1. 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

2. 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).

3. From a global and historical perspective, Intoxicant use is a norm

Societies differ only in respect to which drugs
are defined as acceptable or unacceptable.

4. From a global and historical perspective, Intoxicant use is a norm


Societies differ only in respect to which drugs
are defined as acceptable or unacceptable.
Definitions may change over time.

5. From a global and historical perspective, 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)

6. From a global and historical perspective, 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)
In the more complex human context, drug use
fulfills important instrumental and symbolic
functions for individuals and the social group.

7. 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.

8. 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.”

9. 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.

10. 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.

11. 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.

12. 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.

13. 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.

14. Drug
Zinberg, 1982
Set
Setting

15. 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.

16. BLUNTS & BLOWTJES

17. Blunts & Blowtjes




Cannabis preparation rituals
Combination of Cannabis and Tobacco
Symbolic meaning
Self-regulatory function of rituals in different
cultural contexts

18. The ritual sharing of drugs

In the Netherlands, heroin and cocaine are
primarily obtained and frequently used at socalled deal and use addresses.

Usually several people are present in a pub-like
atmosphere and in 50% of registered
observations drugs were shared.

19. The ritual sharing of drugs

Instrumental function of drug sharing
– Preventing withdrawal. "Helping" with a
"betermakertje" (a little dose to ameliorate
withdrawal) is a common motivation.

20. The ritual sharing of drugs

Symbolic and social functions of drug sharing
– Opening of communication channels;
– Strengthening ties among individual users
– Strengthening social networks;

21. The ritual sharing of drugs

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.

22. 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%


23. 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.

24. 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.