YOUNG MEN AND DRUGS

-A NATIONWIDE SURVEY
The NIDA Research Monograph series is prepared by the

Division of Research of the National Institute on Drug Abuse. Its

primary objective is to provide critical reviews of research problem

areas and techniques, the content of state-of-the-art conferences,

intearative research reviews and significant oriainal research. Its

dual publication emphasis is rapid and targeted dissemination to the

scientific and professional community.

EDITORIAL ADVISORY BOARD

Avram Goldstein, M.D.

Jerome Jaffe, M.D.

Reese T. Jones, M.D.

William McGlothlin, Ph.D.

Jack Mendelson, M.D.

Helen Nowlis, Ph.D.

Lee Robins, Ph.D.

Addiction Research Foundation

Palo Alto, California

College of Physicians and Surgeons

Columbia University, New York

Langley Porter Neuropsychiatric Institute

Unversity of California

San Francisco, California

Department of Psychology, UCLA

Los Angeles, California

Alcohol and Drug Abuse Research Center

Harvard Medical School

McLean Hospital

Belmont, Massachusetts

Office of Drug Education, DHEW

Washington, D.C.

Washington University School of Medicine

St. Louis, Missouri

NIDA RESEARCH MONOGRAPH series

Robert DuPont, M.D. DIRECTOR, NIDA

William Pollin, M.D. DIRECTOR, DlVlSlON OF RESEARCH, NIDA

Robert C. Petersen, Ph.D. EDITOR-IN-CHIEF

Eunice L. Corfman, M.A. EDITOR

Rockwall Building 11400 Rockville Pike Rockville, Maryland, 20852
YOUNG MEN AND DRUGS

-A NATIONWWIDE SURVEY

by

John A. O’Donnell, Ph.D.

Harwin L. Voss, Ph.D.

Richard R. Clayton, Ph.D.

Gerald T. Slatin, Ph.D.

Robin G. W. Room, M.A.

February 1976

NIDA Research Monograph 5

NATIONAL lNSTlTUTE ON DRUG ABUSE

11400 Rockville Pike

Rockville, Maryland 20852
Drs. O'Donnell, Voss, Clayton and Slatin

are from the Department of Sociology,

University of Kentucky, Lexington, Kentucky.

Mr. Room is from the School of Public Health,

University of California, Berkeley, California.

The study was supported by:

the Special Action Office for Drug Abuse Prevention (DA 3AC678),

the National Institute on Drug Abuse (DA 01121).

DHEW publication number (ADM) 76-311

Library of Congress catalog card number 75-43388

For sale by National Technical Information Service

Springfield, Va. 22161

Stock Order #PB 247 446; Papercopy: $6.75; Microfiche: $2.25

i i
FOREWORD

The National Institute on Drug Abuse publishes this landmark

study with particular pride. Young mens’ drug use has been

examined in other nationwide studies, but none before has

captured the most critical population and period of use.

In the late 1960’s nonmedical drug use increased nationally

in a great, unprecedented surge. The Nation is still trying

to deal with this new, higher level of drug use and to understand why it occurred. The young men contacted in this study

were the population on the cutting edge of this dramatic change.

This documentation of their experiences is an important piece

of social history. Not only will this new knowledge help us

understand a very puzzling and important social change in

America, but it also offers clues to other nations which are

only now beginning to recognize the global implications of

these changing patterns of drug use.

O’Donnell and his associates captured the right group at the

right time. They also managed to collect an unusually rich

array of information. This first report is an encyclopedia

of contemporary American drug use. The data provide many

possibilities for further analysis. Thus, while we work out

the implications of this comprehensive and detailed first

report, we can look forward to further understanding from

continued mining of its rich data base.

Robert L. DuPont, M.D.

Director

National Institute on Drug Abuse

iii
i v
v
ACKNOWLEDGMENTS

A study of this scale and precedent, to which so many contributed so much

so unstintingly, makes adequate acknowledgment impossible. Our great thanks

to those at each stage from conception onward who gave advice, review and

support. Special appreciation is owed to Dr. David Nurco, who was primarily

responsible for the contacts with Selective Service to obtain the sample;

to Lawrence G. Grossman, Warden of the Federal Correctional Institution,

Lexington, Kentucky, for arrangements so that inmates could be interviewed

for several of the pretests; to Dr. Ira Cisin, Professor of Sociology at

George Washington University, for crucial advice in the design and carrying

out of the study.

The tasks of recruiting, training and supervising interviewers, and of data

management, would have been too great for the resources available to the

investigators. An experienced survey organization was needed, and Temple

University's Institute for Survey Research, in Philadelphia, was selected.

Under the overall direction of Dr. Leonard A. LoSciuto, Director of the

Institute, data collection and reduction involved the efforts of the entire

permanent staff of 138 interviewers. The largest debt is owed, of course,

to the interviewers, who with interest, perseverance and courage performed

the difficult task of locating respondents, persuading them of the importance

of the study and conducting the lengthy and sometimes difficult interviews.

Another contract was made with the University of California, Berkeley, to

share in the design and conduct of the study. Dr. Don Cahalan guided the

work at Berkeley and made important contributions throughout the study.

Susan Sheffield was active in planning the study and data collection,

particularly in the design and pretest of the interview schedule.

Finally, thanks are owed to many who cannot be named, the students, prisoners,

union members and others who were interviewed in the pretests and above all

to the respondents, whose cooperation made the study possible.

v i
SUMMARY

1. The best estimates of use, among men who were 20 to 30 years old in 1974,

are:

Lifetime Use Current Use

(Any use to time of interview) (Any use in 1974 or 1975)

Cigarettes 70% 60%

Alcohol 9 7% 92%

Marihuana 55% 38%

Psychedelics 22% 7%

Stimulants 27% 12%

Sedatives 20% 9%

Heroin 6% 2%

Opiates 31% 10%

Cocaine 14% 7%

2.

3.

4.

For most drugs, half or more of the users used the drug less than 10 times.

While use was not under medical direction, some use of the stimulants,

sedatives and especially the opiates is best seen as quasi-medical.

The data suggest a possible decline in use of cigarettes. Such use has

been less common among the younger men (slightly over 60 percent of them

have used cigarettes) than among the older men (about 75 percent).

The peak periods of incidence (new cases of use) were 1968-72 or 1969-73

for all drugs except alcohol. This is partly due to the restricted age

range in the sample. Contributing to the drug epidemic of the late 1960s

were the facts that:

a) larger proportions of men in the younger cohorts than in the

older cohorts used all drugs, except alcohol and tobacco

b) these younger cohorts were larger in number

c) the median age at onset of use was lower in the younger than in the

older cohorts

In addition, there is some suggestion in the data that when the use of

drugs became more widespread in the younger cohorts, more men in older

cohorts experimented with the drugs than would have been expected to do

so.

5. Differences between blacks and whites in drug use seem to be diminishing.

Among whites there is a strong inverse relation between age and use for

all drugs except tobacco and alcohol; more of the younger men have used

the drugs. This is not true for blacks; smaller proportions of the

younger than the older blacks have used the drugs. In the older cohorts,

the percentages of users were higher for blacks than whites for most

drugs, but in the younger cohorts the differences were negligible.

vii
6. There is no indication of any recent decline in the annual prevalence

of use of any drug, with the possible exception of psychedelics. This

means that there is no basis to suggest that the drug epidemic has ended;

indeed, for several drugs, notably cocaine, the data are consistent with

a continuing increase in use.

7. Veterans, whether they served only in the United States, overseas in places

other than Vietnam, or in Vietnam, show no higher rates of current drug

use than nonveterans. For the sample as a whole, their rates of lifetime

use are not significantly different from those of nonveterans, except

that marihuana and heroin use was higher in a few of the eleven cohorts.

8. Use of any of the nine drug classes is associated with use of all the

others. If tobacco is excluded, alcohol and marihuana were almost always

first and second in the time order in which drugs were first used, and

use of other drugs was rare if alcohol and marihuana had not been used.

9. Reported involvement in criminal behavior varies directly with drug use,

as do arrests, appearances in juvenile courts, convictions and prison

sentences.

10. Less than 3 percent of the sample reported treatment for drug use. The

largest number reporting treatment was for alcohol use but this was a

minute fraction of the alcohol users. The next largest number reported

treatment for heroin use; they constituted 14 percent of all heroin users.

One-third or more of the men who used heroin most extensively were

treated.

11. Many variables are found to be associated with both lifetime and current

drug use. Use tends to be higher:

a) the larger the city in which men lived to age 18

b) among the unemployed, or part-time employees

c) the less conventional men are, in terms of a variety of indicators

of conventionality, including marital history, current living

arrangements, and expressed attitudes

d) the lower the educational level achieved

e) among men who have entered college and report the social sciences,

fine arts and humanities as their college major.

viii
CONTENTS

FOREWORD

KEY GRAPHS

ACKNOWLEDGMENTS

SUMMARY

LIST OF TABLES

Chapter

1

2

3

4

5

6

7

8

9

10

11

12

13

Introduction

Lifetime Prevalence

Current Prevalence

Estimates of Drug Use in the Population of Young Men

The Drug Epidemic

Attitudes, Motivations and Contexts

Problems and Benefits Attributed to Drug Abuse

Drugs, Crime and Criminal Justice

Multiple Drug Use

A Total Drug Use Index

Drug Use and Military Service

Treatment for Drug Use

Regional Variations in Use

APPENDIX

I Quasi-Medical Use 135

II Specific Drugs Used Within Drug Classes 138

REFERENCES 141

INDEX 142

iii

iv

v i

vii

x i

1

13

33

42

48

62

76

81

98

105

118

125

131

i x

LIST OF TABLES

1.1 Distribution of the Total Sample, Interviewed Men

and Men Not Interviewed, and of the Corresponding U.S.

Male Population, by Year of Birth

1.2 Regional Distribution of the Sample, as of Dates of

Registration and Interview

2.1 Lifetime Use and Total Number of Times the Drugs

Were Used by Drug Classes (Percentages, n = 2510)

2.2 Lifetime Use of the Drug Classes by Birth Cohort

(Percentages)

2.3 Lifetime Use of the Drug Classes by Race (Percentages)

2.4 Comparison of Whites and Blacks on Lifetime Drug Use

by Year of Birth (Percentages)

2.5 Lifetime Drug Use by Size of City of Residence to

Age 18 (Percentages)

2.6 Lifetime Use of Drugs by Education (Percentages)

2.7 Drug Use by Race and Whether or Not Now in School,

for Men Born After 1950 (Percentages)

2.8 Lifetime Use of Drugs by Current Family Status

(Percentages)

2.9 Lifetime Use of Drugs by Current Employment Status

(Percentages)

2.10 Lifetime Highest Frequency and Quantity of Use for

the Total Sample and for Users Only (Percentages)

2.11 Distribution of Criterion Variables by Extent of Use

of Alcohol (Percentages)

2.12 Variations in Use, by Extent of Use of Marihuana

(Percentages)

3.1 Cumulative Percent Reporting Current Use Within

Selected Time Periods

3.2 Current Use by Year of Birth (Percentages)

3.3 Current Use by Race (Percentages)

3.4 Current Use by Education (Percentages)

9

10

13

14

15

16

17

19

20

21

22

24

26

28

34

35

37

37

3.5 Current Use by Current Family Status (Percentages) 39

x i
3.6

3.7

4.1

4.2

4.3

4.4

5.1

5.2

5.3

5.4

5.5

5.6 Annual Prevalence of Drug Use, 1957-1974 (Percentages)

5.7 Use by Friends, Availability, and Chance of Future Use

of Drugs, by Extent of Marihuana Use (Percentages)

6.1

6.2

6.3

6.4

6.5 Expectations for Future Use of Each Drug (Percentages)

6.6 Drug Use Among Current Friends of Respondents

(Percentages)

6.7

6.8

7.1

Current Use by Size of City of Residence at Time of

Interview (Percentages)

Current Use by Lifetime Extent of Use (Percentages)

Estimates of Drug Use in the Total Population of Young

Men 20-30 Years Old in 1974, on the Assumptions:

a) that the Interviewed Sample is a Random Sample of

the Population; b) that None of the Noninterviewed

Men Used Each Drug; c) that All of the Noninterviewed

Men Used Each Drug (Percentages)

Distribution of Interviewed and Noninterviewed Men by

Year of Birth and City Size (Rate Per 1000)

Estimated Fates of Drug Use, and Numbers of Users

Estimated Rates of Current (1974-75) Drug Use, and

Numbers of Use

Number of New Cases of Use by Drug and First Year

of Use

New Cases of Use by Drug and First Year of Use in

Percentages

Median Age at First Use of Drug Among Users by Year

of Birth

Year of First Use of Alcohol, by Birth Cohorts

(Cumulative Percentages of Total Sample)

Year of First Use of Marihuana, by Birth Cohorts

(Cumulative Percentages of Total Sample)

Methods by Which Drugs Were Obtained, Ever, First, and

Usually (Percentages)

Routes of Administration of Drugs Ever Used, by

Experimental and Other Users of Each Drug (Percentages)

Reasons for Not Using Drugs, or Using Them Less Than

Ten Times (Percentages)

Reasons for Drug Use, for Experimental and Other

Users of Each Drug (Percentages)

Availability of Drugs (Percentages)

Attitudes and Opinions About Selected Drugs by Use

of Those Drugs (Percentages Responding "True")

Problems of Specified Types and No Problems Reported:

Percent of Total Sample (n = 2510)

39

40

42

44

45

46

49

50

52

54

55

58

60

62

63

66

67

70

72

73

74

77

xii
7.2 Percent of Users Who Reported Specified Types of

Problems

7.3

7.4

8.1

8.2

8.3

8.4

8.5

8.6

8.7

8.8

8.9

8.10

8.11

8.12

8.13

9.1

9.2

9.3

10.1

Percent of Users Reporting Bad Trips, Fights, Staying

High More Than a Day, Memory Lapses, and Dependence

Due to a Given Drug

Percent of Users Who Perceived Benefits From Drug

Use and Their Perception of the Overall Effect Drug

Usage has had on Their Life

Self-Reported Criminal Acts by Use of Marihuana and

Other Drugs (Percentages)

Self-Reported Criminal Acts by Extent of Marihuana

Use (Percentages)

Self-Reported Criminal Acts by Extent of Alcohol Use

(Percentages)

Self-Reported Criminal Acts by Age (Percentages)

Median Age for Initial Occurrence of Self-Reported

Criminal Acts Admitted Through the Age of 20

Initial Occurrence of Self-Reported Criminal Acts

Through Age 20 by Age Groups (Percentages)

Actual and Predicted Incidence of Criminal Acts and

Drug Use by Age 20, and Ratio of Actual to Predicted

Number

Number of Respondents by Extent of Marihuana Use and

Age Groups, Ethnicity, and Education

Nontraffic Arrests by Extent of Marihuana Use and Age

Groups, Ethnicity, and Education (Percentages)

Juvenile Court Appearance by Extent of Marihuana Use

and Age Groups, Ethnicity, and Education (Percentages)

Crime Conviction by Extent of Marihuana Use and Age

Groups, Ethnicity, and Education (Percentages)

Sentence Served by Extent of Marihuana Use and Age

Groups, Ethnicity, and Education (Percentages)

Law Problems Due to Drugs, Self-Reported Criminal

Acts, and Drug Offenses by Contacts With the Criminal

Justice System (Percentages)

Number end Percent in Each of Ten Pure Scale Type

Patterns of Ever-Never Use

Percent of Users and Nonusers of Each Drug Who Have

Used the Other Drugs

Users Across Pairs of Drugs and Time Order of Usage

(Percentages)

Index Scores for Each Category of Extent of Use for

Eight Drugs Used in Construction of Total Drug Use

Index

78

79

79

82

82

83

84

86

87

88

89

90

91

92

93

96

99

100

103

106

xiii
10.2

10.3

10.4

10.5

10.6

10.7

Total Drug Use and Criminal Activities

Total Drug Use and Peer Activities at Age 16

10.8 Total Drug Use and Countercultural Involvement

10.9 Attitudes Toward Unconventional Behaviors and Total

Drug Use

11.1

11.2

11.3

11.4

12.1

12.2

12.3

12.4

12.5

13.1

13.2

Use of Specific Drugs and Total Drug Use Index

(Percentages)

Total Drug Use and Problems, Consequences, Selling,

and Turning Others On

Birth Year, Race, Residence and Total Drug Use

Education, Employment, Marital Status, Current

Family Status and Total Drug Use

Drug Use and Military Service

Vietnam Service and Drug Use

Lifetime Use of Heroin and Marihuana by Military

Service and Birth Cohort

Onset of Drug Use, Relative to Dates of Entering and

Leaving Service (Percentages)

Number of Times Treated, All Drugs

Number of Men Receiving Treatment for Specific Drugs

Selected Characteristics of First Treatment Experience

of Those Treated for Heroin Use

Selected Characteristics of Treated and Nontreated

Heroin Users

Reasons for and Problems Associated With Heroin Use:

Treated and Untreated Heroin Users

Lifetime Drug Use by Regions and Divisions of U.S. in

Which Respondents Lived at Time of Interview

(Percentages)

Current (1974-75) Use of Drugs by Regions and Divisions

of U.S. in Which Respondents Lived at Time of Interview (Percentages)

108

109

110

112

113

114

115

116

119

120

122

123

125

126

127

128

129

132

133

xiv
1 Introduction

This is a preliminary report on a study of

the nonmedical use of psychoactive drugs

among young men in the United States. The

data were collected from October, 1974, to

May, 1975, by interviews with 2,510 men from

an original sample of 3,024. The sample

was selected by standard sampling procedures

to be representative of all men in the

general population who were 20 to 30 years

old, inclusively, in 1974. This report is

based on the 2,510 completed interviews, but

it does not include a complete analysis of

the data. Its aim is to make the major

findings of the study available quickly to

policy makers and other researchers. Some

questions of importance are ignored or treated superficially. Further analyses will be

completed and additional reports will be

published later.

One of the consistent findings produced in

numerous follow-up studies of persons treated

for addiction to heroin and other opiates

has been that nearly all of the ex-addicts

relapse within a short period of time. Then,

in 1972, the initial report of Robins' study

of Vietnam veterans was released. In Vietnam, 29 percent of Robins' sample of enlisted

men used narcotics (opium and heroin were the

only two widely available) a total of more

than 10 times and more than once a week;

further, 20 percent of the men reported that

they had been addicted to narcotics in Vietnam. However, in interviews with the men

some eight to twelve months after their

return to the United States, only one percent

indicated that they had been readdicted to

opiates. Robins' investigation showed that

relapse was not inevitable.

One explanation for the discordant findings

hinges on the fact that all of the earlier

studies were based on samples of treated

addicts. Persons who sought treatment or

were placed in treatment programs by the courts

were not a representative sample of opiate

users; apparently they were the residue of

that population after repeated filtering

operations had removed all who gave up the use

of opiates fairly easily. While the Vietnam

veterans did not constitute a random sample

of young American men, they were more representative of American youth than any sample of

treated heroin users. Thus, one implication

was that the widely held belief about the

high probability of relapse was not necessarily true for heroin users in general.

Consistent with Robins' findings is the

existence of persons who have used opiates

and become addicted to them, both through

self-administration and in medical treatment,

but who subsequently quit using the drugs

without treatment or with only minimal treatment for withdrawal symptoms. Unfortunately,

estimates of the number of such individuals

have not been available.

The view that ideas derived from treatment

populations may be erroneous has been suggested by investigations in the area of alcoholism.

For a number of years, studies of alcoholics

were confined to persons in treatment for

alcoholism or Skid Row populations. As a

result, the image of the typical alcoholic

was that of a homeless derelict. When studies

were conducted on alcohol use in the general

population, sizable numbers of persons who

were married and employed were found to have

serious drinking problems. In short, many of

the older ideas about alcoholics had to be

discarded.

These developments strongly suggested that a

study of drug use in the general population

might increase knowledge appreciably; such a

study was discussed by the staff of the

Special Action Office for Drug Abuse Prevention

1
and sociologists in the Department of

Sociology, University of Kentucky, and the

School of Public Health, University of

California, Berkeley. This led to a grant

application, and in June, 1973, a grant was

awarded to the University of Kentucky. A

contract was established with the University

of California to share in the design and

execution of the study, and later the

Institute for Survey Research, Temple

University, was selected to collect and to

edit the data. The second year of the study

was funded by a grant from the National

Institute for Drug Abuse (Grant No. DA01121).

