Measuring the Developmental Nature of Multiple Drug Use

There have been a number of studies in which attempts have been made to measure or assess multiple drug use. Some of these are from general populations while others are focused on specific subpopulations of users. The studies are grouped more on the basis of the approach taken to assessing multiple drug use than on the patterns uncovered. There are at least four different groupings of studies and some studies fit into more than one grouping. Developmental Patterns of Onset of Use One of the most influential attempts to describe patterns of multiple drug use is the “stages of drug use” model developed by Kandel. Kandel posited that persons proceed from licit to illicit drugs and from use of less to more serious drugs. The stages of drug use involvement that she identified were: (1) no use of any drugs; (2) use of beer or wine; (3) use of cigarettes and/or hard liquor; (4) use of marijuana; and (5) use of illicit drugs other than marijuana. Although it is not made explicit by Kandel, there is an implication that the drugs from the earlier stages of development are “carried forward” into the later stages of drug involvement. Thus, a marijuana user is likely to continue his or her use of cigarettes/hard liquor and beer Read more […]

Regional Variations in Use of Drugs

Data on the Locations where men were Living at the time of the interview became available late in the process of preparing this report. The computer tape has not been checked with the interview schedules, but it is known that the Location of one respondent is Listed incorrectly. Consequently, data are available for 2,509 rather than 2,510 men. The importance of the available data justify inclusion of a brief discussion of regional variations. Data on the Lifetime use of all drugs except tobacco and alcohol are presented in Table “Lifetime Drug Use by Regions and Divisions of U.S. in Which Respondents Lived at Time of Interview (Percentages)” in terms of the four regions and nine major divisions of the United States. The percentages for the regions are offset and enclosed in parentheses to facilitate comparisons. For five of the drugs the rank order of the regions is the same; the West had the highest percentage, and was followed by the Northeast, North Central and the Southern regions. This pattern was observed for marihuana, psychedelics, stimulants and sedatives; it also held for cocaine, as the apparent tie between the North Central and Southern regions disappeared when an extra decimal place was used. Read more […]

Multiple Drug Use

In this post attention is focused on multiple drug use or the reported use of at least two of the drug classes examined in this study. This is an initial report, and the question whether use of one drug leads to or “causes” use of another drug is not addressed, but the data can be used to establish the temporal order of usage. Use of pairs of drugs One tactic used by previous researchers to study multiple drug use is to examine all of the possible combinations of drug classes, note how many cases are observed for each combination and determine if some combinations are observed more frequently than would be expected by chance. As an example, one possible pattern is that none of the nine drug classes were used. It should be noted that in this and later analyses in this chapter, quasi-medical use of stimulants, sedatives and opiates was treated as no use of the drugs. In addition, there are nine different patterns in which one, and only one, drug class was used. If one adds the patterns in which two, three or more of the nine classes were used, the total number of possible patterns is 512. Only 86 of the 512 patterns actually emerged. This clearly established that it is not a matter of chance which drugs are found together Read more […]

A Review of Drug Abuse Data Bases

This chapter will identify and describe briefly data sources which may be used to project nonmedical drug use among young adults in future years. A wide variety of sources have potential utility in this regard. They range from individual studies conducted by local school districts or States to major national surveys involving thousands of respondents. Because of the proliferation of research on drug use in recent years, it was necessary to place some limitations on the data to be presented here. First, it was decided that since a complete review was conducted in 1974 (), it was unnecessary to duplicate those efforts. () The studies reviewed here are more recent and, with the exception of the earliest National Surveys, were not covered in the 1974 review. Second, this review is limited to those data bases which are national in scope. State and local surveys have severe limitations for purposes of making national projections of nonmedical drug use. For example: 1. The definitions used for nonmedical use often vary from one local or State survey to another. 2. Various local and State surveys are conducted in different time periods, so that it is often difficult to piece together a national profile. 3. The Read more […]

The Diagnosis and Treatment of the Phencyclidine Abuse Syndrome

David E. Smith, M.D., Donald R. Wesson, M.D., Millicent E. Buxton, Richard Seymour, M.A., and Honey M. Kramer Our first exposure to Phencyclidine occurred during the summer of 1967 in the Haight-Ashbury District of San Francisco in which the drug was first introduced as the “PeaCe Pill” during a rock concert. We saw that day between twenty-five and thirty acute Phencyclidine toxic reactions. In some respects, these reactions were like the bad LSD trips we were used to treating, but in other respects quite different, with greater physical toxicity and paranoid thinking. We had samples of the “PeaCe Pill” analyzed through a local Bay Area toxicology laboratory and found that the psychoactive drug was PCP. The “PeaCe Pill” was not well received by the majority of individuals in Haight-Ashbury at that time, although Phencyclidine became the drug of choice for a small number of users who continued to use it on a chronic basis. For them most part, Phencyclidine was a drug of deception, usually marketed as “THC” or as one of the psychedelics which were more in demand. Within the past five years, however, Phencyclidine has become increasingly visible as a primary drug of abuse under a variety of street names, including “hog,” Read more […]

