The social psychology of cannabis consumption: myth, mystery and fact

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Myth
Mystery
Facts
Conclusion
Bibliography

Details

Author: M. I SOUEIF
Pages: 1 to 10
Creation Date: 1972/01/01

The social psychology of cannabis consumption: myth, mystery and fact

Ph.D. M. I SOUEIF
Professor of Psychology, Cairo University, Cairo, Arab Republic of Egypt

Myth

The famous cultural anthropologist B. Malinowski defined myth as follows: "Myth as it exists in a savage community... is not merely a story told, but a reality lived. It is not of the nature of fiction, such as we read today in a novel, but it is a living reality, believed to have once happened... and continuing ever since to influence the world and human destinies." On the function of myth, he added, "The function of myth is to strengthen tradition and endow it with a greater value and prestige..." (B. Malinowski 1954.)

It is easy to find examples attesting to the fact that contemporary societies create their own myths, or revive old ones, in spite of all verbiage about a civilization based on scientific methodology. The reader may only remind himself of the whole cult established to justify and add glamour to racial prejudice, or, of the arguments siding for, or against, the changing role of women.

The whole gamut of beliefs and attitudes adopted by vast numbers of people (including some decision-makers and workers in the field of mental health) as to the social psychology of cannabis consumption can adequately be cited as a typical example of a myth lived in our modern society. R. H. Blum put it eloquently: "Consider the legends of lotus-eaters, assassins, of 'marihuana-crazed killers', of the 'miracle' tranquillizers that were thought to cure mental illness... Part of the drug mythology of scientists as well as of the public has to do with the risks of drug use. Reviewing the 'social' dangers (crime, accidents, suicide, psychosis, etc.) arising from psychoactive drug use (other than alcohol and opiates), it is amazing to find how little reliable evidence there is measured in terms of either verified field reports or careful experimental studies. Reputable scientific journals and scientific groups have published reviews which, when original sources are examined, are found to be an expression of opinion rather than fact." (R. H. Blum 1968.)

As any other myth, that of cannabis comprises layers of elements which were drawn together through a very complex process of transmission across generations and cultures. It is propagated in a number of versions some of which are pro and others are con (but seldom neutral), depending on the transmitter's affiliation.

According to modern Arabic historians cannabis came to be planted and used in Egypt around the mid-twelfth century A.D., during the reign of the Ayyubid dynasty on the occasion of the flooding of Egypt by mystic devotees coming from Syria (M. K. Hussein 1957). It is interesting to note that the herb aroused a lot of controversy from the very beginning. At least three different groups of writers and poets took part in the heated debates about it: sympathizers with hashish * against alcohol (e.g. Ibn Al-Saegh), defenders of alcohol against hashish (e.g. Al-Isaardi) and those who condemned both (e.g. Al-Qadi Al-Fadel). Going through a representative sample of poems that were published in the twelfth and early thirteenth centuries, we can count 10 desirable behavioural changes claimed to be produced by cannabis consumption. They are: euphoria, acquiescence, sociability, carefreeness, feeling of importance, independence of the world or ataraxy (as the Greek Stoics used to call it), meditativeness, activation of intelligence, jocularity and amiability. By way of comparison with alcohol the following qualities were attributed to hashish: that it was cheap, not prohibited by the Islamic religious authorities, that a comparatively small quantity was enough to get the desired effect, that it did not smell like alcohol, and therefore was not easily detectable, and lastly, that it was never pressed by the feet to be made ready for consumption. On the other hand the adversaries pointed out 5 undesirable effects resulting from hashish use: submissiveness, debility, insanity, some sorts of organic brain damage, and prostitution ( ibid.).

* Note by the Editor: The word "hashish" in French has been spelt differently by different writers; the spelling used by the Commission on Narcotic drugs is "hachich".

In the seventeenth century A.D. a comprehensive Arabic pharmacopia was published by Daoud Al-Entaqui, in which the author mentioned cannabis under the Persian name Shahdang. The author prescribes the drug for the treatment of various somatic afflictions, after which he proceeds (in a rather reserved tone) about its psychotropic effects. Four such effects are underlined: euphoria, lethargy, sensory debilitation and temporary sexual potency tailing off into impotence.

It is a well known fact that such writings are still consulted by certain sectors of Egyptian society as sources of wisdom, not as documents of historical interest. The impact this material still has on the minds and conduct of numerous Egyptian nationals, users as well as non-users is amazing.

