Drug Abuse

SECTION 2A - THE FUNCTIONAL DRUG TAKER THEORETICAL AND CONCEPTUAL CONSIDERATIONS

Naturalistic studies of drug users (Waldorf, 1980), employing the range of qualitative methods usual in anthropological and sociological field work, consistently show those who end up in drug treatment or are experiencing problems with drug taking comprise a specific category of drug takers who are, by no means, typical (Young, 1971, Einarson et al, 1989). Estimates differ as to the fraction of the total population of drug takers which those in treatment comprise, but it is thought to be considerably smaller than the total population of drug takers (Powell, 1973; Agar, 1973; Polsky, 1971, Nelson, 1979; Holden, 1989; Erickson, 1987). Research on drug takers, however, often is confined to studies of a captive and an atypical sample of those in treatment (Hartnoll et al, 1985). This is partly because of ease of access and the inherent difficulties of finding a representative sample of participants in illicit activities. Generalisations derived from this population are likely to be inapplicable to all drug takers and only pertinent to understanding the drug taker who has sought help (Catton & Shain, 1976). Moreover the category of drug takers who are in treatment themselves may not be homogeneous. Some may seek treatment voluntarily, perceiving that their drug taking is out of control, producing consequences which have become intolerable or incapable of being resolved without outside assistance. Others may be in treatment as a result of heavy pressure from families, friends or employers. Some may resort to treatment as a way of escaping this pressure or accommodating to it rather than as a direct result of problems from the drug taking itself.

Others may be in treatment because of some difficulties with law enforcement agencies. Agreeing to undergo treatment may provide legitimate mitigating circumstances, explaining away or reducing the penalties attached to legal misdemeanours for which sanctions are impending. Hence we should not assume dysfunctionality.

Likewise, those not in treatment may be similarly heterogeneous. That a drug taker is not in touch with agencies may be more a function of the type and range of services available, their geographical accessibility, the suitability of the professional ideologies of those in the treatment industry and their congruence with the clients' general world views, rather than due to the client not wishing to undergo treatment. For some, prior experience with treatment agencies, or the reputation of such agencies may be such as to put off those who do define themselves as in need of treatment. Thus, often, suitable forms of treatment are not perceived as being currently available or within the drug taker's horizons of opportunity. This may be a function of the gender bias of the treatment industry - the lack of availability of child care; or of ethnic bias - the lack of provision for ethnic minorities; regional disparities in the number and types of clinics; class factors etc. Consequently we must avoid concluding that because someone is not, or has never been in treatment that there is a level of functionality, and that the drug taker is satisfied with the drug taking and/or the way drug taking is integrated normally into other aspects of his/her life.

Furthermore, we need to be clear about the variety of problems and difficulties for which drug takers will seek treatment and not conclude from the fact of being in treatment that the factors leading up to the treatment are the result of the person's drug taking (Ben-Yahuda, 1984). Much has been written about the problematic status of concepts such as addiction, drug dependency and the often woolly conceptual confusions underlying their use (Zinberg & Harding, 1982; Young, 1971; Peel, 1985; Drew, 1987). Drug taking is never solely a purely physical experience but is affected by the setting, the context, the milieu, as well as by the person's psychology and life history, each of which has symbolic culturally defined and structured aspects. It is necessary to try to grasp the total structure of the drug taking experience and its context in the client's life rather than to arrive at too quick judgements regarding physical addictions or deficiencies. Even the more tentative formulation that some suffer from drug related problems evokes the caution that correlations are not causations, and that what may be crucially significant for the drug taker are other factors such as unemployment, homelessness, loneliness, etc., rather than the drug taking itself (Levine, 1984). Were such factors not a problem, the drug taking itself might be quite harmless.

This issue is further complicated by the tendency in much drug research to equate levels of use with levels of harm (Zinberg, 1982). It is assumed that the more drugs are consumed, the more harmful to the user, regardless of any other relevant factors, such as what is deemed to be culturally acceptable behaviour, regarding levels of consumption or frequency of use, or of the significant structural factors about the drug taker's life which may affect unproblematically or problematically the drug taker. To use a gambling analogy. For Kerry Packer to gamble away 10 million on the gambling tables in Monte Carlo or London in a night may be utterly unproblematic (for Kerry Packer!) but quite disastrous for someone with less access to resources. Similarly with drug taking. Furthermore for those whose lives require regular time schedules--whose work, for example, is of the nine to five variety, daily intakes of drugs may prove disastrous. On the other hand for artists, musicians (Winick, 1959) or academics, drug use may still be heavy but structured into irregular time schedules embodying a different logic and with a different outcome. Thus the same pattern of use may produce different effects, depending on situational and structural factors in the context of the drug taking, all of which need to be examined if we are trying to assess functionality (Zinberg, 1984).

