grund sifaneck-cross-cultural dimensions of self-regulation-towards a multi-drug model

Cross-Cultural Dimensions of Self-Regulation:

Towards a Multi-Drug Model

Jean-Paul Grund, Ph.D.

The Lindesmith Center, Open Society Institute,

Department of Sociology, UCONN

&

Stephen Sifaneck, Ph.D.

Institute for AIDS Research,

National Development & Research Institutes,

John Jay College of Criminal Justice, CUNY

Is use of intoxicants abnormal? Deviant behaviors of (a minority of) consumers of

illegal drugs are often directly attributed to a

substance which renders them powerless. This

popular wisdom is in various forms mirrored in

several scientific explanations:

Over-powering pharmacological properties:

“[Drugs] hijack the brain, eroding, but not

erasing, the ability to control ... use.” (HDK, NYT, 41798)

deficient personality structures, impaired

psychological development, acute distress,

psychiatric problems.

Environmental deficits, (poverty, racism).

From a global and historical per-

spective, Intoxicant use is a norm

Societies differ only in respect to which drugs

are defined as acceptable or unacceptable.





Definitions may change over time.






We are not alone. A wide variety of species

deliberately seek to change their consciousness

by ingesting a range of psychoactive

substances. (Siegel, 1990)






We are not alone. A wide variety of species

deliberately seek to change their consciousness

by ingesting a range of psychoactive

substances. (Siegel, 1990)

In the more complex human context, drug use

fulfills important instrumental and symbolic

functions for individuals and the social group.

Conceptual Problems and Bias (1)

Discourse: a strong concensus on nomenclature

remains absent despite several efforts over the

last decades (Edwards et al., 1981).

The concept of addiction, for example, is

generally presented as an isolated individual

behavior without acknowledging the impact of

"central cultural conceptions of motivation and

behavior" (Peele, 1985) that vary across

cultures and effect drug taking behavior.

Conceptual Problems and Bias (2)

Methodological limitations traceable to biased

samples of addicts, generally collected in

treatment settings lead to problems of

conceptual generalization.

– Behavior that is dysfunctional or abnormal

from the clinician's perspective can be highly

functional from the drug user's perspective.

– Just as law enforcement personnel, clinicians

generally see drug users “at their worst.”

The Presenters’ Bias

it is necessary to look beyond the clinical

presentation of drug use and study its various

expressions in their natural environment.

Studying drug use in its natural setting offers a

significant opportunity to collect basic

information on patterns of use, interactions

and other behaviors of drug users.

It can show how these behaviors interact with

external determinants, such as drug policy.

Some observations

90+% of alcohol users consume in a controlled

fashion with few or no negative effects.

Similar ratios have been observed in traditional

opium using cultures.

Women, particularly those with children, have

higher abstinence rates than men after

treatment for alcohol problems.

Nowadays we see few “Bad Trips,” despite

significant levels of psychedelics use.

Some observations

The average dose of XTC in the Netherlands is

1-1.5 tablets, while in Britain it is not unusual

to take 4 or more tablets a night.

Swedish cannabis users have much higher rates

of psychiatric morbidity than Dutch users.

Dealing cocaine smokers use more cocaine, but

experience less cocaine-related problems than

street users.

Ketamine is typically snorted in New York,

swallowed in London, and injected in Moscow.

Some observations

Although cannabis can be bought without fear

of procecution in so-called coffee shops

throughout the Netherlands, only 1.7 to 3 % of

the population over age 12 used the drug in

1996 (LMP).

Despite much stricter policies, a government

study found in 1996 that 4.2 to 5.3 % of the

U.S. population had used marihuana in the last

month.

Pharmacology is not Destiny

Different people respond differently to the

same drugs.

The same people respond differently to the

same drugs under different conditions.

The effects of drugs are moderated by the

psychological make-up of the user and the

social environment in which drugs are

consumed.

Zinberg, 1982

Drug

Set Setting

Functions of Ritual

Ritualized behaviors serve a multitude of

instrumental and symbolic functions, both for

individuals and their social group.

– Reduces fear and uncertainty;

– Strengthens self-confidence, social solidarity;

– Prepares for the execution of certain tasks;

– Symbolizes transitions from one state to

another, for example in a wedding

ceremony, or when getting high.

BLUNTS & BLOWTJES

Blunts & Blowtjes

Cannabis preparation rituals

Combination of Cannabis and Tobacco

Symbolic meaning

Self-regulatory function of rituals in different

cultural contexts

The ritual sharing of drugs

In the Netherlands, heroin and cocaine are

primarily obtained and frequently used at so-

called deal and use addresses.

Usually several people are present in a pub-like

atmosphere and in 50% of registered

observations drugs were shared.


Instrumental function of drug sharing

– Preventing withdrawal. "Helping" with a

"betermakertje" (a little dose to ameliorate

withdrawal) is a common motivation.


Symbolic and social functions of drug sharing

– Opening of communication channels;

– Strengthening ties among individual users

– Strengthening social networks;


Symbolic and social functions of drug sharing

– Opening of communication channels;

– Strengthening ties among individual users

– Strengthening social networks;

– Smothering social conflict and feelings of

animosity;

– Creating and reinforcing feelings of identity,

social solidarity and group cohesion.

Non-Injecting Heroin Use in NYC (A. Neaigus, PI)

Sample: N = 611 NIUs

Sample typology:

– Never injectors 70%

– Experimental injectors 8%

– Ex-injectors 22%

Use alone 34%, with single partner 21%

Reported no dependence 35%

A paradoxical observation

The ability to exercize control over individual

drug use is not evenly spread over all users.

– Some cocaine users, such as dealers, use

large amounts of cocaine seemingly with

little or no cocaine-related problems.

– Other users --typically the "down and out"

street junkies-- actually use much less

cocaine, but seem most susceptible to

cocaine-related problems.

Two conclusions

Self-regulation is more than limiting the intake

of drugs. It is a multidimensional process,

which includes prevention and management of

drug related problems.

The effectivity of rituals and rules in regulating

drug use is moderated by additional factors

which impact on the individual's ability to

comply with these rituals and rules.

grund sifaneck-cross-cultural dimensions of self-regulation-towards a multi-drug model

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