Reprinted from Sociological Focus 1 (Winter 1967): 39-51, with the permission of the publisher.

 

Public attitudes and controversy regarding marihuana currently focus around two countervailing trends, one liberal and the other punitive. On the one hand, we find that knowledge about marihuana is relatively widespread and that an increasing number of persons have either smoked marihuana or know those who have. No less than Time magazine's 1966 Man of the Year was described as having this attribute.' The emergence of the "marihuana cult" and "let's legalize pot" movement is a parallel development. Simultaneously there has been a demand for reconsideration or elimination of criminal sanctions against users or sellers of marihuana.2 In these several respects we have experienced a liberalization of attitudes. On the other hand, we find that where reasonably reliable data is available, the rate of arrests for marihuana offenses is increasing at an unprecedented rate. This pattern has been accompanied by the view that criminal sanctions be retained.3 Some may deplore one or the other of these trends, but trends they are.

 

While there is disagreement among professionals (Henry Giordano and James L. Goddard, for example) regarding the dangers of marihuana use, there is general agreement that more information and research is needed. The paucity of our knowledge has recently been emphasized by The President's Commission on Law Enforcement and Administration of Justice which observed, "with the possible exception of the 1944 La Guardia report, no careful and detailed analysis of the American experience [with marihuana] seems to have been attempted."' The Commission called for the National Institute of Mental Health to "execute a plan of research . . . covering all aspects of marihuana use." 5

 

Much of the extant research and literature on marihuana is chemical or pharmacological in nature.° Research within a sociopsychological or sociological frame of reference is limited. Notable exceptions are the La Guardia Report and the work of Howard Becker.? Thus, cutrent literature largely by necessity draws on early research and rather heavily on personal testimonials.° Only recently a few research studies with direct relevance to marihuana have started to be reported.° The above citations are the most notable exceptions to the recency of most investigations in this area.

 

The assumption of the virtual inevitability of the marihuana-opiatesequential-use pattern continues to dominate much of our thinking. Although informed persons recognize that marihuana use is not always a prelude to opiate consumption, such antecedent use of marihuana is commonly conjured up in defense of the continuation of penal sanctions which punish the possession and selling of marihuana. It would seem, however, that Ball et al. have laid this myth to rest. Conspicuous differences were reported as a matter of fact in the extent of experience with marihuana on the part of Northern metropolitan as compared to Southern addicts." Similarly, Robins and Murphy have presented excellent documentation demonstrating that there are many marihuana users who have not moved on to the use of opiates.11

 

Relatively little, however, is known about the factors which sustain a marihuana-use pattern or about the transition process from the use of marihuana to the use of hard drugs. It seems apparent that increased knowledge about this transition will not only contribute to the store of information on the emergence of opiate-use patterns following marihuana use, but may also help to clarify our thinking with respect to the use of penal sanctions in dealing with marihuana users. Unless reliable data reiarding this transition process can be collected, we will continue to strike in the dark and the level of exchange will remain on the impressionistic and, too often, emotional level. Ball and his associates feel that enough is known to characterize what they designate as the "dominant relationship" between marihuana use and the use of hard drugs. The relationship is summarized as follows:

 

The incipient addict is predisposed to opiate addiction by his use of marihuana for the following reasons: marihuana is taken for its euphoric effects, it produces a "high"; both marihuana and heroin are only available from underworld sources of supply; both are initially taken within a peer-group recreational setting; both are illegal; the neighborhood friends with whom marihuana use begins are often the same friends who initiate the incipient addict to the use of opiates. A principal effect, then, is one of differential association—becoming part of a drug-taking group.12

 

While the validity and general applicability of some of these statements may be open to some question, the fact is that they tell us little about the transition from marihuana to the use of opiates. Unfortunately, information about the factors related to the transition is at best difficult to obtain. It is necessary to rely on either the observations of: (1) marihuana smokers who have not used opiates or those who have used opiates and stopped, or (2) on the personal testimony of hard drug users describing their present and/or past experiences with marihuana. The remainder of this paper draws primarily on the last of these groups and is exploratory in nature. Selected experiences with marihuana of a sample of individuals with a history of drug use are described. Specific attention will be given to the perception of marihuana as a drug used for kicks and to experience with marihuana as related to different drug-use patterns. Unfortunately, the source of data (questionnaire responses) available for the present paper does not permit an examination of the transition process per se. It is felt, however, that further investigation along the lines projected may be helpful in illuminating the movement from experience with marihuana to the use of hard drugs.