In modern Europe, the drug was mentioned by Prosper Alpino in his book " De Medicina Aegyptorum" as early as the sixteenth century, by Rumph of Hanau in "Herbier d'Amboyne" towards the end of the seventeenth century, and by C. Linnaeus in Amoenitates Academicae slightly after the mid-eighteenth century, and a whole host of other writers e.g. R. Meunier 1909. The years from 1840 to about 1860, however, have special significance in the European history of cannabis lore. In 1843 T. Gautier had his first-hand experience with the drug recorded in "Le club des hachichins ". In 1845 Moreau de Tours, the French psychiatrist, published a book entitled Du hachisch et de l' aliénation mentale. In 1846 C. Baudelaire took hashish and wrote an article to convey his experience under the title, "Du vin et du hachich comparés comme moyens de multiplication de l' individualité". About 1856 the same poet published his famous five essays on hashish, viz. Le goût de l' infini, Qu'est-ce-que le haschische, Le théâtre de Séraphin, L'homme-dieu and Morale (C. Baudelaire 1928). In 1857 the Pharmaceutical Association in Paris initiated a "concours" on Cannabis indica (ibid.).

In his writings, Baudelaire talked about cannabis from various points of view. For example, he mentioned what he claimed to be authentic historical facts, botanic information, the chemistry of cannabis, various routes of administration of the drug, its immediate effects on various functions and organs, the psychology of dreams... etc. The following is a sample of the immediate effects as claimed by Baudelaire: attacks of non-motivated joy interspersed with intervals of astonishment during which the person may try, in vain, to attain a reasonable degree of self-control, a feeling of being full of energy, panic attacks, a feeling that simple words and ideas seem bizarre, that relationships between ideas are becoming vague, that all senses are becoming sharp, some experience of synaesthesia, depersonalization, perceptual illusions, slowness of perceived time, and lethargy all over.* Gautier, also, enumerated various immediate effects of the drug, e.g. changes in body image, distorted perception of objects, hypermotility and hyperesthesia ( ibid.).

For vast numbers of westerners, it is still the literature of the mid-nineteenth century period which constitutes the core of the myth. It is interesting to note that that same literature was itself influenced, through a very complex process of cultural diffusion, by parts of the myth lived in the East. A whole movement, known by literary historians as "Orientalism ", took place towards the end of the eighteenth and the beginning of the nineteenth centuries, during which numerous European minor and major men of letters became fascinated by the Orient. They studied, translated and imitated (in their own languages) many literary works imported from India, Persia and the Middle East (e.g. The Arabian Nights). However, we are not in a position to elaborate on this point. It is enough to quote a literary historian to render the perspective a bit more clear: "Between the institution of the Asiatic Society of Bengal, 1784, and the foundation of the Royal Asiatic Society of Great Britain, 1824, works of orientalist study were aimed at the common reader of good education and took trouble both to interest and inform him" (F. Moussa Mahmoud 1957). Two more facts should be taken into consideration; ( a) that this movement was not limited to one country but spread almost all over western Europe, and ( b) that it had its reflections on a number of disciplines other than literature (e.g. philosophy and linguistics). Against this cultural background the experimentation with hashish carried out by men like Gautier, Baudelaire, Delacroix, Daumier and others should be evaluated.

* C. Baudelaire, Le théâtre de Séraphin.

Many writers still relate the story of "The old man of the mountain" who used to induce a state of passive and thoughtless obedience into his young followers by the use of hashish to have them assassinate his opponents. The story is ascribed to Marco Polo in his "Travels". (Incidentally Baudelaire mentioned the story as an authentic piece of historical information.) The truth of the matter, however, is that hashish was not mentioned by Marco Polo. It was opium and a beverage (not specified) which were said to have been utilized by "the old man of the mountain" to attain his clandestine aims (Marco Polo 1955; A. Hordern 1968). Moreover, it may be of some benefit to remind ourselves of the following remark made by J. Masefield to the effect that "it is difficult to read Marco Polo as one reads historical facts. One reads him as one reads romance." (J. Masefield 1907.)

The trouble with many statements made by Arab poets and writers of the Middle Ages and by men like Baudelaire, Gautier and the rest, to specify hashish effects on man's behaviour, is that they do not look flagrantly unbelievable or erroneous. Since they depend on some attempt at introspection, casual observation and anecdotal reports they seem to imply a grain of truth (like any other piece of common-sense psychology).

