Hashish consumption in Egypt, with special reference to psychosocial aspects

Sections

Contents
A. Historical Background
B. Plan of Work
C. Method
D. Results and Discussion
E. Conclusion
F. Summary

Details

Author: M. I. SOUEIF
Pages: 1 to 12
Creation Date: 1967/01/01

Hashish consumption in Egypt, with special reference to psychosocial aspects *

Ph.D. M. I. SOUEIF Cairo University, Cairo, United Arab Republic

Contents

  1. Historical background

  2. Plan of work

  3. Method:

    1. Construction of the interviewing schedule

    2. Standardization of the schedule

    3. Training of the interviewers

    4. Reliability and validity

    5. Subjects

    6. Procedure

  4. Results and discussion:

    1. Distribution of the habit among social groups

    2. Methods of consumption

    3. Volume of consumption and some correlates

    4. Indices of attachment to the habit

    5. Commencement of the habit

    6. Motivation

    7. The sitting or hashish party

    8. Family background

    9. Temperamental traits

    10. Perception, memory and thought processes

    11. Productivity

  5. Conclusion

  6. Summary

  7. References

Grateful acknowledgement is made to M. el-Sayed for his aid in data processing and computation, A. Mahmoud and M. A. Hannourah for helping in statistical analysis, Engineer Fattouh and M. M. Ghoz for drawing an illustration of the josah, and to A. Nessim for the photographs. The data on which this work is based was collected in the course of a research project undertaken (from 1958 to 1962) by the Committee for the Investigation of Hashish Consumption in Egypt, including: Dr. M. Zeiwar, Dr. M. Moursi, Dr. M. I. Soueif, M. Khairi, S. Maghrabi, E. Y. el-Sayed, F. A. Farag and S. Naeem. The present author was responsible for the interpretation of the data and for writing two detailed reports published in Arabic by NCSCR (National Centre for Social and Criminological Research), in 1960 and 1963. The author is chairman of a new Committee set up by NCSCR in May 1966 to take over the research.

The present paper is a report on research in progress on the study of hashish consumption among Egyptian males conducted at the National Centre for Social and Criminological Research (NCSCR), Cairo, UAR.

A. Historical Background

More than eighty-five years ago, the Egyptian Government first embarked upon a definite policy of national prohibition of the cultivation, sale, transportation, possession and use of hashish. The evidence that this policy was but slightly effective could be gathered from two main sources:

  1. A quick survey of the successive legislation on record since 1879 shows a persistent tendency towards enforcing still severer penalties on users as well as traffickers. This tendency, presumably, reveals that the problem has continuously been growing in terms of size and resistance.

  2. There is some indication that the absolute amount of hashish consumed in this country has been increasing most of the time during the last twenty years. At the same time other narcotic substances, including opium, cocaine and heroin, seem to have remained at the same level or even retreated. This conjecture is based partly on views expressed by the personnel of the Central Narcotic Information Bureau, Cairo (CNIB), and partly on the actual amounts of drugs seized from 1946 to the end of 1965 (Table 1).

The first annual report of CNIB published in 1929, expressed the need for a careful study of the problem and suggested a number of "subjects for the most serious discussion by experts in law, medicine and psychology" [ 7] . In line with this suggestion is the following view recently expressed by P. H. Hocht: "There are three major approaches to drug addiction: medical, legal and sociological. The above-mentioned approaches; have to be taken into consideration in every narcotic addiction control programme because they cannot be separated from each other" [ 13] . The second Brain Committee also adopted the same attitude towards planning future research. This was explicitly expressed as follows: "The phenomena of habituation, dependence and addiction involve a complex variety of social, medical and psychological factors. We feel that this feature of contemporary life deserves thorough study so that remedial action on all fronts may be planned with full knowledge and understanding" [ 10] .

TABLE I

Quantities of hashish, opium, cocaine and heroin seized in Egypt from 1946 to 1965

 

Hashish

Opium

Cocaine

Heroin

Year

kg

g

kg

g

kg

g

kg

g

1946 2108 331 2439 237 1 124 1 267
1947 8843 639 4331 415 1 181 1 605
1948 9655 453 4605 590
-
405
-
220
1949 14983 99 6118 420
-
361 4 18
1950 17734 919 3680 617
-
347
-
636
1951 13509 995 1406 20
-
8
-
402
1952 11953 517 2694 196
-
-
-
315
1953 2931 655 1475 380
-
-
-
12
1954 4933 159 1892 252
-
-
-
23
1955 9332 334 2800 213
-
3
-
-
1956 10028 885 2131 878
-
8
-
-
1957 11406
-
1648
-
-
578 1 156
1958 18658 221 1382 203
-
21
-
-
1959 4576 528 1394 241
-
-
-
24
1960 8886 306 1463 757
-
-
-
1
1961 6920 422 1923 623
-
-
-
-
1962 4937 677 976 212
-
-
-
-
1963 13037 940 1501
698.
-
-
-
-
1964 17958 650 2332 753
-
-
-
-
1965 12020 398 1247 276
-
-
-
-

In February 1957, the Board of Experts for planning future research at NCSCR submitted a memorandum recommending a well-integrated scientific study of the problem. In November 1957, a Committee was set up to carry out the enquiry.

