Attitudes of young people towards drug use
Summary of surveys
SUMMARY OF BRITISH RESEARCH
Discussion - Implications for future policy
" SOCIAL ACTION "
Author: Richard HARTNOLL , Martin MITCHESON
Pages: 9 to 24
Creation Date: 1973/01/01
B.A., M.B., D.P.M., M.R.C. Psych. Martin MITCHESON Drug Dependence Clinic, University College Hospital, London
It is common to talk of "youth" as if there really exists a uniformity of attitudes and behaviour across a whole generation. It is all too easy to refer to "drugs" as if all prohibited substances can be discussed in one breath. And it is almost second nature to discuss the attitudes of young people towards drug use in a manner that denies the validity of anything they might be saying. If we are to gain a balanced view of attitudes towards drug use, it is necessary to look at a very large number of different groups, to avoid generalisations that cover various kinds of drugs, and to try to understand the situation from the point of view of the person or group concerned rather than on the basis of our own opinion.
Unfortunately, it is not yet possible to fulfil these requirements in any more than a very crude fashion. Little research has been carried out in this area, and what has been done is usually restricted to small groups and tends to over-simplify. The information in this paper is derived from a variety of sources. Some comes from sociological surveys based on postal questionnaires, some from series of interviews. Other sources are more indirect, such as the press, especially underground [ 1] newspapers. Some information is very impressionistic - based on the experience of people who have had considerable contact with various groups of young people. Despite the difficulties of measuring attitudes at all and despite the fairly haphazard nature of many of the sources of information, it is possible to discern several clusters of attitudes among different sections of the population. The groups of people considered are by no means a representative sample of young people, and we do not regard the proposals which follow as any more than a preliminary set of suggestions.
The main variables which can be used to discuss attitudes to drug use are the age of the people concerned, whether they have used various drugs or not, the amount of contact with drug users, their social group (e.g. school, college, neighbourhood, underground, church, etc.), social class, type of drug and parental use of drugs. The next section summarises various surveys that have been carried out.
* Adapted from a paper (Doc. No. UN/SOA/SEM/48/WP.3) read at the United Nations Conference on Drugs in Modern Society: Community reactions to drug use by young people, held at Geneva, December 1972.
Most of the research in this area has been concerned with students or schoolchildren, either because they are easily accessible, well-defined groups, or because particular concern has been expressed about them. The emphasis here is on British work which illustrates general problems.
Dr. Hindmarch 1 compared attitudes of schoolchildren towards various drugs for drug-using and non-drug using populations (fieldwork done in 1969/71). He found positive attitudes towards amphetamines in both groups (this contrasts strongly with the same author's findings with university and college students, cf. below). Both groups expressed almost neutral evaluation of cannabis. LSD was viewed as particularly harmful by non-drug users, but drug users were almost neutral in their attitudes to it. He comments: "It is the positive attitudes held by both the drug and the non-drug users towards amphetamines that gives cause for concern, particularly when one considers the comparative ease of obtaining amphetamines and related stimulants." ...." Most school-aged adolescents are unaware of the dangers of amphetamine abuse." Amphetamines were by far the most common drug used. Thus, out of a total sample of 1,126 schoolchildren (aged 13-17), 103 (9%) admitted non-medical drug use. Of these drug-takers, 87% used amphetamines, 31% cannabis, 10% LSD and 0% opiates. However, 79% had experimented with other psychoactive drugs [ 2] such as organic solvents, glues, tranquillizers, sleeping tablets and cough syrups, many of which could be found at home.
He also asked both groups (users and non-users) about their attitudes towards drug users and found some interesting differences. Drug users believed themselves to be more interesting as people, while non-users thought drug users were less interesting as people. He suggests that this difference in attitude "could point to one of the basic motives for taking drugs - the apparent enrichment of one's basic personality." But he also found that "this bolstering of ego does not seem to enhance the social aspects of interpersonal relationships, since the drug users themselves feel quite isolated, while the non-drug users, interestingly enough, feel that drug users have more friends and are really ' with it ' ". He comments: "In this respect the non-drug users may be tempted to take drugs in order to increase their social contacts, and involve themselves in a subculture which is really ' with-it '."
Dr. Wright 2 gave a simple questionnaire to several classes of schoolchildren aged 14-15 in Wolverhampton (in 1969). The main impression from this small study was that many of the children were seriously misinformed about the different effects and relative dangers of various drugs. The main source of this dangerously inaccurate information was television, followed by newspapers. Friends, parents and teachers were relatively unimportant sources of information. (This was in a group with little contact with drug use - it is not necessarily true for other groups where there is a higher rate of drug use.)
Dr. Wiener 3 questioned (in 1967) a sample of 1,093 children from four areas of London with low, medium, high and very high levels of drug use in the community. He found, not surprisingly, that drug use depended in part on the local availability of various drugs. Of the total, 5.5% admitted to using drugs, but he felt that 7-10% would be a more accurate estimate (very similar to Hindmarch). He points out that 75% of these were occasional users only, so that regular users are probably less than 2% of the school population. The most common drug used were amphetamines followed by cannabis. A few had tried LSD or heroin, but only one continued to use regularly (LSD).
He found that drug users tended to live a life more typical of older teenagers, i.e. were more precocious. Thus, they spent more time in a mixed group going to pubs and clubs than non-users, and had more money which they spent on tobacco, alcohol, clothes and drugs. Users also saw themselves as "more disobedient, less respectful of property and more impulsive" and seemed to have a "more delinquent outlook on life ". They also knew more about drugs and had more favourable attitudes towards them.