A number of questions, however, could be raised to which such a way of handling the subject cannot provide satisfactory answers. Examples of such questions are the following: Among the cited descriptions, which is placebo effect and which is genuinely caused by the drug? Which is idiosyncratic and which is general? What are the chronic effects of the drug, and can they be deduced by simply extrapolating from acute effects? These and other similar questions can only be adequately answered by closely following the rules of the scientific study of human behaviour. A. Hordern puts it clearly that "Scientific method, statistics, controlled trials, blind assessements and the use of placebos are concepts now of sufficient familiarity to be known even to educated laymen. It was not always so: these techniques were developed gradually over the last 350 years, and only within the last 30 have they been fruitfully combined to produce objective clinical work." (A. Hordern 1968.) Even so, the utilization of these techniques in the investigation of cannabis consumption has a shorter history still. "Until the spectacular resurgence of use of marihuana by western society during the past decade, scientific interest had been largely dormant. During the past three years, in particular, this interest has been rekindled, in part because of the social importance of the drug, in part because of the possibility of doing more precise studies, and in relatively small part because research funds became available." (L. E. Hollister 1971.) By the same token, no matter how paradoxical this may seem, ingredients of myth have also been reactivated. T. Roszak, in an illuminating hint on the subject maintains that, "Correctly understood, psychedelic experience participates significantly in the young's most radical rejection of the parental society." (T. Roszak 1970.) Both attackers and defenders of the Establishment created their own versions of a "cannabis myth"; each "to endow their faith with greater value and prestige". Projected on this turbulent background, G. L. Mizner and associates, in evaluating what has been going on, during the last few years, by way of scientific investigation stated it as follows: "Despite this, few large-scale studies have been done, that were likely to yield reliable figures on drug use patterns, attitudes toward drug use... etc". (G. L, Mizner et al. 1970; cf. also Interim report 1970.) Moreover, D. L. Manheimer et al. (1969) underline the fact that most of the systematic research in the field has been conducted on student populations, to the exclusion of older non-student groups.

Mystery

Among the many definitions given in the Shorter Oxford Dictionary for the word "mystery" is the following: "Something beyond human knowledge or comprehension; an enigma." The literature on the effects of cannabis on human behaviour is replete with statements depicting the various aspects of the enigmatic character of these effects. S. Allentuck and K. M. Bowman (1942) hold that, "Marihuana is unique in the reactions it produces in its users". L. D. Clark and E. N. Nakashima (1968) hint on "the very unpredictability of marihuana on different individuals, and on the same individual at different times and under different conditions". A. T. Weil and N. E. Zinberg (1969) maintain that, "the greatest puzzle about marihuana is the enormous discrepancy between its subjective and its objective mental effects. A person high on marihuana in a neutral setting may tell the experimenter that he is 'stoned' and is having a major psychopharmacological experience, yet the experimenter is unable to show objectively that the subject is different in any way from one who is not high." In another context, the same authors claim that, "the researcher who sets out with prior conviction that hemp is psychotomimetic or a 'mild hallucinogen' is likely to confirm his conviction experimentally, but he would probably confirm the opposite hypothesis if his bias were in the opposite direction". (A. T. Weil, N. E. Zinberg and J. M. Nelsen 1968.)

Among the numerous questions which invited almost contradictory (direct and/or indirect) answers from various students the following are an accidental sample: Is cannabis criminogenic or not? Is it a stepping-stone towards taking opiates? Is it more harmful than alcohol? Is it more harmful than some of the medically prescribed psychoactive drugs? Is it aphrodisiac?

From an epistemological point of view, the core of mystery is irregularity. The core of science is regularity. "Scientific research is based upon the belief that a natural explanation can be found for every observable phenomenon. It assumes that the universe is an ordered cosmos in which there is no result without a cause." (T. Hillway 1956). This is what H. Feigl had in mind when he described the main job science strives to accomplish: "On the descriptive level this results, for example, in systems of classification or division, in diagrams, statistical charts, and the like. On the explanatory levels of science sets of laws or theoretical assumptions are utilized... The facts of science often belonging to heterogeneous domains,... become integrated into a coherent, unifying structure." (H. Feigl 1953.) The same idea was expressed by K. Pearson almost 80 years ago (K. Pearson 1892). It is the basic contention of the present author, however, that, occasionally, one should refresh one's memory about these fundamental components of a scientific outlook.

One or two other points should also be made explicit. Some areas of research seem to be more resistant to the quest for regularity than others. Judging at face value the effects of cannabis on man have proved to be one such area. However, the resistance displayed by this or any other area is usually a function of the complexity of the phenomenon, the amount of competent efforts set to handle it and the quality of the socio-cultural climate encompassing both phenomenon and student. The truth of the matter is that we have here cannabis consumption as a very complex topic, the amount of competent effort put in it was, until very recently, deft- itely meagre and the socio-cultural climate so emotionally charged (and still is to a great extent) that it certainly discouraged a good deal of potentially able investigators. Without going into details about the multiplicity of factors involved, the turn of the tide that we started to witness during the last few years holds promise that some rapid advance is likely to take place. Impressionistic approaches and anecdotal reports, though still finding their way to the press, are gradually giving way to more research based on sound methodology.

Facts

Prologue

In this section the reader will be presented with a panoramic view of factual information on the social psychology of cannabis consumption. What mainly recommends the following material as reasonably dependable is that standards of modern behavioural research were adhered to in the process of collecting and analysing the data. We will, however, try not to encumber the reader with statistics or with the technical language of statistical inference and psychometry. Those who are interested in closely examining procedures of methodology are advised to satisfy their desire elsewhere (e.g. M. I. Soueif 1967; 1971). Though we will be referring to investigations carried out by a number of research workers, we will be relying most of the time on the work conducted by the Committee for the Investigation of Hashish Consumption in Egypt. A few words about this research, therefore, would not be out of place.