B. Plan of Work

It was deemed desirable to start by constructing a standardized interviewing schedule to be utilized as a fact-finding survey. A series of pilot surveys were planned, in which moderately sizeable samples of hashish users and controls, derived from various sectors of the Egyptian society, were to be interviewed. It is hoped that when we complete that stage of the work, and after a proper evaluation of the data thus accumulated, much larger samples will be interviewed. It is also anticipated that in due time intensive investigations will be conducted comprising individual case studies and laboratory experiments testing the validity of certain hypotheses based on verbal reports given by interviewees.

C. Method

(i) Construction of the interviewing schedule

The method used for the construction of the schedule took account of available previous work to discover in its broadest outline the total universe of hashish use questions, as defined by psychiatrists, psychologists and other workers in related fields [ 1] , [ 3] , [ 6] . A total of approximately 100 items was collected in this way. When pruned of duplications these came down to about 20 items only. These were considered a starting point for the Commiittee to conduct free interviews with a number of hashish users who volunteered through "contact men" [ 14] . Interviewees were then encouraged to give any sort of information about their own experiences and opinions relating to the hashish habit, no matter how trivial it seemed to them. About 60 items were identified through these interviews. A few more suggestions were solicited from colleagues expert in psychology, sociology and medicine. These exceeded 200 points apart from questions about personal data relating to age, education, monthly income, marital status, etc.

The main topics covered were the following:

  1. Personal estimation of the distribution of hashish use in different sections of the society.

  2. Hashish use as experienced by the interviewee.

  3. General appearance.

  4. Perception and thought processes.

  5. Temperament.

  6. Interviewee within social context.

  7. Sexual behaviour.

  8. Self-image and related points.

  9. Interviewee's opinion regarding the increasing severity of the successive legislations prohibiting hashish use and traffic.

  10. Hashish effect on appetite for food, drink, and general energy output.

  11. Cumulative effects of hashish habit.

  12. Pattern of family background.

  13. History of the habit in the family.

  14. Pattern of relations within the conjugal family of the interviewee.

  15. Work conditions.

  16. Recreative activities.

  17. Description of the group or " hashish party".

  18. Personal data.

(ii) Standardization

To provide for a high reliability of the tool and permit comparability of information from case to case, it was decided to standardize the interview with respect to wording and sequence of items. After a series of trials it was decided to word the questions in colloquial Arabic. This proved to be perfectly comprehensible to all subjects of all levels of literacy (or illiteracy). It also helped lessening the artificiality of the interviewing situation and seemed to have facilitated the interviewee's appreciation of the interviewer's neutrality as defined by L. A. Dexter [ 9] . According to this author, one of the means to achieve neutrality as perceived by the interviewee is to talk as the interviewee does. Regarding sequence of questions, two main points were taken into consideration:

  1. Interviewing, as viewed by the interviewee, should not acquire the characteristics of an investigation carried out by one of the law-enforcement officials. The bearing of this rule on choosing the appropriate sequence for questions is shown in the fact that all items about personal data were relegated to the end of the schedule. By the time the interviewer reached this point the interviewee would normally be expected to understand the nature of the work and that it had nothing to do with law enforcement.

  2. A. C. Kinsey and his colleagues pointed out that it would often be necessary to build up rapport after an interview has actually started and that it would be advisable, therefore, to begin a conference with the items that were least likely to disturb the subject [ 16] .

In conformity with this rule, the interview was made to commence with 14 questions seeking information about the interviewee's opinion concerning the range in which hashish use is spread. It is only with item No. 15 that the interviewer begins to ask about personal aspects of the drug habit.

It should be noted that the schedule comprises 18 parts, the items of each part converging towards one main topic. By and large, the intrinsic cohesion of each part is so great that had we thought of randomly scattering the items all over the schedule it would have made the whole thing seem stupid, which might have induced the interviewee to answer in a careless way.

As to the sequence of the parts, except for the beginning and the end of the schedule, no strictly defined pattern was followed. Only a few points were taken into consideration. For example, it was decided not to lump together all parts tapping areas very close to the ego. Ego-oriented parts were interspersed with situation-oriented parts. This sort of alternation was thought to lessen the amount of anxiety usually aroused by ego-oriented questions. Another point was to arrange for optimum accuracy in items seeking information about most intricate and elusive functions. Parts including such items were kept about the middle range of the interview, where the interviewee was supposed to have had enough training for the sort of co-operation required, and did not yet feel tired or bored.

As to the construction of a schedule for controls, it did not cost us much effort. Only those items of the experimental schedule which dealt with first-hand experience with the drug were excluded. The rest constituted the control schedule.

(iii) Training of the interviewers

Following are the criteria which were used in the selection of the interviewers:

  1. A B.A. degree in psychology was considered a minimum requirement.

  2. Desirable personality characteristics such as adaptability, interest, above-average intelligence, availability, dependability and other qualifications listed by P. B. Sheatsley were taken into consideration [ 17] .