 

DATA COLLECTION PROCEDURES

 

The primary data were collected by questionnaire in conjunction with a study concerned with anti-narcotic testing." Subjects represent an availability sample of persons in the Nalline testing program in Chicago, Illinois and Oakland, California, as well as drug users incarcerated in the Santa Rita Rehabilitation Center, Pleasanton, California. The population represents drug users on probation, on parole, and/or incarcerated. All subjects in the above groups were reached during the months of May and June, 1963. In 1965 a group of research patients at the United States Public Health Service Hospital, now the National Institute of Mental Health Clinical Research Center, at Lexington, Kentucky completed the questionnaire.

 

Chicago and Oakland subjects were contacted at the time of their appearance , at the Nalline Testing Center. All Chicago subjects were contacted by this investigator. The distribution of questionnaires in Oakland was made possible through the assistance of Captain Thorvald Brown of the Oakland Police Department and at the Santa Rita Rehabilitation Center through the help of Dr. James Terry, Chief Medical Officer. The Lexington data were collected by permission of the Research Committee and through the help of Dr. Charles Haertzen. Only willing subjects were included in the study. No subjects were "forced" to participate. After the elimination of unusable questionnaires, 306 subjects remained. The subjects represented 100 from Oakland, 71 from Chicago, 45 from the Santa Rita Rehabilitation Center, and 90 from Lexington. In the discussion which follows, the numbers in several instances fall short of these totals because of non-response.

 

POPULATION CHARACTERISTICS 14

 

The population was predominantly non-white (seventy percent) and male (eighty-five percent). There was nearly a balanced proportion among the single, the married, and the divorced-separated-widowed categories. The population was skewed toward an older age group with a mean age of 31.6 years. This is somewhat older than one would expect in an addict population. Viewed in terms of residential history the subjects were relatively stable. Approximately two-thirds had lived in their present community four years or longer. Those who were incarcerated were asked how long they had lived in the last community they lived in. The majority (sixty-four percent) had not graduated ffom high school while about one-fifth indicated they were high school graduates. A still smaller proportion (fifteen percent) claimed to have had some college.

 

Criminal involvement as measured by a relatively crude sentences-served index did not suggest an especially high degree of criminality. The maximum, medium, and minimum involvement groups represented forty-three, forty-three, and fourteen percent of the population respectively.15

 

Drug-use patterns were identified by an open-end question which asked the respondent to list all drugs he recalled using in the last five years. Marihuana was not included in the pattern forming process. Although drug-use patterns of the responding group (N = 247) were quite varied, a very high proportion (eighty-seven percent) reported the use of one or more opiates during the preceding five years. Approximately one-half (forty-nine percent) of the entire group reported a straight opiate consumption pattern exclusive of marihuana. Within the opiate group, straight heroin users were by far the most frequent. More than a third (thirty-six percent) were hard-core heroin users exclusive of marihuana. The second most frequent group (thirty percent) was the opiate-amphetamine pattern.

 

About one-half of the population started using drugs before they were twenty years of age. A sizeable minority (eighteen percent) indicated they were twenty-five years of age or older when they started to use drugs, while the remainder (thirty percent) initiated their experience between twenty and twenty-five years of age.

 

Two hundred and ninety-eight subjects responded to an independent question concerned with marihuana use. Of these, two hundred and sixty-five (eighty-nine percent) had experience with marihuana. Fifteen subjects claimed that marihuana was the only thing they used. Of those experienced with both marihuana and other drugs, one hundred and ninety-six (seventy-eight percent) had this experience prior to using other drugs, while fifty-four (twenty-two percent) estimated that this use occurred about the same time they started using other drugs. Thirty-three persons indicated they had never smoked marihuana. With respect to this sample, it is clear that experience with marihuana at one time or another is widespread among drug users. It is apparent, however, that marihuana use is not always antecedent to the use of other drugs. It is noted specifically that in one hundred and two instances (thirty-four percent) the experience or non-experience with marihuana fails to support the claim that marihuana use precedes the use of other drugs.

 

PERCEPTION OF MARIHUANA

 

The one hundred and ninety-six subjects who had used marihuana prior to the use of other drugs were selected for closer inspection with special reference to their perception of marihuana as a drug used for kicks. Attention was directed to this group under the assumption that it offers a fertile point of departure, albeit crude, for exploring the transition process from marihuana to hard drug use. For this sample, information was available on one hundred and eighty-five persons regarding the first drug they used for kicks. (Eleven persons did not respond.) The following discussion looks intensively at this population. Data were obtained by an open-ended question, "What is the first drug that you can remember using for kicks?" This question offers an ideal means for identifying how marihuana is perceived by persons who by their own admission have moved from marihuana use to the use of hard drugs.