His research was carried out several years ago, and the personal experience of some teachers, police and Release [ 3] suggests that drug use in some schools in London as well as elsewhere shows a different pattern. More children may have tried drugs, although for the majority it is still probably occasional experimental use, and amphetamines are less common, cannabis, LSD and barbiturates being more prevalent. This is consistent with Wiener's own predictions. "As drug-taking appears to be on the increase in America despite punitive measures against it, it might well prove to be the case that drug taking in the immediate future will continue to increase whatever course of action is taken by the authorities." He continues: "If this is so, the problem becomes one of educating people to be able to differentiate between drugs which are potentially damaging and those which are comparatively safe. This is probably a long-term consideration. In the short-term the only serious problem concerns the minority of subjects which might not at this stage be users but who will later be tempted to try hard [ 4] drugs." Perhaps the most worrying development is the increased use of barbiturates and other sedatives by children and young people. In some areas, LSD seems to be causing considerable concern.
Kosviner and Hawks 4 enquired about attitudes to cannabis use among over 1,000 university students. Their results confirm that users of cannabis are consistently more favourable towards its use and legalisation than non-users. They also found that the great majority of cannabis users have little intention or desire to try injecting drugs, but that there may be a few who are vulnerable. The full analysis of the data which includes demographic information, information regarding psychological and physical health and various attitude scales, may provide information regarding the very small group at risk.
Binnie 5 used a questionnaire to assess student opinion on drug use, its dangers and legal control, to look at the relationship between attitudes towards amphetamines, marijuana, hallucinogens, opiates, alcohol and tobacco, and to investigate ways in which users of drugs are perceived to differ from other students. (Two drawbacks of this study are that "user" included anyone who had tried any of the drugs mentioned, and it suffered from a high non-response rate.)
The majority of both users and non-users saw alcohol and tobacco as only a slight or negligible risk to both mental and physical health and maintained that the public attitude accurately described the dangers of these drugs and that the present legal controls were adequate.
The majority of users and non-users saw opiates as a serious danger to both mental and physical health, maintained that the public attitude accurately described the dangers and that legal controls should be strengthened.
A majority of both groups saw "Pep" (amphetamines) as only a slight or negligible threat to mental or physical health, although non-users were more likely to think legal controls should be strengthened (whereas users were more likely to want them relaxed or abolished).
Users' attitudes to "Pot" (cannabis) were consistently much more favourable towards the drug than non-users, both regarding mental and physical risk, the accuracy of public opinion and the legal controls required.
With regard to LSD, the majority of users and non-users agreed that it seriously endangers mental health and that the public attitude accurately describes the dangers. However, in both cases the proportion of non-users holding these views is substantially greater than the proportion of users. Users and non-users disagreed as to its effect on physical health and on the question of legal controls, the response of users in both cases being more favourable.
As regards the experiences of drug users [there were 10% of the sample, of which "Pot" was the most common (58%) followed by" Pep" (53%), LSD (l%), and opiates (5 %)] most had already taken drugs before arriving at university, most find no difficulty in going for a week or two without it (also applies to six of the 12 opiate users in the sample). "Pep" was taken predominantly by the individual alone or with one or two friends, whereas "Pot" and LSD were most frequently taken in company of up to ten people. Over 90% had never mentioned their drug use to any doctor, and "soft" [ 5] drugs seemed available to a substantial minority of non-users if wanted.
For all drugs, except LSD, the majority of users did not feel that the drug had had any lasting effect. LSD users felt that they had more understanding of themselves and were more in contact with reality since taking the drug, but a substantial minority also said they felt more unstable and afraid.
As regards the student's attitudes to drug users, a similar pattern emerges. The majority of users and non-users saw alcohol and tobacco users as no different from the general population, although this opinion was held more strongly of tobacco users than alcohol users.
"Pep" users are seen by both groups as generally no different from the general population with the exceptions that they are perceived as more emotionally unstable and less able to cope with life (This is similar to Hindmarch's findings for schoolchildren.)
Users had a consistently more favourable attitude towards both "Pot" and LSD users, seeing" Pot" users as more interesting, more creative, more successful academically and more able to cope with life, and LSD users as more creative but more emotionally unstable. Non-users saw "Pot" users negatively in the respects stressed by users, and LSD users as less able to cope with life and less successful academically. Both users and non-users saw users as less conformist.
Young 6 surveyed attitudes towards marijuana in a London technical college. He found that 76% of users thought it should be legalised compared to 42% non-users. Five per cent users and 33% non-users considered it addictive, and 20% users and 67% non-users that it leads to heroin. Ninety-seven per cent users and 40% non-users had acquaintances using marijuana, and 24% users and 10% non-users acquaintances using heroin. Users were also more likely to drink and smoke than non-users.
These findings confirm the other studies which show considerable divergence of attitude towards marijuana use between users and non-users.
Hindmarch 7 compared users of various drugs with non-users among students He found that the over-all attitude of both the drug users (of any drug) and the nonusers was positive to both cannabis and LSD, and strongly negative to heroin and amphetamines. Only those who themselves took heroin or amphetamine had positive attitudes to them. Drug users who had not taken heroin had a particularly negative attitude to that drug, even more than those who had taken no drugs.
He found striking differences between the "hard" and the "soft" drug users in the origin of their primary drug experience. The "soft" drug cult revolves more in the "Love ", "Peace ", "Hippy" and "Musical world" of social contact with group experience. Few of the "soft" drug users indulge alone, and to many "heads" (LSD users) the social setting is of major import ". "... On the other hand the ' hard' drug users are alone or in groups of two or three when taking their drugs. Setting is of little import and so is the presence of other persons having a similar experience."
The "soft" drug users have a high regard for "heads" and to be called a "head" is a complimentary term: while "speed freaks" [ 6] (Methedrine users) and "fixers" [ 7] are regarded with suspicion and abhorrence. None of the cannabis users wished to take any drug save LSD, mescaline and psilocybin, they had a particular aversion to "hard" drugs.