Each interviewer was trained for three months before starting the job. The main steps involved in the training programme were the following:

  1. Lectures were delivered dealing with the main aim of the study, practical difficulties sure to be confronted in the field, methodological problems involved in the construction and administration of the schedule and the method to be followed in recording different types of answers to different types of questions.

  2. Trainees were made to observe some senior members of the Committee interviewing a number of hashish users.

  3. Each trainee was made to interview a number of hashish users under the supervision of senior members of the Committee.

  4. A guide including written instructions was prepared and trainees were required to know it thoroughly.

(iv) Reliability and validity

Re-take reliability was considered most adequate to our purposes. We were mainly concerned with the consistency of responses on different occasions. Retakes were made on 45 adult male hashish users and 45 controls over a period ranging from 7 to 15 days. Neither interviewees nor contact men were told on the first interviewing that a re-questioning would be held in a week or two.

Tables II and III supply information about re-take reliabilities for experimental interviews and controls in terms of coefficients of correlation or percentages of agreement. Inspection of the tables indicates that on the whole the two schedules were satisfactory. In the experimental schedule, out of 258 coefficients of stability 251 ranged between 0.40 and 1.00. Median value for correlations reached 0.74. This is far beyond 0.001 level of significance. Out of 140 percentages of agreement, 133 percentages ranged between 60 and 100, with the main bulk (86 percentages) reaching 80 and above.

In the control schedule 130 coefficients of stability were computed, 126 of which ranged from 0.40 to 1.00. Median correlation was 0.90. Also 113 agreement percentages were computed. Only 5 of these percentages did not reach 50 or above.

TABLE II

Reliability of the interview administered to hashish users

 

Hashish habit items

Personal data items

 

Frequency of correlations

Frequency of percentages of agreement

Frequency of correlations

Frequency of percentages of agreement

90-100
30 29 44 2
80-89
17 50 14 5
70-79
30 29 21 1
60-69
41 16 4 1
50-59
34 5 1
-
40-49
15 1
-
-
30-39
3
-
1
-
20-29
1 1
-
-
10-19
1
-
-
-
0-9
1
-
-
-
Total
173 131 85 9

TABLE III

Reliability of the interview administered to controls

 

Hashish habit items

Personal data items

 

Frequency of correlations

Frequency of percentages of agreement

Frequency of correlations

Frequency of percentages of agreement

90-100
35 40 37 6
80-89
9 34 12
-
70-79
10 16 5 1
60-69
10 11 1
-
50-59
4 3 2
-
40-49
2 1
-
-
30-39
3
-
-
-
20-29
1
-
-
-
10-19
-
1
-
-
0-9
-
-
-
-
Total
73 106 57 7

By and large, the controls seem to be more reliable than hashish users. This might be tempting to theorize about the type of personality prevalent among hashish takers. However, some reservations should be taken into consideration. The difference between the corresponding median correlations or percentages is not very sizable. Moreover, the medians under comparison are based on somewhat different sets of responses elicited by different sets of questions.

To determine how valid the interview was in unearthing relevant data, it was necessary to adopt several methods. No single method could be found suitable for the various types of questions. A very crude method for estimating internal validity was first utilized. We devised an internal test-retest scale using 20 questions in the experimental schedule and 10 in the control. These questions were exact repetitions, selected to represent the various areas tapped by the interview. The number of times an interviewee contradicted himself was his score. 40 per cent was the uppermost limit of self-contradiction to be tolerated, otherwise the whole material gathered from that particular subject was to be rejected. The method of validation against external criteria could be made use of in a limited number of questions. For example, we obtained information about the structure and functioning of small groups gathering to take hashish. This information was elicited by questions applied to subjects and some controls who happened to have joined such groups for one reason or another. The answers given by those controls were thought to provide an external criterion against which to validate the information provided by the subjects. It was argued that the controls would be less exposed to the variables which might induce the subjects to give false information. A third method we used in the present study was internal consistency of the answers. This is known to be one of the main methods of validation which can be utilized in the absence of external criteria. By internal consistency we mean that the interviewee's total responses to the various items tapping one area should provide a reasonably well integrated picture. We also made use of a fourth method, viz. the method of agreement with reasonable expectation [ 14] .

Left: Apparatus for smoking hashish: the josah, a chafing dish and fire tongs. From time to time the user adds pieces of live coal from the chafing dish onto the clay head. Right: A diagram of the josah.

Full size image: 107 kB, Left: Apparatus for smoking hashish: the josah, a chafing dish and fire tongs

(v) Subjects

The following four groups of Ss were interviewed:

Group A comprised 204 hashish takers, all permanent residents of the city of Cairo, aged between slightly less than 20 and 52 years, with a modal age of 22 years and 6 months. Thirty-one Ss were illiterate, 43 semiliterate, 110 had done 4 to 9 years of formal schooling and 20 were university graduates. The majority earned between 5 Egyptian pounds (about $10.40) and £E35 per month. 99 Ss were married, 92 were unmarried bachelors and 13 were divorced or separated. 196 Ss were Moslems and 6 were Christians.

