her, or with somebody else that I'm quite familiar with that does it. I won't do it with a friend of mine that doesn't have anything to do with it. You know, I'll either go off and do it some place else and then come back, or I won't do it.

Most of our controlled subjects did not use when those who were unsympathetic were around, but occasionally a subject did take that risk.

I: Do you feel more inclined to use drugs when you're alone or when you're with friends?

R: Well, it really doesn't matter much. If I feel like getting high in some manner or another, usually I'll do it independent of my surroundings, unless there are some really deeply personal feelings of the people that I happen to be with, which has happened a couple of times. And then I'll either go get high or I'll say, "OK, I'll see you in a few minutes; I'm just going to go to the bathroom." Something like that, but that doesn't usually happen. It's happened once or twice with a couple of friends of mine, like if I wanted to get high on heroin or something like that.

I: It sounds like it's more likely to happen with heroin.

R: Oh, heroin's the only one. But anything that I shoot, I don't do that in front of somebody else that doesn't do it because, you know, people have feelings about it. And they form opinions and a lot of the opinions I don't think are just. I just sort of feel like, "You like the way I am, so what you don't know won't hurt you." So that's the way it goes.

The research team doubted whether users who took such risks and violated what was an important sanction for others, had the ability to retain control. But the man just quoted apparently did have that ability because he had other sanctions that he observed carefully. The woman quoted next also broke a sanction that most controlled subjects observed-that is, not to use in a group containing both compulsive and controlled users. Her ability to rank her drug use much lower than her work on her hierarchy of values was in itself a controlling sanction.

I: Did you begin getting a habit during the time when you were working the afternoon shift?

R: I guess I came close to getting a habit, but I never really felt sick or anything like that. Like my friend, you know, he used to get up at 8:30 in the morning and get off, you know, while I was home sleeping. I wouldn't see him until about one o'clock in the afternoon and he'd already be high, and he'd say, "Come on, let's go over to my house and we'll do some dope." And I'd turn him down and say, "No, I'm going to go to work; I'll do it tonight," and I went to work. All during the day he might have got off four or five times, plus at night he used to do it a lot more than I did it, so he got a habit. Out of the six or seven people I hung around with, there were only three of them that really had a habit. The others sort of, they'd get off a lot, but they sort of controlled it in a way.

As might be expected, the commitment to earning a living was a crucial factor in limiting drug use.

I: What does your drug use look like?

R: What do you mean by that question?

I: Are you going to continue on weekends, or do it more than weekends? You've been doing it so many years, are you gonna stop doing it weekends, are you gonna do it every day?

R: I have a family to support and everything, so I have to be cool about the whole thing.

I: What do you mean about being cool? In which respect? What do you intend doing?

R: I'm gonna take it easy, don't overdo it. Control myself.

Many subjects had a primary commitment to work that went beyond earning a living. The next subject had not only made that commitment but had also learned to follow the essential rule propounded by Andrew T. Weil in 1972: "Less is more." By exercising care and specificity in the use of his drug, he was able to preserve his enjoyment of it.

R: So I really like working, you know, because if I wasn't working, I'd be drinking all day and smoking all day. And you know, when you do it like that, you don't even really want to. I enjoy it much more just doing it once a night, like having some beers and a few joints. I enjoyed it a lot more than if I had done it all day. No* I have ways to restrict myself. I talk to myself about when to and where to and whom to do it with. It's like having rules about when it's OK.

Controlled users generally valued the status gained from work far more than compulsive users.

R: I've done a lot of work. That's why it's very important that I remain in control, because I've done a lot of work in the union. I'm on the central committee and this would really destroy it. I'd have to take-maybe get thrown out altogether. Or I'd certainly lose my status and my position. I worked hard to get that. I don't think that there'd be any effect on my job, but I'd just as soon not let anyone know.

I: Is that part of the reason that you're interested in discontinuing use?

R: Yeah, very much so. It's the fear of someone else finding out in the union or at work. And I've worked with these people for seven years and been with the union for about eight years. And it's just too much for me to lose. It doesn't counteract the good feeling that I get from the heroin; it just doesn't balance it.

Controlled users also accepted the responsibility that went with work status.

R: Well, of course, nobody in the hospital is supposed to use narcotics. Nobody knew that I use. I never got a habit. I had too much work to do, and there was too much-I felt too much of a commitment to get strung out. But I have chipped for about five years.