The project has been under way since 1957, and is sponsored by the National Centre for Social and Criminological Research (Cairo) (M. I. Soueif 1967). Recently we completed a major part of it and a full report is now in the course of preparation (M .I .Soueif 1971).

A total of more than 1,000 hashish takers and over a thousand controls were interviewed and objectively tested for a number of well-defined psychological functions. The examiners were all qualified psychologists expressly trained for this work. The interview was standardized and almost exhaustive, raising more than 400 units of query. We made sure that every single item included in the interview, together with the tests, were reasonably reliable. One of the main criteria we had in selecting our tests was freedom of culture bias (in so far as that was attainable), to make possible future comparisons, hence generalizations, across cultures. Among our subjects 850 takers (serving sentences for cannabis use) and 839 controls were prison inmates. The rest were free citizens. All were Egyptian males whose ages ranged from 15 to slightly over 50 years. They represented a fairly wide spectrum on most of the relevant variables, e.g. education, socio-economic status, marital status, urbanism-ruralism, etc. Our hashish takers were all regulars. We defined regular users as those who were taking hashish at least once a month through the preceding year up to the time they were examined. For imprisoned takers the following qualification was added: "... or up to the time they were put under arrest". Controls were defined as those males who had never taken cannabis nor any other narcotic substance as specified in Act 182 passed in June 1960 by the Egyptian Government for the prohibition and/or regulation of the use of narcotic substances. Noteworthy, here, are two points of differentiation between our project and most of the western studies carried out to date, viz. that we concentrated on ( a) males, to the exclusion of females, and ( b) regulars to the exclusion of casuals. The reason for not including females is the simple fact that in Egypt hashish taking is almost exclusively a male phenomenon. In scanning all our prisons we found only 20 females who were convicted for cannabis consumption. The picture here is largely different from the one drawn in western literature where females are reported to constitute about one-third of cannabis users (D. L. Manheimer, et al. 1969). One also gets the impression that in the West "regularity" is not yet a well-established dimension of the phenomenon (in its recent flare-up). Rather, most users take the drug on a casual basis and adopt an experimental attitude towards it (W. H. McGlothlin et al., 1970). Other points of disparity between the two pictures should also be noted. For example, in the west the phenomenon has an intermittent history with short peaks of epidemiological dimensions and rather long intervals of sobriety, which entails discontinuity between generations of (white) takers, (e.g. the generation of the late 1930s and that of the late 1960s in U.S.). This is in line with some results reported by D. I. Manheimer and colleagues (1969) in their attempt to determine the generality of marihuana use among older persons and among young adults in San Francisco.

In Egypt, by contrast, we have a continuous history, which can be traced back in minute detail throughout this century and part of the last one (M. I. Soueif 1967; cf. also E. W. Lane 1860). With such different histories, it is quite understandable that two different sets of values and practices would be generated around the habit. In fact the social structure of the group of Egyptian cannabis takers seems to differ largely from that of their western kin. Such points of discrepancy between the two pictures should be kept in mind for a proper evaluation of a certain range of variability in man's experience with the drug.

The Δ9-THC content of cannabis is believed to account for most of the pharmacological effect produced in man. The amount of this ingredient contained in hashish has been estimated at 5 % weight, as compared to marihuana which is said to contain 1% (WHO Technical Report No. 478). Taking into consideration, however, that ( a) almost all hashish illicitly marketed in Egypt is smuggled into the country from abroad, which usually entails unfavourable conditions of storage and a relatively long time elapsing between harvesting the herb and using it, ( b) "all active substances contained in preparations of cannabis deteriorate with time", ( c) inactivation of Δ9-THC is particularly rapid if the herbal material is exposed to or stored at high temperatures ( ibid.), and ( d) as the Middle East area in general is rather warm most of the time, it follows, that the Δ9-THC content of the hashish actually used in Egypt may be better estimated at about 3 % weight.

PATTERNS OF CANNABIS USE AND CORRELATES

Smoking was found to be the prevalent method of consumption for cannabis in Egypt as well as in other parts of the world (M. I. Soueif 1971; WHO Technical Report No. 478; Canada Commission Interim Report 1970; F. Ames 1958; I. C. Chopra and R. N. Chopra 1957; A. Benabud 1957). The importance of this point is shown by a number of facts. First, that cannabis is taken in a more or less unified way wherever it is used, a fact which permits a certain degree of validity in generalizations made about drug effect across social groups and communities. Secondly, that the majority of users all over the world expose themselves to Δ9-THC at its maximum potency. Isbell et al. (1967) maintain that this ingredient is three times as potent when smoked as when ingested. Thirdly, one of the main reasons why smoking became the method chosen is the fact that it gives a quick and well defined feed-back. "The onset of psychological effects is almost immediate with the smoking of more potent forms of cannabis, and the peak effects usually occur within the first quarter-hour following inhalation... Absorption by the gastrointestinal tract is relatively slow." (Interim report 1970.) Within the framework of the modern learning theory, as defined by psychologists like C. Hull, an immediate and well defined feedback (or reward) is a good reinforcer of the habit (E. R. Hilgard 1956). Smoking is practised in various forms in different parts of the world. Cigarettes are more common in the West, pipes in Morocco (A. Benabud 1957) and the josah, also a pipe in Egypt (M. I. Soueif 1967).