 

One hundred and thirty-five respondents (seventy-three percent) identified marihuana as the drug they first used for kicks. Two points are of interest here: (1) the fact that marihuana is perceived as a drug by an appreciable number, and (2) the fact that it is perceived as a drug used for kicks. It should be emphasized that neither in the open-end question concerning the drug first used for kicks or in any question prior to the marihuana experience question was any reference made to marihuana per se. Only the word "drug" was used. The question referring specifically to experience with marihuana appeared six questions after the question concerning the first drug used for kicks. It is not probable, however, that respondents were induced to list marihuana as a drug first used for kicks simply because a question appeared later with the word marihuana in it.

 

Fifty of the respondents (twenty-seven percent) who had in fact used marihuana prior to using other drugs did not list it as the drug they first used for kicks, but instead listed some other drug.

 

Judging from the responses of this sample it may be said that drug users, like non-drug users, vary in their perception of marihuana as a drug and as a vehicle for euphoria. This, of course, does not mean that marihuana may not have been used for kicks at the time it was initially used. It does mean, however, that in terms of recall and present perceptions, marihuana may or may not be perceived as a drug or as a drug which was first used for kicks.

 

The striking point is the high percentage of hard drug users who do perceive marihuana as a drug. This seems inconsistent with the increasing tendency and preference on the part of some, this observer among them, to place marihuana in a non-drug category. One would not be surprised to find hard drug users themselves in this group, but this is not in evidence here. Interesting too is the fact that hard-core heroin addicts also tend to perceive marihuana as a drug." Of fifty-seven hard-core heroin users—who had used marihuana prior to using other drugs and for whom data were available on the drug they perceived as the first drug used for kicks—forty-four (seventy-seven percent) listed marihuana as the first drug they remembered using for kicks.

There is some evidence to suggest that those who perceive marihuana as a drug used for its euphoric quality tend to be otherwise oriented toward marihuana. (See Table 1.) Those who perceive marihuana as a drug used for kicks, as opposed to those who do not, are more apt to list marihuana as a drug they used during the preceding five years, and by a slight margin are more apt to list marihuana as the drug preferred. The differences as measured by chi-square, however, were not statistically significant.

 

Using chi-square, the perceivers and non-perceivers were further compared on selected personal-social and drug-pattern variables to determine if there were any significant differences between the two groups." Of the eleven variables investigated, two were statistically significant ( < .01), education and drug preference. Non-perceivers as opposed to perceivers were less apt to be high school graduates with twenty and forty-three percent in this category respectively. Non-perceivers were slightly less apt to prefer marihuana as well as amphetamines, but were markedly less apt to respond "none" to the drug preference question. On the other hand, non-perceivers were more apt to list an opiate as the drug of preference. Seventy-three and forty-two percent of the non-perceivers and perceivers, respectively, listed an opiate as the preferred drug. The difference, however, was largely absorbed in the extent perceivers of marihuana as a drug used for kicks were inclined to say they did not prefer any drug. Forty percent and seventeen percent of the perceivers and non-perceivers respectively responded "none" to the drug preference question.

 

In sum, while firm conclusions are not possible, there is a tendency for perceivers as opposed to non-perceivers to be more oriented around a marihuana-use pattern (Table 1) and to respond "none" when asked what drug they preferred. While a "none" response may suggest a drug non-specific point of view, it seems a more probable explanation would be that it is a "non-drug" response, an orientation away from drugs. The two groups differed quite markedly with respect to formal education and drug preference and the differences were statistically significant.

 

DRUG-USE PATTERNS AND MARIHUANA EXPERIENCE

 

Experience with marihuana as it is related to selected drug-use patterns was selected for special attention. Basic data are presented in Table 2. Totals in the cells differ because of non-response on some items and the loss of cases in the cross-tabulation process.

 

Subjects with mixed-use patterns (opiates combined with amphetamines and/or barbiturates) as opposed to the opiate patterns are more apt to have experience with marihuana. The incidence of experience with marihuana, however, in no instance falls below seventy percent. The differences are even more marked with respect to the use of marihuana within the previous five years. Since the latter data were obtained by an open-end question (and in view of the marked differences in the two kinds of experiences) this could represent recall error and/or a commitment to the opiates.

 

Within the opiate category, hard-core heroin addicts are more apt to have experience with marihuana than the non-hard-core group. The difference is considerably diminished, however, when we turn to the use of marihuana during the preceding five years.

 

Preference for marihuana presents no marked differences pattern to pattern. It is of interest, however, that the opiate-amphetamine group, a mixed pattern, has the highest proportion of marihuana preferrers.