These issues relate to what has been a recurring problem of much drug research - the individualistic, psychologistic and reductivist assumptions which focus attention on drug taking as if it is solely the result of the individual drug taker's psychological (and sometimes even genetic) make-up rather than a complex result of psychological and social mediations where the drug taking is a part of a subcultural experience (Robins, 1973). The act of drug taking should not always been seen as an individual choice but as a socially defined experience.   The concept of a functional drug taker, from this perspective, forces attention to the nature of the social connections of the drug taker and to the norms and values of the reference group with which the drug taker identifies (Bourgeois, 1989; Johnston, 1987).

Functionality or dysfunctionality depends too, at least in part, on the perspective from which the drug taking is being perceived. If the dominant values are hostile to drug taking, the drug taking is often conceived as dysfunctional for the person and for the overall equilibrium of the social group comprising straights or non drug takers. The drug taker will be categorised as a deviant, who has insufficiently internalised the values of straight society, or, through individual or social pathology, is incapable of adhering to them. However, a thoroughly integrated social system, held together by common, shared values has rarely existed historically. Much more likely, especially in complex differentiated societies exhibiting patterns of structured inequality and uneven access to valued resources, is a complicated texture of subcultural variations. There may be confusion and even disagreement over basic values, legitimate pursuits, and socially approved life styles. The drug taker may be well integrated into his or her own subcultural patterns. These may define drug taking as legitimate, acceptable forms of social practice. From the perspective of the apparently deviant subculture it may not warrant a deviant label or the application of social sanctions. The drug taker, internalising and adhering to the subcultural mores associated with drug taking, may be perfectly functional, able to conform to normative expectations and able to role play as an acceptable member of his/her community.

What marks contemporary industrial societies, however, is an unequal distribution of power. Not all are in a position to apply legal sanctions to those who are outside their own subculture. There are legally disapproved of social practices which tend sometimes to have a subcultural dimension. Contemporary societies are characterised by the concentration of the legal means of force, coercion and control in the hands of the government. Fear of the application of legal sanctions and desire to avoid them may structure the patterns of interaction of those engaged in the illicit acts. Illegality may produce various patterns of what has been called secondary deviance, i.e., ways of behaving which are the result of the likelihood that the behaviour of those who engage in illicit acts will incite negative sanctions, where the perpetrators of the act will be subject to stigmatisation, degradation ceremonies or forcibly deprived of their liberty. Legal rules defining inappropriate behaviour warranting legal sanctions selectively privilege some subcultural norms and practices and penalise others (Heckathorn & Lucas, 1982). This itself is sufficient to affect those social practices and the groups who identify with them which have become defined as illicit such as hard or illegal soft drug use.

Studies of subgroups engaged in illicit activities have demonstrated that being engaged in covert activities necessitates certain rules of behaviour enforcing secrecy, care over social disclosure, rituals regarding relationships with members of the out group, etc., all of which exert an influence over the social context and meaning of the illicit activity. When considering the issue of functionality, it is important to separate conceptually those aspects of social practice which are the result of the illicit activity itself, and those which are the result of its legal status (Reinarman et al, 1988). For example, dysfunctionality may result from the conditions in which drug taking occurs, such as, needing to take place covertly, perhaps in unhygienic conditions, hurriedly, or in a context where educational issues surrounding drug use cannot be properly aired, or where there is a likelihood of much misinformation. Social disclosure by the drug taker of his or her practice may set up certain dynamics of social exclusion (Downes, 1977). These may independently give rise to problems, leading to dysfunctionality for the drug taker. The illicit activity may be particularly problematic for the practitioner where it is associated with a deep cultural taboo such as, for example, surrounds being a junkie. The effects of the existence of this taboo will be far more problematic for the taboo breaker, in the absence of structural sources of support from other tabbo breakers. A crucial element of this structural support may also be the generation of structures of meaning emphasising deviance disavowal (Feldman et al, 1981), i.e., where the values of straight society are disavowed and themselves seen to be hypocritical/dysfunctional--productive of real deviance etc. Psychologists sometimes talk of the phenomenon of 'denial'. Seen from a social perspective, such denial may be part of the way in which a deviant subculture collectively defends itself against apparently hostile forces.