Egyptian takers usually take hashish in small groups of between 4 and 6 persons. One and the same josah is used by the whole group. It is passed around for each person to take a pull or two, following the proper technique (H. S. Becker 1953). The social psychologist cannot fail to note a unified set of rules of étiquette prevailing at most hashish sittings. For example, members of the party should equally share the cost. Each should perform according to a sense of fairness towards the rest when it is his turn to inhale. Topics of conversation which are very personal and/or very serious, are considered unsuitable for the occasion. Jokes with aggressive connotation against any member are usually avoided. Brooding on one topic for more than a few minutes is not accepted.

In their pattern of interaction members of the party enjoy a degree of egalitarianism which allows for social nearness without completely ignoring the inter-person rank differences. The conversation that usually goes on covers a number of ordinary topics, e.g. work, family problems, social affairs, religious issues, sex and politics. Nearly half of our cases reported that their groups had leaders. It is a democratic type of leadership (in the sense defined by K. Lewin and R. Lippitt 1955) emerging by some sort of natural selection. The leader is described as generous, modest, solicitous for the sitting, amiable, inviting respect, verbally fluent and usually is not off-balance.

The average amount of the drug consumed by an Egyptian user is estimated at about one gram per time. In the United States the quantity estimated varies widely from one author to another averaging about 3.6. gm of marihuana, and in India a recently reported figure is 1.9 gm of ganja (G. S. Chopra 1969). These estimates when worked out in terms of mgs of Δ9-THC, become 30, 36 and 57 respectively (WHO Technical Report No. 478).

We found a very big difference between our two groups of hashish users, the prisoners and the non-prisoners, regarding the frequency of their use of the drug per month. For the latter it is around 11 times, but for the former it exceeds 60. If it is true that the majority of Western users take cannabis on a casual basis then great caution should be exercised in generalizing from our experience, particularly with respect to what may be considered chronic effects of the drugs.

Dividing our prison consumers into moderates (those who take the drug 30 times a month or less) and heavy takers (above 30) we could establish a number of significant relationships which should be of some psychiatric interest. Heavy takers, compared to moderates, tend to take a bigger dose of hashish per time. They take it at definite hours of the day, and they start the habit earlier in life. Moreover, they also tend to take opium and alcohol. Heavy takers, thus, present us with a rather pathological picture.

MOTIVATION

Contact with experienced friends or acquaintances, and availability of the drug, seem to be prerequisites for initiation into the habit (A. Lewis 1968; WHO Technical Report No. 478).

Within this setting a number of motives are impregnated into the candidate. Asked about their salient motives for trying hashish for the first time our consumers enumerated the following wants arranged in their order of frequency: ( a) going along with a group of personal friends and responding to their pressure; ( b) seeking euphoria or a "high"; ( c) emulating "real men"; ( d) simply imitating others; ( e) satisfying one's own curiosity; ( f) trying to forget about one's personal problems; ( g) attempting to overcome depression of mood; ( h) aiming at cure or improvement of some body ailment; and ( i) trying to enhance sexual enjoyment.

Such motives, though more differentiated, do not seem to differ much from the ones cited by the investigators of Oakland, California (A. Lewis 1968; W. H. McGlothlin et al. 1970). The Oakland students concluded that "induction into drug use is a developing experience that depends on access to drugs, acceptance by drug-using associates and kinds of image that youngsters have of drugs" (A. Lewis 1968).

The point to be stressed, here, is that initiation into the cannabis habit does not put on a psychiatric veil (at least in so far as conscious drives are concerned). It is not to be concluded, however, that adopting the habit has nothing to do with psychiatric disorder. It should always be kept in mind that conscious needs account for some part of the individual's motivational repertoire. One should also remember the simple fact out of the total number of persons approached to try the stuff a certain percentage manage to turn down the invitation, another percentage make the experiment, but they do not continue the practice, and only a limited fraction of all those canvassed takes to the habit.

Faced with these obvious facts the student has to think of a sufficient cause that would explain the acceptant's behaviour: either in terms of personality traits that predispose the carrier, and/or some specific characteristic of their pattern of interaction with the others. Sufficiently detailed and valid information is not yet available about those who refuse the invitation and those who try but do not take to the habit. Till data about such questions come to light, no conclusion should be drawn about how normal, subclinical or pyschiatrically disturbed are those persons who begin to take cannabis more or less regularly.

Facts about the dynamics of recruitment of new entrants must also be established, because this is essential for devising future plans for prevention.

