Salient: Victoria University of Wellington Students' Newspaper. Vol. 32, No. 10. 1969.
Marihuana — and the myth of addiction
and the myth of addiction
Our society surrounds the taking of drugs with a great deal of mythology, i.g., that All drug-taking leads to addiction, or that LSD is Always taken 'for kicks', or that one shot of Heroin converts an ordinary person into a confirmed addict. This article will examine one piece of conventional wisdom: that those who use marihuana inevitably graduate to the use of harder drugs*.
* e.g., Heroin, Cocaine, Opium.
There is a conflict of opinion on this subject. This is best exemplified by considering the following four quotations:
"There remains an increasing progression from marihuana to the amphetamines and on to heroin and cocaine. This is helped by smoothly operating pushers ... for the persons concerned this is inevitably tragic, ending either in suicide or complete physical wreckage." The Times, 21/12/65
"The abuse of Cannabis is dangerous because only too frequently it leads to very much more serious drug addiction particularly heroin addiction (as in the United States.)"
The International Control of Drugs. U.N. Bulletin (n.d.) p.27.
"Cannabis is not addictive, its use does not cause serious crime or unacceptable sexuality, and it does not lead to addiction to hard drugs. The major problem with (this) drug is that it is illegal."
Laurie, P. (1967): Drugs. Penguin Books, 1967, p.158.
"It can clearly be argued that on the world picture Cannabis use does not lead to heroin addition ... our witnesses had nothing to add to the information already available, and we have concluded that the risk of progression to heroin from Cannabis is not a sufficient reason for retaining control over this drug."
Cannabis: Report of the Advisory Committee on Drug Dependence (The Wootton Report). HMSO, November 1968, para. 51, p.133.
This conflict of opinion is also reflected in the New Zealand setting. A number of magistrates, police officers and newspaper editorialists have reasserted and aligned themselves with the quotation from the U.N. Bulletin referred to above: that is, they support the truth of the 'progression hypothesis'. Only one person (John Dobson, principal psychiatrist at Christchurch Public Hospital) has chosen to challenge this claim. Most of the evidence fails to support the belief of an "increasing progression from marihuana to the amphetamines, to heroin and to cocaine." (cf. Bull. 1967; Klein & Phillips, 1968; LaGuardia Report, 1944; O'Donnel and Ball, 1966; Schur, 1963, and Zingberg & Weil, 1969). The only evidence to support such a conclusion is provided by Wade (1969) and Ball et. al. (1967).
The only way to consider the claims of the progression-hypothesis is to examine the evidence on which such an hypothesis is based.
No observers have (ever) suggested that there is any pharmacological reason why escalation from pot to heroin should occur. In the terms used by Lewis (1968), most observers attribute progression to one of three factors: "association with friends who are heroin addicts; ... or an increasing dissatisfaction with the pleasure gained from Cannabis vis a vis Heroin; ... or as a consequence of a predisposition to marihuana and also to heroin." (ibid. p.54). In elaboration on these three factors other writers imply the presence of personality characteristics which lead an individual to try marihuana, and these same characteristics are then held to also lead a person to try other, harder drugs. It is in this sense that the term 'predisposition' has and is being used.
Ball et al (1967) retrospectively examined the case histories of 2213 addicts admitted to Lexington and Fort Worth hospitals in 1965. They concluded that marihuana-smoking could rightly be seen as a predisposing influence in the etiology of opiate addiction in the U.S.A. They explain this relationship in the following terms:
"The incipient addict is predisposed to opiate addiction by his use of marihuana for the following reasons: marihuana and heroin are only available from underworld sources of supply; both are initially taken within a peer group recreational setting; both are illegal; the neighbourhood friends with whom marihuana use begins are often the same friends who initiate the incipient addict to the use of opiates.
The data of the present study support the conclusion that marihuana use is closely associated with opiate addiction in the high drug-use metropolitan areas of the East and West Coast, but not associated with opiate addiction in the twelve Southern States." (cf. Lewis, 1968, op. cit. p.54.)
Granting the appropriateness of the evidence by which this conclusion was reached, the above statement prompts several questions. Firstly, if the relationship is "a close one" in the East and West Coasts but not in the Southern States, then the nature of the casual link is most certainly sociological in nature. Secondly if the relationship is sociological it is most likely as Ball et al note, that this is because of propinquity: but, this cannot provide a total explanation since propinquity also is operative in the Southern States but does not seem to result in progression to other drugs. Thirdly, the comments by Ball et al provide no clue as to how much more likely marihuana-users are to progress than are non-users, and surely this is the critical issue. All these authors do is observe that marihuana-use and opiate-use are "closely associated". As a final caution I ought also to note that this study used heroin addicts as a sample and is therefore unlikely to either have an adequate sample of heroin-users (i.e., not all heroin users become addicts. cf. Davis & Munoz, 1968) or an adequate sample of marihuana-users. This research is thus suggestive of a possible trend and no more.
A much more sophisticated attack on the problem has been used in an unpublished report by Paton (1969), in which an attempt is made not only to secure evidence as to whether 'progression' is a 'fact', but to estimate 'how much of a fact it is'. First of all Paton (in Wade, 1969) argues from statistical grounds and suggests three different ways in which it could be shown that no such relationship could exist: firstly, if it might be demonstrated that the onset of heroin use came earlier than Cannabis-use; Secondly if the use of the two drugs is the country leapt to their feet to declaim their ignorance. Moralists mumbled non sequeters from Whapakiwi to Pahiatua.page 5
unrelated it might be expected that the number of Cannabis-users would be about the same in a heroin-using population as in a normal population; Thirdly, one could examine historical records, and if it could then be shown that if heroin taking began much later (or much earlier) than Cannabis-taking, or at the same time but at a different rate, then one would have some reason for supposing that the two drugs had little to do with each other. Paton was forced, on the British evidence (cf. Contra. Wootton Report) 1 to reject all these three possibilities: Cannabis and the amphetamines are habitually taken at least two years before the average age at which heroin is first taken (this 2-year time lapse is also reported by Ball et. al., op. cit.); Cannabis-use among a heroin-using population is much higher than among a 'normal' population.2 On the third question Paton has shown that in 1958 the number of Cannabis-offences rose dramatically, followed two years later by a similar up-turn in heroin-related offences. From that time onwards offences related to both drugs have maintained a steady growth rate of about 50% per annum.