It follows then from the above discussion, defining functionality or dysfunctionality in relationship to the existence of subcultures that we also need to focus on the question of the degree of convergence in values and the sources of subcultural conflict between those of the drug taker and the wider society. We also need to focus, too, on those who identify with the dominant norms and values embodied in the legal systems, for they are part of the social construction of deviance.

If we pose, for example, the question of who is affected, positively or adversely, by the drug taking and make judgements as to the net balance of consequences emanating from the activity in question we may arrive at some problematic conclusions. Some have examined, for example, drug taking within the context of a framework which sees it as part of the unreported and unreportable informal economy (Auld, 1985; Adler, 1985). Here economic exchanges evade the formal economy's legitimate flows through the national accounting and taxation systems, which are reserved for legitimate earnings and consumption. Nevertheless, in the informal economy the hustling, scoring and consumption activities mirror the economic activities of the formal economy and can, from some perspectives, be judged by the same criteria. Consider, for example, the case of a community suddenly affected by the closure of its key source of employment. Most of its adult inhabitants are thus thrown into unemployment, its shops suffer from reduced cash flows, its youth become separated from access to the workforce and forms of training and skill enhancement. The net balance of consequences for that community may be highly adverse following from the decisions made by a few factory owners or managers that it is unprofitable to continue with production. Such decisions in market societies are common, permitted and indeed upheld by the legal system and those making them seen as perfectly functional members of the community: entrepreneurial market organisers. Consider, now, the situation of many run down urban areas, with high unemployment, structurally declining industries, poor housing and few facilities. It is in such contexts that drug taking sometimes becomes normalised as for example in the ghettos of New York or Chicago, or more recently in Liverpool, Glasgow or parts of London (Haw, 1985; Ditton & Speirits, 1981). By normalisation is meant that it has become a part of the normal social practices of the community, no longer an isolated, marginal activity but general, integrated into the everyday lives and routines of the community's members (Gay et al, 1984). From the perspective of the informal economy, the drug taking and its associated activities of the production/supply/distribution and consumption of drugs may be an essential aspect of the way in which the community is reproduced and sustained (Hughes et al, 1971). It may offer valuable means of identification and sources of social solidarity as well as structuring alternative modes of access to resources - an alternative 'exchange' system. This may be a way of redistributing valued goods and services, providing cheaper access to food, leisure and commodities than would be available were the drug taking not to exist.

Similarly, the activities surrounding drug taking may be valued means of identity formation for those who participate and facilitators of prestige and satisfaction to those offered little of either by legitimate society (Feldman, 1968). They may offer forms of integration into adult life which offer valued 'careers' and rewards, forms of specialised training, and skill enhancement which provide valuable sources of social meaning (Walters, 1985).

For those most heavily involved in the drug taking informal economy, the business of getting access to the drugs, to the money for obtaining them, of avoiding detection, of consuming unproblematically and pleasantly may require qualities of planning, skill, resourcefulness and self discipline developed to a high degree. Even though hustling for the money may sometimes involve illegality (Jarvis & Parker, 1989; Mott, 1986), such as breaking into shops, offices, factories or private homes, mugging, etc., to do that successfully without further injury or adverse consequence to oneself may itself provide a certain prestige and status from one's peers in a context where few opportunities exist for alternative outlets for ones energies (Lewis, 1985).

Who benefits from these forms of illegality? When judged by the utilitarian calculus of the greatest happiness of the greatest number one could say that the functioning of this illegal activity in the informal economy is no worse than that of the formal economy. Existences are sustained, a great deal of purposeful activity and business is going on, and positive identities are being sustained through social rules and rituals (Weppner, 1973).

For those householders who have sometimes been the victims of petty crime and larceny the above discussion may seem shocking. We have long been exposed to the media stereotype of the drug addict, snatching old ladies' handbags or breaking into the homes of more law abiding citizens, invading their privacy and violating their space and need for security. Such events do happen and one does not need to exonerate the perpetrators.