RESEARCH OBJECTIVES

The study was to be nationwide and restricted

to young men. The latter stipulation was

based, in part, on the idea introduced in

initial discussions that a sample might be

drawn from Selective Service registrants.

However, the primary reason for this restriction was that funds were available for a study

based on a sample of approximately 3,000

persons. Some forms of drug use are

relatively rare, and for these drugs, estimates would have to be based on small numbers,

for example, the percentage of respondents

who had used heroin. If the study were

restricted to young men, the segment of the

population most likely to have used drugs,

the number of users might be sufficiently

large to provide reasonably precise estimates.

If older men or women were included, the

number of drug users would be limited and

might be too small to permit the derivation

of stable estimates.

The study was conceived in accordance with

three broad principles. No previous drug

study combines all of them.

(a) The study would be conducted with a

sample representative of the general population, rather than of clinical or other

special populations.

(b) All of the commonly used psychoactive

drugs would be studied in a standard framework to allow comparisons between drugs in

patterns and correlates of use.

(c) In addition, detailed information on the

correlates and consequences of drug use, as

well as the respondent's life situation,

would be collected. These data could be

linked to the respondents' patterns of drug

use.

In these terms the study was concerned with

the natural history of drug use. Although

this term has varying connotations, they all

share a concern with the patterning of

behavior and events in time. In previous

studies drug use has usually been examined in

terms of "ever" use or current usage. In the

present study, data were to be collected on

the respondents' history of use.

Given the restriction of the sample to young

men and the limitation on its size imposed

by the budget, four areas of focus were

listed in the grant application:

1. The Natural History of Nonmedical Drug

Use. The first goal was to obtain retrospective histories of use of nine classes of

drugs (tobacco, alcohol, marihuana, psychedelics, stimulants, sedative-hypnotics, heroin,

other opiates and cocaine) including (a)

periods of experimentation, (b) regular use,

(c) cessation and resumption of use, and (d)

patterns of substitution, sequence, and

simultaneous use of drugs. Of special

interest to the researchers were instances of

cessation of use, whether or not these were

associated with treatment, and if so, with

what types of treatment.

2. Estimates of Incidence and Prevalence.

The second focus was to be on age-cohort

differences with particular emphasis on (a)

current use (within the past year), (b) use

within any given year (1957-1974), and (c)

use at a given age for all respondents, for

example, use at age 18.

3. An Examination of the Question of a Drug

Epidemic. Attention was also to be focused on

the belief that an epidemic of drug use

occurred in the late 1960s and, if such an

epidemic occurred, to chart its course across

the drug classes. Data were to be obtained

on differences in the onset, length and

decline of the epidemic by region, race and

other demographic variables.

4. Exploration of the Correlates and Determinants of Drug Use. With drug use as a

dependent variable, the fourth focus of this

study was to determine the correlates and

possible determinants of differences in use,

especially demographic, life style, life

stage, associational and attitudinal

variables.

Each of these areas of focus implied different and to some extent contradictory

considerations in the research design. For

example, with a narrow age range, the estimates of the incidence and prevalence of drug

use would be more precise, but a narrow age

range would restrict generalizations. On

the other hand, a wide age range would give

a better chance of bracketing the occurrence

of a drug epidemic, at the cost of less

2
precise estimates of incidence and prevalence.

It was decided to select as the target population the twelve-year range of men who would

be between 19 and 30 years of age at the time

of the interview. Younger men were excluded

to avoid any need to obtain parental consent

to conduct interviews. Older men were not

included because earlier studies suggested

that drug use would be relatively infrequent

among men over 30 years of age. Many studies

have shown that the teen-age years are the

ones of greatest vulnerability to drug use.

Hence, the older men in the sample would

have passed the vulnerable years before the

presumed epidemic began in the mid-1960s,

while the younger men would not have. It

was concluded that an age range of approximately 12 years would permit comparisons of

incidence under differing conditions of

prevalence of use.

Restriction of the age range left another

problem unresolved. Among others, Abelson

(1972) has suggested that the number of men

between 19 and 30 who would report having

used heroin would be too small to provide

adequate information about the natural

history of such use. Stratification of the

sample to increase the probability of including heroin users was considered, but this

approach was rejected for a number of reasons.

While areas of high use could be identified

in a number of cities, different criteria

would have to be used from city to city;

consequently, it was difficult to establish

an acceptable basis for stratification.

Further, with the exception of New York City,

most areas of high heroin use were distinctive only in relative, not absolute terms. To

obtain a sufficient number of respondents who

had used heroin, a sizable part of the

sample would have to be assigned to such

high-use areas, and the effect would be to

limit the precision of estimates for use of

all other drugs in other areas.

Consequently, a second small sample was

selected from the high-use areas of New

York, for a separate study. This study will

not be described in this report, except

where the early findings in New York are

relevant to the credibility of the data

obtained in the nationwide survey.

METHODOLOGY

The Sample

Almost all nationwide samples are stratified

probability samples, with areas of the

country selected first, then households

within the selected areas, and finally

individuals from the selected households. A

household sample seemed to be a poor choice

for this study because it is precisely its

target population, young men, who are least

likely to be found in households. Hundreds of

thousands of young men would be away from

home, at college, or in the armed forces,

with lesser but not negligible numbers in

prisons or other institutions. Even the

Census misses large numbers of persons, and

it is thought that these are mostly young

men, especially those who belong to minority

groups residing in large metropolitan areas.

This might not matter greatly in some investigations, but this study was of drug use,

and there were reasons to believe that those

young men who were least likely to be

included in a household sample were most likely

to have histories of drug use.

What is most desirable for the selection of

a sample is a list of the individuals in the

target population. Such a list exists or

could be constructed from information available in a number of governmental agencies

such as the Census Bureau, Social Security

Administration, the Department of Defense, the

Veterans Administration and the Selective

Service System. The most reliable source for

this sample was the Selective Service System.

Since 1940, almost all young men in the

United States have been required by law to

register with Selective Service when they

reach the age of 18. In actual practice,

there are two groups whose names do not

appear in Selective Service files. The first

comprises those men who enlist in one of the

services before the age of 18 and who remain

in the service beyond the age of 26. If

released before age 26, they were obliged to

register; consequently, it is only those who

reenlist who were never obliged to register.

The number in this group is so small that it

can safely be neglected.

The second group consists of those young men

who fail to obey the law; they simply do not

register and are not detected in this

failure. It is, of course, impossible to

know exactly how many such men there are,

but Selective Service officials were able to

demonstrate convincingly that their number is

small, almost certainly less than five percent of all young men. This conclusion is

based on studies in which their statistics

were checked against census data, Bureau of

Vital Statistics compilations, and lists of

high school graduates and automobile drivers'

licenses. One of the major factors assuring

complete lists was citizen involvement. Each

local board is composed of uncompensated

volunteers drawn from the geographical area

served by the board to assure familiarity with

the neighborhood environment.

3
The age range of the sample could readily be

translated into registration years. Men aged

19 to 30 in early 1974 (when it was expected

that interviewing would start) would have

registered in the years 1962 through 1973.

The 1973 registrations were eliminated

because in that year there was a change in

policy, and no men were drafted into the

services. This did not remove the obligation

to register, but there was considerable

confusion about that, and for 1973 the number

of men failing to register was higher than

usual.

These registration years included the years

of the Vietnam war, when there was opposition

to the draft among young men, and it seems

reasonable to assume that the proportion of

men who failed to register must have increased

in those years. Once again, there is neither

a basis to estimate the size of the increase,

nor to reject the estimate that it was small.

Even among the men most opposed to the war,

the usual response does not seem to have

been failure to register. Rather, almost

all young men continued to register, and

opponents of the war sought deferments or,

in some cases, left the country when it

appeared that they were about to be called

for induction. This meant that their names

appeared in the Selective Service records.

For this study, then, Selective Service

information seemed the ideal source for sample

selection. This is not to claim that their

list of young men was 100 percent complete,

but it did not seem to fall far short of

that, and it certainly had no rivals for

completeness. Selective Service is authorized

by law to release data for research purposes,

and Mr. Byron V. Pepitone, Director of

Selective Service, arranged to have only

staff members of Local Boards draw the sample

by procedures established by the investigators.

He made the sample available to the Special

Action Office, which in turn made it available to the research team. This did not

involve the release of any confidential information from Selective Service files, such as

classifications or other Board actions.

The sample may be described as a multi-stage

stratified random sample. The first step

had been taken by Temple University's

Institute for Survey Research before this

study was designed. Their sampling frame

had been constructed as follows. The approximately 3,000 counties in the United States

were divided into two groups. The first

included Standard Metropolitan Statistical

Areas (SMSAS) or combinations of contiguous

SMSAs in which the total population was 1.8

million or more. These 18 areas included 40

percent of the projected national population

for the 1970-80 decade. For administrative

purposes they were divided into 40 primary

sampling units, and these were included in

the frame with a probability of 1.0.

The remaining counties were clustered into

primary sampling units. Individual SMSAs

were recognized as separate units, and nonSMSA counties were clustered into units of

two or more contiguous counties. These units

were grouped into 30 strata, each with a

projected mid-decade population of 4.2

million. Fifteen were SMSA units, and 15

were non-SMSA units. Within these groupings,

primary sampling units were stratified on

the basis of region, growth rate, industrial

structure and, in the South, racial composition. Within each stratum, two units were

selected with a probability proportional to

the size of the projected mid-decade population. Thus, in addition to the 18 areas or

40 primary sampling units selected with

certainty, 60 units were selected with

varying probabilities.

All units and areas were definable in terms

of counties (with minor exceptions in New

England), and the basic element in the

Selective Service System was the county.

In general, the pattern was to have one Local

Board per county, with the exceptions that in

metropolitan areas there could be many boards

in one county, and in a few rural areas one

board served several counties. By random

procedures, two boards were selected in each

of the 100 primary sampling units, and then,

within each of the registration years,

individuals were selected from the lists

maintained by these boards. Each step made

the probability of selection dependent on

the number of men in the area, and these

probabilities cancelled each other, so the

net result was an equal probability sample.

In less technical language, an area with many

men had a better chance to be selected than

an area with few men, but within areas

selected the men from less populous areas had

a greater chance to be selected than men from

areas with a large population. Thus, it can

be said that all young men in the United

States had an equal chance to be selected.

Since all steps in the procedure were random,

the eventual sample--3,024--should be

representative of all young men in the

continental United States. Alaska and Hawaii

were excluded because of the added costs

field work in these states would involve.

The Interview Schedule

The interview schedule is too long to be

included as part of this report. Specific

items will be described as the data are

analyzed in the body of the report. Researchers

4
who need to see the full schedule can obtain

a copy by writing to any of the authors.

The core of the interview, given its purposes,

had to be questions about past and current

drug use. A recurrent problem in studies

such as this is the number of drugs or drug

classes to include: with a larger number,

more details are obtained, but more time is

required to obtain them. The decision was

made to focus on nine: tobacco, alcohol,

cannabis, psychedelics, stimulants, sedativehypnotics, heroin, other opiates and cocaine.

The same questions were to be asked about

the history of use of each of the drugs, or

classes of drugs, but these had to be

reduced to a minimum to save time and to

avoid boredom, which was a problem in earlier,

longer versions of the schedule. Pretests

also showed that some questions were irrelevant or inappropriate when asked about a

drug that had been used only a few times.

The solution was a series of screening

questions to determine which drugs had been

used and how often; these were followed by

detailed questions only for the drugs that

had been used 10 times or more.

In addition to the series of items on drug

use, areas covered in the interview included

residence to age 18, occupation and education

of parents, religion, education, brief

occupational history, marital history,

military service and criminal behavior.

Finally, the interview included two short

self-administered questionnaires to obtain

factual data and some indicators of attitudes

and values.

Because of delays in starting the field work,

there was more time for pretesting than is

usual. There was an extensive period of

informal pretesting by the investigators,

their assistants and students as the

schedule went through numerous versions,

sometimes on as few as six to ten men, sometimes on as many as 30 to 60. Efforts were

made to do pretests on as wide a range of men

as one would expect to find in a national

sample. Student volunteers, both users and

nonusers of drugs, were used. To pretest

on heavy users, interviews were done through

street contacts in Berkeley and with prisoners

in Lexington. To include blue-collar workers,

interviews were arranged in Lexington with

members of a union who were on strike. These

pretests were done over a period of several

months, and no record was kept of their

number, but they totalled about 200. With

the exception of the student volunteers, all

of the men interviewed were paid for their

time, usually five dollars per interview.

Next came formal pretests, with four experienced interviewers in Philadelphia, and

fifteen, some experienced and some not, in

New York City. Interviewees were selected

by household survey techniques. Each of these

steps led to revisions in the format, question

content and wording, as well as to elimination

of many questions. A final pretest in

Philadelphia was conducted by three experienced

interviewers and several of the Temple

staff members who would be supervising field

work. The interviewees were selected from

Selective Service registrants not included in

the sample. In all of the formal pretests

interviewees were paid $15 per interview, as

was planned in the study. Thus, all aspects

were pretested before the field work began.

Data Collection

A total of slightly more than 160 interviewers,

most with experience in other studies, were

recruited; because of the subject matter of

this study, a special effort was made to

obtain males, young persons and blacks, but

the modal interviewer was a middle-aged,

middle-class white woman. The effects that

interviewer characteristics may have had on

the data collected will be analyzed in later

reports.

Interviewers were brought to Temple's Philadelphia office for four-day training sessions,

and five separate sessions were conducted to

keep the groups reasonably small. About one

and a half days were spent on principles of

interviewing and the recording of responses;

an equal amount of time was spent reviewing

and practicing on the schedule used in this

study. The remainder of the time was spent

on procedures for locating research subjects,

the administrative procedures for mailing of

reports, and similar matters.

Training continued even after the formal

sessions. On their return home, interviewers

completed one interview, which was returned

and edited quickly. Only after at least one

interview had been completed satisfactorily

was an interviewer permitted to begin on the

list of cases assigned to him or her. Even

then editing continued to be educational, and

requests were sent for answers to questions

which had been skipped incorrectly, or had

not been completed.

Under the close supervision of experienced

data processors, the editing and coding were

done as the interviews were returned. In the

early weeks of data collection, special

attention was paid to items which seemed to

be difficult for a number of interviewers,

and memoranda were prepared to give more

detailed instructions.

5
Before the field work began, changes of

address were requested from the post office,

and letters were sent to subjects to update

the addresses obtained from Selective

Service records, some of which were then

more than ten years old. The mobility of

young men between the ages of 18 and 30 is

high, and the work involved in obtaining

current addresses was greater than had been

anticipated. Much of it had to be done in

the field by the interviewers themselves,

with numerous reassignments of cases as

changes of address were discovered. Toward

the end of the data-collection period, when

most interviews had been completed and the

remaining subjects were those difficult to

locate, as many as eight staff members in

the central office of the Institute for

Survey Research spent weeks making telephone

calls and writing letters to pursue all

available leads.

Temple's experience was that different interviewers found different methods to be effective in securing interviews; as a result, no

general procedure was required of all interviewers. The most frequent approach, however,

was to telephone, in order to make an appointment for the interview; by telephone the

study was described only in general terms,

but the content and purpose of the interview

were described in some detail when the

interviewer met the subject.

The men interviewed were paid a flat fee of

$15 for the time they spent in the interview.

This was paid in the form of a money order

at the end of the interview. Since there

was no variation in this procedure, there is

no way to measure its effect. The interviewers believed that the majority of the subjects

would have been willing to be interviewed

without any payment, but that a sizable

minority agreed to the interview solely or

mainly because of it. Thirty-six men in the

sample were deceased; of the remaining 2,988,

84 percent were interviewed, and interviews

were refused by only 6 percent of those who

could be located. Without payments, it may

be guessed that the completion rate might

have been approximately 60 to 65 percent.

CONFIDENTIALITY OF INFORMATION

The Comprehensive Drug Abuse Prevention and

Control Act of 1970 authorized the Attorney

General to make a grant of confidentiality

in drug research. On October 16, 1973, the

principal investigator was given the grant,

which covered all who worked with him on the

project. It provided authority

to withhold the names and other identifying characteristics of persons who

are the subjects of research conducted

pursuant to and in conformity with this

research project. You may not be compelled in any Federal, State or local

civil, criminal, administrative, legislative, or other proceeding to identify

the subjects of such research.

This removed fear of any legal compulsion to

divulge information, but the more probable

sources of a breach in confidentiality lie in

the research staff who handle the data, and

steps were taken to minimize that risk. One

principle was to reduce to the minimum the

number of staff members who had access to

both the interview data and the identity of

the man who had provided it. It was necessary

to keep these together until the interview

had been edited, and until the Institute staff

made a validity check with the respondent to

determine that the interview had been done.

Only a few of the highly trusted staff of the

Institute had access to the data during this

period, and the identifying information was

separated from the rest of the schedule as

soon as possible. From that point on no one,

with one exception, could match data with the

persons to whom they applied. The exception

was the principal investigator, who still

maintains a master list of the names of respondents and their case numbers in order to plan

a second stage of interviewing for the sample

as a whole or some sub-sample of it, if it

should be desirable.

This left what is always the major danger of a

breach in confidentiality, the interviewers

themselves, as essentially the only persons in

the project who would know both the identity

of the individual and the data he furnished.

There is no absolutely certain way to prevent

breaches by interviewers, but the practical

steps available were taken.

First, of course, was care in the selection of

interviewers. Second, in the training their

responsibilities were emphasized. They were

advised that the less they talked about

interviews the better. Realistically, it is

difficult for a person not to tell his or her

spouse or friends about interesting experiences; consequently, heavy emphasis was placed

on never naming or otherwise identifying a

respondent. One of the reasons why the

interviewers were urged to arrange for privacy

in the interviews was to avoid having a member

of the family overhear anything he said.

There was little chance that a person would be

assigned to interview a man known to him or

her, but the interviewers were instructed

that if this happened the interview was not

to be completed, but was to be returned for

reassignment. Further, if a respondent lived
in the interviewer's neighborhood so that

later social contact was possible, the situation was to be discussed with the field work

supervisor before the interview was attempted.

No breaches of confidentiality are known to

have occurred, and now none can occur. The

validation letters returned by the respondents indicate strongly that they perceived

the interviewers as professionals and had no

fear that confidential information might be

disclosed.

CREDIBILITY OF THE DATA

Because the data are based on the answers the

respondents provided in personal interviews,

an important question arises, namely, how

much reliance can be placed on their answers?

The possibility clearly exists that when

respondents are asked about deviant and

socially disapproved behavior, they may

exaggerate, minimize or deny what they actually did.

Exaggeration has been feared mainly in

questionnaire studies of school samples,

especially when questionnaires are administered to groups of students. In interview

studies the primary concern of investigators

has been with the possibility that respondents

may minimize or deny behavior. Two of the

methods employed to assess this possibility

can be reported at this point.

Since the study was focused on drug use, the

major question relates to the chance that

drug use would be denied. One approach is to

examine the findings in the second sample in

New York City. That sample was drawn from

the areas in Manhattan where heroin use was

known to be high during the 1960s; as many as

23 percent of the total population, aged

15-44, in some areas have been reported as

drug abusers, and most of these as heroin

users. The lowest rates reported for the

areas from which the sample was selected were

3 to 6 percent.

Since more males than females and more

younger than older males can be expected to

have used most drugs, the New York City

sample should show fairly high rates of drug

use if men did not deny use that had actually

occurred. Among the first 140 men interviewed

in the New York City sample, the expected

high rates of use were observed. The

percentages of men who reported having used

each drug or drug class were: tobacco, 84;

alcohol, 99; marihuana, 74; psychedelics, 25;

stimulants, 28; sedatives, 24; heroin, 22;

opiates, 36; and cocaine, 39.

used drugs were obtained from a variety of

sources--some from treatment agencies, some

from drug arrest records and some from among

those who had tested positive for opiates in

Vietnam. Information was not supplied about

individual drug histories; thus, it is not

known exactly how many had used heroin or

other drugs, nor how many had been arrested,

but it is known that the percentages should

be high. The names of these men were added

to the sample, and they were in no way

distinguishable from the other men in the

sample; consequently, any difference in

reported drug use could not be due to differential handling by interviewers. Only 52 of

these men were interviewed; in the last months

of field work, when all efforts were focused

on obtaining as high a completion rate as

possible in the national sample, no further

attempts were made to locate and interview

the other 48 men.