The great majority of drug-users taking "soft" drugs (mainly cannabis) did so without any apparent detriment to career and social life. The opposite was true of "hard" drug users.
Government Social Survey. The data for this survey was collected in 1969 from an age-stratified national sample in England and Wales. The survey was presented in a health education and general drug use context and concerned attitudes to both legal and illegal drugs. Due to statistical problems, the results of this survey are not yet published.
Several patterns emerge from the surveys reported above.
Drug use by schoolchildren consisted primarily of amphetamine use. Such use was viewed favourably by both users and non-users, whereas cannabis and LSD use was not. Few were aware of the dangers of amphetamine use. In the past two years this pattern seems to have changed - amphetamines are less readily available, barbiturates and LSD became more common. Cannabis use has probably become more widespread, as it has in the general population. Generally, most children had heard of LSD, cannabis and heroin, but were grossly misinformed (or ignorant of their effects, use and dangers). Very few appreciated the dangers of barbiturates. Older children tended to show a drug use pattern that resembles that of university students. Drug users at school tend to be more precocious than non-users.
Drug use by students contrasted to that of schoolchildren. The most common drug was cannabis, not amphetamines. (This is subject to considerable qualification at this stage - it is not clear how comparable the samples of students and schoolchildren are. It is possible that the colleges surveyed contained a much higher proportion of middle-class students than the schools, and this alone would make a considerable difference. However, Young found that his students who now used marijuana had used mainly "pills" while at school.)
Students were unanimously opposed to opiate use, and very few, even of the users of other drugs, showed any tendency to experiment with opiates.
Attitudes towards LSD were more complex. Users tended to be more favourable towards it, but a fairly high proportion were still wary of it. The publicity given to the findings that LSD may affect chromosome structure played a part in this. It is our impression that when the work of Cohen, Marinello and Black 8 was not substantiated there may have been a rebound effect.
These sociological surveys, apart from their many methodological drawbacks, give only a statistical picture of attitudes towards drug use. Other sources are needed to supplement this picture. The next section is concerned with certain significant groups of young people. Inevitably, such groups are not random samples in the way that subjects of sociological surveys tend to be. They are usually self-selecting by virtue of their common involvement in areas that may include drug use. The groups discussed below are also atypical in that they tend to publicize their attitudes, and thus both reflect and influence the views of others. Presumably there are other groups in society that hold different attitudes, but since no research has been done on them and they do not publicize them, there is no way of knowing their approach, nor the sort of influence they have on others. It is perhaps assumed by politicians and others that there is a "silent majority" who are in favour of the present status quo.
It is an oversimplification to talk of a unitary youth culture. What may be perceived (by the mass media at least) as an undifferentiated movement, can be more accurately described as the simultaneous development of several distinct strands. These separate threads may well have arisen for similar historical reasons and certainly they intertwine and influence each other, but it is more useful for purposes of analysis to distinguish the various elements of the post-war generation.
An artificial but convenient starting point is to classify some of the major elements. These could be described as the student movement, specific political groups, popular protest movements, the Underground and working-class groups.
In England, the student movement has tended to revolve around questions of control over colleges, although it has also been involved in wider protests, especially over the Viet-Nam war. Groups with specific political orientations, usually "left-wing" but with differing ideologies and strategies, are often drawn from the student population but are distinct from the student movement in that their areas of interest are usually outside the colleges - industry, Northern Ireland, etc. Popular protest movements are not identifiable by groups of people who belong to them but by events occurring at a particular time in response to a particular situation. The two prime examples are the Campaign for Nuclear Disarmament, at the end of the 1950s and the Anti-Viet-Nam-War protests at the end of the 1960s. The Underground arose in a different fashion. Whereas the movements mentioned above were founded on traditional "left-wing" political ideologies, the Underground developed as a cultural movement involving concepts of alternative life-styles. Working-class groups are very different from the predominantly middle-class movements already mentioned. They rarely articulate an ideology or direction and often appear to involve overt violence or the threat of it. The Teddy Boys, [ 8] Mods and Rockers [ 9] and Skinheads [ 10] are all examples of this. Often they are easily identified by a uniform that aggressively asserts they are members of a particular group.
When considering the attitudes of young people towards drug use, it is important to look not just at the attitude of a number of individuals, but at the social context of the people concerned, the movement or value system which is their primary reference group and the way in which drugs are used in that group. The elements mentioned do not include all young people, but they cover much of what is often lumped together and called the "youth culture ". Sometimes, especially in the sensational press, this become synonymous with "drug culture". A closer analysis reveals the fallacy of such generalisations.
For example, in recent years the student movement has received considerable publicity. This is true of the increased drug use amongst students. Both may reflect a general dissatisfaction with life in the societies of western Europe, but the two phenomena cannot be combined and treated as one undifferentiated "problem". The main force of the student movement has little to do with drugs - rather it has been concerned either with conflicts over college matters or with mass protest over Viet-Nam. Similarly, although the members of many "left-wing" political groups may tend to use illegal drugs, especially cannabis, such use is of secondary importance alongside the particular political concern. Drugs are a more central part of some of the other two types of group mentioned. They demonstrate two very contrasting sets of attitudes which are well worth examining.
By no means all groups of working-class youth use drugs, but if they do, the drugs of first choice (in England) tend to be amphetamines (taken orally) - drugs which encourage extrovert behaviour - a great contrast to the way in which cannabis and LSD are used by the Underground (cf., below). Since many of these working-class groups arise amongst those who live on anonymous housing estates of industrial towns, who have little to hope for at school and even less to find fulfilling at work, amphetamines give a lift and self-confidence that the rest of their life denies them.