Paton then attempts to get a more direct test of the progression hypothesis. He argues that the clinching evidence would be to know the incidence of heroin-taking among Cannabis-users, and this is, of course, not known since the incidence of Cannabis-use is an unknown factor. However, using Bayer's theorem one can get an approximation from the opposite incidence—that of cannabis-use among heroin-users. Using this theorem (cf. Wade, 1969, p.118). Paton estimates that between 7:5% and 15% of Cannabis users will be, or are users of heroin (not that they will become heroin-addicts3). This conclusion receives additional, if limited support, from an earlier British Study (cf. Beckett, 1967) which reports that about 10% of those interviewed who used marihuana had also used heroin.
Thus we have the evidence and the conclusions. Some assert a definite relationship (cf. Ball et al; Paton op. cit; U.N., op. cit.) others opt for no relationship (cf.
Wootton, et al; Laurie op. cit.) Where a relationship is assumed to exist it seems that this is a product of the social use of the two drugs rather than anything inherent in the pharmacological nature of the drugs themselves.
One further question remains to be dealt with: how can we explain the apparently contradictory conclusions? Comments from magistrates, most newspaper editorialists and others can generally be explained in terms of a blind repetition of the comments of others, and in the process the tentative conclusion becomes the dogmatic fact. However, the evidence of Ball et al, and that of Paton is of a different nature altogether. They both conclude that there is a relationship, and that it is of the order of 10%. Ball observes that this is true for the East and West coast metropolitan areas, but not in the Southern states: this could point to the source of the conflict, since it may well be that different communities use drugs in different ways. Carey (1968) shows that in the Bay Area marihuana (and LSD) are both widely used, whereas heroin and related drugs are used very infrequently. Allowing for the two-year time-lapse suggested by Paton, does not alter the firmness of the support for this conclusion. Carey has studied communities where heroin is used widely and with other authors (cf. Feldman, 1968; Klein & Phillips, 1968) has shown some of the (sociological) differences between the two types of community —basically these turn on the nature of social class factors within the communities.
I would conclude by making two further observations. If the main line of causation is explained in terms of accessibility and incidentally the illegality of both, then one solution to this would be the legislation of marihuana. Given the fact that it is a relatively harmless substance, that it is susceptible to taxation provisions, this might be a reasonable solution to the dilemma. Secondly, this approach can only be evaluated following full scale research into the physiological and sociological consequences of taking marihuana: At present the law prevents such research being undertaken: a relaxation in this direction might well provide for a more rational discussion of drugs and related issues.
- Ball, J. C.: Marihuana Smoking and the Onset of Heroin Use. Brit.j.Criminol., 1967, 7, 408-12.
- Ball, J. C. et al.: The Association of Marihuana Smoking with Opiate Addiction in the United States. Paper to the Ann. Mtg. American Sociological Assn., San Francisco, August, 1967.
- Ball, J. C. & O'Donnell, J. C.: Narcotic Addiction. Harper & Row, New York, 1966.
- Davis, F. & Munoz L.: Heads and Freaks: Patterns and Meanings in Drug Use among Hippies. J. Health & Son .Behav., 9, 1968, 156-63.
- Bewley T.: Recent Changes in the Pattern of Drug Abuse in the U.K.Bull. Narcot., 1966, 18, 4, 1-13.
- Lewis, Sir A.: A Review of the International Clinical Literature Relating to Cannabis. Appendix 1., Wootton Report (1968) pp. 40-63.
- Carey J. T.: The College Drug Scene. Prentice Hall, N.Y., 1968.
- Klein J. & Phillips, D. L.: From Hard to Soft Drugs: Temporal and Substantive Changes in Drug Usage among Gangs in a Working Class Community. J. Health & Son. Behav., 9 1968, 139-45.
- Schur, E. M.: Narcotic Addiction in Britain and America. Tavistock Publications, 1963.
- LaGuardia Report: Mayor's Committee on Marihuana (New York). Lancaster, Penn. 1944.
- Wade, N.: Pot and Heroin. New Society, 23rd January, 1969.
- Beckett, D.: Should we Legalise Pot. New Society, May 18th, 1967.
- Zinberg, N. E. & Weil, A.: Cannabis: The First Controlled Experiment New Society, 329 January 1969, 84-86.
- Feldman, H. W.: Ideological Supports to becoming and remaining a Heroin addict. J. Health & Son. Behav., 9, 2, 1968, 131-38.
1 In passing I might note that Paton's evidence was made available to the Committee but was not used.
2 No reliable statistics as to prevalence are available. Bewley (1966) suggests that in a student population 4% will be 'steady users' and 1 on an 'occasional basis'. Carey (1968) in a survey of student users in the San Francisco Bay area suggests that a total of 25% will use pot. No figures are available for New Zealand.
3 O'Donnell & Jones (1968) J. Health & Son. Behav. 9, 2, 1968, pp. 120-130. have estimated that about 50-60% of heroin users become addicts. Thus Paton's figures of progress from pot to heroin addiction would have to be modified from 3.25-7.5%.