Of the 52 men interviewed, 98 percent said

they had used tobacco and alcohol; 89 percent

had used marihuana. The percentages who

reported use of the remaining drugs were:

psychedelics, 60; stimulants, 64; sedatives,

62; heroin, 81; opiates, 62; and cocaine, 73.

In addition, 71 percent said they had had

trouble with the law because of their drug

use, most frequently for heroin use and next

most often for marihuana use. Eighty-one

percent admitted they had an arrest record.

Seventy-three percent had used a needle to

inject drugs, and 54 percent had been treated

for drug use. In both of these tests, then,

the data furnished by respondents were of

the order to be expected if they were telling

the truth; there was no evidence of wholesale

denial of drug use.

Although it has not been possible to complete

them as yet, further checks are possible.

Urine specimens were requested from the

respondents; they were tested for the presence

of drugs. However, only about 70 percent of

the men furnished a urine specimen. It is

not clear how useful these will be, but if,

as expected, some interviewers obtained

specimens from almost 100 percent of their

assigned respondents, it will be possible to

check the laboratory findings against the

statements of the men about their drug use

within the preceding 24 to 48 hours.

The interviewers rated each respondent on his

truthfulness, and the data will be analyzed

according to these ratings. In addition,

data will be examined to see if responses

vary, or to what extent they vary, with

interviewer characteristics, including use of

drugs by the interviewers and their attitudes

toward drug use.

Second, the names of 100 men known to have

7
Another way to check the credibility of the

responses is to compare the findings with

those of other studies. This will be done

more rigorously in later, more detailed

reports, but it can be said that the extent

of drug use found in this study equals or

exceeds what would be expected from comparable

studies.

Those who have done similar studies will

agree that the most persuasive evidence of

credibility, though the least quantifiable,

is found in the internal consistency of the

responses. This includes not only the common

procedure of asking the same question in

several places, or in several forms, but in

expected relationships among variables. Thus,

one expects to find more criminal behavior

among the users of drugs who obtained them

only through illegal channels than among

others. The analysts have been impressed

by the degree of such consistency found in

the analysis completed to this time.

In summary, then, additional checks on the

credibility of the data are possible, and

they will be made. On the basis of the ones

available, there does not appear to be any

particular reason to question the credibility

of the data analyzed in the following

chapters. This statement is made with respect

to the possibility of deliberately false

answers to questions. The reader is reminded

that there are other sources of error in the

retrospective reporting of data, such as

failures of memory. Some of the men in the

sample were reporting behavior as much as

20 years before the date of the interview,

and it would not be surprising that, when a

respondent reported his first use of alcohol

as occurring at age 13, the correct age was

actually 12 or 14.

COMPARISON OF INTERVIEWED SAMPLE WITH MEN

NOT INTERVIEWED, AND WITH U.S. POPULATION

It will be recalled that the sampling design

produced a sample of 3,024 men. Of these,

2,510 were interviewed; 36 had died; 7 were

located but were incompetent and incapable

of being interviewed; 174 were located but

refused the interview; in 17 additional

cases informants refused to give information

on the subjects' location; 263 men had not

been located at the time it became necessary

to terminate the field work; and 17 men had

known addresses outside of the United States,

but these became known after the overseas

trips were completed, or the men were not

available when these trips were made.

The reasons why men could not be located

were varied. Young men are probably the most

geographically mobile group in the population,

and many had moved from the places where they

had originally registered with Selective

Service. Addresses were up to 12 years old

when attempts at tracing them began. Urban

development and highway construction had

wiped out whole areas in some cities; as a

result, the old neighborhood no longer existed,

and there was no one available to furnish

leads. In a few cases the available information was completely inadequate for tracing

purposes; local draft boards had been vandalized, records destroyed, and all that was

known was a name and date of birth. In a

few other cases, the man's address was known,

but he was not available on the only trip it

was economically feasible to make to his

area. One, for example, was snowbound in a

camp on the Alaska pipeline; another was a

bush pilot missionary in North Africa, who

was away from his base when the interviewer

passed through it.

It is quite understandable, therefore, that

the rate of completed interviews was not

higher, and field work was terminated only

when the investigators were satisfied that

even a sizable further expenditure of time

and money would produce only a few additional

interviews.

Subtraction of the 36 who had died and the

7 who were incapable of being interviewed

leaves 2,981 men who could have been interviewed and 471 (15.8 percent) of them were

not interviewed. It is necessary, therefore,

to examine the extent to which 2,510 interviewed men are representative of the target

population.

Because of the confidentiality of the

Selective Service records, only information

that would help locate the sample subjects

was made available to the researchers. There

are, therefore, only two variables on which

the missing 471 men can be compared with the

2,510 who were interviewed. These are year

of birth and place of residence at the time

of registration with Selective Service.

The data on year of birth are presented in

Table 1.1. It should be noted that four

respondents gave dates of birth outside the

1944-54 range. Two, born in 1941 and 1942,

are included in the 1944 cohort; these are

presumably men who registered later than when

they were legally required to register and

gave false birthdates to conceal that fact.

Two more, born in 1955 and 1956, are included

in the 1954 cohort; one gave a false age in

order to enlist in the military early; it is

not known why the other man gave Selective

Service a different date of birth than the

one he gave to the interviewer. These four

cases represent such an exceedingly small

8
Table 1.1. Distribution of the Total Sample, Interviewed Men and Men Not Interviewed, and of the Corresponding U.S. Male Population, by Year of Birth

Total Sample1

Interviewed Not Interviewed U.S. Male Pop.*

YEAR OF BIRTH (n) Percent (n) Percent (n) Percent Percent

1944 228 8 174 7 54

45 219 7 171 7 48

46 239 8 196 8 43

47 315 11 254 10 61

48 266 9 223 9 43

49 266 9 215 9 51

1950 274 9 234 9 40

51 278 9 245 10 33

52 300 10 261 10 39

53 281 9 247 10 34

11

10

9

13

9

11

8

7

8

7

7

7

9

9

9

9

9

9

10

10

54 315 11 290 12 25 5 10

Total 2981 100 2510 101 471 98 98

1Tota1 excludes 36 deceased and 7 incompetent men.

2From Table 156, p. 1-354, United States Summary, PC (1) - 1D, Census of Population, 1960.

percentage of the total number of interviewed

men, or of the cohorts to which they are

assigned, that their inclusion will not

affect the analysis presented in this or

later reports.

Two comparisons should be made in the table.

First, the distribution of the total sample

should be compared with the total male

population. For this purpose the 1960 Census

data for males 5 to 16 years old were used to

provide an estimate of the size of the target

population before the men registered with

Selective Service. While only 6 of the

percentages are identical in the two

columns, the match is close. The largest

difference is two percentage points for the

1947 cohort, and this is exaggerated by

rounding; with another decimal the difference

is 1.2 (10.6 and 9.4). The sampling procedure

produced a sample truly representative of the

total population with respect to year of

birth.

between those men who were interviewed and

those who were not. A glance is sufficient

to show that it was the older men who were

less likely to be interviewed. To the

extent that age is related to drug use, or

to other variables examined in this report,

this could introduce bias into the findings;

this must be taken into account in generalizing from the findings obtained in the interviews to the population of young men.

The same kind of comparison can be made in

Panel A of Table 1.2, which shows the distribution of the sample by region of the United

States, as of the time of registration with

Selective Service. Data were not located on

the distribution of the U.S. male population

for men exactly comparable with the Selective

Service registrants, but because males who

were 5 to 14 years old in 1960 could not

differ greatly in geographical distribution,

they are used for comparative purposes in

the table.

The other comparison that should be made is First, it may be observed that the total

9
Table 1.2. Regional Distribution of the Sample, as of Dates of Registration and

Interview

A. Distribution, as of Date of Registration, of the Sample, of Interviewed Men and

Men Not Interviewed, and of U.S. Male Population, Age 5-14 in 19601 (Percentages)

Northeast

Total Sample Interviewed Not Interviewed Male Population,

(n) Percent (n) Percent (n) Percent 5-14 in 19601

647 22 517 21 130 28 23

North Central 882 30 762 30 120 25 29

South 967 32 816 32 151 32 32

West 485 16 415 17 70 15 16

Total 2981 100 2510 100 471 100 100

B. Distribution, as of Date of Interview, of Interviewed Men, and of U.S. Male

Population, Age 16-26 in 19702 (Percentages)

Male Population

Interviewed 16-26 in 1970

Northeast 18 22

North Central 28 27

South 33 32

West 18 18

Outside 2 -

Total 99 99

1From Table 233, p. 1-618, United States Summary, PC (1)-1D, Census of Population,

1960.

2From Table 56, p. 1-282, United States Summary, Part 1, Section 1, Census of

Population, 1970.

10
sample is almost perfectly representative

of the population with respect to region of

residence at age 18. Second, the men who

were not interviewed were disproportionately

from the Northeast--the rates of completed

interviews were somewhat higher in the

Western states and even higher in the North

Central states. This, too, is a potential

source of bias, but a small one; the distribution of the interviewed men does not differ

greatly from that of the total population.

In Panel A the address as of age 18 is used,

whereas in Panel B the address as of the time

of interview is used to permit comparison

with the 1970 Census. Because data by single

years of age were available, comparisons can

be made with exactly the same age group.

The westward tilt of migration is observable

in the difference between the distributions

for the interviewed men between the two

panels and between those for the entire

population. There was a percentage point

increase for the West in the population, and

almost the same increase was observed among

the interviewed men. Again, it is clearly

men from the Northeast who are underrepresented by the interviewed men.

The only other variable on which the interviewed men can be compared with those who

were not interviewed is the size of the city

in which they lived at age 18. Because the

missing men resided disproportionately in the

larger cities, the data on city size also

pertain to a potential source of bias. These

data are presented in Chapter 4, and an

attempt is made to estimate the effects of

this bias.

For all other variables, data are available

only for the men who were interviewed. A

description of the sample in terms of these

variables will be presented in later

chapters in relation to drug use.

ORGANIZATION OF THE REPORT

This report is organized into thirteen

chapters. In Chapters 2 and 3 data are

presented regarding lifetime and current

prevalence of drug use, as well as some

correlates of use. In Chapter 4 these data

are used to estimate the numbers of men, in

the approximately 19,000,000 represented by

the sample, who have used the various drugs.

The incidence (the number and percent who

began use in each year) of drug use is

examined in Chapter 5 to shed light on the

presumed occurrence of a drug epidemic in the

late 1960s.

Chapter 6 pertains to the contexts and

motivations of use, and some drug-related

attitudes and opinions of the men in the

sample. Data are presented on the ways in

which the men obtained drugs, the ways they

used them, and the reasons given for using or

not using the different drugs.

The consequences of drug use, the problems

reported by users and the benefits they

perceived are discussed in Chapter 7. Some

of these data became available shortly

before the deadline for completing this

report; as a result this discussion is both

tentative and incomplete.

In Chapter 8 the relation between drug use

and criminal behavior is examined. The

respondents gave information regarding ten

specific offenses rather than all of the

offenses they may have committed. Information

about their contacts with the criminal

justice system is also presented. The

relation between drug use and crime is an

extremely complex one, and months of further

analysis will be needed to attempt answers to

the questions of greatest practical and

theoretical significance. This chapter must

be read as only an initial exploration of a

complex area.

Thus, the first eight chapters are concerned

with the nine drug classes, and the correlates of use are examined with respect to

each class separately. In Chapter 9 the

question of multiple drug use is addressed;

the time order in which the drugs were used

and the associations between use of each

drug and use of all others are examined.

This approach is continued in Chapter 10 in

which the development of a Total Drug Use

index is presented. The TDU index gives a

score for each respondent, taking into account

which drugs he has used and the extent of his

use. This index is then used to reexamine,

in a more parsimonious way, many of the

correlates of use noted in the earlier

chapters, as well as to examine other correlates.

In the last three chapters specific questions

of interest are examined. Data on the

relation between military service and drug

use are presented in Chapter 11. Relatively

few men in the sample were ever treated for

drug use, and their number is too small for

detailed analysis, but the available data

are presented in Chapter 12.

Finally, in Chapter 13 data on regional

variations in drug use are presented. These

data became available too late for detailed

analysis, but this brief description is

included because of widespread interest in

regional differences.

11
CAVEATS

Before the data are presented, it is appropriate to repeat a caution noted earlier.

Only a preliminary analysis of the data has

been completed. The field work was not

completed until May, 1975, and most of the

data were not available until June; for some

of the variables the data are not as yet

available. Consequently, data are presented

descriptively, and the analysis is based

largely on percentage differences. More

rigorous statistical analysis is needed, but

it will require more time than was available

for the preparation of this report.

Although data banks are never free of error,

the writers are confident that the data on

which this report is based are essentially

free of coding error. There are undoubtedly

some errors in the data that can be corrected

as analysis continues. Finally, time has

limited the number of relationships that

could be examined. The interview schedule

is rich in variables not yet examined, but

these will be covered in subsequent reports.

In addition to these general cautions, a

specific caution is in order. The sample

was selected to be, and may safely be

considered, representative of all young men

in the United States. Most of the analysis,

however, consists of comparison of one part

of the sample with another, and there is no

basis to assume that all of the parts are

representative of the corresponding parts of

the population. Specifically, the sample

is really the sum of eleven independently

selected random samples, one for men born

in 1944, one for men born in 1945, and so on

through 1954. Each of these is a representative sample, and when these birth cohorts

are compared with each other, differences

found between them will be real differences,

allowing for sampling error.

The situation is different when whites are

compared with blacks, or one region of the

country with another. It is reasonable

to assume that the whites in the sample are

representative of whites in the population

because they constitute 84 percent of the

sample. However, the blacks may not be

representative of all blacks in the population. Similarly, when the sample is divided

into the four geographical regions, the four

parts may or may not be representative of

each of the regions. As one moves to smaller

units, such as geographical divisions, states

or cities, it becomes almost certain that

the small parts of the sample are not representative of the small geographical units.

Caution must, therefore, be exercised in

generalizing from parts of the sample to

parts of the population of young men, even

though one may generalize from the whole

sample to the total population. The situation

is closely analagous to the familiar polls of

election years, which predict accurately who

will be elected President, but furnish no

basis to say what the vote will be in a

specific city.

12
2 Lifetime Prevalence

Measures of lifetime prevalence (defined as

any use in the person's lifetime) are crude,

and they are presented only as an initial

way of describing the respondents' experiences with drugs. Later in this chapter

attention will be devoted to more refined

measures reflecting the extent of use.

Before the data on use of the drug "classes"

are presented, several comments about the

classifications are necessary. First, the

category labeled marihuana includes use of

marihuana, hashish, and hashish oil. This

class could be called cannabis, but the term

marihuana was used in the interviews in

reference to all three drugs, and this usage

will be followed in this report. It does

not include THC, which was counted in this

study as a psychedelic. Second, while

heroin is an opiate, there is sufficient

interest in it to warrant treating it separately. Hence, the term opiates is used in

reference to all opiates other than heroin.

A similar rationale justifies separate

treatment of cocaine.

In Table 2.1 data are presented on the use,

at any time in the man's life, including use

Table 2.1. Lifetime Use and Total Number of Times the Drugs Were Used By

Drug Classes (Percentages, n = 2510)

No Less than 10-99 100-999 1,000 or

Use Used 10 times times times more times

Tobacco 12 88 9 10

Alcohol 3 97 4 14

Marihuana 45 55 17 14

Psychedelics 78 22 12 8

Stimulants 73 27 12 10

Sedatives 80 20 10 7

Heroin 94 6 3 2

Opiates 69 31 20 9

Cocaine 86 14 9 4

10 59

35 44

13 11

2 *

4 1

2 1

1 1

2 1

1 *

*Less than half of one percent.

13
Table 2.2 Lifetime Use of Drug Classes by Brith Cohort (Percentages)
only a few times, of each of the drug classes

Alcohol ranks first, with 97 percent having

used it. Tobacco is second, with 88 percent

and marihuana third, with 55. Opiates rank

fourth. Next in order are stimulants,

psychedelics, sedatives, cocaine, and heroin.

It is also to be noted that the extent of

use varied markedly. Most of the men in

the sample who used tobacco at all used it

more than a thousand times, and this is true

for more than 40 percent of those who used

alcohol. (The number of "times" a man used

the drug refers to the occasions of use.

One occasion could mean one alcoholic drink

or many, one marihuana cigarette or many,

and so on.) While marihuana was used by

more than half of the sample, only 11 percent

used it a thousand times or more, and for

all other drugs, this frequency was reported

by one percent or less of the sample. While

drugs were used by many of the men, their use

was often not extensive.

Birth Cohorts

The sample was selected from men who had

registered with Selective Service in the

years 1962 through 1972. Since registration,

with minor exceptions, occurred when a man

became 18, the sample may be regarded as

consisting of 11 birth cohorts, with the year

of birth ranging from 1944 to 1954.

Lifetime drug use is shown by year of birth

in Table 2.2. In this table the data pertain

to cigarettes rather than tobacco; there

appears to be a lower prevalence of cigarette

use in the younger cohorts. There is little

variation in the column for alcohol, but for

all other drugs there is a clear tendency for

the percentages to be higher in the younger

cohorts. Drug use has been much more widespread among the younger than the older men

in the sample.

Race

In Table 2.3 the lifetime use of the drug

classes is shown in terms of race. Only

whites and blacks will be considered in more

detailed analyses; the other groups are too

small for analysis. Some of the differences

between whites and blacks are small and

could be due to sampling variation. Nevertheless, blacks exceed whites in the percentages for marihuana, heroin and cocaine to an

extent that suggests a real difference.

The first two tables show relationships

between lifetime use and race and between use

and year of birth. These three variables are

presented in Table 2.4, and there is a complex

but clear interrelationship. In the table

the data for whites and blacks are presented

by year of birth; adjacent years are combined

to reduce the 11 cohorts to four age groups.

Blacks and whites are similar in terms of

tobacco use. The same trend towards less use

by younger men that was seen for cigarettes

in Table 2.2 is apparent for blacks and

whites. The minor variations for alcohol

can be ignored as easily due to sampling

variation.

However, a surprising pattern emerges for the

other drugs. Among whites, the tendency for

more use by younger men is even clearer than

Table 2.3. Lifetime Use of the Drug Classes by Race (Percentages)

Total White Black Spanish Other

Used (2510) (2103) (303) (48) (56)

Tobacco 88 88 87 83 88

Alcohol 97 97 94 94 98

Marihuana 55 54 65 54 48

Psychedelics 22 22 25 21 18

Stimulants 27 28 25 23 27

Sedatives 20 20 24 13 20

Heroin 6 5 14 6 5

Opiates 31 31 34 15 29

Cocaine 14 13 24 10 11

15
Table 2.4. Comparison of Whites and Blacks on Lifetime Drug Use by Year of Birth (Percentages)
Table 2.5. Lifetime Drug Use by Size of City of Residence to Age 18 (Percentages)
in Table 2.2. But the tendency does not

appear for blacks, where each row shows a

U-shaped curve, and the youngest blacks

report less lifetime use than the youngest

whites for most drugs, and no more use for

any drug. Explanations for this difference

will be sought later, but meanwhile it should

be kept in mind that the inverse relationship

between age and drug use, for all drugs

except alcohol and tobacco, holds only for

whites. Indeed, except for blacks born

before 1947, the pattern for most drugs is

the reverse of the pattern for whites; there

is less use in the younger groups.

Residence to Age 18

Respondents were asked to name the city where

they had lived most of the time to age 18.

This age was chosen because it was approximately a mid-point in the age range when

most drug use might be expected to have

started. The size of the city was coded, and

lifetime use by size of city is shown in

Table 2.5.

Tobacco and alcohol show negligible variation,

but for all other drugs the pattern is

identical. With a minor exception for opiates,

the percentage is always highest for the

largest cities, those with populations of a

million or more. Without exception, the

percentage is always lowest in places under

2,500 in size. Between the two extremes, the

trend is generally downward from left to

right, and is even more regular if the

categories are reduced to five by combination

of the cities from 100,000 to 999,999 and

those from 25,000 to 99,999.

It is worth emphasizing that while size of

the city of residence to age 18 is clearly

associated with drug use, it is still true

that even in the smallest places in the

United States drug use was by no means

absent. Among men from cities over 1,000,000

in size, 70 percent had used marihuana. The

figure drops to around 60 percent in smaller

cities, and finally to 43 percent in places

under 2,500. Yet, 43 percent is still a

sizable figure, even though it is substantially lower than those for larger places.