Group B included 49 hashish takers, all from semi-urban and rural parts of Upper Egypt, ranging in age between slightly under 20 and 47 years with a modal age of 20 years. 14 Ss were illiterate, 15 semi-literate, 13 had completed 4 to 9 years of formal schooling and one was a university graduate. The majority earned between £E 3 and 35 per month. 29 Ss were married, 18 unmarried bachelors, one divorced and one widowed. All were Moslems.

A clay model of a hashish party taking place in a poor district.

Full size image: 91 kB, A clay model of a hashish party taking place in a poor district.

Hashish users were defined as those male Ss who were habituated to use hashish at least once per month through the preceding year up to the time they were interviewed. 90 per cent of group A took the drug 5 times or more per month and 94 per cent of group B 3 times or more.

Group C consisted of 115 controls from Cairo, age between slightly less than 20 and more than 50 years with a modal of 22 years and 6 months. 14 Ss were illiterate, 25 semi-literate, 67 completing between 4 and 9 years of formal schooling and 8 university graduates. The majority earned between £E 5 and 35 monthly. 47 Ss were married and 68 were unmarried bachelors. 108 Ss were Moslems, 6 Christians and one Jew.

Group D comprised 40 controls from Upper Egypt. Ages ranged between 15 years and slightly above 50 years with a mode of 45 years. Eleven Ss were illiterate, 10 semi-illiterate, 17 completing from 4 to 9 years of formal schooling and 2 university graduates. The majority earned between £E 3 and 22 monthly. 20 Ss were married, 12 were unmarried bachelors, one subject was divorced and one was widowed. 38 Ss were Moslems and 2 were Christians.

Controls were defined as those male Ss who never had the experience of taking hashish nor any other narcotic substance as specified in Act 182 passed in June 1960.by the UAR Government as to the prohibition and/or regulation of the use of narcotic substances.

It should be noted that all interviewees were paid volunteers. They were all reached through key-men [ 14] . No prison or mental hospital inmates were included.

(vi) Procedure

The standardized experimental and control interviewing schedules were individually administered to users and non-users respectively. It will be recalled that a relatively small number of items did not come up to the standard required for reliability. The following values, however, were considered minimum estimates of reliability for an item to be accepted and included in the analysis: 66% agreement, 0.50% for product moment and 0.40% for coefficients of contingency and phi. To be sure, the standard error measurement would be large in a big proportion of the items, and about this we had no illusion. The leniency implied was considered suitable and even necessary, in some respects, to the whole cultural setting encompassing our investigation. Each interview was completed in one session of approximately 90 minutes for experimentals and 60 minutes for controls.

D. Results and Discussion

(i) Distribution among social groups

Hashish consumption and controls among industrial labourers and artisans were compared to other social categories (e.g. civil servants, peasants, artists and merchants); comparisons were also made as among males and females, literates, semi-literates and literates, persons whose ages lie between 20 and 40 years, and those above 40 and below 20 years, and the married and unmarried men. On the whole, these findings are congruent with the data reported by I. C. and R. W. Chopra [ 6] . Group A, however, differed from Group B regarding two points. Whereas the former stated that hashish was more frequently consumed by people with low income compared with those earning average or above average income, the latter held that it was the average and above average who took the drug more frequently. The disparity between the two views may be the reflection of a genuine cultural difference in the social profile of the phenomenon as we move from urban to rural districts. Group B also maintained that hashish was more frequently used in villages and rural districts than in towns and big cities, but group A expressed an opposite view. According to the CNIB annual reports, the amount of hashish seized in big cities usually out-weighs the quantity seized in rural areas. This fact favours the opinion held by Cairo Ss. The same fact, however, may simply be a function of the degree of police control in big cities in contrast to villages and semi-rural areas.

(ii) Methods of consumption

Ways of taking hashish were reported as follows, arranged in order of frequency and preference. First was smoking by "josah". This was mentioned by about 95% of Ss. Smoking in cigarettes came second in order. About 48 % of group B said they took hashish both ways. Some three other methods were specified but were said to be rarely used. These were: (a) boiling with water almost the same way Turkish coffee is made; (b) swallowing in form of pills, and (c) mixing the drug with some kind of food.

It is interesting to note that smoking was also reported by other investigators to be the most frequently practised method in several parts of the world [ 1] , [ 3] , [ 5] , [ 6] , [ 8] . By using the josah Egyptian takers do not depart from the general tradition, but they add their own variation. The josah does not differ much from the nargileh, mentioned by some European writers who visited Lebanon, except in that the josah is cheaper, hence more common among the poor. Both are closely related to the dynamics of a typical hashish sitting.

(iii) Volume of consumption and some correlates

The average frequency for taking hashish was reported by group A to be 12 times per month, with the upper 10% of the sample exceeding 50 and the lower 10 % taking it no more than 5 times. The corresponding figures for group B were 8 times, with 2% taking more than 50 times and 36% less than 5 times. Incidentally the retake reliability (r 11) of this item was 0.82. In terms of expense, 51% of group A and 65% of group B stated that this habit cost them not more than £E 2 a month, and only 2% of each group would spend more than £E 10.