Nevertheless, naturalistic studies of drug takers reveal that most drug takers also revile those who perpetrate harm against the person or domestic property as a means of hustling for money for drugs (Sharff, 1987; Pearson, 1987). Most drug users prefer to sustain their habits through the network of drug dealing at the grass roots level, through, less frequently stealing from shops and institutions or from the wealthy rather than from those activities where the poor, the weak, the unprotected suffer. There is a code of ethics among drug takers which define acceptable and unacceptable ways of financing one's drug taking which defends, at least in part, the underprivileged, the weak, etc. Recent developments in criminology known as new realism may rightly have taken up the law and order issues related to lawlessness, larceny and burglaries in working class areas, arguing that the working class have as much need of protection within their communities as those more advantageously located in the social structure (Young, 1987). Nevertheless it would be hard to make an overall judgement that the informal economy of drug takers is an unmitigating evil.

What seems more problematic is that the skills, resources, talents of the successful drug taker, dependent upon the performance within the informal economy, often have few alternative opportunities in which they could be utilised. Drug taking is time structuring--providing a way of organising ones life and giving it meaning, a form of work in which the associated rituals enable a self sustaining lifestyle, which provides a functional role where other alternatives are limited and often non existent (Preble & Casey, 1969). If we are to parade our antagonism to working class youths in the inner and outer suburbs of our cities creating meaning for themselves through drug taking, it behoves us to address the question of what opportunities there are made available (Pearson, 1987). We need to ask what are the basic means of self survival in a market society from which increasing proportions of the young are permanently excluded (Auld et al, 1984). Where this is the case, perhaps the most dysfunctional youths are those who personalise and internalise their failure and who continue to conform in a ritualistic way. It is perhaps paradoxical that so many young people do, and who despite contrary evidence, will not give up on the goals of finding a job, earning a decent income, being a good and law abiding citizen even though all the evidence points to the extreme difficulties of their achievement, at least on any generalised scale.   Perhaps illicit drug taking and ultra conformity mirror each other.

It is not part of our intention to delegitimise the conformist or to romanticise the drug taker. We cannot avoid the very real social problems and agonies for the drug takers and their friends and families which drug taking frequently produces. What is being highlighted, however, are questions of the distribution of power, resources and opportunities in a society and the way in which these normally work to the selective advantage of some and to the disadvantage of others. It is no accident that where drug taking has become sufficiently normalised as to capture the energies of large numbers of young people, it is in areas of poor housing, few amenities and inadequate job opportunities. But again addressing the question of who benefits, or who is harmed from normalised drug taking, it is possible to see the situation where pervasive drug taking is localised in areas of low socioeconomic status as, in a paradoxical way, functional for those groups whose identities are built upon the existing pattern of power and resources and its unequal benefits there from. To the extent to which no challenge emanates from the ghetto which might cause a social threat to the status quo; to the extent to which precisely the same social values are being pursued--whether of wealth, material possessions, hedonism in leisure, fun loving enjoyment, albeit through illicit means, then there is little incentive to do anything, politically to alter present arrangements or address the structural questions. The class, and ethnic differentiation (Friedman, S.R., 1988) within urban areas geographically isolates within certain communities the casualties of inequality and renders them and it invisible (Macgregor, 1989).

These questions are also pertinent when considering another aspect of functionality: the extent to which a functional pattern of drug use may be disrupted by external factors which undermine that functionality (Pearson, 1987). For example, a drug taker in employment which provides the economic wherewithal to sustain the practice, a source of positive identity, satisfactory peer relations and structured time routines, imposing obligations on the drug taker, may suddenly be affected by retrenchment (Peck & Plant, 1987). or, a stable living situation in a shared household may be broken up by the landlord selling the house, or a sexual partnership which had brought security may have broken down. This change in the person's social context may disrupt the forms of integration of the person's identity into the social fabric and break down the patterns in which the drug taking was quite fully integrated into the daily rituals and routines of the drug taker. These changes may be person specific, i.e., the drug taking career is affected by individual contingencies which might be within his/her control. But they might be quite beyond the person's control but nevertheless producing consequences which dramatically shift the drug taker into dysfunctionality. Research seems to suggest that some people can sustain a pattern of use for a long period of time, which then is undermined, requiring quite radical readjustments in orientation or life style. It is just such situations which might propel one to seek treatment, or exit from the drug taking career--or to be for a period of time in a state of drift between functionality and dysfunctionality before perhaps a new pattern of use is adopted (Pearson, Blackwell, 1983; Crawford, 1983).