The same point can be made for the other

drugs.

The relationship between city size and drug

use is not contingent on age and race, but

these variables are related to each other,

and it is difficult to estimate their relative

effects on drug use. For example, blacks

are more likely to be from large cities; 31

percent of the blacks, in comparison with 12

percent of the whites, were raised in cities

over 500,000 in size. Only 33 percent of

blacks, but 50 percent of whites, were raised

in places with less than 25,000 in population.

With regard to race and age, identical proportions of blacks and whites were interviewed

in the 1947-49 and 1953-54 birth cohorts, but

22 percent of whites and only 16 percent of

blacks were born in 1944-46, while 29 percent

of the whites and 35 percent of the blacks

were born in 1950-52.

The blacks, therefore, are over-represented

in the largest cities and among the younger

men, and both city size and age are factors

associated with more drug use. One effect

of this can be exemplified by the difference

between whites (54 percent) and blacks (65

percent) in marihuana use. If the distributions by age and city size were the same

for blacks as for whites, the overall percentage of marihuana use would be 60 percent

among blacks. This would eliminate half of

the difference between blacks and whites.

Even this reduction is almost certainly an

underestimate because the measure of city

size is a crude one. More of the blacks

presumably lived in poorer, more crowded

neighborhoods than whites who lived in cities

of the same size. If data were available

to control such variables, nearly all of the

difference between the races might be

explained.

It'might appear that the opposite argument

could be made; perhaps city size and age seem

more strongly related to drug use than they

really are because of the distribution of

blacks, who have high use rates, on these

variables. This can be rejected because city

size is strongly related to lifetime drug

use with race controlled. The inverse relation

between age and drug use is strong among

whites for all drugs except alcohol and

tobacco. Because whites constitute 84 percent

of the sample, this relation also holds for

the sample as a whole, despite the fact that

it does not hold for blacks.

Education

The data on lifetime use of drugs are presented

in Table 2.6 by education; the last year

of school completed serves as the measure of

education. Because race has been shown to be

associated with a number of variables, the

data are presented separately for whites and

blacks, and the 104 cases in other ethnic

categories are ignored because the numbers

become too small for cross-tabulations.

For both races there is a clear trend toward

less use of tobacco with increasing education.

There is no association between education

and alcohol use. The only linear trend among

the other drugs is for heroin; among whites

18
Table 2.6. Lifetime Use of Drugs by Education (Percentages)
the percentage of heroin use drops regularly

as education increases, and this is roughly

true for blacks too.

Among whites the lowest percentage of use is

found among college graduates for all drugs

except alcohol. This holds for blacks for

all drugs except psychedelics and opiates.

In addition, those who attended college but

did not graduate tend to show the highest

percentage of use. This is true among whites

for all drugs except tobacco, alcohol, heroin

and opiates, and in the last case the percentage falls only one point short of being the

highest. For blacks, the only exceptions

are tobacco and heroin. This relationship

holds for all except the 20 and 21 year old

men.

For these young men "some college" has less

meaning as a description of completed

education, because many of them were still in

college and will graduate. These relationships help to explain away some of the blackwhite differences in drug use; college

graduates show less use, but only 7 percent

of blacks, in contrast with 21 percent of

whites, are college graduates.

The fact that the youngest groups do not fit

the pattern of the other groups with respect

to education, and the general impression that

at least some forms of drug use have been

especially common on college campuses,

suggest an examination of those men who were

still students at the time of the interview.

To control age, only those born after 1950

were included in Table 2.7. Of 870 whites in

that age group, 31 percent were still

students, as were 19 percent of the blacks.

There were a few still in high school and

some in graduate school, but most were

college students.

The reader's attention is called to the fact

that the numbers of black students are small--

11 and 13 in the two age groups. Despite

this, the findings are striking. If one

Table 2.7. Drug Use by Race and Whether or Not Now in School, for Men Born After 1950

(Percentages)

WHITE BLACK

Total 1951-52 1953-54 Total 1951-52 1953-54

Number In School At

Interview

Number Not In School

At Interview

(273) (108) (165) (24) (11) (13)

(597) (310) (287) (104) (54) (50)

Tobacco In School 83 86 81 71 73 69

Not In School 87 89 85 83 80 86

Alcohol In School 96 97 96 92 91 92

Not In School 97 98 97 94 93 96

Marihuana In School 63 69 58 62 82 46

Not In School 60 59 62 67 70 64

Psychedelics In School 25 27 24 29 45 15

Not In School 34 31 38 18 17 20

Stimulants In School 30 38 25 17 36 0

Not In School 33 33 34 23 20 26

Sedatives In School 25 28 22 17 27 8

Not In School 26 23 30 24 24 24

Heroin In School 5 5 5 12 27 0

Not In School 8 8 8 9 17 2

Opiates In School 31 32 30 38 45 31

Not In School 38 33 43 36 33 38

Cocaine In School 16 17 15 25 36 15

Not In School 20 19 21 21 24 18

20
examines the total columns, the general

pattern is that those who have left school are

more likely to have used drugs than those

still in school. Among whites the only

exception is marihuana; among blacks the

exceptions are psychedelics, heroin, opiates

and cocaine. The surprising finding is that

among the men born in 1953-54, the youngest

men in the sample, there are no exceptions.

In the 18 comparisons possible, all 18 show a

higher percentage of use among those who have

left school. The young men still on campus

show less use than their off-campus peers.

To examine this further, the data for whites

will be used because the numbers on which

their percentages are based in Table 2.7

are sufficiently large to warrant some

confidence in percentage differences. The

fact that the youngest men still in school

show less drug use than their off-campus peers

does not seem to be due to any decrease in

the use of drugs by students. Only for

marihuana, stimulants and possibly sedatives

do the 20-21 year old students show less use

than the 22-23 year old students, and these

could well be differences that will disappear

as they become a little older. However, for

non-students, the younger group shows more

use of all drugs, except for heroin, than the

older group. The data are consistent with

the hypothesis that campus use was higher than

among non-students of the same age until a

few years ago, but that non-student use has

increased to the point of equalling or

slightly exceeding student use.

One other educational variable, college major,

is related to drug use. Thirteen hundred

(52 percent) of the sample did not attend

college. Of the 1,210 who did, 344 indicated

that their college major was Social Science,

Fine Arts or Humanities. Except for tobacco

and heroin, this group reported higher percentages of drug use than did those with

other majors or those who did not attend

college. The differences tend to be substantial; 69 percent used marihuana, as compared

with 52 percent of those with other majors

and 53 percent of the non-college group. For

psychedelics the corresponding percentages

are 35, 17 and 22; for stimulants 39, 25 and

26; for sedatives 32, 17 and 19; for opiates

36, 29 and 31; and for cocaine 22, 11 and

14. The pattern differs only for heroin;

5, 3 and 8.

Current Family Status

The variables discussed thus far might, after

further analysis, be seen as causes or

determinants of drug use. 'This is not the

case, or at least is less clearly so, for

the variables remaining to be discussed in

this section. An obvious hypothesis is that

the more conventional men are, or the more

committed they are to others and to the

system within which they live, the less likely

they are to use drugs. Additional measures

of conventionality will be developed later,

but the available data on current family

status and part of the data on employment

are relevant.

Both marriage and employment are likely to

occur years after drug use usually begins,

Table 2.8. Lifetime Use of Drugs by Current Family Status (Percentages)

Parental

Married Home Independent Coupled

(2510) (1309) (285) (796) (120)

Tobacco 88 90 78 87 91

Alcohol 97 97 94 97 100

Marihuana 55 46 51 68 82

Psychedelics 22 13 20 34 52

Stimulants 27 21 16 38 53

Sedatives 20 13 14 31 46

Heroin 6 3 6 9 18

Opiates 31 26 26 37 52

Cocaine 14 7 12 23 41

21
so in the literal sense they could not be seen

as causes of drug use. If they are tentatively accepted as indicators of conventionality, and the further assumption is made

that this conventionality has been present

many years, their relation to drug use may be

examined.

In Table 2.8 lifetime use of drugs is shown

for four groups: married and living with

one's wife; living with a woman to whom the

man is not married, or "coupled"; living

in the parental home; and living independently.

The findings are striking. With the exception of tobacco and alcohol, each drug shows

the same pattern. The percentage is lowest

for the married, next lowest for men living

with their parents, higher for those living

independently and highest for those living

with women to whom they were not married. A

minor reversal occurs for the stimulants, as

those still in parental homes show a lower

percentage than the married.

The pattern holds perfectly for whites for

all drugs except tobacco and alcohol, and

the relationship is strong for all drugs; the

percentage difference in use between the

married and coupled averages 35, except for

heroin; 2 percent of the married and 16

percent of the coupled men had used heroin.

The pattern generally holds for blacks; the

exceptions are psychedelics and stimulants,

where the coupled show lower percentages of

use than the men living independently. The

relationship is, however, weaker among blacks;

the average percentage difference between

the married and coupled men is 16, and the

corresponding difference among whites is

35. Among blacks, 11 percent of the married

men and 21 percent of the coupled had used

heroin.

The pattern also holds for the 104 men in

other ethnic categories, except for minor

reversals on marihuana and psychedelics.

The relationship between family status and

drug use is even more marked for these men.

The difference in drug use between the

married and coupled averages 67 percent; for

heroin the figures are 2 and 33. There were

only 6 men who were coupled, so the percentages may be unstable. The most conservative

interpretation is that the relation between

drug use and family status holds for all

men, with minor ethnic differences that may

be due to small bases for percentages.

The respondents were also classified on the

basis of whether or not they had ever been

married. With the exception of tobacco and

alcohol, higher percentages of those never

married reported use of all drugs, and

usually the differences are sizable. This is

not due to age, because the differences hold

within four age groups for whites and for

blacks, except those born in 1950-52.

Current Employment Status

For employment, the data available permitted

division of the sample into four groups:

Table 2.9. Lifetime Use of Drugs by Current Employment Status (Percentages)

Working 30 or Students, except

more hours for those working Working less

Total per week 30 hrs. or more than 30 hrs. Unemployed

(2510) (1980) (282) (35) (213)

Tobacco 88 88 84 77 92

Alcohol 97 97 96 97 96

Marihuana 55 52 62 74 72

Psychedelics 22 19 27 40 41

Stimulants 27 25 30 37 41

Sedatives 20 18 22 23 35

Heroin 6 5 6 6 18

Opiates 31 30 31 31 44

Cocaine 14 12 17 29 31

22
those who were working 30 hours per week or

more; students except for those in the first

group; those working less than 30 hours; and

the unemployed. These groups are defined as

of the date of the interview. The relationship between employment and drug use may be

seen in Table 2.9.

If one again ignores tobacco and alcohol,

the pattern is identical for the other seven

drugs. Those who were working 30 hours or

more show the lowest percentage, and the

percentages increase from left to right, with

the partially employed and unemployed showing

the highest percentages. The older men, who

report lower percentages of drug use, would

be expected to be among the full-time employed.

On the other hand, blacks are far more likely

to be unemployed than whites, though what

effect this would be expected to have is

unclear because of the complex relationships

among ethnicity, age and use. The statistical

facts are as expected. Among whites, 5

percent of the 28-30 year olds were unemployed,

9 percent of the men 25-27, 10 percent of the

22-24 year olds, and 10 percent of the men

who were 20 or 21. Among blacks the corresponding percentages are 12, 28, 17 and 24.

Therefore, the relationship between lifetime

use of drugs and current employment status

was examined with simultaneous controls on

ethnic group and year of birth, for all drugs

except tobacco and alcohol. Among blacks,

only 15 were classified as students and 12 as

employed less than 30 hours per week;

consequently, the only comparison possible is

between the 213 employed full-time and the

63 unemployed. The differences between these

groups hold for blacks, but are considerably

smaller; it is only for cocaine and heroin,

where the differences are 9 and 10 points,

respectively, that the differences approach

those in Table 2.9. In short, the relationship between employment status and drug use

exists for blacks, but is weak, while it is

strong among whites.

In general, the oldest group of whites (those

born in 1944-46) contribute little to the

difference in drug use between the men

employed full-time and the unemployed. Only

for marihuana and opiates does the difference

exceed a few percentage points. The other

three age groups contribute more; the two

youngest groups contribute the most and

approximately equally. No such regular

pattern is seen across the age groups among

the blacks.

The respondents were asked, "How much money

do you make now before taxes'!" Answers were

recorded for whatever units of time the men

chose to use and the unit chosen may be taken

23

as an indicator of subjective social class

identification. Those who reported income

by the hour, day or week may be roughly

equivalent to blue-collar workers, and those

who reported by month or year to white-collar

workers.

Whether or not this interpretation is correct,

the findings are clear. For whites, those

who used hour, day or week as the unit for

reporting income show consistently higher

percentages of drug use than the men who used

month or year as the unit, and the relationship is maintained with year of birth

controlled. Both groups are consistently

below the percentages for the unemployed.

This pattern does not hold at all for blacks.

There is, then, evidence that indicators of

conventionality or of having a stake in

the system are associated with lower rates

of drug use. The point should again be made

that even among the conventional men drug

use is not absent. Among those who used

month or year as the unit, for example, 50

percent had used marihuana, 3 percent heroin

and 10 percent cocaine.

MEASURES OF THE EXTENT OF USE

Data on the number or percentage of men who

have ever used a drug, while useful, conceal

extensive variations in the amounts and

patterns of use. More refined analysis will

be possible if the users can be separated

into several categories, ordered on amounts

and patterns, though the number of categories

which it is practical to define will vary

with the number of users.

Two sets of questions from the interview

schedule were used to develop the indexes of

extent of use for all of the drug classes.

2)

1) Table 2.1 showed the data obtained

from a question posed for each drug

class: "About how many times in

your life have you used these drugs

on your own?" The pre-coded answers

were "less than 10 times," "less than

100 times," "less than 1,000 times,"

"1,000 times or more." A fifth

category was "never used."

Those who reported having used a

drug 10 or more times were asked a

series of questions about use of

the drug in each year from 1957 to

1974. For each year in which use

was reported, the respondents were

asked to indicate the extent of use

in that year. The categories were:

(a) almost every day, usually in
Table 2.10. Lifetime Highest Frequency and Quantity of Use for the Total Sample and for Users Only

(Percentages)
large amounts Extent of Use Indexes: Alcohol and Marihuana

(b) almost every day, sometimes in

large amounts

(c) almost every day, never in large

amounts

(d) about once or twice a week, sometimes in large amounts

(e) about once or twice a week, never

in large amounts

For alcohol, the first category consists of

those who never used alcohol, and the second

those who had used it less than ten times.

Four other categories were defined from a

cross tabulation of the questions on lifetime frequency and amount of use. The

categories were defined as follows:

(f) about once or twice a month, sometimes in large amounts

(g) about once or twice a month, never

in large amounts

Total Amount Never Used Sometimes Used

of Use Large Amounts Large Amounts

(Lifetime)

(h) less than once a month.

One measure of extent of use can be based on

the answers to these frequency-amount questions

In Table 2.10 the data are presented separately

for frequency and amount for the year in

which each was highest.

Under 100 Group 3 Group 4

Under 1000 Group 3 Group 5

1000 or More Group 4 Group 6

To describe the groups in words and to give

them names for use in later discussion, the

men were described with respect to alcohol

use as follows:

1. Nonusers

2. Experimental users

3. Light users

4. Moderate users

5. Heavy users

6. Heaviest users

No use of alcohol at any time

Used on less than 10 occasions

Used more than 9 but less than

1000 times, and never in large

quantities

(76) 3%

(93) 4%

(491) 20%

Used 1000 times or more, but

never in large quantities, or

used less than 100 times, sometimes in large quantities

(318) 13%

Used more than 99 but less than

1000 times, sometimes in large

quantities

(599) 24%

Used 1000 times or more, sometimes in large quantities

(933) 37%

It should be emphasized that the names attached to the six groups are not intended to

express a judgment that the alcohol use was

negligible or excessive, but simply to label

relative amounts of use within this sample.

That this purpose is served should be evident

in Table 2.11, in which the six groups are

compared on eight criterion variables. It

was their similarity on these variables that

justified combining the two cells labeled

Group 3 above into "light users" and the two

labeled Group 4 into "moderate users," and

keeping the other cells as separate groups.

The alcohol measure quite clearly distinguishes the six groups on variables that have

traditionally been regarded as important

indicators of drinking behavior. The labels

heavy and heaviest use are justified in more

than a relative sense. For example, of those

so labeled 45 and 55 percent, respectively,

have used alcohol to the extent of being

unable to remember what had happened to them,

and 71 and 84 percent have driven a car

while drunk. Moderate and light may be

misnomers, since the percentages on these

variables, while lower than for heavy users,

25
Table 2.11. Distribution of Criterion Variables by Extent of Use of Alcohol (Percentages)
are by no means negligible. Even among the

Light users 14 percent have had the experience of not being able to remember, and

25 percent admit to driving while drunk.

The findings in Table 2.11 suggest that it

may be possible to build a better measure,

but that this one will serve for the initial

analysis as an improvement over a simple

dichotomy of use and no use. It also

establishes that for a clear majority of the

sample alcohol was used to the extent that it

could have caused problems for the user and

others.

1. Nonusers

2. Experimental users

3. Light users

4. Moderate users

5. Heavy users

Marihuana groups were constructed by the same

method. In addition to those who never used,

and those who used less than 10 times, the

classification in terms of frequency and

amount was as follows:

Total Amount Never Used Sometimes Used

of Use Large Amounts Large Amounts

(Lifetime)

Under 100 Group 3 Group 4

Under 1000 Group 4 Group 5

1000 or More Group 5 Group 5

Thus, with respect to marihuana use the men

were described as follows:

No use of marihuana at any time

Used on less than 10 occasions

Used less than 100 times, and

never in large quantities

Used more than 99 times but less

than 1000 times, never in large

quantities, or used less than 100

times, but sometimes in large

quantities

Used 100 times or more, sometimes

in large quantities, or used over

1000 times, never in large quantities

These groups are compared on seven variables

in Table 2.12; again, the groups produce the

expected regular increases in percentages

from experimental to heavy use.

Extent of Use Indexes: Psychedelics, Heroin,

Cocaine, Tobacco

The number of respondents who had ever used

psychedelics, heroin and cocaine was

relatively small, especially those who had

used these drugs 100 times or more. Thus,

it was decided that the most appropriate

way to classify these respondents was simply

in terms of the number of times the drug had

ever been used.

The situation for tobacco is similar, but

for different reasons. In the first place,

less detailed information was obtained, and

this was primarily concerned with use of

cigarettes. Second, most (59 percent) of the

(1128) 45%

(423) 17%

(231) 9%

(227) 9%

(501) 20%

users fell into the category of 1,000 times

or more.

For these four drugs, therefore, the following

categories will be used to measure the extent

of lifetime use: no use, under 10, 10-99,

100-999 and 1,000 or more times (Table 2.1).

Extent of Use Indexes: Stimulants, Sedatives,

Opiates

A different kind of problem arises in constructing indexes of the extent of use for

the stimulants, sedatives and the opiates.

Drugs in these classes are sometimes prescribed by physicians for medicinal purposes.

Thus, it was necessary to utilize questions

that would differentiate between medical and

nonmedical use of these drugs.

Stimulants were the first of these classes

mentioned, and the respondents were told:

27
Table 2.12. Variations in Use, by Extent of Use of Marihuana (Percentages)
Some drugs are used medically and also

are used by people on their own. By

medical use, we mean according to a

doctor's direction--pretty much in the

amounts and at the time he directs.

Anything else we define as use on your

own.

Here is a list of drugs called stimulants. Please tell me which of the

drugs on Card 3 you have ever used on

your own, even once. Do not include

any stimulants you only used medically.

For sedatives and opiates, a respondent was

handed separate cards and asked to indicate

which of the drugs on the list you have "ever

used on your own, even once." The respondent

was again reminded to exclude any sedatives

or opiates he had only used medically.

Respondents seemed to have little difficulty

with the distinction between "use on your

own" and "medical use." There is no reason

to believe that medical use was included in

the responses given, except for a handful of

cases in which the age at first use is so low

as to make it difficult to believe that the

use could have been on the respondents'

initiative.