The amount of hashish consumed per time in group A ranged from 0.32 gm. to 2.16 gm., with an average of 1.08 gm. For group B the corresponding figures were 0.43 to 4.32 with an average of 1.08. This piece of information, however, should be taken with caution (r 11 = 0.47). Ss could not give an accurate estimation of the amount of drug they took in one sitting, since it is the custom for a group of hashish users to share the expenses of the evening and to pass the josah round while smoking.

The total number of regular hashish users in this country is very diffcult to estimate. On one hand, our experimental samples are relatively small and the reliability of information obtained about the average amount of hashish consumed by the individual per time is rather modest. Besides, the severe penalty inflicted on traffickers (recently put up to capital punishment though no cases have yet been executed) and the penalty on users (up to several years imprisonment) make it risky to depend solely on official statistics of convicted cases. There are indications, however, that the number involved is seriously large. Suffice it to say that the CNIB 1 report based partly on reports of the Pernament Central Anti-Narcotics Bureau of the Arab League estimated the amount of hashish which could be smuggled into the country during the year 1964, in spite of coast-guard, frontier-guards and police forces, to be around 27,000 kilograms. Assuming that this figure is not far from the truth, that it represents the amount smuggled and locally consumed per annum for the last few years and that our averages (of frequency per month and amount of drug used per time) were rather stable over the last five or six years, we then have on our hands approximately 180,000 habitues. The seriousness of the socio-economic implications of this figure becomes all the more prominent if we take into consideration the fact (expressed by most of our subjects and controls) that the majority of hashish users are young men, between 20 and 40 years old. This should be considered in the light of another fact, viz., the estimated number of all Egyptian young men of this age (by the end of 1964) does not exceed 3 million. 2Here is an example attesting to the validity of the opinion stated by the WHO Expert Committee on Addiction Producing Drugs as follows: "Abuse with habit formation, may... become so widespread as to be detrimental to society" [ 12] .

Some revealing correlations could be established. For instance, coefficients of contingency 0.51 (for Cairo) and 0.79 (for Upper Egypt) were estimated between the number of times a month Ss would use hashish and the number of hours they worked per day. Coefficients of contingency 0.36 (group A) and 0.63 (group B were computed between the amount of hashish consumed per time and the number of hours worked per day. These intercorrelations tempt speculation on a consistently negative relationship between work conditions and the volume of hashish consumed, the latter tending to increase with deteriorating work conditions. The relationship between marriage and frequency of hashish taking tends to be negative in group A, viz., married Ss take the drug less frequently than those who are unmarried. In group B, however, a positive coefficient of contingency could be established. We are not in a position to decide whether this discrepancy reveals cultural differences between urban and rural hashish takers or whether it was an artifact caused by the structure of our groups. No correlation could be established between marriage and the amount of hashish taken per time.

Central Narcotics Intelligence Bureau.

This estimation was based on the census of 1960, in which the number stated was 2,435,000.

(iv) Indices of attachment to the habit

53 % of group A and 60% of group B stated that they were using hashish regularly since they commenced the habit. 39 and 36% of the two groups respectively said they took the drug at certain times of the day which they never changed. Since group A included 53 opium consumers over and above being hashish takers, it was deemed desirable to ask them a few questions about opium taking. 55 % of this subgroup stated that they had to take opium regularly at definite times of the day. Leaving aside those Ss who took opium on rare occasions, the percentage of definite timers becomes 80 instead of 55. It is quite obvious that definite timers among opium takers far exceed those among hashish habitues.

70 % of group A and 65% of group B said they would like to get rid of the habit. The reasons for this expressed desire were arranged by the two groups in one and the same order. First came financial reasons (59% A, 59% B), followed by considerations of physical health (44 % A, 25 % B) and last came fear of legal responsibility (14% A, 12% B). These findings look analogous, in some respects, to those reported by E. C. Hammond and C. Percy (18). In their study of tobacco smoking, 62.5% of their group of smokers stated that they had interrupted smoking because of certain physical ailments they suffered from as immediate effects of smoking, whereas only 6.3% of the group said that they stopped smoking under the influence of the recently publicized scientific findings relating lung cancer to heavy smoking. A little imagination can equate, from the point of view of consequences to the individual, the harm done by lung cancer to that of a heavy sentence of several years imprisonment. Both can be detrimental to the individual, yet both are perceived as possible dangers, not sure to follow, hence they do not act as effective deterrents against tremendously reinforced habits.

(v) Commencement of the habit

70% of group A and 62% of group B started taking hashish before the age of 20. Out of these percentages, 22 and 20% respectively commenced before the age of 16, and 52 and 53% between the ages of 16 and 18. Very few Ss (4% of A and 9% of B) made their first attempt at taking cannabis after the age of 28.

The pattern of relationship between early commencing the habit and level of education was found to be complex indeed. In the Cairo sample illiterates and university graduates contributed the same proportion (25%) of early starters (before the age of 16). The majority (57%) of those who completed high school education started between the ages of 16 and 17 years. As to group B not a single high school graduate started before 16 and all illiterates began before 21.