Similarly too, there may be class and gender and ethnic factors which structure the mode of coping with such situational transitions. A middle class drug taking head of a household with dependents, who has always been in well paid, apparently secure employment, may be far more adversely affected, symbolically, by retrenchment than a working class counterpart with dependents. Perhaps the latter has access to an extended ethnic kinship structure and is used to insecure jobs and frequent retrenchments and periods without work. Similarly too, class, ethnic and gender factors may sometimes work in the same directions, overlapping and accentuating the effects of each. At other times, one or other may crystallise in importance, entirely annihilating or rendering insignificant the effects of the others. How class, ethnicity and gender structure the drug taker's identity and opportunities and varying overlap, coalesce and diverge is of course an empirical question which may also be overlaid by psychological variables. Their combined effect is important in the constitution of functionality but cannot be determined a priori.

From the above argument, we may also conclude this section by claiming that functionality or dysfunctionality emanates from the social context of the drug taking and the way in which the drug taker is integrated or not into a stable pattern of subcultural affiliations which provides identity, meaning, rules, and expectations through which daily life can be managed and negotiated. Just as with, say, religious commitment, participants vary in their involvement in religious rituals, practices and sanctions, so, too, with drug taking (Young, 1971).

Additionally we would argue that the effects of the drugs on the drug taker are only partly due to the pharmacological qualities of the drugs themselves. Equally and perhaps more important are the symbolic aspects of drug taking (Becker, 1963) which socially constitute and define the physical effects of the drugs, acceptable forms of use and socially desired effects. The same drug taken in the same doses and with similar heavy patterns of use may produce disastrous effects in one person but be quite under control in another. The difference may be as much to do with the varying social locations of the users as to do with psychological histories.

Another relevant consideration, is the way in which an individual becomes initiated into a drug using subculture, the role of crucial gatekeepers who can soon provide for and facilitate entry, who can teach the newcomer the ropes. This pedagogical process may be crucial to being accepted as normal or, alternatively as miscuing or misappropriating the rules. The nature of this early social learning of appropriate cognitions and the rules endorsed by the drug taking subculture may relate to functionality. one is likely to have a much better time at one's first cocktail party if taken there by someone who knows the ropes, whose behaviour reveals a fluency in the taken-for-granted rules of acceptable behaviour. People need role models of social success. Compare that experience with going to a party with the socially gauche. Someone who unwittingly disrupts the cues and is outside the cognitive frame of reference of successful party goers can so easily produce jarring and prickles. So, too, with drug taking. Learning the rules and their internalisation, especially those germane to the group's own definitions of functionality or otherwise, may be crucial to the production of the performance of functionality. The question of the content of the cognitions is less significant than their social approved nature (Des Jarlais et al, 1989). Social groups often cognitively acquiesce in a set of beliefs which are scientifically unsound. Functionality within those groups may, from a cognitive point of view, simply mean appearing to go along with whatever frame of reference prevails. Thus, to be accepted, within a New Age crystallography group, may presuppose that one appears to believe in the faith healing potential of crystals. What is significant is not what one does believe, but that one seems to practice the beliefs such that social confirmation from others is forthcoming. Actual belief may only be important if the commitment to the beliefs themselves, rather than to the associated rituals and practices, are what essentially binds the group together (Cleckner, 1988). With injecting drug takers, for example, raising doubts about sharing may be socially defined as sufficient for others to doubt one's 'clean' HIV status, even though at a cognitive level individual members may think that this is merely prudent behaviour (Turner et al, 1989).