After a voluntary ban by many doctors on prescribing amphetamines, barbiturate-alcohol mixtures, which also encourage uninhibited behaviour, have become more common, as has LSD in some areas. Interestingly, however, in these groups LSD seems to be used more in the way that amphetamines were used then in the self-conscious introspective fashion of the Underground.
The attitudes of a particular working-class group are described in an article by Sheila Yeger 9 about drug use in a grey industrial town in England.
In contrast to the self-styled "beats", [ 11] these boys do not consider themselves to be rebels, though they do seem to regard themselves as a group apart ... Drugs are as much a part of the culture of this group as their mode of dress (smart "mod ") [ 12] and the music they prefer (Reggae). [ 13] Yet the great majority of them use drugs only at weekends. They are almost all "pillheads" (using amphetamines and amphetamine-barbiturate combinations). Some smoke pot sometimes, but most say that it's "no good" or "useless compared to pills"... As many of them are using, say 40 at a time, it is obviously a very expensive business. Yet they seem to regard it as a top priority expenditure and willingly go penniless for the rest of the week. The fetching of the pills, their distribution, the haggling over prices, the inevitable cheating, are all part of a weekly ritual, which, one feels is every bit as important as the pill-taking itself.
These youngsters are not, on the whole, layabouts. They work hard during the week as apprentices or on the railways. Perhaps their jobs are monotonous, but they get through Monday to Friday in eager anticipation of the weekend and in particular of Saturday night ... That is the climax. Everybody, or so they will assure you, everybody was "blocked" (stoned) on Saturday night. They stay awake throughout the night on Saturday, taking more pills as the effects of the first batch begin to wear off, comparing their feelings of well-being, analysing their symptoms.
When the effects of the massive overdoses they have consumed begin to wear off and there are no more pills to restore the sense of well-being, they experience a kind of nightmare hangover... This, too, is all part of the ritual, not to be foregone. In the week, the group will be fortified, will re-establish its special identity with tales of how "bad" John was on Saturday, of how Mick fell down the stairs at the discotheque "blocked out of his mind ".
At the end of the article she comments, "While I would in no way wish to justify or condone their abuse of drugs, there is little doubt, that to these particular youngsters, they represented the key to a different kind, a different quality of life... Without these stimuli they felt dead, or at least, permanently half-alive ".
Most of them, she noted, grew out of it within a few years and settled down. "Within the group, however, there are always one or two for whom the whole ethos of drug-taking holds a special appeal, and these are the ones who come to regard it rather more seriously than their mates. These, I would suggest, are probably young people with personality problems or severe domestic problems". She described one boy, Terry, who started to use heroin on a more than casual basis. "The interesting aspect of all this is that the group which encourages and fosters the light-hearted use of drugs tends to reject its member who becomes more seriously involved. Terry becomes the scapegoat for all their fears. They will refer to his consumption with morbid fascination, will express the belief that he's ' gone too far ', will conjecture as to how he can be helped to 'get off the stuff'."
Wiener, earlier in his research, noted a similar pattern of drug use where amphetamines were taken by working-class children at a discotheque in order to keep awake at night. It is not clear how typical this sort of drug use is. It is certainly less common than it was two or three years ago, and the description just given omits the use of alcohol, sometimes with Mandrax [ 14] that is another increasing trend in some groups. Without detailed study of different groups in different areas of a period of several years, it is impossible to detail the complex and quickly-changing patterns of use and attitudes. Inspector Young's experience with the Newcastle Drug Squad confirms this. In his area he was "unwilling to estimate less than ten different 'scenes ', all overlapping to some degree, all with differing attitudes to their role in society and with each other ... I find that attitudes change as quickly as the slang ".
Undergound groups, which have sometimes been called "hippy ", "beat" or "bohemian", grew up around a particular tradition in music - not the music referred to under the generic label "pop" - but a mixture of jazz, blues and to some extent, folk. Later it incorporated elements from early "rock" music. The use of particular drugs - at first marijuana and later LSD, grew with this musical development. The music of the Underground is different from the easy-to-dance to, rhythmically simpler music of the more working-class groups who have been more likely to use amphetamines. The music of the Underground and its drugs are intimately linked - the music is essentially for listening to and experiencing, not for dancing. Around the music and the drugs, a whole set of inter-related attitudes and life-styles are emerged.
It is too simplistic to think of the Underground as a clearly conceptualized framework. Rather, it has evolved, often blindly, often in a contradictory fashion. But although the Underground is a continually shifting pattern of ideas with no easily identifiable membership, it is possible to tap the general flow of attitudes by examining Underground literature. One of the most fruitful sources of information is the underground press which reflects, crystallizes and, in turn, influences attitudes drifting about various underground groups at any one time. These contrast very strongly with those described in the last section.
All items, whether primarily informative or comment, are favourable towards the use of marijuana. The debate concerning its legalisation is closely followed, especially events in Canada. It is seen as harmless, or relatively so, compared to alcohol, tobacco, barbiturates, etc. The major dangers of its use are seen to arise from the fact that it is illegal.
Attitudes towards LSD are also generally favourable, though more complex. LSD is seen as a much more powerful drug which should be used with discretion. It is surrounded by a mystique that promises a new and enriching experience of life and of oneself if used correctly, but that threatens a vision of hell if unwisely used. Much of the writing of the underground press expresses the belief that LSD does not create what does not exist but allows new experiences of what is already there, be it within the person's consciousness or sub-consciousness, or in the outside world. (This is also the rationale for its use in psychotherapy.) This experience may be very frightening, especially if the individual is in a very insecure situation or has no set of expectations in terms of which to interpret the changed perceptions of self or others. For this reason, attitudes towards LSD, although in principle favourable, often include an element of caution. Leary's [ 15] dictum: "better not to take a trip at all, than to take yourself on a 'bummer' [ 16] " expresses this warning not to use it until one is ready. Another part of the underground mythology concerning "bad trips" [ 17] is that the LSD can be "bad", i.e. adulterated with other substances, such as amphetamines, and that this is a contributory factor. In fact, evidence suggests that this is not the case, and that the previous theory, that the state of mood of the users is of primary importance, is more correct.