(vi) Motivation

Asked about their conscious motives in taking hashish for the first time, group A ranked these motives in the following order: conformity to a group of personal friends (89%), seeking euphoria (89 %), curiosity (74%), trying to appear like "real men" (65%) and lastly came the desire for sexual excitement (25%). Group B ranked these motives a bit differently. First came euphoria (100%), followed by curiosity (85%), then conformity to a group of friends (80%), then to look like "real men" (75 %) and very near to the end was mentioned the search for sexual thrill (30%).

Concerning motives for persisting with the habit the two groups agreed on the following ranking: first the pressure of being habituated to the drug, secondly the soothing effect of the drug which helps them to bear the problems of every day life and thirdly euphoria. It should be noted that this information was elicited from those Ss who said that they would not like to stop taking hashish.

As to the drives conductive to resuming hashish use after interruption, first was mentioned the yielding to pressure of a social occasion when Ss found themselves surrounded by a group of old fellow-users (40%), while the attempt to forget about personal problems (15%) was the last motive mentioned.

(vii) The sitting or hashish party

98 and 88 % of groups A and B respectively reported to have used hashish most of the time, in a small group of fellow users. The reliability of this item was 1.00. The size of the groups ranged from 4 to 6 members (r 11 = 0.75). In these small groups the members would feel social nearness, though, more often than not, they belonged to various occupational categories and sometimes different socio-economic levels (r ll = 0.90). Their conversation covers the following subjects arranged in order of frequency: sex, work, social affairs and family problems. The conversation is usually witty and humorous. In the majority of cases (57% ) in group A and 75% in group B), the sitting has a leader whose main characteristics are modesty, sense of humour, ability for organizing the sitting, fluency in conversation, open-handedness, capacity to take more hashish, seniority of age and seniority of status, arranged in order of frequency. Our two experimental groups were in very good agreement about rank ordering the leader's characteristics (rho = 0.81). Asked about the qualities that would exclude a person from the group, interviewees agreed on excluding the stingy, the disagreeable, the non-smoker of hashish and the haughty. About 95% of our users preferred to take hashish, and did take it, in the evening.

(viii) Family background

The existence of a father or a male relative known to S to be using hashish himself was definitely related to the subject becoming hashish taker. Thus 58% of group A in contrast to 20% of their controls (group C) and 38% of group B in contrast to 12% of controls (group D) reported a history of the habit in some male members of the family. The differences between experimentals and controls were significant (X 2 for A and C = 95.35, significant beyond 0.001; and for B and D = 4.39, s. at 0.05). It should be remarked that the reliability of the items unearthing this information was quite satisfactory (0.80 for experimentals and 0.91 for controls). J. M. Watt cited R. N. and G. S. Chopra as reporting that in 62.76% of a group of 1,238 cannabis users there was no history of the habit in the family (23). Since no control data were reported, we find it very difficilt to interpret their findings.

Our experimentals did not differ significantly from controls regarding the style of their upbringing, particularly with respect to variations from extreme punitiveness to extreme permissiveness. When asked whether they felt their fathers were interested in them, experimentals had this feeling significantly less than controls (A and CX 2 = 7.91, s. beyond 0.01; B and D X 2 = 8.84, s. beyond 0.01). Experimentals reported significantly higher frequency in inter-parental conflicts than controls (A and C X 2 = 8.68, s. beyond 0.01; B and D X 2= 4.91, s. at 0.05). A sizeable proportion of experimentals reported that they had stepmothers.

(ix) Temperamental traits

Hashish takers were found to suffer from some manifestations of anxiety as defined by a few items selected from the Taylor Anxiety Scale (22). Their sleep was fitful and disturbed, they found it hard to get to sleep, and they lost sleep very early in the morning. They tended to be more ascendant, impulsive, suggestible and socially shy, than controls.

Some personality characteristics seem to oscillate a good deal between two opposite poles under both conditions: being drugged and being deprived of the drug. Thus in group A, instead of 41% reporting a tendency towards ascendancy when free of drug-effect (and not craving for the drug), only 26% remain so when drugged while the rest move towards submissiveness. However, when deprived of the drug 58% of the group shift their positions towards more ascendancy and unease. In group B, the corresponding percentages were 36, 29 and 60. Again in group A, 35% reported sociability inclinations when free of drug effect, but 71% expressed a desire to mix with the others when under hashish influence. Nevertheless, when deprived of the drug, only 25 % would maintain their sociable tendencies. In group B, the corresponding percentages were 40, 85 and 23. In group A, 27 % said they tended to be negativistic (i.e. adopting a point of view almost always opposite to that suggested by others) when free of drug-effect, but when under drug-effect this percentage came down to 18 to go up again to 50% when deprived of the drug. Correspondingly, in group B the percentages were 40, 30 and 57. In group A, 54 % said they would usually get depressed at trifling reasons, but when drugged the percentage decreases to 29 only, yet when they are deprived of the drug the proportion increases up to 53 %. In group B the corresponding percentages were, 59, 12 and 66. Pugnacity has also been found to follow the same trend of fluctuation.