The process of learning the technology or techniques of drug use is especially important in the case of the opiates because a mistake in quantity or in shooting up can have disastrous results. Thus beginning users gradually acquire technical sanctions and rituals, though sometimes with frustrating consequences:

I: When you got high, did you fix your own shot or did someone fix it for you and shoot you with it?

R: Most of the time we would fix everything together, and I would just get a smaller amount than they would. At first, someone would have to do it for me, until a while later I learned to do it myself. Because the times we would be around doing that, other guys would be so busy trying to get off themselves and I would be sitting around waiting on them to get through. When they got through, they'd be so high that I'd end up by myself waiting for them to come out of it before I could even get off.

The next response illustrates how fascination with the ritualized technique of use served as a sanction until the subject had greater faith in his own sense of control. It also shows that the same rituals do not have controlling power for junkies.

R: I've always had a fascination with the process of getting off. At my introduction to junkies, I thought maybe they were much more addicted to the ritual than to the substance, to the activity of sitting around, cooking the dope, and the act of injecting it. And when I first did that, it was a fascination with me. But I don't think of it so much any more. It's just merely the most efficient way to use the drug. And I think, you know, at one point there was a great deal of elaboration of tying off and pumpin' in, and all that. I was never really into it. I'm not now.

As the same subject pointed out, learning the techniques and the rules for safety that went with them was not like taking a formal college course.

I: Did whoever it was that showed you give you instructions and do's and don'ts?

R: No, I don't think so. I just think it's things that you pick up from standing on the corner listening to older dudes. Being around older dudes who knew more about it, you just pick up these kinds of things as you go along. Once you get into it, you're gonna pick up all these different things. Say, you run into a person who's dealing, and you've been down here all day trying to cop, and you say, "Well, I'm going to cook it. You all going to come on? Come on over?" You sit down. He says, "Yeah, man, you shouldn't do such-and-such a thing." You pick it up there, you pass it on. Pass it on, person to person.

Even in this casual way the information got transmitted.

R: Sometimes they tell you, don't use this spike here because this type of spike is too big. That's what they call a coke spike. But you shouldn't shoot heroin with that 'cause it puts a big hole in your arm, and all you do is flush blood back and forth. You'd be doing it all day long. Bleeding like a dog. Yeah, and don't get off on dirty needles, or on dirty water or with anything that's not clean or reasonably clean.

Another constant source of anxiety was the question of buying the drug and knowing something about its quality. That concern led many subjects to adopt a sanction requiring companionship when using opiates, and especially when using a fresh supply.

I: Do you have any rules about using drugs?

R: Oh, yeah, private rules. I'm always wary when I cop some heroin and I don't know what the strength is, what it's like. Usually, if you ask the person you buy it from, forget it; I mean, it's always "fantastic." So I'll always take too little. I'll always have to end up getting off again, a second time. If I'm snorting it's different, you can keep on snorting. One of my rules, which I find females have more than males, is never to get off shooting up alone.

Both that subject and the next woman subscribed to the rule of using alittle at a time until they knew what the stuff was like. Only rarely did junkies subscribe to such a rule.

I: Are there any things you check on before you use a drug?

R: Well, I usually know who it's coming from, I make sure of that. I just won't buy it from anybody on the street. And I know the amount I'mdoing, you know, so 1 don't do an overdose. If I have to break it up and do it in two or three hits, then that's how I'll do it rather than do it all at once.

Controlled users, again in contrast to compulsive users, did not just look for dope; they looked for a dealer in whom they had confidence.

R: I buy from this one guy who lives near work. I met him kind of by accident after I moved here. I really had no intention of using again. I: Do you only buy from him?

R: Yes. I trust him in the sense that his stuff is always pretty good. I have no desire to make further connections with other people.

This caution meant that controlled subjects could use only under specific conditions, a restriction that would have been insupportable for an addict.

R: What I don't want is to get messed up by heroin, which for me in a strange city means that I don't really want to meet people who are into dealing drugs just the way it's structured in this country right now unless I can meet people who are friends of mine. I've always tried to score from people I can relate to.