But the definition of medical usage was fairly

narrow, and it is known that people commonly

use medications in ways which would be nonmedical according to the definition employed

in this study, but yet in a manner more closely

resembling medical use than what many would

describe as "drug abuse." For example, a man

1. No use

2. Quasi-medical use

may have had an opiate such as Darvon or

Demerol prescribed for some medical condition

and used only part of the prescription. Later,

when the same or similar symptoms appeared,

he used the remainder of the prescription.

According to the definition utilized in this

study, such use would correctly be classified

as use "on your own." Similarly, a man could

have used an opiate obtained by his wife by

means of a prescription if he decided that

he had a pain which called for an opiate.

This too would be correctly classified as

use "on your own."

Most physicians would probably frown on such

self-diagnosis and self-medication, and some

of it may be technically illegal, but it

appears to be a common practice. Certainly

such quasi-medical use should not be confused

with the use of opiates for other purposes.

The fact that almost one-third of the sample

reported using opiates on their own suggests

that quasi-medical use was an appreciable

part of the use reported in this study.

This necessitated the development of criteria

to separate quasi-medical from other use of

the opiates. Eleven variables were judged

to be useful criteria, and the users of

opiates who met all eleven are classified as

quasi-medical users of opiates. (The

criteria, and the reasons for not accepting

those who met 10 of the 11 as quasi-medical

users, are described in Appendix I.)

The classification of opiate users thus

becomes:

(1731) 69%

(286) 11%

3. Experimental use (less than 10 times and failed (300) 12%

one or more criteria)

4. Light use (10-99 times and failed one or more (145) 6%

criteria)

5. Heavy use (100 or more times and failed one or (48) 2%

more criteria)

The heavy users could be subdivided further by combine the light and heavy users.

extent of use, but the numbers would be too

small for analysis. Indeed, in the analysis According to this classification, the fact

of the data, it was sometimes necessary to that 31 percent of the men in the sample have

29
used opiates takes on a different meaning.

Eleven percent of the sample, or more than

one-third of the men who reported opiate use

were using them in a manner not far removed

from legitimate medical usage. Thus, only

20 percent of the sample can be said to have

used opiates in a way that could reasonably

be seen as abuse of opiates, and in only 8

percent of the sample was this use more

than experimental.

Eleven similar criteria (Appendix I) were

used to identify quasi-medical use of

stimulants. The classification of users of

stimulants then becomes:

1. No use (1821) 73%

2. Quasi-medical use (108) 4%

3. Experimental use (less than 10 times and failed (207) 8%

one or more criteria)

4. Light use (10-99 times and failed one or more (242) 10%

criteria)

5. Heavy use (100 or more times and failed one or (132) 5%

more criteria)

This classification does not change the

general picture of use as much as was noted

for opiates. Twenty-seven percent of the

sample used stimulants; removal of the 108

cases of quasi-medical use reduced to 23

percent the proportion whose use might be

labeled "abuse," and in only 15 percent of

the sample did this exceed experimental use.

For sedatives, ten criteria (Appendix I)

were used to identify quasi-medical use;

this produces the classification:

1. No use (2002) 80%

2. Quasi-medical use (99) 4%

3. Experimental use (less than 10 times and failed (177) 7%

one or more criteria)

4. Light use (10-99 times and failed one or more (158) 6%

criteria)

5. Heavy use (100 or more times and

more criteria)

The change in the general picture resembles

that for stimulants more than the change noted

for opiates. Twenty percent of the sample

used sedatives; removal of the 99 quasimedical users reduced this to 16 percent, and

in 9 percent of the sample, use was more than

failed one or (74) 3%

experimental.

A general point should be made about these

classifications of quasi-medical use for

three classes of drugs. The definition of

quasi-medical use is a rigorous and

30
conservative one. This is only in part

because of the requirement that all criteria

be met; it is clear in Appendix I that

relaxation of the requirement would shift

only a few men from the experimental to the

quasi-medical category. The definition is

rigorous because the criteria are applied to

the entire history of drug use. For

example, if a man ever used one of these

drugs to get high he was not classified as

a quasi-medical user, even though most of

his use might, if more detailed data were

available, be categorized as quasi-medical.

The classifications used here require that

all of a man's use of opiates, stimulants

or sedatives was quasi-medical.

VARIATIONS IN THE EXTENT OF USE

The measures of extent of use of each drug

have been developed primarily for use in

Later chapters, but it is worth determining

whether they change any of the findings

reported in the first section of this

chapter. In the following analysis, experimental and quasi-medical use will be ignored,

but the cutting point used will vary from

drug to drug to provide an adequate number

of cases for analysis.

In Table 2.2, there was almost no variation

by birth cohorts in the percentage that had

used alcohol. Although not shown in tabular

form, among the heaviest alcohol users there

is a clear trend for the younger cohorts to

show lower percentages; this may mean only

that it takes a number of years to have

used the drug a thousand times. In the six

oldest cohorts, the percentages of heaviest

alcohol use are over 40; in the next three

they average 35, and in the two youngest

28.

The older cohorts reported lower rates of

marihuana use, but the Lowest rate was at

Least half as high as the rates observed in

the younger cohorts. These differences

are accentuated when extent of use is considered. For moderate and heavy marihuana

users, the percentages increase steadily from

12 percent for the two oldest cohorts to

37 percent or more in the five youngest

cohorts. No only did fewer men in the older

cohorts use marihuana, but those who did

used it less. The data examined thus far

are consistent with the possibility that,

after marihuana use became popular among

youth, some older men tried it a few times

to see what it was like, but did not use

it extensively.

For psychedelics, heroin and cocaine all

use other than experimental was included;

for these drugs the patterns do not appear

to differ appreciably from the patterns

in Table 2.2.

Differences might be expected when both

experimental and quasi-medical use are

excluded for stimulants, sedatives and

especially opiates, because there are many

quasi-medical users. For stimulants and

sedatives the changed basis for comparison

accentuates the patterns observed in Table

2.2; the younger cohorts exceed the older

ones more markedly. For opiates only a

moderately higher percentage was observed

for younger cohorts in Table 2.2, and this

difference is somewhat greater when the

cohorts are compared on light or heavy

opiate use.

Alcohol use was reported by 97 percent of

the whites and 94 percent of the blacks

(Table 2.3). When the comparison is restricted to heavy and heaviest alcohol use, the

comparable figures are 64 and 44. For

moderate and heavy marihuana use, instead

of any marihuana use, blacks still exceed

whites by 39 to 27 percent. The percentage

of heroin use was 5 for whites and 14 for

blacks. With experimental use excluded,

the figures are 2 and 8. For cocaine, the

percentages were 13 for whites and 24 for

blacks; with experimental use excluded, they

are 5 and 13. In short, racial differences

in drug use remain or are accentuated when

extent of use is taken into account.

DISCUSSION

In this chapter data have been presented on

the relations between a number of variables

and use of the nine drug classes. There is

a danger of becoming lost in details,

especially since these variables interact

with each other. The major source of

confusion is race, because some variables

operate differently for whites and blacks.

A summary of the major findings may therefore be useful.

The statistical relations are clear for

whites, who constitute 84 percent of the

sample. There are 303 black respondents.

This is a sufficiently large number to permit classification on one variable and

usually on two variables, but cell sizes

then tend to become so small that comparisons

must be made with caution. There are also

104 subjects who fall in several other

groups; each group is too small, and even

the combination of them provides too few

cases for analysis; in addition, there is

Little justification on any grounds for

combination of these diverse groups. Therefore, they have usually been excluded from

the analysis.

31
There are marked differences in drug use by

birth cohorts. For whites the pattern is

clear. There is no variation for alcohol,

but for tobacco the younger cohorts show less

use, and for all other drugs more use. The

patterns for blacks resemble those of whites

for tobacco and alcohol but differ for all

other drugs. The general pattern for blacks

is a U-shaped curve, with the three oldest

and two youngest cohorts showing less use

than the middle six cohorts. There seems to

be a strong possibiiity that the two races

have been converging with respect to drug use,

with whites showing increases and blacks

decreases to approximately equal levels, but

this cannot be asserted with confidence

because the oldest and youngest groups of

blacks are the smallest.

Respondents were asked where they had lived

most of the time to the age of 18, and the

size of the city they named was coded. For

all drugs except tobacco and alcohol, city

size is directly related to drug use. This

is true for whites and blacks separately as

well as for the sample as a whole, but blacks

are more likely to come from large cities.

The relation between education and drug use

is not strong, but there was somewhat less

use among those who have graduated from

college, and somewhat more among those who

attended college and did not graduate. This

holds for both whites and blacks, but blacks

are less likely than whites to have entered

or graduated from college.

Of those who ever attended college, rates of

drug use are clearly higher for those who

gave the Social Sciences, Fine Arts or

Humanities as their majors. Blacks, of

course, are less likely to attend college

and to report these majors. One negative

finding is that the men who were still

students when interviewed reported no more

drug use than their non-student peers; in

the two youngest cohorts, those born in

1953-54, lifetime prevalence of drug use was

lower among the students than among nonstudents. This seems to be as true for blacks

as for whites, though the numbers of students

among the blacks are so small that the

estimates may be unreliable.

Current family status and whether or not

the men were ever married were strongly

related to drug use. Those married and living

with their wives had the lowest percentages,

while those living with women to whom they

were not married had the highest percentages

of drug use. Those ever married showed less

use than those never married. These relationships were weaker for blacks than for whites.

Current employment status is also related to

drug use; the lowest rates are observed among

the full-time employed, and progressively

higher rates are found among students, the

part-time employed, and the unemployed. The

relation remains with a control on age. It

is strong for whites, and weak for blacks;

in other words, the fact that blacks are more

likely to be unemployed does not account for

their higher rates of drug use. The period

for which income was reported, a possible

indicator of subjective social class, was

strongly related to drug use for whites, but

not for blacks.

The racial differences are, in short, complex.

Some variables are related to drug use in the

same way for whites and blacks, but others

are strong for whites and weak or non-existent

for blacks; further, one variable, year of

birth, is related to drug use in almost

opposite directions for whites and blacks.

Blacks show higher percentages of use of

marihuana, heroin and cocaine than the sample

as a whole, but controls on age and city

size alone are sufficient to explain one-third

to one-half of the difference. It seems

plausible to assume that simultaneous controls

on all of the variables would explain all of

the difference, but there are not enough

cases to control all variables in a tabular

analysis. For this reason, two kinds of

analysis will be used in later parts of this

report.

At times there will be multivariate analysis

of the entire sample, without reference to

race or ethnic groups. In effect, such

analyses will be based on the assumption that

differences by ethnic groups are artifacts,

due to their relationships with other variables,

so that ethnicity can be ignored when the

other variables are controlled. For the

entire sample, it will be possible to control

for at least three or four variables if the

number of categories in each is small. Yet,

the requisite assumption will never be fully

justified, because controls on three or four

variables will rarely, if ever, remove all

differences between ethnic groups. At other

times, the ethnicity variable or the blackwhite part of it will be used in the analysis.

32
3 Current Prevalence

This chapter deals with the question of current use, defined in a variety of ways.

While it is important to know something of

the extent to which a drug has ever been

used by a population, an equally important

consideration is the proportion who continue

to use the drug.

As discussed in earlier chapters, the amount

of information collected about a man's drug

history, including his current use, was

dependent on the total use of each drug

reported by the respondent. Only men who

reported using a drug ten times or more were

asked specific questions about current use

of that drug; specifically, these men were

asked if their last use had been within 24

hours, 30 days, or if longer, the month and

year of most recent use. It is thus possible

to define current prevalence or "current

users" among this group in terms of various

time periods-- anywhere from use within the

last day to use within the last year or more.

Respondents who had used a drug less than 10

times were asked only the year of most recent

use. It is problematic in the case of the

men who reported use in 1974-75, the year

prior to their being interviewed, whether

they should be counted as current users;

perhaps they were still in the experimental

stage with the possibility that some will

become regular users, while others may have

stopped using and will never use again. A

partial solution to this problem is provided

by information concerning the respondent's

perception of the chances that he will be

using each class of drugs three years after

the interview. When those who have used a

drug less than 10 times were categorized into

two periods of most recent use, pre-1974 and

1974-75, and their responses to the question

about chances of future use into no chance

and some chance, it was found that the degree

of association between these two variables,

as measured by Gamma, ranged from a low of

.57 for opiates to a high of .97 for alcohol;

the Gammas for marihuana and cocaine showed

strong associations of .92 and .70, respectively. Clearly, these results suggest the

inclusion of the experimenters whose most

recent use was in the year prior to the

interview in the category of current users.

The basic findings on current use within time

periods ranging from 24 hours to 12 months

are presented in Table 3.1. The percentages

are based both on the number of those who

ever used each drug and on the total sample.

The distributions in the first six rows of

the table apply only to those men who used

a drug at least ten times. The last row

applies to all users. Use in 1974-75 is

generally employed as the definition of

current use in this report because it is

then possible to classify those who used a

drug less than 10 times as well as those for

whom more specific data were obtained.

Most of the interviews were conducted from

November, 1974, to March, 1975; a few were

done in October, 1974, and April and May,

1975. The mean time period covered by "use

in 1974-75" is about a year; for individual

respondents it ranges between 10 and 17

months.

The most conservative definition cf current

prevalence is use of a drug within the last

24 hours. It will be noted that among those

who have ever used drugs, prevalence is

highest for the socially acceptable drugs,

cigarettes and alcohol, with 72 and 48

percent, respectively, reporting use. Marihuana ranks third; approximately one-fifth

of those who have ever used it indicated use

within 24 hours. The popularity of these

three drugs is also evident in the percentages

33
Table 3.1. Cumulative Percent Reporting Current Use Within Selected Time Periodsa
Table 3.2. Current Use by Year of Birth (Percentages)
of the total sample who report use within the

same time period; these range from 50 percent

for cigarettes to 11 percent for marihuana.

These figures contrast sharply with the very

low or zero percentages who report use within

24 hours of drugs such as the psychedelics

and stimulants.

A broader definition of current use includes

use within the last 30 days. This results in

alcohol replacing cigarettes as the drug of

highest prevalence--more than 80 percent of

the users and of the total sample have used

alcohol within this time period. Of those

who used marihuana, almost half reported

that they had used it within the last month;

with the total sample as the base, the proportion is slightly more than one-fourth.

With current prevalence defined in terms of

use within a month, stimulants and sedatives

show sizable increases in prevalence among

users in comparison with a definition based

on a 24 hour period, although they still

rank below tobacco, alcohol and marihuana.

Some of this increase is due to fairly infrequent quasi-medical use. On the basis of

the screening procedure discussed in Chapter

2, the percentages of quasi-medical users

among current users of stimulants and sedatives

are 24 and 37, respectively.

Two interesting patterns of change are noted

when the definition of current use is broadened to include use within the past twelve

months. On the one hand, cigarettes and

alcohol show relatively small increases; this

is consistent with the fact that these drugs

are commonly used on a daily, weekly or at

most monthly basis. On the other hand, the

percentages for current users of the other

drugs show marked increases when the time

period is increased to a year. In the case

of the stimulants, sedatives, and opiates,

which increase to 32, 30 and 20 percent,

respectively, some of the increase is due to

infrequent quasi-medical use of these drugs;

one-fourth to one-third of the current users

of these drugs are quasi-medical users.

The last row in Table 3.1 is of special

interest because the difference between it

and the row above indicates the extent of

current experimental use of all but one

(tobacco) of the nine classes of drugs examined in this study. With the addition of

experimental users whose most recent use was

in 1974-75, it will be seen that the increase

in percentages of current users ranges from

a low of 2 percentage points for alcohol to

a high of 24 percentage points for cocaine.

Except for heroin, which increases 3 percentage points (from 28 to 31 percent) there

is an average increase of about 14 percentage

points for the other drugs. Cocaine appears

once again as a drug of recent popularity;

51 percent of those who ever used cocaine

are current users, but almost one-half of

the current users had used it less than 10

times.

VARIATIONS IN CURRENT USE BY SELECTED

CHARACTERISTICS

While the drug by drug differences in current

use are of interest, variations by such

characteristics as year of birth, race and

education are more relevant to an understanding of drug use. The broad definition of

current use, any use in 1974-75, including

experimental use within this period, is

utilized to present the data by selected

characteristics in Tables 3.2 through 3.7.

Year of Birth

The most salient feature involving year of

birth is the marked tendency for more men in

the younger cohorts to be using drugs

currently (Table 3.2). While no clear tendency exists for cigarettes and alcohol,

there is a definite trend in the case of

marihuana; 49 percent of the youngest men

(20 years old) in the sample are current

users in comparison with 26 percent of the

oldest cohort (30 years old). Although

less pronounced, the same general pattern is

evident for all the other drugs.

That the younger men are more likely to be

current users is not surprising in view of

the generally higher incidence of drug use

among the younger men and the fact that

they have started using more recently than

the older men. It may be that use begins

to decline after a number of years of use,

but the analysis of cessation of use is

incomplete, and it is too early to make such

an assertion.

Race

Data on current use for whites and blacks

are presented in Table 3.3. Blacks exceed

whites in current use of marihuana, heroin,

opiates and cocaine, but show a lower percentage of alcohol use.

Since racial differences in lifetime use of

drugs were related to age, age was controlled

in the examination of current use and race

(Table not shown). The same trend toward

convergence of whites and blacks that was

noted for lifetime use was observed for

current use. Specifically, for those drugs

(marihuana, heroin, opiates and cocaine)

for which blacks exceed whites in current

use, the racial differences are greatest

36
Table 3.3. Current Use by Race (Percentages)

RACE

Drug Total1 White Black

n 2510 2103 303

Cigarettes 60 59 66

Alcohol 92 92 85

Marihuana 38 37 48

Psychedelics 7 8 7

Stimulants 12 12 11

Sedatives 9 9 8

Heroin 2 1 4

Opiates 10 10 13

Cocaine 7 7 10

1

Included here are 104 who classified themselves as other than white or

black.

Table 3.4. Current Use by Education (Percentages)

EDUCATION

Less Than High School Some College

Drug Total High School Graduate College Graduate

n 2510 394 933 713 470

Cigarettes 60 81 65 54 38

Alcohol 92 87 93 93 91

Marihuana 38 39 35 44 34

Psychedelics 7 7 7 10 5

Stimulants 12 11 13 14 8

Sedatives 9 10 9 9 8

Heroin 2 5 2 1 *

Opiates 10 10 11 10 9

Cocaine 7 7 6 10 4

*Less than half of one percent.

37
among the older men. For example, whereas

21 percent of whites born in 1946 or earlier

were currently using marihuana, the percentage for blacks in this age group was 39--

a difference of 18 percentage points. However,

among the youngest men in the sample, those

born in 1953 or 1954, the percentage of

current users for whites was 49 in comparison

with 51 for blacks, a difference of only 2

percentage points. Conversely, where whites

exceed blacks in current use, the differences

are greatest among the younger men. For

example, among the youngest men 10 percent

more of the whites than of the blacks were

current users of sedatives; the comparable

difference was 1 percent among the oldest men.

Education

In Table 3.4 the data on current use are

presented for four levels of completed education. It will be noted that cigarette use

declines considerably as education level

increases; the percentage of current users

among college graduates is about half that of

men with less than a high school education.

Current use of alcohol shows little variation

by educational level, although the percentage

is slightly lower among high school dropouts.

Current use of marihuana evidences a complex

relationship with educational level. Current

use is greatest (44 percent) among those with

some college education; the next highest

figure (39 percent) is found among those with

less than a high school education. College

graduates are essentially identical to high

school graduates in extent of current use of

this drug. Weak negative relationships also

exist for psychedelics, stimulants, sedatives,

heroin, opiates, and cocaine; however, here

again those men who attended college but did

not graduate tend to deviate from the overall

downward trend.

The possibility that age was responsible

for these patterns of current use in relation to education was controlled by

grouping the sample into four age categories:

20-21, 22-24, 25-27 and 28-30 years old. The

patterns observed within these groups were

essentially the same as those shown in Table

3.4. Also, in another table not included

here, the relationship between undergraduate

major and current use was examined for all

men who had ever attended college. With

social sciences, fine arts and humanities

distinguished from other majors, it was found

that current use was higher for those in the

social sciences, fine arts and humanities

category for all drugs except cigarettes and

heroin. The differences were small (on the

order of one to three percentages points) for

alcohol and opiates, but much larger for the

other drugs where they ranged from 5 to 18

38

points. Both former and current college

students were included in this analysis, and

it is not known whether these differences

are due to past or current influences of the

college milieu. Nevertheless, the differences

are consistent, and they agree with the

findings of other studies of college populations.