Obviously, there is a definite pattern of oscillation of temperamental traits, swinging between two opposite poles, that of social ease, a desire to mix, acquiescence, elation and agreeableness (globally called euphoria) when under immediate drug-effect and that of ascendancy, seclusiveness, negativism, depression of the mood and pugnacity (which may be considered as main components of a psychic withdrawal syndrome) when Ss are deprived of the drug. This pattern of oscillation of the temperament may be considered the behavioural core of a state of psychic dependence. One of the most salient characteristics of this state is a need to continue taking the drug not only to attain the feeling of well-being, but also to avoid feeling low. In so far as it implies lack of control over one's emotionality, the control being deferred to an agent external to the ego, psychic dependence is detrimental to the individual, viz., the habitue.

The following are some important questions raised by this problem: (a) When does dependence start? (b) How to recognize it objectively? We have the impression that the state of psychic dependence starts when the user surpasses the stage when the experience of hashish use is only noxious; in other words when he learns how to find it pleasant. "There is little doubt that the initiate has often to be cajoled or encouraged or even ridiculed into his first attempts at smoking" (23). Psychic dependence, thus being a state of mind acquired through a process of social learning, is determined by the interaction between the basic principles of learning, the action of the drug and personality structure.

From a purely methodological point of view, the validity of the verbal reports given by our interviewees depicting the state of psychic dependence in all its facets can easily be tested. A carefully carried-out double blind study with the drug and placebo on a group of hospitalized users seeking relief of habituation would seem quite adequate to our purpose. To ensure objective and reliable observation a number of well-standardized tests for the assessment of specified psychological functions and personality traits said to be affected by the drug (or by drug deprivation) should be administered to the patients periodically during administration of the drug and placebo.

Whether this plan can actually be executed while the whole atmosphere surrounding the problem is clouded with emotions, sentimentally impeding a rational approach, is a point to be tackled on its own.

(x) Perception, memory and thought processes

A number of cognitive functions were reported to become discorded under the immediate effect of hashish consumption. The majority of group A said time was perceived to slow down, yet 64 % of group B held that time went faster than usual. The discrepancy between the two groups was statistically significant at 0.001 (X 2= 10.91). The majority of both group A (83%) and group B (77%), however, perceived distances to get longer. 43% of group A and 62 % of group B perceived object sizes to become bigger. Contours and inner details of perceived objects became blurred for 58% of each group. Colours looked brighter than usual for 48 % of group A and 54 % of group B. At the same time, for 30% of group A and 25 % of group B colours looked more dim when under hashish effect.

A sizeable proportion of our subjects complained of memory impairment for recent events when under drug effect. 70 % of group A and 65 % of group B said they suffered from something like flight of ideas. As to competency of thought processes, 61% of group A and 71% of group B said their thinking was competent enough under the drug. However, 75 % of group A and 72% of group B stated that they quickly changed the topic of thought or conversation when under drug effect. It is doubtful if this last piece of information is consistent with that preceding it. Competent thinking needs sustained attention and concentration for a reasonable length of time.

45 and 61 % of Cairo and Upper Egypt subjects respectively reported that they occasionally tried to think of their personal problems when under drug influence, and a big majority of both groups (86 and 83 %) stated that they could often work out adequate solutions. The reliability of these statements is quite satisfactory (agreement between first and second interviewing ranged between 80 and 89%). Whether the impressions are valid as objective descriptions of the subjects' state of mind can only be decided either by administering good tests of intellectual functioning (e.g., tests of concept formation, speed and accuracy of problem solving processes and so forth) or by carefully carried-out detailed individual case studies.

(xi)Productivity

Under both conditions of being drugged and craving for the drug, the work capacities of Ss were reported to get impaired as to quality and quantity. To throw some light on the correlates of this temporary deterioration, a number of correlations were computed for our Cairo sample. A coefficient of contingency 0.61 was estimated between deterioration in quantity of production and disturbance in time perception. This same deterioration was found to be significantly correlated to distortion in auditory perception (C = 0.55), to distortion in colour perception (C = 0.38), to distortion in visual perception of object contours (C = 0.22), to distortion in distance estimation (C = 0.22) and to size perception (C = 0.20). No significant correlation could be established between deterioration in quantity of production and thought disorder. Interesting significant correlations were estimated between deterioration in quality of productivity and deficits in cognitive functions. Similar trends could be detected in our Upper Egyptian sample.

E. Conclusion

The work reported in this article provides reasonably reliable answers to a number of questions concerning hashish consumption in Egypt. Many more questions, however, are still to be answered. Systematic scientific research using standardized tools, control data and adequate techniques of statistical analysis should be encouraged to gain territory from impressionistic approaches leading to anecdotal reports.

F. Summary

  1. This paper reports on the construction and administration of a standardized interviewing schedule, comprising about 240 items, to two groups of cannabis takers from the city of Cairo (204 Ss) and from Upper Egypt (49 Ss) and to two control groups (115 and 40 Ss respectively).