Other drugs are mentioned less frequently, and when they are it is almost always disapprovingly. Thus "speed" is described in one article as a drug which makes people "intolerant, uncreative, paranoid and anti-social ". In contrast to the sensitising effects of cannabis and LSD, "speed" is perceived as producing brash arrogance and destroying awareness of self and others. Barbiturates, and similar drugs, are also stongly deprecated. Several articles stress the dangers of use and emphasise how irresponsible and antisocial it is to become a liability to other people through such use.
Heroin and the opiates are generally viewed in a fairly orthodox manner. Articles tend to give a fairly balanced picture of the nature of addiction. These drugs are of little significance in the Underground primarily because they have properties which are seen as antithetical to the values of a culture which esteems freedom, and which sees itself its an alternative form of social existence. Speed, barbiturates and opiates are seen as "mind-deadening" rather than "mind-expanding" drugs. However, there is often support for the users of these drugs, when they are in conflict with the Establishment, even though the drugs themselves are not advocated.
Marijuana and LSD are by far the most important drugs of the Underground. Far more space is devoted to them in the underground press than to all other drugs. Detailed accounts of their history of use, the different varieties, their properties, preparation, cultivation, availability, regularly appear. They are a very significant part of the whole underground culture and it is worth examining the meaning of their use in a wide context.
Their use is often seen as part of a whole movement towards an alternative way of life. This may be felt only vaguely or it may be expressed very articulately. The values of this counter-culture are primarily anti-materialistic, anti-competitive, anti-bureaucratic, and very much in favour of personal and collective freedom and co-operative or communal existence. Marijuana and LSD are central to this ideology. (One argument used against marijuana is that it reduces motivation to work !)
During the past few years, a small section of the Underground has developed a more definite political stance relating the use of marijuana and LSD to a theory of political change. Thus one article argues that "dope has made a significant contribution to bringing people together, exposing the Establishment to ridicule and creating an incipient revolutionary movement". This element is fairly vociferous, probably only a small number in the Underground hold a coherent political ideology and are primarily concerned with working towards long-term change. Most, although seeing themselves as non-conformist, and as in some way part of" an alternative culture ", do not articulate an explicit ideology. Conversely, there are those who see drugs as a block to further progress. Thus, John Lennon has said recently that it is necessary to get past the "post drug depression" if the revolution is to come of age.
Thus there are several distinct trends which can be discerned within the Underground. One is the emphasis on self-expression, hedonism and a search for individual enlightenment. Within this cluster of attitudes there are several sub-groups - the use of LSD is a good example. Another is the role of drug-use as a political weapon. These trends can often be traced to the influence of a few highly articulate individuals or groups. As their influence has spread, so it has become distorted, mingled with other influences and losing its original purity and power. As one moves away from the mainstream of the Underground movement, the use of certain drugs is no longer, for many, associated with a particular ideology, aesthetic or political. It often becomes almost indistinguishable from the purely social use of, for example, alcohol. This is particularly true of cannabis, but not so much of LSD. There still remain overtones of the original influences, even in student groups which would not consider themselves part of the Underground, but the effect of the Underground movement has been to increase the popularity of cannabis until so many respectable people smoke it that its use is ceasing to be the trade mark of the Underground. Despite this dilution, it is clear that the attitudes of the Underground towards drugs differ considerably from the attitudes of working-class groups.
Apart from young people who use drugs within the framework of a particular group or value system, there are other users who cannot be categorised so easily. Often cannabis is used in social gatherings in much the same way as alcohol. Not much can be said about such use, save that surveys suggest it is increasing with little apparent harmful effect, such as increased road accidents or deterioration in work capacity. LSD is sometimes taken because it is there and for no deeper reason, and the same no doubt applies to most drugs. There are hardly any sources of information about such use, which is probably on a fairly casual basis, and for that reason this paper has concentrated on certain sections of the youthful population. It seems likely that although experimentation with various drugs is quite common, few young people use drugs regularly outside of a group where such use is part of the sub-culture.
One group which is of interest, although numerically small, is the opiate-using sub-culture. Opiate addicts in England tend to be poly-drug users, but they do not tend to overlap with other drug-using groups who on the whole view the addicts as "sick". Generally, the attitudes of the addicts towards opiate use is ambivalent. On the one hand they get satisfaction from fixing but on the other feel they want to escape from their self-imposed imprisonment. "Heroin is a beautiful drug" and "I want to be normal" may often be expressed in the same breath. Many addicts will say that the only frustrating aspect of heroin lies in the problems of obtaining supplies. One might expect their attitudes towards the government treatment centres to be strongly favourable, but for several reasons they are usually ambivalent. One reason lies in the policy of many of the clinics. The tendency has, in the past few years, been to reduce considerably the amount of opiates prescribed, so that a number of addicts, especially those who used to receive large prescriptions from private doctors, feel they do not get enough. In some cases this is certainly true. Also, several clinics will now prescribe methadone only, not heroin. Many addicts prefer heroin, especially if the methadone is offered in oral form. These two factors lead to a considerable amount of conflict between doctor and patient. As a result, many addicts consider that the replacement of individual doctors by the clinics has lead to the increased use of" Chinese" [ 18] heroin and barbiturates instead of pure heroin. They rarely remember how over-prescription helped create an expanded demand in the first place by initiating new cases.