Another relevant issue is how the drug taker is integrated into the subculture of drug taking. It is unlikely that every member of the subculture will be integrated in precisely the same way. Subcultures contain a variety of roles, and status hierarchies where the individuals location in this network of roles may be a function of dimensions defined by the subculture as socially significant. Functionality within the subculture may be dependent on how one is ranked by other members within the status hierarchy. If the central values of the subculture relate to style, artistic insight or what have you, those who most display style and insight and are regarded by others as the embodiment of the ideal are likely to be more functional than others. But within the overall frame of values, there may be some roles made available which are still within the boundaries of the subculture but not of such high status. The sick role, for example, may be a characteristic of some drug using subcultures. Embracing the sick role (so long as the way one does so is defined as acceptable by the group) may not necessarily indicate dysfunctionality but a successful internalisation of the expectations for a role with which one and the group feel comfortable (Sharp, 1976). These divergent roles may have important gender differentiated characteristics (Jeffries, 1983; Oppenheimer, 1989; Perry, 1979; Rosenbaum, 1985; Frigon, 1989; Gomberg, 1982; Blom & Van den Berg, 1989). Some male drug takers, for example may be quite contented with a functioning role as the dysfunctional--receiving in exchange emotional servicing from other female members. The varied roles possible within a subculture depend upon a complicated texture of role taking and role making, of role embracement, and role allocation, the outcome of which constitutes the social structure of the subculture.

Dysfunctionality, and functionality are socially mediated experiences. Both are, by definition, defined initially from the perspective of the subculture itself. Dysfunctionality will be associated with the application of negative sanctions from the subculture.   If one does not react to them appropriately, this could result in exclusion from the group. Thus, studies of therapeutic communities for psychiatric patients, for example, have pointed to the importance of the acceptance of the 'sick' role as part of the process of healing, (but not too sick such as to shatter the norms and functioning of the group). Those who reject, overtly, the sick role or who refuse to play at being sick, become the object of sanctions and rituals designed to enforce conformity to 'sick patient in need of healing' or find themselves excluded (Sharp, 1976).

Finally the question of functionality must also include the drug takers other subcultural attachments and affiliations. It may be that the functional drug taker is someone whose life is not solely structured around drugs, whose use of drugs is marginal, incidental, or subservient to other subcultural values and commitments, equally important or in certain circumstances more salient to the drug taker (Erickson, 1987). We need to explore the extent to which the drug taker's focal concerns are successfully integrated within forms of life in which drug taking is not a crucial element. Some studies of drug taking careers report a transition from an initial encounter with drugs which initially is combined with other valued activities, but which over time get displaced. The drug taking itself becomes the focal concern and around which other social practices become organised. Whilst this might not of itself be a symptom of dysfunctionality, it could involve danger points if the activities associated with drug taking become for any length of time unsustainable, and productive of stress or dissatisfaction. This might be the case, for example if one values social contact with other non drug takers but is unable to sustain the social obligations following on from such attachments. This might incur the risk of being marginalised. Because of the social stigma attached to injecting drug use, some users attempt to compartmentalise their lives, not permitting cross overs from one subculture to another, keeping secret the fact of injecting drug use from valued peers in the non using parts of their lives (Pearson, 1987).

Others engage in injecting drug use in a non subcultural manner, injecting solo and covertly. This pattern has long been associated with injecting drug users attached to the medical profession where access to drugs is professionally available. A deep negative social stigma attaches to such practices, especially from the medical profession itself and its power structures which can disqualify the offender from practising (Parssinen, 1983). Others have alternative affiliations which are more compatible with drug using subcultures, being less proscriptive regarding injecting drug use and where the content of the subculture is in some ways synchronous with some drug using subcultures.

Indeed, in some cases, it may be that the subculture in which the drug using occurs contains members and participants some of whom use drugs and others do not, and between whom there is a mutual understanding and tolerance. This situation may be found, for example, in certain recreational subcultures where a variety of leisure pastimes may be defined as legitimate and conducive to pleasure, and where the choice regarding participation in drug use or not is not attached to social obligations, or expectations emanating from the subculture itself.

Research indicates that some regular or occasional users will often be in social situations where they may choose not to use, even with the same peers with whom they have used on previous occasions (Pearson, 1987). Functionality, thus, within that subculture may be independent of the drug use itself and related more to other valued commitments. The functional drug user whose affiliations and attachments include non drug related commitments will be engaging in a continued cost-benefit analysis, making decisions as to whether and under what circumstances to use and engaging in calculations regarding relative pleasures and relative risks consequential upon drug using. Circumstantial and situational factors play an important role here. What may be mandatory, appropriate, acceptable or merely tolerated in one circumstance may not be so in others.

