Introduction
Material and method
Discussion
Summary
Acknowledgements
Author: M. GOMBEROFF, , R. FLORENZANO,, J. THOMAS,
Pages: 27 to 33
Creation Date: 1972/01/01
In western culture the use of marihuana had a considerable increase during these last years [ 4] , [ 9] , [ 14] , [ 15] . The news media in Chile have written about consumption centers, specially at school and university levels, since the end of 1968 till this date. Until this date, marihuana users went practically undetected. Since 1968, however, the demands for psychiatric help have been on the increase by patients with an adverse reaction to the drug. About this time began the inquiries into marihuana smoking among adolescent and post-adolescent patients who had sought help due to diverse pathologies.
Consultations with many colleagues and personal experience led us to believe that in a number of schools and especially among the upper grades the use of marihuana was not only starting as an individual problem but was to reach a massive range.
We were asked by a school to develop a preventive campaign against the use of this drug. This work gave us the opportunity of investigating the prevalence of consumption in that school, the likely motivation, as well as the effects produced in a selected group of students, in a country where its use had just begun to develop. There was a general impression that this school was quite representative of a large gathering of adolescents, of the school age group which had been found to be seeking psychiatric help this year. It was this group which at the same time had initiated the massive use of marihuana in our country. This factor then provided us with a sample of marihuana users that would allow us to study the etiology and initial effects of cannabis use in a social environment which had been free of it in the past.
This group of adolescents could also provide us with an homogeneous control group of non-smokers, to compare with those who smoked marihuana. In all the literature we reviewed, we could not find any work with similar control groups.
This study was made before the initiation of the preventive campaign.
Our study is fundamentally of a descriptive nature, due to the fact that the motivations and the effects of the use of marihuana vary a great deal from one culture to another [ 2] , [ 3] , [ 5] , [ 7] , [ 16] , and also because, in our country no previous work has been done on this subject.
The sample was made up from 734 students of a co-educational high school in Santiago, Chile. As described in another work by the authors, to be published [ 8] , their ages fluctuated between 13 and 18 with a similar proportion of boys and girls. Among these students' parents, 63 % had finished high school, and 44 % had college degrees.
A questionnaire was designed consisting of 61 questions divided into three categories. The first part referred to age, grade, parents' marital status, and their educational and professional backgrounds, religion and church attendance, the number of brothers and sisters, place occupied among them, etc. The second part dealt with use, effects and motivation of alcohol and tobacco use. The third section involved use, effects, motivations and other aspects of marihuana. The questions were generally presented on a multiple choice basis, and occasionally, as open topic.
The questionnaire was submitted first to a group of 25 students who had volunteered to collaborate in the campaign to prevent the use of marihuana. This allowed us to modify our original questionnaire. Two days later, and with a promise of secrecy from the first group questioned, the questionnaire was distributed simultaneously to all the other students.
This was done by those students of the first group who had been briefed by doctors, psychiatrists and social workers. It was explained to the students that this poll was anonymous and that it was of importance for understanding and developing a project to solve the problems of marihuana in their own school. This approach and the fact that students circulated the questionnaire, receiving only advice from the outside, served to obtain full co-operation from the student body.
First we divided two sub-groups from the total number of questionnaires answered: students who smoked marihuana and those who would like to try it. With the object of comparing the first group to the one who did not smoke marihuana, we extracted from the latter a sample of 75 students by systematically stratified sampling of class and sex.
We only studied effects and conscious motivations in this work. The statistical analysis was made in the χ 2 method (chi squared) [ 10] .
Adverse reaction
Effects producing symptoms such as panic, fear, depersonalization, confusion, depression and paranoid syndrome, during or after the use of marihuana. In this we followed the descriptions of M. H. Keeler [ 11] .
Spontaneous recurrence
As the reappearance of sensations that were originally felt during the reaction to the drug, without using marihuana or any other drugs in the interval between these two effects. We continued to use the definition of ideas by M. H. Keeler [ 13] .
The number and proportion of students who had used marihuana is shown in table 1, and those who would like to try it is indicated in table 2. The rest of this description will only refer to the first group of 51 students.
A small percentage of the group studied began to smoke in 1965, increasing later on during 1967 and 1968, and reaching an abrupt peak in the first 6 months of the year 1969 (table 3).