The policy that is adopted towards drug use depends on which long-term objectives are seen as both desirable and realistic. One aim, which is sometimes stated, could be the elimination of the "drug problem ". But this begs the question as to what is the "drug problem ". Is it just illicit use of drugs listed as dangerous? What of the millions of alcoholics throughout Europe - is alcoholism not a "drug problem" purely because it is legal. Tobacco, too, is responsible for a vast amount of illness and premature death. The heavy sales of barbiturates and tranquillisers can hardly be ignored simply because they are not included in certain legislation. And in some or many cases use of cannabis may present far fewer problems than many legal drugs.
Not only is there difficulty over which are the most problematic drugs, but questions about the nature of the "problem" must be faced. Is drug use a problem at all? If so, to whom is it a problem? And what sort of problem is it; what is its origin? Thus most social drinking seems to have few disadvantages. Some, however, causes concern, but it is often not clear whether it is called a problem because it is harmful to the individual and the immediate family, because it may be economically damaging to the society, or because it offends puritanical beliefs. And once it is decided that certain drinking is a problem, does the difficulty lie in the inadequacy of the individual, or is his social situation so intolerable that the best of us would turn to drink?
Even if all these questions are answered, and they rarely are, elimination of a "drug problem" may not be a realistic aim. It may not be possible to stop groups of young people using drugs because, as we have seen they fulfil an important function in those groups. Drug use, legal and illegal, medical and non-medical, is an integral part of our lives and we must learn to come to terms with it and concentrate on reducing its most damaging aspects (once it is agreed what these are !). The evidence discussed earlier in the paper suggests that non-medical drug use often occurs among young people who feel alienated from the wide society or who find little fulfilment in their social circumstances. (This is not saying that all users are in this position.) It is beyond the scope of this paper to discuss the wide-ranging social and political issues that are raised by such considerations, but the post-war period of rapid social change and the concomitant disenchantment with the nature of western societies on the part of some sections of young people are clearly relevant to the development of the" drug problem" as to many other phenomena, such as rising rates of suicide, mental illness and delinquency. For example, it is no coincidence that the heavy use of amphetamines by groups of working-class young people was found on dreary housing estates built piecemeal after the War without provision of any community amenities, or in depressing industrial towns. While fathers worked at monotonous jobs waiting for the drinking session at the weekend, so their sons worked at equally monotonous jobs waiting for their weekend "lift ". It was not just that alternative recreational facilities were not available, but that there was nothing in the future to hope for.
Although these broader issues are not the immediate concern of this paper, the suggestions that follow must be seen as limited in scope within the context of wider social problems.
The aim of these proposals is to suggest ways in which the more harmful effects of non-medical drug use may be reduced. The proposals fall into two general categories. One would be called " education " in a wide sense, the other " social action ".
Many users do not in fact come to any harm. Thus most of the members of amphetamine-using groups settle down after a few years. The same is true of the majority of students who smoke cannabis (Hindmarch found this to be the case in his research), or of those who consider themselves part of the Underground. However, there are some who do suffer considerably. It is suggested that rather than rely on legal controls to limit this damage (and it can be argued that in some cases those legal controls themselves are responsible for some of the damage, which includes the consequences of prosecution and the alienation of the police), we should concentrate on providing reliable information about drugs and their use, especially about what to do with casualties (education), and at the same time help provide supportive services to prevent or deal with these casualties (social action).
The way in which this should be done will vary according to the group concerned, whether they are users or non-users, whether they are schoolchildren or older.
The research of Hindmarch and Wright reveals extensive lack of understanding among schoolchildren of the dangers of various drugs. Most of the information seemed to come from the mass media. Nor is the lack of understanding limited to schoolchildren. Binnie found that students considered alcohol and tobacco to be a negligible risk to physical health. Inappropriate use of drugs, such as aspirin as a remedy for stomach pains, is another example in the wider field. The use of the mass media by advertisers promoting drugs, be they " popular " remedies, alcohol, tobacco, stress relievers, etc., plays an important role in this.
This suggests several areas where general education about the use of drugs is necessary. The first concerns the mass media. It is difficult and perhaps undesirable in a free society to control their output, though it could be fruitful to discuss ways of encouraging the media to provide a more balanced and accurate coverage. It is also important to look more closely at the insidious effects of much advertising. Another area concerns education in schools. There are problems in this. Some feel that drawing attention to drugs will in fact have the opposite effect to what is desired. One way of avoiding this might be to include discussion about drugs within a wider course concerning health. Illegal drugs, which often appear to be surrounded by a certain aura of mystery and excitement, would be dealt with in a straightforward, factual way alongside other drugs such as alcohol, tobacco, aspirin, sleeping tablets, etc. within a course including other matters, such as hygiene, prevention of infection, first aid, etc. Such innovations in a school curriculum would, of course, entail educating the teachers themselves.
Whatever way is used to educate people, whether it is in school, through the mass media, in books or within groups, it is vital that the information be accurate, otherwise the source of information will be discredited. If someone trying cannabis discovers they do not immediately descend into hell, despite over-enthusiastic warnings, they are that less likely to believe warnings about other drugs.
So far, we have concentrated on very basic, general " education ", which might affect an undifferentiated population of children or adults, most of whom consume several " acceptable " drugs without any clear idea of what they might be doing, but relatively few of whom are likely to use drugs in what is perceived in a " deviant " way. It is among these latter groups that casualties arising from drug use are likely to occur, and a different approach is required for them. Whereas the purpose of the educative policies regarding the larger, general population of non-deviant users is to promote a more balanced and responsible use of all drugs, the aim of policies concerning smaller, more specific groups of people who use various drugs in deviant ways is to reduce the amount of harm done.