Current Family Status

In Chapter 2 it was found that the current

family status of the men in the sample was

strongly related to lifetime use of drugs.

The same relationship holds for current use

of drugs (Table 3.5). Once again, the

highest percentages of use are observed for

those men living with women to whom they

were not married. They are followed by

those living independently and the men still

living in the parental home. The married

men living with their wives show the lowest

percentage of current use for every drug

except cigarettes and alcohol. Even among

these men one-fourth are currently using

marihuana, and the percentages for the other

drugs are not negligible.

Employment Status

Employment status also appears to be linked

to current use. Comparison of the full- time

workers (30 or more hours per week, n = 1980)

with the unemployed (n = 213) shows the

latter group to be, on the average, 12 percent

higher in current use of all drug classes

except alcohol. Two other employment status

categories, student (n = 282) and part-time

(less than 30 hours per week, n = 35) fall

intermediate between the full-time and

unemployed categories in the percentage of

current users. For two drugs, sedatives and

cocaine, those working part-time slightly

exceed the other groups in current use.

Size of City of Current Residence

The city or town where a respondent was

residing when he was interviewed was coded in

terms of population size. In Table 3.6 the

relationship between current use and city

size is reported; the 36 men who were interviewed in locations outside the U.S. are

included in a separate category because size

of city was not coded for them.

For all drugs except cigarettes and alcohol,

current use varied directly with city size.

This positive trend is quite evident for

marihuana; for example, 53 percent of the

men residing in cities of one million or

more were currently using this drug in

comparison with only 28 percent of the men

living in communities of less than 2,500.
Table 3.5. Current Use by Current Family Status (Percentages)

CURRENT FAMILY STATUS

Married, Living Coupled, Living Living In

Drug Total With Spouse With Partner Independent Parental Home

n 2510 1309 120 796 285

Cigarettes 60 62 69 58 47

Alcohol 92 91 96 94 87

Marihuana 38 25 68 56 38

Psychedelics 7 3 17 14 7

Stimulants 12 6 32 20 6

Sedatives 9 5 26 14 7

Heroin 2 1 11 2 2

Opiates 10 8 16 13 9

Cocaine 7 2 24 13 7

Table 3.6. Current Use by Size of City of Residence at Time of Interview (Percentages)

Cigarettes

Alcohol

Total1 Outside 1,000,000 100,000 25,000 2,500 Less Than

U.S. Or More Plus Plus Plus 2,500

(2,510) (36) (146) (631) (575) (757) (352)

60 64 57 61 58 59 62

92 97 92 93 93 91 88

Marihuana 38 36 53 44 42 32 28

Psychedelics 7 19 7 8 8 8 4

Stimulants 12 11 12 14 13 10 9

Sedatives 9 14 12 11 10 8 5

Heroin 2 6 4 3 1 1 1

Opiates 10 14 15 11 11 9 6

Cocaine 7 11 12 9 7 6 4

1Total includes 13 cases where size of city is unknown.

39
Table 3.7. Current Use by Lifetime Extent of Use (Percentages)

Drug

Total EXTENT OF USE

Users Experimental Light Moderate Heavy Heaviest

Alcohol 95

Marihuana 69

Stimulants

Sedatives

Opiates

43

44

33

Cigarettes 86

Psychedelics 34

Heroin 31

Cocaine 51

52 92 95

(93)a

98 98

(491) (318) (599) (933)

34 74 79 93

(423) (231) (227) (501)

- -

Quasi-Medical Experimental Light Heavy

24 27 50 70

(108) (207) (242) (132)

37 27 56 68

(99) (177) (158) (74)

35 17 48 75

(286) (300) (145) (48)

Less Than 10 To 99 100 To 999 1000 Or

10 Times Times Times More Times

b 24 48 89

(231) (249) (260) (1471)

22 46 49 60

(291) (192) (57) (10)

11 54 41 50

(72) (41) (17) (18)

41 66 63 64

(214) (103) (24) (11)

aNumbers in parentheses represent the number who have ever used in the

category.

b

Information not obtained in interview.

40
Though small relative to marihuana, the

percentages of current users for the other

drugs, especially heroin, opiates and

cocaine, also display pronounced positive

relationships with city size. The divergent

percentages for the respondents who were

located outside of the U.S. may reflect

nothing more than the instability of percentages based on only 36 cases.

Current Use and Extent of Use

Finally, current use, defined as use within

1974-75, will be examined in terms of various

measures of lifetime extent of use. The

order in which the drugs are presented varies

from other tables because of differences in

the measures of extent of use.

The data in Table 3.7 indicate that there is

a positive relationship between the extent

of lifetime use and current use; the percentages for current use increase with the

extent of use. This pattern is marked for

marihuana, and equally marked for stimulants,

sedatives and opiates, if quasi-medical use

is ignored.

The same pattern is observed for cigarettes,

psychedelics and, with minor reversals, for

heroin and cocaine. In general, the

inference is clear: the more a man had used

a drug in the past, the more likely he was

to be using it currently.

This discussion of current use may be concluded

with a brief comment on a finding implicit

in Table 3.1. If the percentage of current

users of a drug, in the columns based on

any use of it, is subtracted from 100, the

result is the percentage who implicitly

claim to have quit using the drug. Thus, 14

percent of the cigarette smokers have not

smoked within the last year, 5 percent of

alcohol users have not used it within the last

year, and in these terms 31 percent of the

marihuana users have quit. Obviously, the

percentages are highest for the drug classes

showing the lowest extent of current use.

Cocaine ranks high in the percentage of lifetime users who were current users.

Whether or not the lack of continuity in use

of these drug classes may be regarded as an

indication the men have quit using them is an

important question, and it is one not

considered in this initial report. Men who

used a drug class 10 or more times, but who

indicated their most recent use was more

than one month prior to the interview were

queried concerning whether or not they

believed that they had quit using that drug.

Preliminary analysis of this information

suggests that most of those who were not

current users (over 90 percent for all

classes, except alcohol where the figure is

80 percent) perceive themselves as having

quit. Further analysis will allow a description of the "quitters" in more detail in

order to determine the correlates and,

hopefully, the causes of quitting.

41
4 Estimates of Drug Use in the

Population of Young Men

The data presented in this report pertain to

the 2,510 men who were interviewed. However,

the major questions of interest relate to

the population of young men from which the

sample was drawn. While it is of interest

that 55 percent of the men who could be

located and interviewed indicated that they

had used marihuana, a more important question

is: How many of the approximately 19,000,000

men between the ages of 20 and 30 in the .

United States have used marihuana? Obviously,

a similar question may be posed for each of

the drug classes.

If all of the 3,024 men in the sample, or

all of the 2,981 men capable of being interviewed, had been located and interviewed,

the task of making projections to the population of young men would not be problematic.

The original sample was randomly selected

and was representative of all young men in

the country; if all of them had been interviewed, sampling error could have been

handled by establishing confidence limits

around the percentages of use observed in

the sample. In this event, one would be

reasonably certain that the true percentage

Table 4.1. Estimates of Drug Use in the Total Population of Young Men 20-30

Years Old in 1974, on the Assumptions: a) that the Interviewed

Sample is a Random Sample of the Population; b) that None of the

Noninterviewed Men Used Each Drug; c) that All of the Noninterviewed Men Used Each Drug (Percentages)

Tobacco

Observed Per- A B C

cent of Use 95% Confi- Assuming No Assuming All

In Sample dence Limits Others Used Others Used

88 87-89 74 90

Alcohol 97 96-98 82 97

Marihuana 55 53-57 46 62

Psychedelics 22 20-24 18 34

Stimulants 27 26-29 23 39

Sedatives 20 19-22 17 33

Heroin 6 5 - 7 5 21

Opiates 31 29-33 26 42

Cocaine 14 13-15 12 28

42
of use of a particular drug class in the

population was within those limits. However,

only 84 percent of the target sample was

interviewed, and literally nothing is known

about the drug use of the 471 men who were

not interviewed.

Various assumptions can, however, be made

about their drug use in order to make

inferences about drug use in the population

of young men. The percentages shown in

Table 4.1 were calculated on the basis of

three different assumptions. Shown in the

first column are the percentages of use

reported by the 2,510 men who were interviewed.

Column A is based on the assumption that

these 2,510 men were a random sample from the

population of approximately 19,000,000 men

between the ages of 20 and 30 in the United

States, and the percentages reflect the 95

percent confidence limits within which the

true population percentages would then lie.

There were 471 men who were not interviewed;

if one assumes that none of them had used

any of the drugs, the percentages for the

entire sample (N = 2,981) would be those

shown in Column B in Table 4.1. On the

other hand, if one makes the opposite

assumption, that all of the 471 missing men

had used all of the drugs, the percentages

would then be those shown in Column C. The

confidence limits around these estimates

would be of the same order of magnitude as

those in Column A.

The assumption on which Column A is based

is known to be false, and the assumptions

on which Columns B and C are based are, of

course, highly unrealistic. Nevertheless,

the findings are instructive; this is

especially true for the minimum estimates

given in Column B for such drugs as heroin

and cocaine. The most conservative estimate

is that 5 percent of the young men in the

United States have used heroin, and 12

percent have used cocaine. The upper limits

for these drugs, as shown in Column C, are

highly improbable. For all of the other

drugs the ranges given are undoubtedly too

wide, but they might be useful as rough

guides for policy makers.

The population represented by the sample

in this study was almost 19,500,000. The

death rate in the sample (36/3,024, or .012)

is probably an underestimate of deaths in

the population of young males because this

population count is based on the 1960 Census

when the age range of the men was 5 to 15.

Presumably some males died before reaching

age 18, an age achieved by all of the men in

the original sample. On the basis of these

figures, it is estimated that, at the time

the interviews were completed, the population

represented by the sample was approximately

19,200,000. A better estimate of the population of young males is provided in the Census

Bureau's Current Population Reports (No. 541,

Series P-25, February, 1975). The estimate

for males age 20 to 30 inclusive, was 18,974,

000 as of July 1, 1974; this figure includes

armed forces overseas. For practical

purposes, therefore, the total sample,

excluding the deceased, may be regarded as

representing approximately 19 million men.

If one uses that figure, the percentages in

Column B translate into approximately

950,000 young men who have used heroin and

2,300,000 who have used cocaine. For

marihuana, a crude estimate is that 8,700,000

to 11,800,000 have used it.

More accurate estimates can be made by taking

into account the known characteristics of

the men who were not interviewed. Unfortunately, only limited data were available regarding

these men, because Selective Service supplied

only such information as was needed to

locate prospective respondents. Included

were two variables that were found to be

related to drug use in the interviewed

portion of the sample. One was year of birth.

The other was the size of the city in which

the respondent had lived most of the time

to the age of 18. For the noninterviewed men

the city of residence at age 18 and its

size are known. Table 4.2 was constructed

on the assumption that for the men who were

interviewed, the city of residence to age 18

was the city of residence at age 18.

In this table the interviewees are compared

with the noninterviewed men in terms of

year of birth and city size. In Panel B

those cells where the entry is higher for

the noninterviewed men than the corresponding

entry for those interviewed are underlined.

These cells are clustered in the upper left

portion of the table; in other words, failures

to obtain interviews were more common among

the older men and among men from the larger

cities.

It will be recalled that city size was directly, and age inversely, related to drug use.

The older men were less likely to have used

most of the drugs, but men from large cities

were more likely to have used them. Thus,

the two relationships presumably work in

opposite directions for the noninterviewed

men, and to some extent cancel out each

other. One would, therefore, expect the

rates of drug use among the noninterviewed

men to be roughly equal to the rates among

the interviewed individuals.

43
Table 4.2. Distribution of Interviewed and Noninterviewed Men By Year of Birth and

City Size (Rate Per 1000)

CITY SIZE

YEAR OF BIRTH

1944-46 1947-49 1950-52 1953-54 Total

A. Interviewed Sample (2510)

1,000,000 or More 16 22 22 15 75

100,000-999,999 51 64 73 55 243

25,000-99,999 37 47 62 39 186

2,500-24,999 60 84 82 64 291

Less Than 2,500 43 53 50 36 182

Outside U.S. or Unknown 8 6 6 6 24

Total 216 276 295 214 1000

B. Not Interviewed (471)

1,000,000 or More

100,000-999,999

25,000-99,999

2,500-24,999

Less Than 2,500

Outside U.S. or Unknown

47 47 30 6 130

89 104 66 34 293

51 47 36 30 163

49 79 53 25 206

66 38 38 23 166

8 13 15 6 42

Total 310 327 238 125 1000

C. Expected Number of

Marihuana Users Among

Noninterviewed

1,000,000 or More 13.2 16.0 9.7 2.4

100,000-999,999 18.5 31.4 22.3 10.4

25,000-99,999 9.8 11.9 11.0 7.3

2,500-24,999 9.2 18.9 15.0 7.6

Less Than 2,500 7.4 7.0 10.3 5.8

Outside U.S. or Unknown 1.6 2.4 3.1 0.6

Total 59.7 87.6 71.4 34.1 252.8

Precise estimates, however, can be obtained

and are shown in Panel C of Table 4.2. The

rate of marihuana use observed among the 40

men in the upper left cell of Panel A was

multiplied by the number of men, 22, in the

corresponding cell of Panel B, to arrive at

the figure in the comparable cell in Panel

C. This procedure was followed for each of

the 24 cells in the table, and resulted in

the estimate that, had the 471 missing men

been interviewed, 253 of them would have

reported use of marihuana.

The same procedure was used for each of the

other drugs, and the results are shown in

Table 4.3. Unlike the earlier tables, in

which the percentages were rounded to two

places, three places were retained in this

table to show how small the differences are,

The expected rates of tobacco and alcohol

use among the noninterviewed men are higher

than among the ones interviewed, but by less

than one percent. For heroin the expected

rate is identical to the one observed, and

for all other drugs the expected rates are

slightly lower; the largest difference is

1.7 percentage points for psychedelics.

In the final two columns of Table 4.3 the

estimated cases are added to the observed

cases, and the percentages that would have

been obtained for the total sample of 2,981,

if these estimates are accurate, are shown.

The largest difference between these percentage

44
Table 4.3. Estimated Rates of Drug Use, and Numbers of Users

A. Observed and Estimated Rates of Drug Use

Tobacco

Observed Use In Estimated Use In Estimated Use In

Interviewed Sample Noninterviewed Men Total Sample

(2510) (471) (2981)

n Percent n Percent n Percent

2211 88.1 419 89.0 2630 88.2

Alcohol 2434 97.0 458 97.2 2892 97.0

Marihuana 1382 55.1 253 53.7 1635 54.8

Psychedelics 550 21.9 95 20.2 645 21.6

Stimulants 689 27.4 123 26.1 812 27.2

Sedatives 508 20.2 93 19.7 601 20.2

Heroin 148 5.9 28 5.9 176 5.9

Opiates 779 31.0 141 29.9 920 30.9

Cocaine 352 14.0 63 13.4 415 13.9

B. Estimated Numbers of Men Who Have Used (In Thousands)

Most Probable

Lower Limit Figure Upper Limit

Tobacco 16,530 16,720 16,910

Alcohol 18,240 18,430 18,620

Marihuana 10,070 10,450 10,830

Psychedelics 3,800 4,180 4,560

Stimulants 4,940 5,130 5,510

Sedatives 3,610 3,800 4,180

Heroin 950 1,140 1,330

Opiates 5,510 5,890 6,270

Cocaine 2,470 2,660 2,850

45
Table 4.4. Estimated Rates of Current (1974-75) Drug Use, and Numbers of Use

A. Observed and Estimated Rates of Current Drug Use

Observed Use In Estimated Use In Estimated Use In

Interviewed Sample Noninterviewed Men Total Sample

(2510) (471) (2981)

n Percent n Percent n Percent

Cigarettes 1494 59.5 282 59.9 1776 59.6

Alcohol 2301 91.7 433 91.9 2734 91.7

Marihuana 960 38.2 171 36.3 1131 37.9

Psychedelics 186 7.4 29 6.2 215 7.2

Stimulants 295 11.8 49 10.4 344 11.5

Sedatives 224 8.9 38 8.1 262 8.8

Heroin 46 1.8 8 1.7 54 1.8

Opiates 255 10.2 44 9.3 299 10.0

Cocaine 178 7.1 29 6.2 207 6.9

B. Estimated Numbers of Men Who Used in 1974-75 (In Thousands)

Most Probable

Lower Limit Figure

Cigarettes 10,980 11,320

Alcohol 17,230 17,420

Marihuana 6,880 7,200

Upper Limit

11,670

17,610

7,520

Psychedelics 1,200 1,370 1,540

Stimulants 1,980 2,180 2,390

Sedatives 1,480 1,670 1,860

Heroin 250 340 440

Opiates 1,690 1,900 2,110

Cocaine 1,140 1,310 1,480

46
and those observed in the sample is threetenths of a percentage point for marihuana

and for psychedelics. Rounded to two digits,

the percentages in the two columns are identical.

The estimates in the last column of Table

4.3 are the best that can be made from the

data currently available in this study;

they are based on all of the information

available about the men who were not interviewed, namely, year of birth and residence

at age 18, when the men registered with

Selective Service. An additional variable,

the geographical area in which the men resided,

will be employed in later analyses. If

region is found to be strongly related to

drug use, it could change the estimates

presented in this chapter, but it is anticipated that such changes would be minimal.

It may be noted that the rate of use among

the noninterviewed men would have to differ

from that among the men interviewed by almost

five percentage points to change the rate

for the entire sample by one percentage

point.

On the basis of this analysis it was concluded that the confidence limits shown in

Column A in Table 4.1 may be used as inclusive

of the true percentages of lifetime use of

drugs among the 19 million men who were 20

to 30 years old in 1974. These limits were

applied to produce the first and third

columns of Panel B in Table 4.3. The middle

column is based on the first and third

columns in Panel A, rounded to two digits.

In short, the data in this table show that,

according to the best estimates available,

more than 1,000,000 men in the 20-30 year

range have used heroin, over 2,500,000 have

used cocaine and more than 10,000,000 have

used marihuana.

The same procedure was used to estimate

current use (use in 1974-75), and the

results are presented in Table 4.4. Once

again, the estimates for use of cigarettes

and alcohol among the men who were not

interviewed are slightly higher than the

rates observed among the men who were interviewed; for all other drugs the rates are

slightly lower. When the observed and

estimated numbers are combined to provide

an estimate for the entire sample for a

particular drug, the estimate is very similar

to the percentage observed in the portion

of the sample that was interviewed; in fact,

when the figures are rounded to two

decimal places, they are identical.

To construct Panel B, 95 percent confidence

limits were used to estimate the range

within which the true number of users of

these drugs in 1974-75 probably lies. At

least a quarter of a million men in the 20

to 30 age range used heroin in this period,

and it is more likely that the figure is

one-third of a million. For most of the

other drugs, the most probable figures fall

between one and two million although the

estimate is 7 million for marihuana, 11

million for cigarettes and 17 million for

alcohol.

47
5 The Drug Epidemic

Historically, the term epidemic has been used

in reference to the extensive and rapid

spread of an infectious disease, such as

typhoid fever, that had pathological

consequences both for the individuals who

contracted it and for the communities in

which they lived. Recently, the term has

been used to describe the spreading use

of drugs, particulary heroin.

Many knowledgeable individuals have

suggested that a heroin epidemic began in

the United States in the 1960s. Employing

the year of first heroin use reported by

patients in treatment programs, Jaffe

(1973) and DuPont and Greene (1973) have

characterized the rising use of heroin

as an epidemic, dated its onset as about

1965, and set its peak between 1968 and

1970. These investigators also suggested

that there may have been some variations

by region in the timing of the epidemic.

Their data indicated that the spread of

heroin declined in the late 1960s or early

197Os, but because their respondents were

patients in treatment or samples selected

on a nonrandom basis, their evidence was

by no means conclusive.

While it is questionable whether the

analogy of a disease is appropriate for drug

use, some of the concepts of epidemiology

are useful in an effort to describe patterns

of usage. The question of an epidemic of

drug use refers to an historical issue, not

one of respondents' maturation. However,

both historical and maturational changes are

reflected in the data, because the sample

in this study includes eleven birth cohorts.

