Narcotic Addiction: A Changing Scene?

2015

The purpose of this paper is to explore changes in the narcotic addiction [Narcotic addicts are defined in this study as persons who have used opium, its derivatives, or synthetics for non-medical reasons four or more days a week for at least a month. Onset of addiction was defined in terms of the first occurrence of such a period] scene in an era of rapid social change. The quarter of a century covered by this study embraces an era in which major significant changes have occurred in this society.

The Sample and Data

A sample of 499 subjects was selected from a roster of male narcotic abusers first known to the Baltimore City Police Department Narcotic Squad between the years 1952-1976, inclusive. From each year’s contribution to the roster, ten whites [Only nine whites were available in 1956] and ten blacks were selected in a random, stratified manner, and 402 were interviewed. The data to be analyzed were drawn from a structured interview schedule devised by the project staff; each interview took approximately three hours and was administered by a staff member especially trained for this purpose.

In this report, the data [All appropriate tables have been deleted from this abbreviated presentation and appear in the International Journal of the Addictions, Vol. 16, 6 & 8] have been weighted to compensate for differential sampling by year of entry onto the roster, so that the total for the population and the totals for various groupings correctly reflect population parameters.

Although the selection of subjects was based on year of entry onto the police roster, the information available from the interviews permitted: (1) confirmation of addiction status; and (2) reclassification of addicts into incidence cohorts, defined in terms of the year of onset of narcotic addiction. The present report is confined to those incidence cohorts for which at least ten years of data were available from time of onset of addiction to time of interview. The choice of a ten-year period was felt to provide sufficient sensitivity to any fluctuation (or lack of fluctuation) in the behavior of narcotic addicts. A total of 238 narcotic addicts (103 whites and 135 blacks) qualified for analysis in this manner.

The incidence cohorts constructed for this report reflect the trends across time of the characteristics of new recruits into narcotic addiction. For simplicity, the incidence cohorts have been grouped into three: pre 1955 (1937-1954); 1955-59; and post 1959 (1960-1966).

Trends in characteristics of narcotic addicts

Race

The data of the current study, based on and projected to a roster of all addicts known to the police of Baltimore City over a quarter of a century, confirm the predominance of blacks in the addict population. Indeed, when the data are classified according to the onset of addiction, there is only minor fluctuation in the black-white ratio over time. During the years 1955-59, there seems to have been at least a slight increase in white representation among addicts, but subsequent years showed a slight decline in the white proportion. Thus, it is appropriate to say that for every ten men entering addiction at any given time, seven or eight were likely to be black.

Because of the racial imbalance of the addict population known to the police, the tables in this report, based on sample weighted to provide projections to the addict population, are presented separately for black addicts and white addicts.

Background Characteristics

Although the numbers drawn into the addict population varied considerably across time, it appears that the appeal of addiction was essentially to the same population groups during all the periods studied. There were differences between the background characteristics of blacks and those of whites who were attracted into addiction, but within each racial group of addicts separately, there was little variation in such characteristics across time.

Among the whites in all three periods studied, the median social status of new addicts fell in the semi-skilled, blue-collar class; median educational attainment in all three periods involved dropout at the junior high school level. Social stability (as reflected by years of longest residence before finishing high school or leaving school) showed considerable dispersion among individuals in all three time periods.)

Among the black addicts, the picture was essentially the same: no clear trend in the social status of those attracted to addiction (although the black addicts were consistently drawn from a lower social class than the whites); a consistent picture of early drop-out from school; and no clear trend in social stability.

For both races, the persons who entered addiction later in the quarter century studied were more likely than those who became addicted earlier to have had contacts with juvenile authorities and to have had acknowledged criminal activity prior to first narcotic use.

Introduction to narcotic use

In the pre-1955 period, the median age of onset of addiction for white addicts was just over 18 years; for black addicts, it was more than a year older. During the 1955-59 period, the onset of addiction occurred more than a year and a half earlier on the average; but after 1959, the trend was reversed so that new addicts, both white and black, showed a median age of onset of 18.0 years.

Not all narcotic addicts are always addicted to heroin. It would appear that the ready availability of liquid codeine during the 1955-59 period proved remarkably attractive, particularly to white, addicts. Indeed, among white addicts, liquid codeine was the drug of choice for the majority of new addicts recruited between 1955-59. After 1959 liquid codeine and other narcotics became less readily available () and the pattern of drug choice among white addicts reverted to emphasis on heroin. Among black addicts, although liquid codeine became considerably more popular beginning in 1955, its popularity never seriously threatened the predominant position occupied by heroin.

Trends in narcotic addict careers

All of the addicts in the sample used for this report provided data covering a ten-year career beginning with the onset of addiction. Thus it was possible to describe their entrances and exits to the addict population and their activities during that ten-year period, even if only a small part of the ten years involved active addiction.

In order to study these ten-year careers in an orderly and systematic manner, a typology was constructed around two fundamental concepts: 1) commitment to addiction, as reflected in the proportion of the ten-year period spent actively addicted; and 2) voluntary abstinence, as reflected by the relative allocation of time to nonaddictive periods in the community and to periods of time spent incarcerated.