That a different approach is required for users than for non-users is supported by research in Canada by Dr. R. G. Smart and Mrs. D. Fejer 10. This research was based on the well-documented fact that a given communication has more influence if it is attributed to a source that has high rather than low credibility. The two main elements which determine credibility are the perceived " expertness " and " trustworthiness " of the source. They found that generally students acquired their information from the most trusted mass media, usually magazines or television. Doctors or scientists were viewed as the most expert and trusted communicators. Thus for most students the opinions of doctors or scientists expressed through magazines or television were more credible than friends, whether drug-users or not, teachers or parents. Teachers expert in drugs, however, were almost as credible. The first step in the development of school education programmes, if they are thought desirable, is to educate at least some of the teachers.
Differences were found among users of various drugs, however. Illicit drug-users most often acquired information from friends or their own experience, and trusted and viewed as most expert other drug users. These differences were particularly great for opiates, LSD and " speed ".
These findings confirm the need for more reliable presentation of facts about various drugs in the mass media (preferably by "experts"), and for some teachers to study aspects of drug use in a thorough manner.
The implications for various groups of young people already using illicit drugs, especially those whose use is considered more deviant, are very different. If the most credible sources of information are within the drug-using groups, then it is more useful to feed information through the present channels of communication within the group.
As regards the Underground, the two main channels are the underground press and various organisations that have arisen within the Underground. Those involved in them are usually fairly knowledgeable but are by no means always accurate. If they are fed with reliable information that stands up to close examination, then there is a fair chance that it will eventually filter through the grapevine. Thus sometimes one of the underground papers will carry a warning from Release about particular drugs such as Mandrax or the barbiturates. It has been suggested that the proportion of " bad trips " on LSD, and of severe adverse reactions to cannabis have diminished as a tradition of use, a mythology has developed, so that users now have a " set " of expectations in terms of which they can interpret their experiences. No strict scientific study has been carried out, but it is certainly true that unusual events are less frightening if the person knows what to expect, and is with others who are more experienced. In this way, the underground press and various organisations serve a very useful function in helping to limit the casualties that arise from drug-use. One implication is that perhaps adverse reactions can be reduced by teaching people to " enjoy " the drug. This raises several questions about the purpose of drug abuse control.
The working-class groups who may use amphetamines, barbiturates or LSD are different. They have no visible channels of communication save a grapevine that exists in a particular town or area. Perhaps the only way of feeding information to such groups is through a suitably chosen, sympathetic, unattached youth worker who works in the area, possibly at one of the cafes the particular group frequents, and who is seen by the group as non-establishment, non-moralising and as someone to give help if asked. Such help might sometimes be welcome, for example, in the case of Terry (mentioned above) when the rest of the group became very worried about his increasingly heavy use. The main aim of such an approach would not be to try to persuade against drug use-this would entail total rejection-but rather to provide information and help over dealing with possible casualties. Another possibility is to look at the papers or magazines that such young people read and try to feed reliable information to them. Popular figures-film stars, " pop " groups, etc., can also have a significant influence on their followers and there may be an opportunity to use them as " educators ".
An important but often neglected area of education concerns parents. Dr. Smart has shown that there is a positive correlation between parental use of legal psychotropic drugs and illicit drug use by their children. This underlies the need for greater responsibility on the part of drug companies, their advertisers, the media and doctors in their promotion and prescription of drugs, and for better health education for future generations of parents. How to educate present parents is an important but almost unanswerable question. Parental use of drugs is only one aspect. There is a wide gap between the drug-using groups of young people and their parents' generation which includes most teachers, magistrates, police, social workers and legislators. It is in part this gap which aggravates the problems associated with drug use, as well as causing many other difficulties unrelated to drugs. There is an urgent need to de-escalate the current hysteria among the older generation about drug use, as well as concentrating on reducing the casualties of drug use among the young.
The various organisations and services that have arisen within the Underground as alternatives to the legal, supportive and informative structures of the Establishment exist because of a demand from those who mistrust lawyers, doctors, social workers, etc. who work within an institutional framework. Such services fulfil a function that established social services are unable to provide. Professionals can be accepted in such services as long as they are seen in a non-Establishment role. One example of this is the operation of Release at " pop " festivals. One is a legal advice tent (with qualified lawyers who are members of Release). The other is a " bad trip " tent giving reassurance and help to anyone suffering from an adverse reaction to LSD. (There is always a doctor-again a member of Release-available in case of a medical emergency.) This tent is staffed by volunteers, most of whom have themselves used LSD and are thus able to provide the sort of support that is unavailable in the ordinary medical tent. Examples from other countries include the Haight-Ashbury free clinic in the USA and the Youth Action Centre (JAC) in Amsterdam. The latter is a walk-in centre where young people can obtain advice or help over a wide range of problems. They are staffed by young " informal " professionals who are more acceptable to clients than official professionals.
Thus, some people will go to Release or to one of the other " alternative " organisations when they will not go to the established social or legal services. For this reason, if the harmful effects that arise from some drug use are to be reduced, it is more useful to encourage such services rather than to discourage them. Such encouragement might take the form of financial aid or even just restraint from active opposition. Some advice could be given about how to recognise cases that require urgent medical attention (e.g. barbiturate overdose). It is important, however, to avoid trying to incorporate the underground services within the existing framework. They arose outside it because there was a demand, and they will lose all their effectiveness as soon as they cease to be seen as " alternative " organisations. Such services should be encouraged on a local level so that they can adapt to changing problems in their area. [ 19]
A similar principle could be applied for other groups who tend to use various drugs. Dictating right and wrong, issuing grave warnings, may confirm some nonusers in their beliefs and it may satisfy those who preach, but it will have the opposite effect on the groups concerned. If we are concerned with limiting the number of casualties, it is necessary that whatever supportive services develop should start from the position of those who are using. Thus, if it is decided to provide an " unattached " youth worker to the town where there is a working-class group like that described earlier, the first priority is to be accepted by the group. Only then could any information or help be of use. The moment the youth worker starts to moralise or to give information that does not stand testing, he is likely to be discredited.