What this whole discussion indicates is the variety of modes of drug taking, the ways in which it is differently structured in peoples lives and the impossibility of making judgements about functionality by just focusing on the fact of drug taking itself, the drugs consumed, the frequency of use, the amounts of dosage, or the methods of administration of the drugs. What is significant is to understand the ways in which drugs are used, the culture and ideologies surrounding and structuring drug use, and the milieu in which drug taking occurs (Harding & Zinberg, 1977). We need to start our analysis with the premise that no one is compelled to take drugs. People choose or drift into situations where drug using occurs (Becker, 1965). Continued commitment to drug taking transpires because the drug taking practices provide benefits and rewards which are defined as valuable. The various processes of initiation into drug use and the maintenance of the associated practices are, moreover, rarely purely individual isolated acts. They are socially produced, mediated and symbolically constituted.

We earlier made a distinction between structural factors impinging on social practices over which the individual has little control, and those which are amenable to change or influence. Whilst individuals are located within structures which both constrain and enable what can and cannot be done, most are faced with choices, the outcome of which influence how structural factors are variously played out in individual biographies. Of concern, then, is the process whereby structural contradictions are negotiated, accommodations sought and life tensions managed or resolved, successfully or unsuccessfully as the case may be. Our depiction of subcultural discontinuities, characteristic of a pluralistic society structured by inequalities of power resources and opportunity, suggest that illicit drug taking may be less likely to be managed functionally by those at the lower ends of the social structure, living in disadvantaged conditions with fewer socially desired skills and objectively narrower opportunities.

Whilst at a general level this may be true, if one looks at the situation within each socioeconomic level of society rather than compares between them, we may be faced with basically four kinds of typical responses regarding drug use. Assuming that within each level, the influence of the dominant values is roughly similar, as are the objective means for their achievement as facilitators or obstacles as the case may be, we would expect to find examples of both non users and drug users who can be considered functional with respect to their objective ability to sustain their lives without major difficulty, or dissatisfaction or stress.

Refraining from drug use per se will not by itself produce a stable pattern of integration and self sustaining life styles, nor will the mere fact of drug use by itself create the conditions for the non reproduction of a life style which is relatively problem or stress free. (We use the term relatively because social existence always involves ambiguities, dilemmas and tensions, and few have the material or cultural means to live a life totally free of contradiction.) What, then, are the necessary prerequisites for self sustaining life styles and stable patterns of integration, the absence of which may precipitate a descent into a spiral of dysfunctionality, marginality, and social exclusion, not to mention unhappiness and misery?

Durkheim's insights regarding suicide and the social processes generating varying rates of suicide in different social groups may offer some timely clues. Durkheim's four fold typology of suicide - altruistic, egoistic, anomic and fatalistic - is derived from a consideration of two crucial dimensions: the nature of the prevailing value system and the degree of integration of the social group (Durkheim, 1952). Not concerned to provide explanations of individual cases of suicide but to explore the sociogenic processes and mechanisms which might explain cross cultural variations in the rates, Durkheim shows how individualistic value systems, normlessness and a lack of social integration produce tendencies conducive to higher rates, sometimes together, sometimes separately depending on broader social conditions.

Returning then to issues of functionality and applying (somewhat loosely) these Durkheimian insights, we can hypothesise that functionality is probably related to such issues as the strength of social ties, obligations, and social supports, together with the material means for reproduction of a subculture, and cultural means and resources for sustaining meaningful identities in the given circumstances. A variety of ways of manifesting functionality are clearly feasible. Similar objective circumstances can give rise to a variety of forms of life. Each may embody different value conceptions, focal concerns and social definitions regarding acceptable ways of organising social life around these focal concerns. Drug taking may cross cut important subcultural differences; it may be incidental or marginal to other cultural themes and, except in subcultures organised centrally around drug taking as the focal concern, vary in its social meaning, pertinence and effects depending on how it is integrated and into what form of life it is integrated.

Extending this discussion, then, to drug taking, we can argue that nonproblematic drug taking as a social practice must be associated with certain rules, normative prescriptions and ritualistic practices which regulate and control use for the user and enable a stable mode of existence to be maintained. Just as the larger hegemonic culture regulates and contains drug use and variously constitutes it as normal or as deviant, surrounding it with legal definitions, 'prohibitions', as well as cognitive and moral ideologies, so, too, do illicit drug using subcultures also have their own categories of normality and deviance, aspects of which will clash with those of the hegemonic culture, aspects of which will converge (Young, 1971).