Men |
Women |
Total |
Per cent |
|
---|---|---|---|---|
Smokers
|
36 | 15 | 51 | 6.96 |
Non smokers
|
364 | 317 | 681 | 93.04 |
TOTAL
|
400 | 332 | 732 | 100.00 |
Men |
Women |
Total |
Per cent |
|
---|---|---|---|---|
Ready to smoke
|
67 | 51 | 118 | 17.33 |
Not ready to smoke
|
297 | 266 | 563 | 82.67 |
TOTAL
|
364 | 317 | 681 | 100.00 |
Year |
Total |
Per cent |
---|---|---|
1965 | 1 | 1.96 |
1966 | 0 | 0.0 |
1967 | 4 | 7.85 |
1968 | 7 | 13.41 |
1969 (6 months)
|
36 | 70.90 |
Can't remember
|
3 | 5.88 |
Total number of cigarettes smoked |
Number of students |
Per cent |
---|---|---|
1-2
|
31 | 60.7 |
3-4
|
9 | 17.6 |
5-9
|
2 | 3.9 |
10-19
|
4 | 7.8 |
20-70
|
4 | 7.8 |
More than 70
|
1 | 1.9 |
Time after inhalation |
Number of students |
Per cent (total of replies) |
---|---|---|
1-2 minutes
|
5 | 18.5 |
5-10 minutes
|
14 | 52.0 |
15-20 hours
|
6 | 22.2 |
20-90 hours
|
0 | 0.0 |
More than 90 minutes
|
1 | 3.55 |
No effect
|
1 | 3.55 |
Total replies
|
27 (53 %)
|
100.00 |
No reply
|
24 (47%)
|
|
Total students
|
51 (100 %)
|
As far as the smoking frequency is concerned (table 4), a high number of students (60.7 %) had smoked 1 to 2 cigarettes. Only 9 students (17.5 %) had smoked more than 10. The beginning effect, in most (70.5 %), appears between 1 to 10 minutes after inhalation and lasts a length of time that varies from 15 minutes to 4 hours. The maximum intensity of the effect is reached early: from 30 to 45 minutes after inhalation (tables 5, 6 and 7).
Time after inhalation |
Number of students |
Per cent (total of replies) |
---|---|---|
15-20 minutes
|
11 | 30.6 |
30-60 minutes
|
9 | 24.9 |
1-2 hours
|
6 | 16.6 |
2-4 hours
|
8 | 22.2 |
4-8 hours
|
2 | 5.7 |
Total replies
|
36 (70.59 %)
|
100.00 |
No reply
|
15 (29.41%)
|
|
Total students
|
51 (100 %)
|
Time after inhalation |
Number of students |
Per cent (total of replies) |
---|---|---|
30 minutes | 11 | 39.5 |
45 minutes | 9 | 31.74 |
60 minutes | 1 | 3.58 |
90 minutes | 2 | 7.2 |
120 minutes | 4 | 14.4 |
150 minutes | 1 | 3.58 |
Total answers
|
28 (54.9 %)
|
100.00 |
No answers
|
23 (45.1%)
|
|
Total students
|
51 (100 %)
|
Concerning the effects investigated, we reached the following conclusions: we found 40 effects as shown in groups in order of their frequency (table 8). If these effects are grouped according to their type, physical effects, psychotomimetic and psychotoxic, we observe the psychotomimetic effect as predominant at 50.14 % (table 9). Under the psychopathological point of view (table 10) we most frequently see the senso-perceptive alterations of the illusionary type and alterations of the perception of the self.
As far as adverse reactions are concerned, these appeared in more than 62 % (table 11); their characteristics are described in table 12. In a relatively more reduced percentage (38.1%), this reaction persisted after smoking (table 13).
We also investigated the existence of a recurrent effect, recently described in literature [ 13] . This effect was found at a high percentage (table 14): 10 students or 30.3 %. The types of adverse reaction are described in table 15.
Finally, and as far as the conscious motivations to smoke marihuana are concerned: we observed that the two most frequent motivations, within an almost equal percentage, were the search for a psychotomimetic effect (31.52 %) and curiosity (32.42 %). Rebellion appears in lower proportion along with the uninhibitory and imitation effect and table 16 shows the various motivations in groups, as mentioned above.
Types of symptoms |
Percent |
---|---|
1. Physical
|
8.67 |
2. Psychotoxic
|
35.68 |
3. Psychotomimetic
|
50.14 |
4. Unclassified
|
5.46 |
a Psychotoxic effect: An effect of sedation and euphoria produced by marihuana, which is similar to the effect produced by a mixture of amphetamines and barbiturates.
Psychotomimetic effect: Produced by marihuana and similar to the effect of hallucinogenic drugs of the LSD nature. For these two effects we shall refer to the concept of Goodman and Gilman (9).
Types of symptoms |
Per cent |
---|---|
1. Physical symptoms
|
10.28 |
2. Affective symptoms
|
22.50 |
3. Altered thoughts
|
9.63 |
4. Sense-perceptive alterations:
|
|
Illusions
|
23.79 |
Hallucinations
|
7.39 |
5. Perceiving of the self alterations
|
26.36 |
Adverse reaction |
Number of students |
Per cent (total answers} |
---|---|---|
Yes
|
27 | 62.8 |
No.
|
16 | 37.2 |
Total answers
|
43(84.3 %)
|
100.0 |
No answers
|
8(15.7 %)
|
|
Total students
|
51(100 %)
|
Type of reaction |
Number of students |
Per cent (total answers} |
---|---|---|
Anguish reaction
|
11 | 27.5 |
Depression
|
10 | 25.0 |
Depersonalization
|
9 | 22.5 |
Paranoia syndrome
|
6 | 5.0 |
Physical symptom
|
4 | 10.0 |
Total answers
|
40 | 100.0 |
Number of students |
Per cent (total answers} |
|
---|---|---|
Yes
|
8 | 38.1 |
No.