About one-third of our users reported that they interrupted the habit more than once, and that the interruption went on sometimes for more than a year. Their stated reasons were as follows (again arranged in order of frequency): financial difficulties, fear of legal consequences, health complications and unavailability of the drug. Ironically enough our "free citizens" group of takers mentioned "fear of legal consequences" as their last or weakest motive for interruption. Such bits of information, one must admit, are tempting to speculate on the validity of a philosophy that dictates severe penalties to be enacted upon users presumably as a deterrent.

We asked our habitués why they resumed hashish use. The very first reason they gave was "pressure of circumstance". Here again we are faced with compliance with some psychosocial exigencies. Other stated reasons were: to cope with problems of life, to kill time and because hashish was better (less harmful) than other narcotics. When we posed the question why they continued to take the drug anyway (irrespective of interruption and resumption) our subjects put "euphoria" in the first place. The same observation has been reported on American regular users (W. H. McGlothlin et al. 1970). A close second reason in the case of our users was again "going along with one's friends", followed by "behaving like "real men", "the desire to forget about haunting personal problems", "to alleviate a depressive mood", "to ameliorate some physical affliction" and in the end "to increase sexual satisfaction". Psychiatric elements seem to come to the fore in this set of needs. It is conceivable that after the habit is built in one feels that one cannot do without. With more experience one gets more "enlightened" about the multiplicity of effects of the drug, and the complexity of the whole life-situation encompassing the practise of the habit. Gradually the impregnated habit brings in its train a new set of motives, some of which are psychosocially determined (usually effected via a process of social conditioning) while others are pharmacologically rooted. We, then, talk about dependence designating the plexus of motives systematized around "the drug in vivo" (D. C. Cameron 1970).

EFFECTS

There is almost unanimous agreement now that differentiation should be kept in mind between short-term effects of the drug as experienced by a novice and by a genuine habitué. According to H. S. Becker in order to get a "high" the novice must first learn ( a) to smoke effectively, ( b) to recognize the effects and ( c) to define them as pleasurable (WHO Technical Report No. 478; H. S. Becker 1953). In other words he should first take the necessary steps to acquire a certain frame of reference that would steer his sensations and feelings, derived while taking cannabis, to fall into their right place (i.e. under the category of a "socially recognized pleasant experience"). The experimental work of M. Sherif on the social psychology of perception should be relevant here to help understand and explain the dynamics of this complex process of acquiring "a hashish use frame of reference" (M. Sherif 1935). The work of A. T. Weil and associates give a dramatic illustration of how naive subjects differ in their reactions to the drug from experienced smokers. "With the high dose of marihuana (2.0 grams) all chronic users became 'high' by their own accounts and in the judgement of experimenters who had observed many persons under the influence of marihuana. On the other hand, only one of the nine naive subjects had a definite 'marihuana reaction' on the same high dose." (A. T. Weil et al. 1968.) Similarly, with oral administration of the drug the probability is that the same principle would apply, except that the The social psychology of cannabis consumption: myth, mystery and fact 7 development of the required frame of reference may go through a more complex process.

There is now some evidence that qualitatively, the symptoms triggered when the drug is given orally do not differ significantly from those caused by smoking (Isbell et al. 1967). It has also been reported that, "the symptoms observed under laboratory conditions appear to be similar to those obtained, in a retrospective study of marihuana smokers, who replied to a questionnaire concerning the symptoms they experienced after smoking cannabis in their usual environment". (WHO Technical Report No. 478).

Changes in mood, perception and motility are reported by a number of writers. The commonest mood changes mentioned by our users were euphoria and acquiescence. Hesitancy, suggestibility, carefreeness and a tendency towards more gregariousness were also reported but not by a big majority. At the same time a sizeable proportion of our users said they had seldom experienced mood change towards any of these states. Apparently the latter form a group of users who take the drug to maintain themselves at a certain level of mood stability.

Most of our users, also, told us that their thresholds for perceiving certain stimuli as pleasant went down a bit and the opposite was true for perceiving other stimuli as unpleasant. Hence they tended to have a rather peaceful time with their wives, children, colleagues and superiors. They even tended to be more forgiving when they were wronged by others.

In short, following their own reports, our habitués, when under drug effect, are at ease with themselves and with the world around.

However, psychosomatic changes, some of which are noxious, have also been reported by cannabis takers. Big numbers (sometimes exceeding 50% of our subjects) told us that they usually had feelings of numbness all over, headaches, nausea, tachicardia and suffocation (cf. also W. H. McGlothlin et al. 1970). The majority said that hashish did not affect their readiness to be sexually excited, nor the time involved in coitus to orgasm.