The typology of addict careers presented here is built upon the concepts of opportunity and motivation to use drugs, i.e., characterization depends upon degree of involvement with narcotic drugs in relation to opportunity for voluntary abstinence. This typology takes into account the time spent in each of the following statuses:

1. Addicted;

2. In the community, not addicted;

3. Incarcerated.

Emphasis is on the degree of involvement with narcotic addictive drugs, on opportunity to use such drugs as represented by time in the community as opposed to jail, and on voluntary abstinence,

Degree of involvement is defined as the proportion of the total available time (10 years) during which the subject was addicted. Opportunity to use drugs is defined as the proportion of the base period (10 years) in which the addict was living in the community (as contrasted with being incarcerated)–whether using drugs or not. Voluntary abstinence is defined as the proportion of the period (10 years) in which the addict was living in the community but was not addicted. This formulation assumes that the two variables (opportunity and involvement) are independent at any level of involvement less than 100 per cent. The independent contribution of opportunity becomes more apparent at middle or lower ranges of involvement, where issues of choice become paramount.

Application of these concepts to the data of the present study yields five clearly distinguishable types:

Type I. Low involvement with narcotic drugs as displayed by those who used narcotics on a “daily basis” less than 50 per cent of the time, i.e., less than an aggregate of five years out of the ten; high opportunity in that they spent no more than two and one-half years incarcerated; and high voluntary abstinence as demonstrated by the fact that they were in the community at least seven and one-half years and chose to be addicted only a relatively small proportion of this time.

Type II. Low involvement (used narcotics less than an aggregate of five years); low opportunity in that they spent more than two and one-half years incarcerated; and low voluntary abstinence in that they had relatively little drug free time in the community.

Type III. Medium involvement, with 50-74 per cent of the ten years devoted to the addiction; high opportunity, since not more than two and one-half years of the remaining time was spent incarcerated; and a median level of voluntary abstinence.

Type IV. Medium involvement, with 50-74 per cent of the total period devoted to addiction; low to medium opportunity, since more than two and one-half years were spent incarcerated; and, therefore, little remaining time for voluntary abstinence.

Type V. Highest involvement, with at least seven and one-half of the ten years devoted to addiction; therefore, it follows that opportunity was high and voluntary abstinence was low.

Figure “Characteristic addict careers: the first ten years allocation of time to three activities” displays characteristic patterns of movement among the statuses ON, OFF in the community, and INCARCERATED for the five types described above. Although it is recognized that no single case can adequately represent each type because there is considerable variation among the members, the five typical cases presented in Figure “Characteristic addict careers: the first ten years allocation of time to three activities” convey the fundamental characteristics and differences among the types in the total ten-year developmental patterns.

Using this typology to characterize the ten-year careers, what can be said about trends across time? In other words, what effect do the ambient conditions related to the starting date of a career have upon the nature of the career?

Certain characteristics of the addict’s careers seem to be reasonably stable across time. For example, among black addicts, the modal career during all time periods is best described as Type V: virtually uninterrupted addiction during a ten-year period, with little or no incarceration. This single type characterized 44 per cent of the black addicts who began their careers before 1955, more than half of those who began during 1955-59, and over one-third of those in the subsequent time period.

Among the white addicts, the distribution of career patterns showed a much less pronounced tendency toward uniformity. In the pre-1955 period and in the post-1959 period, approximately one-third of the white addicts displayed a Type I pattern in their ten-year careers, i.e., they exercised maximum control over their habits, with a great deal of time abstinent in the community. During the 1955-59 period, the popularity of this type of pattern declined somewhat.

Some of the trends across time were clearly monotonic. Among blacks, the popularity of Type III and Type IV patterns increased steadily across the time periods studied. Among whites, Type II patterns became considerably more frequent as time went by; concomitantly, Type IV patterns went steadily downward in relative frequency. This latter finding suggests that among whites, the pattern of “confirmed junkie” (Type IV, with much time spent in addiction, much of the remainder spent incarcerated) was being replaced by a pattern (Type II) in which less time was spent in addiction and more time incarcerated.

The remaining career patterns showed quite irregular trends across time. Among the black addicts, the popularity of Type I and Type II careers declined in the 1955-59 period and then increased in the direction of pre-1955 levels. Among whites, Types I and III showed this same tendency to decline between 1955-59 and then to revert. The white Type V’S became more frequent during the 1955-59 period (just as the black Type V’s did) and then subsequently declined in popularity.

In an earlier discussion of career patterns (), it was noted that the ready availability of narcotics other than heroin (particulary liquid codeine) had a marked effect on the patterning of the habit among white addicts. This fact is dramatically illustrated by an analysis of the popularity of heroin during the ten-year careers. The dominance of heroin was determined for each addict by calculating what proportion of months of addiction were characterized as heroin-dominated. For black addicts, there was not very much variation across time, although there was some noticeable tendency for heroin to be less dominant during the 1955-59 period. For white addicts, on the other hand, the picture was completely different. Whites who joined the addict population prior to 1960 showed a very strong tendency to regard some drug other than heroin as their dominant drug. After that time, when liquid codeine became much more difficult to obtain, the pattern of drug dominance for whites became indistinguishable from that for blacks, with heroin being overwhelmingly dominant.

To what extent have criminal activities of addicts changed across time? As a partial answer to this question, we have summarized, for the three cohorts under discussion, the proportion of their income that came from illegal sources during their ten-year careers. The trend shows a slight decline in the importance of illegal income when one compares the addicts who began their careers in 1955-59 with those who began earlier, followed by a noticeable increase among those who began their careers in 1960 and thereafter. In the final cohort, on the average, about three-fourths of each addict’s income (for both black and white addicts) was derived from illegal sources.

 

Selections from the book: “Problems of Drug Dependence, 1980: Proceedings of the 42nd Annual Scientific Meeting, the Committee on Problems of Drug Dependence, Inc.” Louis S. Harris, Ph.D., ed. Comprehensive assemblage of ongoing research on drug abuse, addiction, and new compounds. National Institute on Drug Abuse Research Monograph 34, February 1981.