Another issue that comes up in any discussion of opiate use is the difference that users claim exists between pharmaceuticals-that is, opiates such as Demerol, morphine, Dilaudid, codeine, or methadone that can be legitimately prescribed-and heroin, which cannot be prescribed in the United States and is reputed to produce a big bang. Until recently most pharmacologists, knowing that heroin breaks down to morphine in the body, denied any difference. But, according to C. B. Pert, G. Pasternak, and S. H. Snyder (1973), the most recent work shows that there is more than one kind of receptor site in the brain for opiates, indicating that the differences in effect claimed by users could have a physiological basis. Generally our subjects lauded the superiority of heroin and were suspicious of pharmaceuticals.

R: I never liked bottled pills too much 'cause there's always something involved that kind of scares me. If some person gives me a pill and I don't know what it is, I won't bother with it. I won't take it. No matter what they say it is. I wouldn't give it to anyone. I'd just either throw it away or try to find out what it is.

Nevertheless, a few subjects expressed a definite preference for pharmaceuticals, and they seemed to use that preference as a sanction. They could have used heroin, but this compulsive user regarded the pharmaceuticals as less dangerous.

I: When did you begin getting interested in heroin?

R: It was just this past summer, right around the beginning of the summer. We hit a car and we got a doctor's bag, and we got a big bottle of liquid morphine and a big bottle of liquid Demerol, a bunch of downs, and stuff, so we did that. We had that for a few weeks, about two, three weeks. And then, just when we ran out-you know, all along we'd been doing cars-we hit another doctor's bag and it had a lot more in it, and this we kept to ourselves and it lasted us about a month, a month and a half. And then after that, I was doing Dilaudids and stuff like that, and Demerol from doctors and such. And you know, all the junkies in town were getting scrips downtown-you could buy them pretty easily and methadone. And then I was doing heroin at times with my friend, but I didn't really like that because usually it burned, you know. It wasn't worth all the money you put into it when you could get something pharmaceutical.

Some subjects saw the. pharmaceuticals as safer because they felt they could be sure what was in them.

R: I prefer using pharmaceutical opiates. You always know the quality and the strength of the drug you're taking. With heroin it's something you can never know.

I: Which do you prefer?

R: I only take Demerols now. The price is about the same as heroin and you know what you're getting.

It is quite possible, of course, that users can be no more certain of what is in a bottle labeled "liquid Demerol" than of what is in a glassine bag that supposedly contains heroin. Certain pharmaceutical pills are clearly marked, but others are not, and counterfeiting has become sophisticated. It is probably true (but only probably) that sellers of pharmaceuticals are less likely to adulterate their product than sellers of heroin. Yet our controlled subjects seemed to have an overriding desire to seek out a safer way to use their prized intoxicant, and this led them to invent interesting and sometimes ingenious methods.

R: For a while I was strictly snortin' and it seemed to be pretty wasteful.

And so I went back to injecting it. But I got to feeling somewhat uptight about whatever impurities there might be in the substance. So what I do now is to dissolve it or drop it in my nose, in solution.

I: Why?

R: The nasal membranes, from what little I know about them, seem to be self-cleaning. There are a lot of capillaries there. Well, anyway, it ups the efficiency. There's very little waste with that method, and I'm not having to stick needles in my arm, which you know is somewhat of a trauma even still-the act of doing it.

This search for rules or sanctions sharply distinguished controlled users from compulsive users.

I: Can you recall being told any particular do's and don't's by whoever showed you how to shoot up?

R: Oh, yeah, I can remember when he told me, "When you tie up to hit yourself, when you get the hit, you loosen it [the tie]. Don't shoot up tied." And they'd always tell me never to shoot in the hand 'cause you'll blow it up. And always, when you cop, if you aren't sure about the person you're getting it from, taste it-make sure what it tastes like.

I: So you can get a sense of whether it's good stuff or bad stuff?

R: You can't sense whether it's good or bad dope. Not whether it's good or bad, just that it's dope or not.

I: So it's yes or no, rather than good or bad.

R: Yeah.

It cannot be overemphasized that the establishment of sanctions about the techniques of heroin use is not a mere question of manners but an important safety precaution.

I: Do you like droppers or syringes?

R: I like syringes; I'll never do another dropper again.

I: Why? What's wrong with a dropper?