In this chapter data are analyzed to assess

the incidence and prevalence of drug use

and the timing of changes within the sample

of young men interviewed in this study.

INCIDENCE OF DRUG USE

The data on the incidence of new users are

presented in the first two tables in this

chapter. The number of new users appearing

in each year from 1953 to 1974 is shown

separately for the drug classes in Table 5.1.

For example, four men smoked cigarettes by

1953, and nine more did so in 1954. These

data are presented in percentages in Table

5.2; the base for percentaging in each

column is the total number of men who reported

any use of the drug in their lifetime.

It must be noted that the zero entries in

these tables do not mean that these drugs

were not being used in the United States.

Such an inference could be drawn only if the

respondents had been selected from the entire

age range in the population. Further, the

low rates of incidence in the earlier years

do not necessarily mean that incidence rates

were low in the population of the United

States in those years; for this sample they

were low in the early years in part because

many of the men were too young to try the

drugs. For example, some of the older men

in the sample had used cigarettes and alcohol

before the younger men were born. There is

an increase in the number of new users of

cigarettes and alcohol in the 1960s, but this

is not to be seen as an epidemic because use

of these substances has been widespread in

American society for many years. The appearance of new users in this sample merely means

that the men were reaching the age at which

use of these drugs was common.

This may also be true for the other drugs,

although not necessarily to the same extent.

In other words, the figures in Tables 5.1

and 5.2 may reflect not only the age of the

men in the sample, or maturation effects,

but also the influence of historical changes,

48
Table 5.1. Number of New Cases of Use By Drug and First Year of Use
Table 5.2. New Cases of Use by Drug and First Year of Use in Percentages
particularly in the prevalence of drug use

in the general population. Because of the

restricted age range in the sample, information on the extent of drug use in the population of the United States must be derived

largely from other sources.

of declining numbers following the peak year.

For this reason and others that will appear

later, the next few pages should be read as

simply describing data for this sample, not

as a description of an epidemic. In the

next section, after further groundwork has

been laid, the inferences that can be drawn

about the drug epidemic in the general

population will be discussed.

For the reader's convenience, the largest

figure in each column is underlined in Tables

5.1 and 5.2. With the exception of alcohol,

these figures are found in the four-year

period, 1969 to 1972. The peak year for

marihuana and psychedelics was 1969, whereas

for sedatives and cocaine the new cases

peaked in 1972.

If one temporarily ignores cigarettes and

alcohol, it is apparent that in this sample

use of all of the other drugs was minimal

until the mid-1960s. Noticeable increases

in new cases began around 1963 for marihuana,

in 1965 for stimulants, sedatives, and opiates,

in 1966 for psychedelics and heroin and in

1968 for cocaine.

The five consecutive years in which the

largest percentage of new users appeared in

each drug category are bracketed in Table

5.2. Of the men who ever used cigarettes,

45 percent are included in these peak years,

1965-1969. For alcohol the peak years are

1964-1968, and 45 percent of the new cases

appeared in this period. With the exception

of the opiates, a category that includes a

sizable number of quasi-medical users, approximately two-thirds to four-fifths of the new

users in the other drug classes are found in

the peak five-year periods. Also of interest

is the fact that these peak years are essentially the same--1968-1972 or 1969-1973--for

all of these drugs. The new users of marihuana, psychedelics, stimulants and, to a

slightly lesser extent, of opiates, are

concentrated in the years 1968-1972, and

the peak period was 1969-1973 for the sedatives,

heroin, and cocaine.

As may be seen in Table 5.1, for all of the

drug categories there was a decline in the

number of new cases in 1974, and for most

drug classes a steady decline in the number

of new cases in the sample is evident in the

four or five years following the peak year.

However, in the case of sedatives, heroin

and cocaine there are only one or two years

The median age at first use of each drug or

drug class is shown in Table 5.3. There is

little variation across the eleven cohorts

in the median age at which cigarettes and

alcohol were first used. In each cohort

one-half of the men who ever used alcohol

did so for the first time by the age of 15 or

16. There is some variation among the

cohorts in the median age of first use of

cigarettes, but the range is restricted to

the ages of 15 to 17. While the median age

at which initial use of cigarettes and

alcohol occurred is remarkably similar for

the eleven age cohorts, this is not the case

for the other drugs or drug classes. Rather,

there is a marked downward trend in the

medians from the oldest to the youngest

cohorts. If the median ages are translated

into dates, the resulting years for first

use of cigarettes and alcohol range from

1960 to 1969 in the eleven cohorts, but for

marihuana and psychedelics these years are

confined largely to the 1968 to 1971 period.

The range for heroin and cocaine is essentially restricted to the years 1970 to 1972.

The data in Table 5.3 cannot be taken as

proof of an earlier age of onset of use in

the younger cohorts because limits are set

on median age by the age of the cohorts.

The men born in 1954 were 20 years old in

1974, when most of them were interviewed;

consequently, the median age for them could

not exceed 20. To some extent, higher

median ages in the older cohorts might

reflect only the fact that they were older,

and this permitted higher medians to appear.

The peaking of new cases of use as noted in

Table 5.1 could occur in a number of ways,

which are not mutually exclusive:

1. An increase in new cases could be

produced by higher proportions of

users in the younger cohorts, even

if the size of the cohorts remained

constant. It was seen in Chapter 2

that this factor is present; some of

the increase observed in Table 5.1

is due to the fact that higher percentages of the younger cohorts than

of the older cohorts used drugs.

2. An increase in new cases could be

produced if succeeding cohorts were

larger in number, even if the age at

first use did not change from one

cohort to another and the proportion

of users in the cohorts remained

constant. As noted in Chapter 2,

there are more men in the younger

51
Table 5.3. Median Age at First Use of Drug Among Users by Year of Birth
cohorts than in the older; thus,

this factor was also operating. Part

of the increase in the number of new

cases in the late 1960s was merely a

reflection of the baby boom in the

early 1950s.

3. If the number of persons in successive

cohorts is identical and the proportion using drugs remains the same,

but the age of first use drops between succeeding cohorts, there will

be an increasing number entering

the ranks of users in a given year or

at least within a brief span of years.

If, for example, each cohort usually

produces a given number of new users

by the age of 16, but then in a

subsequent cohort that number is

produced by age 15, there will be a

year or a span of a few years in

which many more new users appear;

in one brief period the persons who

used a drug by the age of 15 in one

cohort would be added to those who

used it by the age of 16 in the

previous cohort. The data in Table

5.3 on median age suggest, but do

not demonstrate, that this factor

was operating.

4. In theory, the same peaking could

be produced if the age at first

use increased between succeeding

cohorts, with the peak occurring

later than in the first case. There

is no hint of such a factor in these

data, and it need not be considered

further.

5. All of the previous possibilities

involve differences between cohorts.

Without such differences an increase

in new cases could be produced by

historical changes that affect alike

all who are living at the time a

change occurs, or at least all who

have entered the age of risk, and

have not yet left it.

There are, then, at least five different

ways in which the observed increase in new

cases of drug use in this sample could

have occurred. Only the fourth can be

eliminated. The first and second are known

to have operated, and the data on median age

suggest, and additional data will establish,

that the third also operated. It will

further be seen that there is reason to

believe that the fifth was a factor, too.

Further analysis is required before the

relative importance of these factors can

be established, but they must be kept in mind

in any attempt to generalize from these

data to the issue of an epidemic in the

general population. A beginning can be

made toward such generalization, and the

effect of the changing age at onset can be

clarified by comparing and contrasting the

year of onset of use for alcohol and marihuana.

The cumulative percentages for new cases of

alcohol use, based on the total number of

men in the sample, are presented in Table

5.4 for each of the eleven cohorts. Comparable percentages for new cases of marihuana use are shown in Table 5.5. The tables

may be compared with each other. Within

each table, either cohorts or years of first

use can be compared, and it should also be

noted that comparisons of diagonals are

legitimate and useful. To illustrate,

figures on a selected diagonal are underlined in each table, and these represent the

age at first use, which may be computed by

subtracting the year of birth from the year

of use. The diagonals are for age 17, and

they enable one to compare the cohorts on

the percentage who had first used alcohol

or marihuana at or before that age.

The table for alcohol should be examined

first, and the comparison should be between

columns. If one allows for sampling fluctuation, any two adjacent columns are essentially similar, except that the one on the

right has been displaced one space downward.

In other words, if each cell in a column is

compared with the cell immediately below and

to the right of it, the percentages are

approximately equal.

This means, of course, that the cohorts are

similar to each other with respect to first

use of alcohol. By age 10, from 5 to 10

percent in each cohort had used alcohol, and

the percentage increased fairly regularly in

succeeding years. By age 17, highlighted

by the underlined diagonal in the table,

the percentages that have used alcohol range

between 69 and 87. The increases are smaller

in later years in each column, but this is

clearly because there were few men left who

had not already used alcohol.

The peak year for new cases of alcohol use

in Table 5.1 was 1966. If the row for 1966

is examined in Table 5.4, it will be observed that even the two oldest cohorts were

still furnishing a few new cases, at age

21 and 22, and that all other cohorts were

contributing sizable numbers, as evidenced

by the fact that the percentages for 1966

average about 11 points higher than for 1965.

The largest increases between 1965 and

1966 are for the men born in the early 1950s.

5 3
Table 5.4 is not subject to the potential

weakness of Table 5.3, in which median ages

are presented, because comparisons can be

made in terms of ages that all the cohorts

have reached. In each column in Table 5.4

the first cell that reaches 50 percent marks

the age at which half of the cohort, not merely

half of the eventual users, had begun use,

and it may be seen that these cells fall

roughly on a diagonal. Those for the youngest

cohorts are slightly above the diagonal

suggested by the oldest cohorts; this

indicates a tendency for first use of alcohol

to be slightly earlier in the younger cohorts.

In terms of the five ways in which an increase

can be produced, then, the peaking of new

cases of alcohol use in Table 5.1 is, to a

slight extent, due to a tendency toward

earlier use in the younger cohorts. There

is no hint of an increased percentage of

use in the younger cohorts; indeed, there

could not be much of an increase because

nearly all of the men eventually used alcohol.

Further, there is no hint of any historical

change that affected all cohorts. Almost all

the effect of the younger men reaching the

age at which alcohol use could be expected

to begin.

Since there is no question of an epidemic

of alcohol use, the similar patterns for the

cohorts in Table 5.4 establish that the

increase in new cases of alcohol use observed

in Table 5.1 is almost entirely a maturational

effect. A certain proportion of new cases

could be anticipated at each age, and as each

cohort moved through that age, it contributed

its expected number of new cases. The same

maturational effect, then, can be expected

to account at least partially for the

increases observed in Table 5.1 for the

other drugs.

However, new cases of marihuana use by cohort

are shown in Table 5.5, and it is apparent

that the maturational effect, which applies

to all cohorts, was not the only cause of

the increase in marihuana use noted in Table

5.1. The same comparisons as were made for

alcohol in Table 5.4 are needed.

While comparison of the cohorts on alcohol

use revealed that the percentages were

approximately equal when any cell was compared with the one to its right and below it,

in the table for marihuana the percentage

in the latter cell is usually higher than in

the former. Indeed, in the lower rows of

Table 5.4. Year of First Use of Alcohol, by Birth Cohorts (Cumulative Percentages

of Total Sample)

YEAR OF BIRTH

Year of 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954

First Use n (174) (171) (196) (254) (223) (215) (234) (245) (261) (247) (290)

1953 or earlier 2 4 1 * 0 0 0 0 0 0 0

54 6 4 2 2 0 1 0 0 * 0 0

55 9 5 3 4 0 1 0 * * 0 0

56 14 7 6 4 0 3 1 1 1 * 0

57 23 12 8 6 * 4 2 3 1 1 0

58 33 21 11 8 3 5 5 4 2 1 0

59 43 31 21 14 7 9 5 5 3 2 0

1960 68 46 32 24 13 13 8 8 4 3 2

61 78 59 43 33 21 20 9 10 5 4 3

62 85 73 59 44 35 31 15 13 8 6 4

63 90 83 69 61 47 41 22 21 9 9 5

64 91 88 83 71 64 55 34 33 16 13 9

65 94 91 89 82 76 71 49 46 26 19 12

66 95 94 94 89 88 81 67 59 40 31 19

67 96 97 94 92 91 91 77 77 53 45 32

68 96 98 95 94 94 93 87 81 73 60 46

69 98 98 95 95 96 95 92 90 82 76 63

1970 98 99 95 97 96 97 93 92 93 84 78

71 98 99 95 97 96 98 95 95 94 92 87

72 98 99 96 98 96 98 95 96 95 97 94

73 98 99 96 98 96 98 96 96 96 98 94

1974 98 99 97 98 96 98 96 97 96 98 95

*Less than half of one percent.

54
the table, the percentages increase from

left to right; this was not observed for

alcohol.

If the diagonals for age 17 are compared in

the two tables, another major difference is

apparent. For alcohol the percentages on

the diagonal are approximately equal; there

is a slight upward trend in the youngest

cohorts, but for marihuana there is a clear

trend toward higher percentages as one moves

from the upper left to the lower right cells.

These percentages change from 1 to 39 percent.

The point can be made another way. Choose

any percentage under approximately 80 percent

in the first column on the left in the alcohol

table, and then look for the figure closest

to it in the columns to the right. To locate

these figures in the columns on the right in

the alcohol table, one has to look eight or

nine rows below the first percentage. If

the same procedure is followed in the marihuana table, one has to move down only two

is clear evidence that the age of onset of

marihuana use was lower in the younger cohorts

of this sample. Thus, the table on median

age of onset was not misleading but accurately

reflected a real change.

Therefore, the increase in marihuana use in

the late 1960s partly resembles the increase

in alcohol use, in that it reflects the

maturational effect and the fact that the

younger cohorts are larger. However, two

additional factors, not apparent for alcohol,

are observed for marihuana. In the younger

and larger cohorts, the average age at onset

was earlier, and the proportion of users was

considerably higher in the younger than in

the older cohorts.

This is, in part, a change in the earliest

use of marihuana. In the youngest cohorts

there were a few cases of use as early as

age 9, 10 or 12, while there was only one

case of use as early as 12 in the oldest

cohorts. Nevertheless, the major change was

or three rows over the eleven columns. Indeed, not in the earliest age at which use was

if one chooses to begin with a figure in the reported, but in the pattern within the

lower third of the first column, the cells cohorts. Among the younger men, the pattern

that equal it in the other columns are likely has been one in which a few men used marihuana

to be in higher rather than lower rows. This by the age of 12, and sizable numbers used it

Table 5.5. Year of First Use of Marihuana, by Birth Cohorts (Cumulative Percentages of Total Sample)

YEAR OF BIRTH

Year of 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954

First Use n (174) (171) (196) (254) (223) (215) (234) (245) (261) (247) (290)

1953 or earlier 0 0 0 0 0 0 0 0 0 0 0

54 0 0 0 0 0 0 0 0 0 0 0

55 0 0 0 0 0 0 0 0 0 0 0

56 1 0 0 0 0 0 0 0 0 0 0

57 1 0 1 0 0 0 0 0 0 0 0

58 1 0 1 0 0 0 0 0 0 0 0

59 1 0 1 0 0 0 0 0 0 0 0

1960 2 0 1 0 0 0 * 0 0 0 0

61 2 0 2 0 0 * * * * 0 0

62 3 1 3 1 1 1 * * * * 0

63 5 2 4 3 2 3 1 1 * * 0

64 6 4 5 5 4 4 1 3 1 * 0

65 7 5 10 8 6 7 5 4 5 2 0

66 9 10 15 13 10 10 10 6 6 5 2

67 13 13 25 19 18 18 15 11 10 9 4

68 14 17 30 30 30 28 26 18 18 17 9

69 17 19 33 37 41 40 41 33 26 28 15

1970 23 25 36 41 48 45 48 45 43 39 27

71 26 28 38 44 51 50 54 53 52 49 37

72 30 29 40 47 54 55 64 58 57 56 49

73 35 32 43 49 56 56 66 61 61 60 55

1974 39 34 44 49 57 56 66 62 64 62 59

*Less than half of one percent.

55
for the first time at the ages of 13, 14 and

15. In contrast, in the older cohorts there

was little or no use prior to the age of 14,

and few new cases appeared immediately thereafter. Thus, in the two youngest cohorts

almost 50 percent of the men had tried marihuana by the age of 18, whereas this was

the case for only two or three percent of

the men in the two oldest cohorts.

The peak year for marihuana onset was 1969

(Table 5.1). All of the cohorts contributed

to this peak (Table 5.5). Another noteworthy

finding in Table 5.5, not observed in the

corresponding table for alcohol, is that the

oldest cohorts continued to contribute new

cases of marihuana use after the peak year.

Indeed, in the oldest cohort more than half

of the eventual users began to use marihuana

after 1969.

It is speculative, insofar as the available

data are concerned, but consistent with other

data, to suggest that there is a normal age

range during which a drug has some probability

of being tried, but before and after which

the probability of trying it is low. For

marihuana the data in Table 5.5 suggest that,

during the years covered in this study, the

"age at risk" began in the early teens. The

fact that in the youngest cohorts the rate

of increase in new cases seems to be declining

in recent years suggests that the highest

percentage will be in the low 60s, and few

new cases will appear after the men reach the

early twenties.

In short, though this is still speculation,

it appears probable that if conditions had

remained the same through their lifetimes,

the percentage of marihuana users in the

older cohorts would not have exceeded 15 or

20. Conditions did not remain the same;

when they reached age 25, and the new cases

should have declined, marihuana use had

become common among their younger friends

and acquaintances, the drug was easier to

obtain, and taboos against its use had been

weakened. In this changed climate, it is

suggested, some men in their late twenties

tried marihuana, at least on an experimental

basis. If this is the case, this is an

historical effect, noticeable only for the

older cohorts, and it also contributed to

the increase in marihuana use in the late

1960s.

Tables similar to 5.4 and 5.5 have been

prepared for all of the other drug classes,

but are not included in this report. The

pattern for cigarettes closely resembles the

one for alcohol, including the tendency

toward a slightly earlier age at first use,

but differing in that the proportion of users

is lower in the younger cohorts. The patterns

for psychedelics, stimulants, sedatives and

cocaine resemble the one for marihuana; they

show that the increases in use of these drugs,

as noted in Table 5.1, reflect a number of

influences: (1) a maturation effect; (2) use

at earlier ages in the younger cohorts; (3)

higher proportions of users in the younger

cohorts; (4) the larger size of the younger

cohorts; and (5) a slight historical effect

observable in the older cohorts. The existence of this last effect, however, is less

certain than for marihuana because new cases

are less frequent in the late twenties for

the older cohorts and there is even less basis

for defining the age at risk for use of these

drugs than for marihuana.

The pattern for heroin also resembles the one

for marihuana, including the higher proportions of users in the younger cohorts, except

that the proportion for the youngest cohort

is smaller than for the four that precede it.

Further, because heroin involves the smallest

number of users, one can be less certain of

percentages. The strongest statement that is

justified is that there is nothing to suggest

that the findings for heroin are different

from those for marihuana.

The data for opiates present a few problems.

First, 29 of the 779 men who have used opiates

reported use at age eight or earlier, one of

them at age one. This suggests inaccuracy

in reporting age, or that some medical use

was included; it will be recalled that about

40 percent of all opiate use was classified

as quasi-medical. The trend toward an

earlier age of first use in the younger

cohorts is as strong as for the other drugs

and is stronger than for cigarettes and

alcohol. The trend toward a higher proportion of users in the younger cohorts is

less marked than for marihuana, psychedelics

and cocaine, or even for stimulants and

sedatives, but as for heroin, the trend is

present. What has been referred to as an

historical effect in the older cohorts is

not seen for opiates or heroin. While all

of these reservations are essential, it

remains true that the patterns for heroin

and opiates clearly resemble the marihuana

pattern more closely than the pattern for

alcohol.

If one keeps in mind the extent to which the

data are affected by the characteristics of

the sample, especially the restricted age

range, it is now possible to re-examine the

data in Tables 5.1 and 5.2 to determine what

they imply about a drug epidemic. While the

maturational effect makes dating the start

of an epidemic in the mid-1960s less precise

than one might wish, data are available that

56
indicate it could not have started much

earlier. The oldest cohorts had entered

their twenties by 1965, and could have been

using drugs before that year, but for most

of the drugs they were not, or few were doing

so (aside from opiates, where quasi-medical

use accounts for much of the early use).