|
13 | 61.9 |
Total answers
|
21(41.38%)
|
100.0 |
No answers
|
30(58.62%)
|
|
Total students
|
51(100%)
|
Number of students |
Per cent (total answers} |
|
---|---|---|
Yes
|
10 | 30.3 |
No.
|
23 | 69.7 |
Total answers
|
33(64.71%)
|
100.0 |
No answers
|
18(35.29%)
|
|
Total students
|
51(100%)
|
If our sample is representative of the group of adoles cents that began to smoke marihuana in Chile, then we, could conclude that this habit began in 1967. There has been a gradual increase since then.The same is happening in other places, as expressed by McGlothlin (15). It is possible to expect then, that this habit which was focused in small areas of consumption will reach a national level.
Number |
Percent |
|
---|---|---|
Anguish reaction
|
2 | 3.39 |
Depression reaction
|
3 | 5.08 |
Paranoia reaction
|
3 | 5.08 |
Physical reaction (epigastralgia)
|
2 | 3.39 |
Depersonalization somatophysical
|
1 | 1.69 |
Fear
|
3 | 5.08 |
The percentage of adolescents that smoke marihuana in our sample is lower than in other countries, such as that found among college students of the United States of America and of Canada (10 %). This is probably due to a higher age factor in comparison to our sample, and also because more time has elapsed since the initial use of marihuana in those countries.
The number of smokers is just as important as the amount of those who would like to try it (twice as many), but have not done so because it is expensive, and because they have not found the opportunity to smoke, etc.
There has been a broad campaign about marihuana in the mass media since the first months of 1969. As we have judged from our results, curiosity is one of the most important motivations to smoke marihuana. We believe that its use would have increased anyway in 1969. However, this increase has been too great. We think that the news media are responsible for awakening the public's curiosity to such vast extent, and thus increasing the interest in marihuana.
aSee footnote table 9
78.3 % of the students had only smoked 1 to 4 cigarettes, and this reflects the fact that the majority began to smoke at about the same time as this inquiry and thus the psychic dependence was still low.
Our findings as to the initial effect, its duration and intensity peak, agree with the literature (Goodman and Gilman [ 9] ). Many students cannot answer questions related to these topics, and we attribute this to the effect of marihuana in altering the ability of a person to perceive time, and therefore to judge peak effect, duration, etc.
The use of marihuana produces effects which vary between different cultural environments, as described by Bouquet [ 3] , Allentuck [ 14] , Ames [ 1] , De Farias [ 7] , Chopra [ 5] , Benabud [ 2] , and Keeler [ 12] , and which depend on the expectations or motivations of the person who uses marihuana, as stated by Keeler [ 12] . The majority of western authors agree that a low dosage produces a psycho-toxic effect and that higher dosages produce a psychotomimetic effect. However, in the northern countries of Africa and of Asia the predominant effect is psycho-toxic [ 3] , even though the dosage used is much higher than in occidental settings. In our sample, the dosage used was much lower, yet the psychotomimetic effect was the most frequently observed. This may be attributed to the fact that the search for a psychotomimetic effect is one of the most frequent conscious motivations to smoke marihuana.
In studies by North Americans [ 12] , "curiosity" is more often cited as the motivation. In North Africa and India where use of marihuana has been traditional, we assume that "curiosity" is not an important factor. It surprised us to find a higher proportion of users in our sample whose motivation was "rebellion against the establishment" as compared to Keeler's in the United States [ 12] .
The high proportion of adverse reactions in our sample may be due to a lack of knowledge about the drug; the same factor could explain the spontaneous "occurrence" of adverse reactions which can only be interpreted as a kind of negative placebo effect. We are inclined to think that these aspects of marihuana use in Chile will become less notable with time. Keeler has pointed out [ 11] that the adverse reactions consist of feelings of anguish, paranoia, depression and unfavorable depersonalization; one of the girls in our sample experienced several of these symptoms' but found pleasure in the experience. We found this case an interesting aberration but did not register it as one of those showing adverse reactions to the drug.
In Keeler's work [ 13] four cases are described where the effects of the drug were experienced spontaneously, i.e. due to a negative placebo effect. We are very surprised to find 10 such cases in the group of students that we studied.
We would also like to mention that the school authorities informed us that in eight cases where adverse reactions had been experienced, the students concerned required medical treatment.
The results we have arrived at must be viewed against the relatively recent beginning of the use of marihuana in Chile. Perhaps, as knowledge of the drug increases and motivations change, the results will also come to vary in some degree.
On the basis of a specially designed questionnaire, we made an anonymous inquiry among the students of a high school in Santiago de Chile.
From a total of 734 students, 51 (6.96 %) stated having smoked marihuana, and 118 (17.33 %) said they would like to try if they had the chance. We communicate in this study the characteristics and effects of marihuana on the smokers, and the conscious motivations for its use.
We would like to acknowledge the valuable aid of Mrs. Olga Berdicewsky in statistical studies and Miss Patricia Provoste in statistical calculations.
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