Changes in various modalities of perception were also reported. The patterns of change, however, are not as simple as they were thought to be. Time perception, for instance, is not always distorted. We have one-third of our users reporting no change. Moreover, against all expectations (suggested by various writers), more than half of our consumers said time seemed to pass quicker-than usual. With distance perception, again, one-third of the group affirmed no change. The rest, however, almost unanimously said that distances looked elongated. In all other perception modalities the majority of our imprisoned takers stated no change. The remaining proportion (about one-third) tended to report alterations in the following directions: object sizes looked bigger, contours blurred, colours seemed brighter and sounds were clearer and louder than usual. So with time and distance perception the majority suffered from some distortion, but the rest of the group did not. With other aspects of perception it was the other way round. Such findings, if corroborated by other investigators should be given due weight when speculating on the performance of any job that involves psychomotor abilities.

We also asked our users about their thinking and memory. The majority replied that the drug did not affect their capacity for adequate thinking (i.e. thinking to the point), but that they found themselves exposed to a rush of ideas reflected in changing topics of conversation at a rather high speed. Contrary to our findings in the non-prison group (M. I. Soueif 1967), only a small minority of our prison users complained of poor memory when under drug influence. The majority said that their memory was not affected. This discrepancy between our two sets of findings, viz. those of prisoners and of non-prisoners may be a function of the fact that the two groups of takers differed from each other regarding frequency of drug taking per month (hence degree of drug dependence). The inference may be made that the person who is more drug dependent performs at "his norm" (when under drug effect) on tasks requiring recall. The less dependent shows memory deficit. Two other findings may further illuminate this point. When we divided our prison users into moderates (who take the drug 30 times or less per month) and heavy takers (more than 30 times) a bigger proportion of the latter reported improvement of memory under cannabis effect. The other example is drawn from the laboratory work of A. T. Weil et al.(1968). Those researchers, comparing the performance of naive and chronic marihuana users on the Digit Substitution Test maintained the following: "Chronic users started with good baseline performance and improved slightly on the DSST after smoking 2.0 grams of marihuana, whereas performance of the naive subjects was grossly impaired". The same pattern of results came out on the pursuit rotor test.

A number of students are increasingly bringing in objective psychological tests for the assessment of short-term drug effects (sometimes using Δ9-THC). Central among those tools are the Archimedes Spiral, pursuit rotor, mirror tracing, freehand drawing and time estimation. Some interesting results were reported, e.g. shortening of the duration of the spiral after image and reduced accuracy with no slowing of performance in drawing, (testees being naive subjects) (L. D. Clark and E. N. Nakashima 1968; L. E. Hollister 1971).

An interesting and seemingly promising finding is the recently reported acute effect named temporal disintegration. "Temporal disintegration means that the individual has difficulty in retaining, co-ordinating, and serially indexing those memories, perceptions and expectations that are relevant to the goal he is pursuing."

The authors maintained the following: "Our findings indicate that (1) high oral doses of THC induced temporal disintegration in normal subjects; (2) the phenomenon stems partly from impaired immediate memory, and (3) temporal disintegration is associated with disorganized speech and thinking". F. T. Melges et al. 1970).

Long-term effects of cannabis consumption are rather difficult to specify in a straight forward way. The present writer does not know of any reported longitudinal study in which a reasonably sizeable group of cannabis users have been followed up to ten or twenty years and in which the relevant variables were objectively assessed. A classical example to be cited here (as a model) would be L. Terman's longitudinal study on one thousand gifted children which was continued for more than twenty years (L. M. Terman and M. H. Oden 1947). Another would be Macfarlane's study of personality development (J. W. Macfarlane 1943). Admittedly our topic may be much more complex than the two examples cited, and one would imagine all sorts of complications arising to render the execution of such a project in the cannabis area next to impossible (at least in those countries where consumption is prohibited). Indirect approaches are, therefore, inevitable, with all the limitations they impose on inference.

Our indirect approach rests on one main basis that we included among our examinees a number of control groups as commensurate as possible to our experimentals. Comparison of hashish takers with non-takers revealed a wide variety of differences regarding personality and psychomotor activity. These differences can be legitimately related to hashish taking in the form of a coefficient of correlation which can be utilized to serve prediction. Treating these differences, however, as causally effected by the use of the drug would not be justified. The argument can always be raised to the effect that possibly hashish takers and controls were not originally commensurate with respect to the variables under study. We find it, therefore, imperative to make it explicit that the differences we could reveal, though definitely associated with cannabis use, are not necessarily caused by the drug but can only be marking the limits of function deficit that may be partly or wholly ascribed to cannabis.

Following are examples of our findings based on verbal reports. Our experimentals tended to give more neurotic responses than controls did on a few selected items of the Taylor Manifest Anxiety Scale (J. Taylor 1953). They described themselves as more ascendant, less hesitant, less tolerant of staying alone and less conflicting with others' opinions than controls. But on other traits such as suggestibility and emotional liability we could not find any appreciable differences.