R: I had a bad experience with one. I didn't like it. The points seem to be bigger in the droppers, and I don't like to leave a big hole in my arm. With syringes, those gauges are pretty small. And also I didn't like the disadvantage of disposal because I like to boil it, and it's not worth a bad case of anything.

Our subjects' responses also illustrated how rituals develop around sanctions. The rule that hepatitis can be avoided by taking care of the needles is strengthened by the choice of where to use the drug and who tries it first.

I: Do you have any special rules about using drugs?

R: Yeah, I don't like to let people use my needle. My boyfriend lets people use his, but he doesn't catch heaptitis. I'm petrified to get sick again. So I have this whole ritual when I do it, you know, including boiling the water. And I have my own needle, and no one can use it. We have other needles in the house. If someone wants to use a needle, there's a needle for them to use if they want to get off in the house.

I: Do you really get off at home?

R: Yeah, or down at my sister's apartment.

I: Is it usually just your boyfriend and you, or are there other people who join you?

R: Well, there have been times when there have been other people there, watching.

I: Who usually gets off first?

R: Well, if it's me and my boyfriend, he usually gets off first 'cause he doesn't go through all those rituals. He just does it. His body just has a tolerance to it.

Our next subject shifted from injected heroin to orally ingested cough syrup because he was afraid of needles. Nevertheless, he and his wife retained all of the rituals they had developed, including cleaning the house.

R: First of all, when I cop I don't take my Doridens too long before I drink my cough syrup, because the cough syrup is hard to get down. Your mouth becomes dry, you gag. Usually, my house doesn't get cleaned until after I get high.

I: Till after you get high?

R: Right. That's my way, anyway. My wife is the opposite. She'd rather tidy up before. She eats before she drinks her cough syrup. I don't eat. She has to eat. I don't or I do-doesn't make any difference. Usually I don't. I don't eat after I do my cough syrup because my taste buds are affected. After a while, after I get off anyway, the taste is ruined for just about everything, except maybe 7-Up or a Sprite (I have a constant supply at home, a couple of quarts), or orange juice. Another rule is, "Don't go over thirty miles an hour," 'cause I usually wind up being the driver on weekends.

Although the development of sanctions and rituals is usually unconscious that is, the user believes he is only-doing things the way he has to do them to be safe, or the way he likes to do them because that's the way he is some users can articulate their rules very clearly.

I: Do you have any rules about using drugs? Any personal rules?

R: Most of the time I won't front money for anybody. And every time I have, I regret it. I did get ripped off recently, which really made me mad. Is that what you mean, that type of rule? Let's see, what else? As far as works go, I'm fairly picky about the works that I use.

I: Do you wash them, boil them?

R: Yeah, and I won't use the same works as somebody who's had hep. I don't use an old cotton usually.

I: Are there any things that you check on before you use a drug?

R: I taste it. A lot of good that does [laugh].

I: You test it for quinine or poison or whatever?

R: Yeah. Or coffee. I used to always want to get off first, and now I let other people get off first. Oh, one of my rules is that if I don't know the dope, I won't do a lot at once. Unless somebody else does it first.

By contrast, the next user was unaware that his sound reasoning about safety was indeed a rule.

R: I try not to smoke in bed. I've had some problems in the past with that. Nodded out with a cigarette, woke up with a big burned blanket or a small fire. I'm very super-conscious of that. Some people I used to chum around with used to come over to my house wrecked, and I used to give them a big pail for an ashtry, hanging around their arm, so they wouldn't burn my furniture.

I: I see. I think that's a very good idea.

R: It worked out well. You're allowed one burn and you're thrown out.

I: That was the house rule?

R: I wouldn't tolerate that shit. I gotta pay for it. I think that's about it on the rules. I've never really thought of that, do's and don't's, they just come natural, I guess. I've been doing them so long.

At times the ritualization of the experience began to carry the force of all the sanctions. For the next subject, using opiates at home was not necessarily safe, but it stood for the carrying out of other sanctions.

I: Where in fact do you usually get high? At home?

R: Most of the time at my house. The only time that I don't get high at my house is if I'm with some people that I don't know very well, or some people that I do know and for that reason don't want coming. And if they don't have a place to go for us to get off, then we either get off in the car or a restaurant, or anything like that. And even under those circumstances I'd rather go back to my house and do it. I'd rather just hold off and go back to my house. But under the circumstances if we have something planned, or you know, I'm gonna get looked at weird and they're gonna start wonderin' about me, I just do it the same as everybody else does. Get high, sit around, and listen to some music for a while. Then go out for a ride in a reasonably comfortable, smooth car. And just ride around, and maybe go to the movies. If I have an appetite, go get something to eat.