Epidemiology and the Course of Narcotics Use

What happens to those who finally succumb to the lure of narcotics? Most such individuals have had at least some prior experience not only with tobacco and alcohol, but also with marihuana and a veritable pharmacopoeia of other substances, ranging from glue and other toxic substances to various opiate-laced drugs, barbiturates, amphetamines, and other somewhat less common depressants, psychedelics, and stimulants (). Only a small subset ever move on to heroin, currently the most common opiate and the one about which there is most societal and policy concern. More individuals are reported to have used nonheroin opiates. Yet, in most communities they abort nonheroin opiate use, or they transform their allegiance to heroin. Although the lure of opium and morphine has been long acknowledged -strengthened by the difficulty that identified compulsive users have had in abandoning their dependence – the myths about heroin are at least as firmly established as those developed in the early struggle concerning opium (). Myths not only exist in the public mind, but are also promoted by addicts and the professionals who work with them. For example, the title of one popular book written by one of the more progressive and enlightened Read more […]

Some Comments on Consequences of Chronic Opiate Use

Charles Winick, Ph.D. Dr. Lukoff’s paper, which has appeared earlier in this report, has presented a very useful analysis of the need to study the details of the subarea prevalence of opiate use as well as the larger national samples of the population. It also contains some trenchant observations on typologies and a number of vigorous assessments of our use of data on methadone maintenance. Prevalence Policymakers and social scientists are especially concerned about that form of opiate use that we can call a chronic relapsing condition. It is more a condition than a disease, because it is so heavily mediated by social and ecospace factors that the disease model, as explicated by researchers like De Alarcon (1969) and Hunt (1973), appears to have limited utility without consideration of social factors. Consider some of the differences in dimensions of opiate use in different communities at the present time (): 1. Street methadone is the primary drug of abuse of 500% more users in New York than in Los Angeles. 2. Texas users are almost 300% more likely to be arrested than New Jersey users. 3. New York users are 200% more likely than Philadelphia users to have a legitimate source of income. 4. Detroit Read more […]

The Resurgence of Hallucinogens

Hallucinogens are ancient drugs. They have been used for thousands of years in religious ceremonies, as sources of inspiration for artists, as medicines, and of course for some simply as a means of altering their perceptions of the physical world. In America, although the consumption of certain hallucinogens has been a part of religious practice among native peoples for many generations, to the general public, the decade of the 1960s is most closely linked with these drugs, popularly called psychedelics. During this decade, widespread experimentation with LSD, peyote, and “magic mushrooms” influenced many aspects of American pop culture. San Francisco emerged as the mecca for psychedelic “love-ins,” beatnik poetry readings, and music called acid rock and psychedelic rock. The image of long-haired hippies wearing beads and tie-dyed clothes and speaking in psychedelic-influenced language is etched in popular memory. Many people flocked to hear the guru of LSD, Timothy Leary, urge everyone in San Francisco’s Golden Gate Park to take the opportunity to experience hallucinogens’ weird effects firsthand. Thanks in part to the advice of Leary and others, the 1960s was a decade of unprecedented psychedelic drug use. The Read more […]

A Strange Class of Drugs

Hallucinogens are drugs that, when ingested, trigger a variety of strange and unpredictable sensations and experiences. Normally, such bizarre perceptions are experienced only in dreams, during periods of extreme emotional and physical stress, or as part of severe mental disorders such as schizophrenia. Psychoactive Chemicals There are dozens of different types of hallucinogens, some of which are produced naturally by plants and some of which are synthesized in laboratories or other facilities. There are many different hallucinogens used today, but the best known are mescaline and psilocybin, which come from plants, and LSD, ecstasy, and ketamine, which are manufactured in laboratories. What these drugs have in common is an ability to alter the functioning of the brain in such a way as to either modify the user’s perceptions or create entirely artificial perceptions. Users of hallucinogens experience a range of odd sensations, from mild distortions of information affecting the senses of sight, hearing, smell, taste, and touch to highly animated and dramatic sensory distortions — the hallucinations that give this class of drugs its name. Altered Perceptions Typically, users of hallucinogens characterize these sensations Read more […]

Bad Trips

Despite the contentions of Leary and other advocates of LSD use, the unpredictable nature of the drug’s effects means that not all LSD trips are filled with spiritual awakenings and entertaining hallucinations. According to LSD researchers, “The most common complaint [about LSD] was an overwhelming state of panic, sometimes involving terrifying hallucinations.” This type of panic attack, known among users as a bad trip, is a temporary condition, but for those who experience them, the consequences can be serious. Occasionally, those suffering panic attacks can become aggressive, and on rare occasions violent. Even if the person experiencing the bad trip remains calm, confused behavior, fearfulness to the point of paranoid withdrawals, and even attempted suicide are possible. Bad trips can last as long as twenty-four hours, although there are undocumented reports of bad trips lasting much longer. Experts believe that the principal cause of a bad trip is overdose. Most bad trips occur when people take more than 250 micrograms, which produces an overwhelming level of serotonin in the brain. The second cause of a bad trip is environmental. Bad trips often occur if the drug is taken in unfamiliar or frightening surroundings Read more […]