On some situational questions controls gave a better impression than users; on others it was the other way round. For example, more controls than experimentals gave the impression that they would not cheat if allowed the chance and would own up if they made a mistake (in a work situation) for which an innocent colleague would be blamed. But more hashish takers than non-takers expressed an altruistic attitude when asked whether they would try to help a friend even if that entailed some personal trouble.

Regarding the question of a possible association between hashish consumption and crime, our main method of study depended on examining the actual criminal records of about 550 users and 450 non-users all detained in our three largest prisons. We were given access to the files kept at the Central Record Office in the Ministry of Interior. In comparing our two groups of subjects we took into account all criminal offences other than those having to do with narcotics (using and/ or pushing). Hashish takers had a decidedly lower criminal record than controls.

We administered a battery of 12 objective tests generating 16 test variables to all our convicted subjects. The tests were selected in order to permit examining the validity of a number of hypotheses formulated on the basis of our findings (gathered through interviewing) in a preliminary stage of the project (M. I. Soueif 1967). Our objective test findings, show a definite tendency for controls to earn better scores on a number of tests requiring speed and accuracy of performance. Great caution, however, should be practised against premature generalization. The data, for example, on a test for time estimation came out against popular expectation. Controls made much more errors than users did. Initial reaction time showed urban takers to react faster than comparable controls, and failed to differentiate between rural users and non-users. Span of memory for "digits forward" did not discriminate between the groups.

Among the most interesting findings were those disclosed when we equated our groups for education (irrespective of urbanism-ruralism). We found that the higher the level of education attained by the two comparable groups the larger the discrepancy between their test scores (with controls giving a better performance). Thus illiterate takers could not be differentiated from illiterate non-takers on most of the tests, in contrast to the groups representing high school level who differed widely from each other on almost all test variables. A tentative explanation is that some learning transfers from scholastic education to performance on the tests. If that premise is to be accepted, then our results show that less transfer takes place in cannabis users than in non-users. If "transfer" is equated to learning (R. S. Woodworth and H. Schlosberg 1954) the inference can be made, that the effect of learning on speed and accuracy of performing simple psychomotor tasks and on tasks requiring estimation and rote memory goes at a slower rate or at a less efficient level anyway in cannabis habitués than in controls. In other words, chronic cannabis users seem to be slower learners than non-users. This inference should be treated as a working hypothesis to generate a number of testable predictions, which if systematically investigated may open a new vista for accumulating valuable data on acute and chronic effects of cannabis consumption.

Conclusion

Obviously there is a growing body of objective knowledge about cannabis consumption in man. Both laboratory experimentation and field research are making definite progress. Certain points of convergence between results obtained through various approaches by independent research workers are beginning to emerge. From a methodological point of view, two major advances have recently been achieved: quantification of effective dose, as the independent variable (directly in laboratory work and indirectly in field studies), and the objectively quantitative assessment of concomitant behavioural changes. Judging by the momentum of competent efforts invested in the field during the last few years the situation seems to promise a wealth of valid information to be generated in the near future.

The present author, however, cannot fail to note a number of shortcomings which would, if not adequately and promptly remedied, impose constraints on the effectiveness of our promised knowledge. For one thing the picture is very much fragmented and will stay so for some time should the same pattern of sporadic uncoordinated small scale studies remain to dominate the stage. A number of such miniature studies would certainly gain more weight in the history of cannabis research if they were considered as explorations to be followed by a well-planned attack on a rather broad aspect of the problem as displayed by a reasonably big and well selected sample of users. Another point is that most of the work reported to date fails to systematically account for individual differences (apart from the current differentiation between naive and experienced subjects) in their interaction with cannabis effects. We know nothing about how personality traits such as extraversion-introversion, suggestibility, level of aspiration and rigidity would interact with the drug. Finding the right formula for the description of this interaction would in all probability lessen the amount of confusion we are now met with in a number of reports. A third point is that a number of investigators who choose to depend on verbal reports to ascertain some drug effects, or disclose some personal data in the history of users, do not report anything about the standardization or reliability of their verbal tools (interviews or questionnaires). In fact one gets the impression that these procedures were never contemplated. To provide grounds for comparability of responses, and give the reader a rough estimate of error implied in judgements based on these responses, such procedures as standardization and establishing the reliability of the tool cannot be dispensed with.

Field and laboratory investigations are both highly needed, especially as we are dealing with an area of research that has direct bearing on application. For in spite of the relative elegance of a laboratory experiment, where the student keeps under control the variables he thinks relevant, field work seems to be the only path to the provision of answers to certain questions which form an essential part of the raison d'être of most of the recent enthusiasm for cannabis research. Examples for such questions are: how cannabis users are initiated into the habit; why do some candidates carry on with the practise while some do not; do cannabis users tend to be single or multiple drug users, and what sort of chronic effects they develop.

A useful analogy may be to liken research to warfare against the spirit of mystery and myth. To excel at such warfare scientists should acquire skill in matters pertaining both to the strategy and tactics of scientific research.

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