Such categories of normality and deviance provide access to the rules prescriptions and rituals, observance of and adherence to which may sustain a pattern of functional drug taking which does not precipitate the drug taker into a spiral of ever increasing problems. This process--of deviancy amplification (Wilkins, 1965)--may end up as help seeking, expressing the need for treatment. We will elaborate below on the significance of drug taking as 'rule governed' activity. For the moment, however we will suggest a number of possible correlates of functionality which might differentiate those who can sustain a pattern of drug use not likely to lead to problems. Such correlates of functionality. we suggest, are equally applicable whether the individual is involved with drug taking or not.

1)    Having friends or valued peers with whom one regularly interacts and who provide a valued source of social attachments, social and/or sexual gratification which one wants to sustain. This entails making time available for the activities which go with friendship renewal and engaging in the associated rituals and ceremonies.

2)    Having varied valued leisure activities, the experience of which one wishes to continue, some of which cannot necessarily be combined simultaneously.

3)    Having obligations to family or partners, the meeting of which one defines as worth while.

4)    Having work commitments which provide a legitimate and valued source of income.

5)    Having access to sources of income which provide non-hassled ways of surviving economically.

6)   Having satisfactory housing conditions which provide shelter, some privacy and some autonomy over space.

7)   Having a fairly stable pattern of values and feasible personal objectives which provide meaning to ones existence - being comfortable with ones life and its opportunities.

8)   Having one's life at least partially mapped out in time sequences which produce a social structuring of time and associated routines and rituals and within which the carrying out of obligations is at least partly sequenced.

These aspects of functionality, when applied to drug taking suggest additional considerations.

9)   Having an accessible source of supply and being in a position to maintain one's costs of consumption without undue adverse consequences to oneself or valued others.

10)    Having preferred drugs or drugs that one tends to stick to and a stable framework for evaluating possible alternative drugs, having access to the 'knowledge' of the effects of the various drugs, desirable methods of administration, ways of controlling outcomes, and decision making abilities based on stable sets of referents.

11)   Being in a structural position where one can exercise, sometimes, autonomy over time and space.

To the extent to which most of these correlates are present, the drug taker may be able to integrate the drug taking into other aspects of his/her life, and keep the drug taking in proportion according to a socially or individually defined regime of regulation. So long as the drug taking has a stable meaning in relationship to some self sustaining set of values, social practices and feasible objectives, and the conditions for the reproduction of these are satisfied then it is likely that a pattern of functionality can be sustained.

Whilst all of these possible correlates or conditions of functionality may enable us to analyse to some extent differences between individuals and whether a pattern of existence is stable and sustainable, it needs to be stressed that whether such conditions are present can by no means be explained in individualistic terms. individual identities and biographies are enmeshed in wider social patternings - which we have here referred to as social structure! (Agar, 1977) Similarly, thoughts, perceptions, values, motives are culturally mediated as are the social practices which both sustain individual identities and simultaneously reproduce social structures. Our task, then, when trying to address patterns of functional drug use, (or indeed dysfunctionality) is to try to grasp and tease out this constellation of individual and social factors and their varied meanings and effects.

Before proceeding to a consideration of our findings, one further issue needs to be highlighted: the importance of distinguishing between pleasure, happiness, satisfaction, a sense of well-being, on the one hand and functionality on the other.   It seems important to make this distinction for the following reason. The integration of the individual into a structure of self sustaining social activities which are not disruptive to the overall integration of the subculture does not necessarily entail a sense of . personal well-being. Psychiatrists have long recognised the phenomenon of certain kinds of families in which the patterns of interaction are such as to generate one member as 'sick'. That person may feel very unhappy-dissatisfied--but be integrated in such deep seated habitual interactive dynamics that are very difficult to break. Both their behaviour and that of other family members is mutually reinforcing and intertwined. The equilibrium of that family structure, its self-regulating mode of reproduction, may continue to be sustained, regardless of the personal unhappiness caused to family members--or from any larger perspective, the pathology of the family dynamics.

Sociologically speaking, one can be totally miserable but integrated functionally into a stable pattern of subcultural activities and practices which both perpetuate the misery and reproduces the conditions in which it occurs. Similarly euphoria or satisfaction may be articulated to a social context which is itself in the process of disintegration.

The significance of this discussion for understanding drug use should be clear. The worried, dissatisfied drug taker may be so caught up in larger subcultural patterns and activities that extrication may be difficult. Hence the need for an integration of an individual and social focus (Becker, 1967).

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