For the next subject, it was exactly the opposite: going to someone else's house had become ritualized, but it had the same effect of reinforcing the use of sanctions.

R: I go to someone else's house to get off. I'm afraid to use in my own house because it might somehow jeopardize my job. I used to shoot myself up, but I haven't done it in so long that I usually let someone else do it now, especially since I can't afford to have tracks on my arms. So I'd be, you know, going to someone's kitchen, getting a clean glass of water, getting the cooker, getting the matches, you know. Boiling the works, getting off, and hangin' out.

I: What do you do afterwards?

R: Usually play music and talk a lot. It's so pleasant. You just talk a whole lot, and, I guess, you fantasize a lot, you feel like your dreams can come true and you start to think about them and little things don't bother you so much. Usually we make sure the shades are drawn. That's about it. And the door's locked.

The next excerpt points up a number of rituals that many subjects followed to ensure comfortable drug use. Cleaning up in a general way supported the basic rule of cleaning the works. Many subjects reported insisting on a bowel movement before getting off, to minimize discomfort from the opiate-induced constipation. Also, the following subject reported the almost universal awareness that experience with the drug brought considerable control over the high state.

R: I usually make sure everything in the house is in order before I get off. So I can relax afterwards and not have to worry about anything, you know. Clean up a bit, make sure there are no loose ends, so I can relax afterwards. Clean up the bathroom, clean up the works, take a good shit. I used to take the telphone off the hook, but I don't now because I find I can control the high enough now to converse intelligently over the phone if I get a call. Get out my favorite records. Make sure the doors are locked.

The choice of a favorite time of day in which to get high, which varied greatly from subject to subject, commonly reinforced the method of getting high.

R: If I have someone here, I'd prefer to get high reasonably soon after I get up. I eat breakfast, sit around straight for a while, get a few things out of the way that I don't have to be troubled with later on. I'd just as soon get high during the daytime because that way I feel it longer. I'm not tired. You know, I'll get high anytime. But if I get high at nighttime, then I hate to go to sleep because I hate to waste the high 'cause it's so expensive. So I end up staying up most of the night or finally just falling asleep 'cause I'm tired.

Choosing a time to get high was not only a ritual. Those controlled subjects who used fairly regularly had to have strong and decisive rules about when to get high in order to prevent the drug from taking over their lives.

I: Is your weekend high confined to Friday, or is it Friday and Saturday, or

R: Fridays and Saturdays. And Sundays I usually sleep it off. Every once in a while I'll do something on a Sunday too. If I plan on not going to work, I'll get it three days.

I: So that it's a planned thing. If you know you're not going to go in to work, if you have a holiday, or if you decide you're going to take a holiday, you feel free to get high on Sundays?

R: Yeah.

I: Otherwise, you

R: Fridays and Saturdays, always.

The next excerpt illustrates not only that decisiveness was needed to keep use in bounds but also that this quality differentiated controlled from compulsive users. Although the subject was a relatively heavy user, he could leave the drug on a shelf for long periods of time.

I: Did you ever have any periods of heavy use or light use?

R: Well, from what they tell me, I have a very high tolerance, so on weekends I'll do quite a bit of it. And you know, other than on weekends I'll do it. Sometimes I'll do it from Friday night right through until Sunday night. Other times I'll just do it Friday night, but just about every weekend I'll do it now. That way a buy will last me for months.

The opulence reported by the next subject-evidenced in buying half an ounce of heroin and half an ounce of cocaine-seemed potentially dangerous. But as she pointed out, she kept use on a social basis so that the one buy lasted a year. Such behavior would have been utterly impossible for a compulsive user.

R: But one time when we did heroin it was very interesting. We had a huge round table and they put a set of works next to each plate. And we had like half an ounce of heroin and half an ounce of cocaine. There was a lot of dope around-we made a great big buy. And we went to dinner and it was an extremely social thing. It wasn't like an addict in the bathroom or in the hallway. It was a lot of fun, and we did it again and again that season.

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