  2. To estimate the reliability of the schedule the retake method was followed and most of the item reliabilities were found satisfactory. Items with low reliabilities were dropped from the analysis. As to validity, a number of methods were utilized.

  3. A number of variables could reliably be established as meaningfully related to hashish consumption as practised by Egyptian users. The utilization of a control group helped obtain unequivocally meaningful results.

  4. Methods of hashish use were described. Volume of consumption and some correlates were specified. The peak age for commencing the habit was found to lie between 16 and 18 years. Main motives for starting to take the drug were the following: conformity to a group of friends, euphoria, curiosity and trying to appear like "real men ". The motives for resuming the habit after interruption were mainly two: conformity to a group of old fellow-users, and trying to forget about one's personal problems. A number of discrepancies between urban and rural Ss emerged in this area.

  5. The structure of the group gathering for taking hashish was described and the personality characteristics of the group leader were specified.

  6. Experiments and controls were compared with respect to socialization variables and personality traits. A family history of the habit was more prevalent among experimentals. They were more neglected by their fathers and more exposed to interparental conflict than controls. Hashish takers were also more anxious than non-hashish takers. No significant differences were found between the two groups in ascendancy, impulsiveness, suggestibility or social shyness.

  7. Temporary changes in a number of personality characteristics and cognitive functions under drug effect were specified. Changes in personality traits when Ss felt deprived of the drug were also specified. Productivity deteriorated when Ss were drugged and when they were craving for the drug. Correlational analysis revealed a number of psychological variables contributing to this deterioration.

G. References

001

Ames, F., "A clinical and metabolic study of acute intoxication with Cannabis sativa and its role in the model psychoses ", J. ment. Sci., 1958, 104, 972-999.

002

Andrade, O. M., " The criminogenic action of cannabis (marihuana) and narcotics ", Bulletin on Narcotics (UN), 1964, XVI, 4, 23-28

003

Anslinger, H.J. and Tompkins, W. F., The Traffic in Narcotics, New York, Funk and Wagnalls, 1953.

004

"Ataractic and hallucinogenic drugs in psychiatry. Report of a study group ", WHO Techn. Rep. Ser. 152: 1-72, 1958.

005

Benabud, A., " Psychopathological aspects of the cannabis situation in Morocco: Statistical data for 1956 ", Bulletin on Narcotics (UN), 1957, IX, 4, 1-16.

006

Chopra, I. C. and Chopra, R. N., " The use of cannabis drugs in India ", Bulletin on Narcotics (UN), 1957, IX, 1, 4-29.

007

Central Narcotic Information Bureau, Annual Report, Cairo, 1929.

008

De Ropp, R. S., Drugs and the Mind, London, V. Gollancz, 1958.

009

Dexter, L. A., " Role relationships and conceptions of neutrality in interviewing ", Amer. J. Sociol., 1956, 62, 153-157.

010

"Drug addiction: the second report of the Interdepartmental Committee ", The International Journal of the Addictions. 1966, 1, 131-146.

011

Expert Committee on Addiction-producing Drugs, Fifth report, WHO Techn. Rep. Ser. 95: 1-16, 1955.

012

Expert Committee on Addiction-producing Drugs, Seventh report, WHO Techn. Rep. Ser. 116: 1-15, 1957.

013

Hoch, P. H., " Comments on narcotic addiction ", Comprehen. Psychiat., 1963, 4, 140-145.

014

Inkeles, A. and Bauer, R. A., The Soviet Citizen, Cambridge, Harvard University Press, 1959.

015

Joachimoglu, G., " Natural and smoked hashish ", Hashish: Its Chemistry and Pharmachology, Ciba Foundation, Study Group, No. 21, London, J. and A. Churchill, 1965, 2-11.

016

Kinsey, A. C., Pomeroy, W. B. and Martin, C. E., Sexual Behaviour in the Human Male, Philadelphia, W. B. Saunders, 1948.

017

Maccoby, E. E. and Maccoby, N., " The interview: A tool of social science ", Handbook of Social Psychology, G. Lindzey ed., Cambridge: Addison-Wesley, 1957, 449-487.

018

Matarazzo, J. D. and Saslow, G., " Psychological and related characteristics of smokers and non-smokers ", Psychol. Bull., 1960, 57, 493-513.

019

Meunier, R., Le hachich, Paris: Librairie Bloud, 1909.

020

Murphy, H. B. M., " The cannabis habit: A review of recent psychiatric literature ", Bulletin on Narcotics (UN), 1963, XV, 1, 15-23.

021

Tanner, R. E. S., " Drug addiction in East Africa ", The International Journal of the Addictions, 1966, 1, 9-29.

022

Taylor, J. A., " A personality scale of manifest anxiety ", J.abn.soc.Psychol., 1953, 48, 283-290.

023

Watt, J. M., " Drug dependence of hashish type ", Hashish: Its Chemistry and Pharmachology, Ciba Foundation, Study Group, No. 21, London: J. and A. Churchill, 1965, 54-66.