There are many aspects that have not been mentioned in this paper. The main point that it has tried to make is that drug-use is not a superficial attachment to our societies but part of it. In several groups drug-use fulfils a central function. In others, it is widely accepted as normal. The approach to drug use taken has been that rather than concentrate on eliminating it, we should examine first why we call it a problem, what is the nature of the problem and then work towards the best way of reducing the casualties of drug use.
I. Hindmarch, The patterns of drug abuse among school children. Bulletin on Narcotics , XXIV, 3, pp. 23-26.
J. D. Wright, " Knowledge and experience of young people regarding drug abuse." Proceedings of the Royal Society of Medicine , July 1970.
R. S. P. Wiener, Drugs and Schoolchildren . Longman, London (1970).
A. Kosviner and D. V. Hawks, Personal communication (1972).
H. Binnie, The Attitudes of Drugs and Drug-Takers of Students at the University-Colleges of Higher Education in an English Midland City. University of Leicester (1969).
J. Young et al., Student Culture Report. Enfield College of Technology (1971).
I. Hindmarch, Patterns of drug use in a provincial university. British Journal of the Addictions (1970).
M. M. Cohen, M. J. Marinello and N. Black, Chromosomal damage in human lymphocytes induced by LSD. Science, Vol 155, 1417-19 (1967).
Sheila Yeger, New Society (1970).
R. G. Smart and D. Fejer, Credibility of drug information for high school students. Journal of Drug Issues, Vol 2, No. 2 (1972).001
1. A description is given later in the paper, cf. pages 17-19. The newspapers referred to include IT (International Times), OZ, FRENDZ and several other smaller publications.002
2. These were usually barbiturates or other sedatives (Hindmarch - personal communication). Often the drug-using schooldchildren were not sure of the exact nature of the drug taken, and were prepared to swallow whatever "pills" were available.003
4. Release is an organisation founded several years ago to provide legal advice for those arrested on drugs charges. Since then it has widened its scope of activity and gives advice and help not only about drugs, but about other social problems. It exists for those who mistrust official legal and social work agencies.004
5. There is no precise definition of " hard " drugs. The term is often used to refer to those drugs which are considered particularly dangerous or addictive. It is sometimes applied to drugs when they are injected. Thus heroin and other opiates are always classed as "hard" drugs. Methedrine (methylamphetamine) which was injected by many addicts a few years ago, and barbiturates which are injected by many now, are also usually termed" hard ". Amphetamines and barbiturates, when taken orally, may or may not be included.005
5. "Soft" drugs are those which are considered to be less dangerous or addictive. Cannabis is usually called "soft ". Orally consumed, amphetamines are sometimes classed as "soft ", rather than "hard ". LSD is often not categorised in this way at all. When it is, it depends very much on the point of view of the individual whether it is called "hard" or "soft ".006
6. This was a term given to regular users of injected methedrine. It later became more generally applicable to any heavy amphetamine user. The term is used much less now than it was a few years ago.007
7. Fixers equals "injectors ", usually referring to those who inject opiates, and sometimes to those who inject any drug regularly.008
8. Teddy Boys belong to the late 1950s. They were identifiable by expensive suits with long, velvet-faced jackets, padded shoulders, and tight "drainpipe" trousers, narrow ties, long pointed shoes and well-greased, swept-back hair that was long at the front and short at the back. They are identified with early "rock 'n roll" music, such as that of Bill Haley and early Elvis Presley.009
9. Mods and Rockers were two antagonistic groups who were involved in several well-publicized fights at seaside resorts in the middle 1960s. The "mods" were neatly dressed, often with pale sports jackets, had short hair and rode motor-scooters. In contrast, the" rockers" were similar to Hell's Angels, with jeans, metal-studded leather jackets, long untidy hair and big motorbikes.010
10. Skinheads appeared at the end of the 1960s. Their uniform consisted of heavy steel-capped boots, jeans held up by braces and turned up at the bottom to show the top of the boots, a particular type of shirt and very closely-cropped hair. They were probably the most overtly aggressive of all the groups mentioned here. Violence was central to the skinhead identity, and was often directed at Pakistanis, long-haired students and others, and at homosexuals. Their music was "Reggae ", a particular form of West Indian music.011
11. "Beats" can be considered equivalent to "hippy" in this context.012
12. See note 9 above. Although the mods and rockers disappeared as identifiable groups, their influence continued and merged with the influence of the skinheads. Often groups of working-class young people, although they do not consider themselves "mods" or "skinheads", adopt some of their styles of dress and music.013
13. See note 9 above.014
14. A hypnotic sometimes given instead of barbiturates as a sleeping tablet. Produces very uninhibited behaviour when mixed with alcohol.015
15. Timothy Leary - author of "Politics in Ecstasy ". Often referred to as the "high priest" of the "psychedelic revolution ".016
16. "Bummer" equals "bad trip", see note below.017
17. "Bad Trips" phrase used for adverse reactions to LSD. Most bad trips appear to be panic reactions.018
18. In the past three years, much of the black market in England has been imported from Hong Kong. It is usually adulterated with barbiturates, amphetamines, chalk, talcum powder, brick dust and sometimes strychnine as well as other impurities. The heroin content varies between 15% and 70%. In contrast, "English" heroin is pure because it comes from medical sources, either stolen from a chemist or prescribed by a drug clinic.019
In England, some local authorities have actually helped to finance such local groups.