 

The higher incidence of marihuana use on the part of heroin addicts as opposed to other users of opiates is consistent with the finding of Ball et al.18 Unlike the latter study, the evidence here comes from a group which is largely a Northern addict population (Chicago and Oakland), and not from a comparison of Northern and Southern addicts where quite marked differences exist not only in the extent of experience with marihuana but in their characteristic drug-use pattern. Unfortunately, in the sample described here the hard-core heroin addicts represented the overwhelming proportion (seventy-four percent) of the opiate group thus vitiating the importance of the trend.

 

Time of experience with marihuana (not presented in table form) as related to drug-use patterns was recorded for those having this acquaintance prior to and about the same time as other drugs. For all patterns this acquaintance usually came before using other drugs. The opiate-amphetamine group was least likely (seventy-four percent) and the opiate-barbiturate-amphetamine the most likely (eighty-seven percent) to have marihuana experience as an antecedent event.

 

When the several kinds of experience with marihuana are combined, with two exceptions it is the opiate-mix patterns that are the most apt to have these collective experiences. Several patterns of collective marihuana experiences are presented in Table 3. Thirty-eight percent and forty percent of the opiate-amphetamine and the opiate-barbiturateamphetamine groups respectively shared the first three marihuana experiences as presented in Table 3. The opiate-use pattern and the two opiate sub-patterns fall considerably short of these percentages. Note, however, that a rather high proportion, fifty-five percent, of the hard-core heroin users are experienced with marihuana and identify it as the first drug they used for kicks. Particularly noticeable in Table 3 is the marked drop-off in all patterns when preference for marihuana is added to the list of marihuana experiences.

CONCLUSION

 

The findings of this exploratory investigation provide additional support for the prevailing professional opinion in this area, namely, that marihuana use is not a necessary antecedent to the use of hard drugs. Perhaps more important are implications of the several rather clear patterns which emerge: (1) drug users who are experienced with marihuana differ in their perception of it as a drug they first used for kicks and (2) there is considerable variation in the kinds of experience with marihuana on the part of drug users characterized by different drug-use patterns.

 

It is recognized that the data do not permit generalizations, let alone conclusions, regarding the relationship of marihuana use to hard drug use. Neither are illuminating insights suggested about the transition process itself. Nevertheless, the varying experiences with marihuana as well as the marked differences in perception of it indicate that these are both interesting and important areas in the epidemiology of marihuana and narcotic drug use and should be subjected to further investigation.

 

Of particular interest is the tendency on the part of perceivers (those who see marihuana as a drug they used for kicks) to have more education; in terms of preference, perceivers tend to veer away from opiates and to be non-drug oriented as identified by "none" responses on the drug preference question. The fact, however, that no statistically significant differences were evident in the drug-use patterns of the perceivers and non-perceivers suggests a need for restraint in emphasizing the significance of the several differences between these two groups.

 

Viewed in terms of drug-use patterns per se there is a tendency for marihuana experience to increase as we move from opiate only to the opiate-mix patterns. A similar trend is evident when the various combinations of marihuana experiences for each of the several drug-use patterns are viewed collectively. These findings suggest but do not conclusively demonstrate that "spree" users or persons characterized by multihabituation are more apt to have experience with marihuana than are single pattern users.

 

It is believed that further investigation is needed along the lines projected in this paper. Research is necessary to build the body of epidemiological data apropos to marihuana use in the population, to develop an adequate typology of marihuana users, and especially to investigate those conditions involved in sustaining a marihuana-use pattern as opposed to those conditions involved in movement from marihuana experimentation use to a hard drug-use consumption pattern.

 

Assuming future investigations sustain the several differences or confirm other differences among drug users regarding marihuana use and perception, there is a need to establish their importance. Closer scrutiny of this kind of information should lead to a better understanding of the transition process that is involved in moving from marihuana use to the use of other drugs. There is, however, a need to develop with greater care and precision, than was possible in the present paper, the drug-use patterns themselves and to spell out the orientation and commitment to these patterns. A number of additional questions are also involved: To what extent are the several patterns transitory or permanent? What personal and social factors are associated with the patterns and what is their significance? When subjected to closer inspection will the differences in marihuana experiences be sustained? If so, a deeper probing is indicated concerning the nature of these orientations and to identify factors which are significantly related to them. With respect to marihuana, given the preliminary findings of this paper, there is a particular need to explore the extent there are differences in the experiential background of those persons representing drug-use patterns which seem to cluster around a complex of marihuana experiences in contrast to those who do not.