For marihuana, the slight increases in numbers

to 1964 could be maturational effects, but

by 1965 the earlier onset in the younger

cohorts is apparent (Table 5.5). In these

cohorts sizable increases are noticeable in

the succeeding years; this was not the case

for the older cohorts. The precise date

for the beginning of the epidemic depends

on the operational definition of "beginning,"

but 1965 seems the latest possible date for

marihuana, and to date it a year or two earlier

would not be unreasonable.

The picture is perhaps clearest for psychedelics. Only one man reported use before 1964,

but the peak year was reached by 1969. If

one bases the comparisons on the percentage

figures in Table 5.2, rather than on the

number of cases in Table 5.1, the patterns

for stimulants and opiates are parallel to

the one for marihuana, while psychedelics,

sedatives, heroin and cocaine follow by about

a year. If one wished to speak of an epidemic

in terms of these four drugs, the beginning

was in the 1966 to 1968 period.

The concept of a period of risk for drug use

was mentioned earlier. In the case of alcohol,

the age of entry into this period would have

to be set no later than age 10; by that age

more than 5 percent of the men were already

using it in all but one of the cohorts

(Table 5.4). It could be said that the period

ends in the early twenties, by which age

almost all of the eventual users had used

alcohol, if the plausible assumption is made

that the few nonusers are likely to remain

total abstainers. This is not an important

matter since it applies to so few men, but

it does explain why the percentages of new

users increase so little in the most recent

years; there were few still at risk.

The picture is somewhat more complicated for

cigarettes. In Chapter 2 it was shown that

the proportion of each birth cohort who

eventually used cigarettes decreased at a

fairly steady rate from the oldest to the

youngest. Reflecting a downward trend, the

pattern for cigarettes differs markedly from

the flat curve for alcohol, the U-shaped

curve for heroin and the generally upward

curves for the other drugs. Overall, 70

percent of the men reported cigarette use;

consequently, the decrease in new cases of

cigarette use in the early 1970s is not, as

in the case of alcohol, due to the diminution

of the group at risk.

It is conceivable that some of the men who

had not used cigarettes by the time of the

interview will do so in the future. Relevant

to this possibility is the respondent's

assessment of the likelihood that he would

be using tobacco three years later. Of the

nonusers, 96 percent indicated that there

was "no chance" they would be using tobacco

in any form in the future.

Of the men who eventually used cigarettes,

94 percent had done so by the age of 20, and

all of the men in the sample were at least

20 years old at the time of the interviews.

Thus, a sizable change in the incidence of

cigarette use in this sample is unlikely.

If one assumes that few nonsmokers will

subsequently begin use of cigarettes, attainment of age 20 could be taken as the end of

the period of risk. In addition, both in

absolute numbers and in terms of the percentage

at risk, the decrease in the number of men

who began to use cigarettes in recent years

is observed not only for the sample as a whole,

but also for each of the younger cohorts.

While speculative, the inference would appear

to be warranted that in the early 1970s there

has been an actual decline in the incidence

of cigarette smoking among young men. One

obvious interpretation is that some young men

have heeded the warning of the Surgeon General

concerning the health hazards connected with

smoking.

The picture is not the same for the other

drugs because the age at onset of use has

been changing. In addition, there is less

evidence to establish an upper age limit for

the period of risk. For example, the percentage of men who have ever used marihuana is

substantially higher among the younger men;

37 percent of the men who were 29 or 30 in

1974 had used marihuana in comparison with

62 percent of those between the ages of 20

and 24. Ranging only from 59 to 66, the

percentages were similar for the five youngest

cohorts, and the rate of increase was slowing.

This suggests that a plateau in the range of

60 to 65 percent will be reached. Extrapolation

of these data would not suggest substantially

higher lifetime prevalence figures for men

younger than those included in this study.

This, however, is not the case for median age

at onset. Of the men who have used marihuana,

the median age at first use is 19 for the

entire sample, but the medians decrease

regularly from 26 for the oldest cohort to 17

for the youngest. This is clearly a trend,

and extrapolation of it leads to the prediction of even younger median ages for new

57
Table 5.6. Annual Prevalence of Drug Use, 1957-1974 (Percentages1

)
users in the future. There obviously is some

lower limit, but the available data do not

show a leveling as yet and thus do not suggest

what the limit will be. The prediction of

a younger median age at first use is consistent with the finding in several studies of

younger men that many of them used marihuana

at an early age. The pattern described for

marihuana is also found, with minor variations, in all of the other drugs, and the

same inferences seem to be justified.

A caveat is in order. To this point the

number of new cases appearing in each calendar

year has been presented. Yet, this is only

part of the issue regarding the existence of

an epidemic; other relevant questions concern

the length of time those who used a drug

continued to use it, as well as the extent of

their use. Nor have data on regional variations been examined. Nevertheless, the data

suggest that there was a drug epidemic in

the latter part of the 1960s. With the

exception of the sedatives and cocaine, the

peak years for new cases of drug use were

1969 and 1970. Although not conclusive,

the data on incidence provide some indications

of a decline following the peak years. However, the incidence of new cases has not

reverted to pre-epidemic levels.

ANNUAL PREVALENCE

Data on annual prevalence, or the percentage

of the total sample who used each drug in

each calendar year, are presented in Table

5.6 for the years 1957 to 1974. A man is

counted in a given year if he used the drug

at least once in that year. If shorter time

periods such as months or seasons were used,

the figures would be appreciably lower

because many of the men used some of the

drugs only a few times in a given year. For

comparative purposes, the lifetime prevalence,

or the percentage of the sample who ever

used a drug prior to the time of the interviews, is also shown.

For two drugs, psychedelics and stimulants,

the highest annual prevalence was approximately

one-half of the lifetime prevalence. For

heroin and the opiates it was only one-third

of the lifetime prevalence, and for sedatives

and cocaine the highest annual prevalence was

about 40 percent of lifetime prevalence. In

other words, more of the men who used these

drugs quit using them, or used them more

sporadically, than was the case for marihuana

and alcohol. The highest figure for the

annual prevalence of marihuana is 37 percent;

this is two-thirds of the figure for lifetime

prevalence. There is, then, a strong tendency

for use of marihuana to continue once it is

begun. This is even more true of alcohol,

because the annual prevalence in the 1970s

is approximately 90 percent, whereas the

lifetime prevalence is 97 percent.

The patterns in Table 5.6 do not simply

duplicate those observed regarding the

incidence of new cases, for which lower

figures were observed in the most recent years

(Table 5.2). In terms of annual prevalence

only the usage of psychedelics and stimulants

shows a downward trend.

The prevalence figures for 1974 are as high

as the peak years for all drugs except

psychedelics and stimulants. Consequently,

there is no basis to suggest that a decrease

has occurred. For sedatives, heroin and

cocaine the data may be taken as indicative

of a leveling of usage, but could as easily

be seen as plateaus on what could still

be an upward trend. For alcohol, marihuana

and opiates, 1974 was the peak year, and

the data are clearly consistent with an

upward trend.

HAS THE EPIDEMIC ENDED?

While the incidence of new cases has declined,

there have been minimal or no decreases in

annual prevalence from the peak years. Thus,

the data do not permit one to conclude that

the epidemic has ended for most of the drugs

examined in this study. There are other

reasons why this is the case. A number of

facts suggest that marihuana was the key drug

in the epidemic of the 1960s. Marihuana was

the first of the drugs to reflect a higher

incidence of use (Table 5.1). Further,

data presented in Chapter 9 indicate that

marihuana use was almost a necessary, though

not a sufficient, condition for use of the

other drugs. This assertion will be documented more fully in a detailed report in

preparation, but it is noted at this point

to explain the presentation of the data in

Table 5.7 in terms of the extent of marihuana use.

It is generally recognized that drug use is

transmitted largely through friendship networks, and it may be seen in Table 5.7 that

use of marihuana by at least a few of the

respondent's friends was almost universal

when the men in this sample first used

marihuana. In addition, 88 percent of the

users indicated that when they initially

used marihuana, it was obtained as a gift.

The comparable percentages for the other

drugs were: psychedelics, 59; stimulants, 62;

sedatives, 63; heroin, 62; opiates, 43; and

cocaine, 71.

The respondents were also asked: "What would

you say the chances are that you will be

59
Table 5.7. Use by Friends, Availability, and Chance of Future Use of Drugs, by

Extent of Marihuana Use (Percentages)

Percent

Reporting:

Extent of Marihuana Use

Total No Use Experimental Light Moderate Heavy

n (2510) (1128) (423) (231) (227) (501)

At least a few friends

were using marihuana

when R started

More than a few friends

are now using: Marihuana

Psychedelics

Stimulants

Sedatives

Heroin

Opiates

Cocaine

Would find it easy to get:

Marihuana

Psychedelics

Stimulants

Sedatives

Heroin

Opiates

Cocaine

At least some chance that in

three years will be using:

Tobacco

Alcohol

Marihuana

Psychedelics

Stimulants

Sedatives

Heroin

Opiates

Cocaine

- - -- 95 97 98 98

48 18 41 69 76 94

14 4 5 16 22 39

16 6 9 14 23 43

13 5 8 11 16 36

3 1 1 * 5 7

6 4 4 6 7 17

8 2 1 3 12 24

70 57 75 82 79 87

32 26 35 32 39 41

41 36 45 40 45 46

40 37 46 41 44 42

17 15 17 14 20 24

22 21 26 19 20 23

20 16 17 18 26 30

66 58 71 72 74 72

91 84 97 94 96 95

38 4 31 72 75 91

8 * 1 5 11 31

15 2 8 17 25 44

14 4 10 13 22 34

2 * * 1 4 8

14 8 10 11 14 29

10 1 * 4 13 37

*Less than one percent.

using each drug, even occasionally, three

years from now? Would you say there was no

chance, a slight chance, a good chance, or

a very good chance? How about (Drug)?" While

these are subjective estimates of future use,

38 percent of the men indicated that there

was at least a slight chance they would be

using marihuana three years later. It is

interesting that this figure is almost identical to the prevalence of marihuana use in

1974, 37 percent.

The respondents' estimate of the likelihood

of future use of each drug or drug class is

directly related to the extent of their

marihuana use. This is particularly noticeable for marihuana; only 4 percent of the

nonusers said there was any chance of use

in three years, but the figures rise rapidly

with extent of use to 91 percent for the

heavy users. In Table 5.7 those who indicated

there was even a slight chance of using a

drug are included. If only those who reported

the chance of marihuana use as "good" or

"very good" are counted, the percentages in

terms of extent of marihuana use would be

nonusers, less than 1; experimental, 4;

light, 27; moderate, 41; and heavy, 73.

Therefore, one can infer that a sizable

proportion of the men who have used marihuana

intend to continue or resume use, and even

4 percent of those who have never used it

recognize some chance of future use.

60
The implication is that there will continue

to be a large reservoir of marihuana users,

and nonusers may learn to use the drug from

them. The possibility of such learning is

apparent in the responses to the question:

"How many of your current friends and

acquaintances use each drug?" (Table 5.7).

Again, it may be observed that the extent of

prior use of marihuana is related to the

likelihood that a man will report having

friends currently using it. This holds true

not only for marihuana, but for all the other

drugs as well. Even among the nonusers,

almost one in five reported that more than a

few of his friends currently used marihuana,

and one in twenty said he had friends who

used stimulants and sedatives. Among users,

substantially higher percentages report

having friends using all of the other drugs,

so that transmission of drug use through

friendship networks is also a possibility for

these other drugs.

The men were also asked how difficult it would

be for them to obtain each of the drugs

within a day if they wanted to do so and had

sufficient funds. While 70 percent reported

it would be easy to obtain marihuana, 40

percent indicated that stimulants and sedatives could be obtained easily, and 32

percent could obtain psychedelics easily.

For heroin, other opiates and cocaine

approximately 20 percent noted it would be

easy to obtain these drugs.

It must also be remembered that the increased

drug use in American society has necessarily

changed the social climate surrounding drug

use. In the years when few people were

using marihuana, one had to overcome numerous

obstacles prior to trying the drug. Today,

a man who knows that at least one-third of

his friends are currently using it and that

more than one-half have tried it at one time

or another can more readily justify experimenting with marihuana. The highest annual

prevalence of marihuana use (37 percent) was

reported in 1974. As a result, it would be

incorrect to infer from the slight decline

in the incidence of marihuana use that a

downward trend has begun. Further, in view

of the linkage between use of marihuana and

other drugs, a similar position must be adopted

regarding the other drugs (see Chapter 9).

Therefore, at least some of the conditions

conducive to the spread of drug use currently

exist to a far greater degree than was the

case in the mid-1960s. Whether the existence

of these conditions will, in fact, lead to

more widespread use is not known. Yet, it

is evident that the data provide no basis

for a prediction that the prevalence of drug

use will decline.

61
6 Attitudes, Motivations and Contexts

Thus far, attention has been focused on the not using the drugs are then examined, as

extent and patterns of use of the various well as data pertaining to the availability

drugs. In this chapter some data are presented of drugs, the chances of future use, and

regarding the contexts of use, including the some of the attitudes and opinions expressed

ways the drugs were obtained and administered. by the respondents about three of the drugs,

The reasons the respondents gave for using or alcohol, marihuana and heroin.

Table 6.1. Methods by Which Drugs Were Obtained, Ever, First, and Usually (Percentages)

Marihuana Psychedelics Stimulants Sedatives Heroin Opiates Cocaine

(1382) (550) (689) (508) (148) (779) (352)

Free, as a gift Ever 93 79 76 77 70 53 81

First 88 59 63 66 63 48 71

Usual 48 30 32 42 27 36 43

Ever 67 78 73 55 77 45 67

First 12 40 32 23 36 29 28

Usual 50 69 63 46 71 41 55

Bought from a

friend or dealer

From respondent's

own prescriptions

Ever

First

Usual

*

0

0

*

0

0

7

3

3

17 1 19 1

7 0 16 *

8 0 15 *

2

1

1

3 3

* 1

* 1

* 1

0 *

* *

2

*

*

From a forged

prescription

Ever *

First 0

Usual 0

*

0

0

3

*

1

5

1

*

1

0

0

*

*

*

Ever 2

First 0

Usual *

1

*

0

5

1

2

7

0

1

1

0

*

Stole the drug

Ever 19

First *

Usual 1

2

*

*

*

0

0

0

0

0

*

0

*

Grew or made own

supply

Some other way Ever

First

Usual

1

1

1

3

1

1

7 2 8 1

2 1 6 *

2 1 6 1

*Less than one-half of one percent.

62
Methods of Obtaining and Using Drugs However, these figures are inflated by the

men who used the drug less than 10 times,

and sometimes only once or twice; for them

the first source of drugs was almost by

definition the usual source.

For each drug except tobacco and alcohol, the

respondents were asked to indicate all of the

ways they ever obtained drugs when they used

them on their own. Those who reported more

than one way were asked how they obtained the

drug the first time they used it and how they

usually obtained it. Answer categories were

provided, as shown in Table 6.1.

Except for opiates, a majority of the users

of each drug had made some purchases from a

friend or dealer. If a man did not obtain

the drug free on the occasion of first use,

he began by buying it. Opiates are the only

drugs for which ways other than these two

account for an appreciable percentage for

first use. Buying drugs was more common as

the usual, rather than as the first, way of

getting all of the drugs; the increase is

accounted for by those who used the drugs

more than experimentally. In general, a

man began by obtaining a drug free, and if

he did not continue use, this was his "usual"

way; if he continued, he shifted to buying

the drug.

A majority of the users of all drugs had at

times obtained drugs free, as a gift from

other persons. This method was least frequently reported for the opiates and heroin.

"Free as a gift" was the source of the drug

on the occasion of first use for a majority

of all users, except for opiates, and this

was especially the case for marihuana (88

percent) and cocaine (71 percent). The percentages for whom this was the usual way of

obtaining drugs average around 35 percent.

Table 6.2. Routes of Administration of Drugs Ever Used, by Experimental1

 and

Other Users of Each Drug (Percentages)

Needle: Needle:

Oral Smoked Sniffed Mainline Other Other

Marihuana

Experimental

Other

(423) 6 98 5 0 0 0

(959) 39 100 15 * 0 *

Psychedelics

Experimental

Other

(291) 94 6 13 1 1

(259) 99 15 39 9 1

0

1

0

*

Stimulants

Experimental

Other

(207)1

96 1 10 * 1

(374) 97 3 26 13 2

Sedatives

Experimental

Other

(177)1

(232)

99 0 2 1 1 0

100 5 11 16 2 *

(72) 11 21 56 35 8 0

(76) 11 21 66 78 18 3

Heroin

Experimental

Other

Opiates

Experimental

Other

(300)1

(193)

54 57 8 2 2 *

71 54 11 11 2 0

Cocaine

Experimental

Other

(214) 10 6 89

(138) 13 11 93

7

37

1

4

0

1

1

"Experimental" means use less than 10 times for drugs other than stimulants, sedatives and opiates. For the latter drugs, quasi-medical users, almost all of whom

had used less than 10 times, are excluded. By definition, all of their use was

oral. 63
The respondents obtained the drug from their

own prescriptions in a fair number of cases

of use of the opiates, sedatives and, to a

lesser extent, the stimulants. For some this

was the first way, and for almost equal

numbers it was also the usual way. It may

seem surprising to find cases of "from your

own prescription" for the other drugs, particularly heroin, marihuana and cocaine.

There are only one or two cases of this kind

for these drugs. These may be coding or

punching errors, which it has not been possible

to check as yet, but some of these responses

could represent accurate answers regarding

use in other countries where heroin and cocaine

may be prescribed.

In a few cases forged prescriptions or thefts

from others were the source of drugs. Another

response, growing or making one's supply,

was given with some frequency only for marihuana, but it was the usual source of marihuana for only one percent of the users.

Other ways of obtaining the drugs appear for

opiates, sedatives and stimulants, but it has

not been possible to examine the individual

interview schedules to determine what these

ways were; in any event the frequency of

these other ways is negligible.

In Table 6.2 the ways in which users ingested

the various drugs are shown. The quasimedical users of stimulants, sedatives and

opiates are excluded; by definition all of

their use was oral. The data are presented

separately for the experimental users (use

less than 10 times) and other users, because

there are some marked differences between

them. In particular, those who used a drug

10 times or more have taken it in more ways.

All of the ways that men ever used the drugs

are included; consequently, the percentages

total to more than 100 percent, but it is

noticeable that for the experimenters the

sums are only slightly more than 100 percent,

while for other users the sums are higher.

Different routes of administration are

associated with the various drugs. Almost

everyone who used marihuana smoked it, almost

all users of psychedelics, stimulants and

sedatives took them orally, and almost all

users of cocaine sniffed the drug. For these

drugs and these routes the figures for

experimenters and other users are almost

identical. On the other hand, sniffing and

mainlining were almost equally reported for

heroin; for other opiates the percentages

were similar for oral use and smoking. For

heroin and opiates there are differences

between the experimenters and the other

users in mainlining and oral use, respectively.

For marihuana and the sedatives the most

64

frequently reported modes of use, smoking

and oral, respectively, have no close second.

However, for all of the other drugs one finds

at least 10 percent of the users reporting

some other mode of use, and heroin was used

by each mode of administration by 10 percent

or more of the users.

All of the drugs were taken orally, although

the percentages were low for marihuana,

heroin and cocaine. Smoking was the usual

mode for marihuana (98 percent); 21 percent

of the heroin users have smoked it, and

more than half of the users of other opiates

have smoked them; some of this is accounted

for by the 208 users of opiated hashish.

Sniffing was a frequent mode for heroin,

cocaine and, to a lesser extent, psychedelics

and stimulants.

Perhaps the most surprising finding is that

all of the drugs have been taken by needle,

and this involved mainlining more than intramuscular or subcutaneous injection. For

all drugs, the percentages of experimental

users who used a needle are considerably

smaller than for other users, and only for

heroin did an appreciable proportion of the

experimenters inject the drug.

In an analysis not presented in tabular form,

the first and usual routes of administering

the drugs were examined. For marihuana

smoking was the first and usual route; this

was the case for 98 percent of the experimenters and 99 percent of the other users.

For psychedelics, stimulants and sedatives

the oral route was the first and usual one

for 90 percent or more of the experimenters

and other users. For heroin, the percentages

for first and usual route were almost

identical for experimenters. However, for

those who used heroin 10 or more times, the

first and usual routes differed. Sniffing

was the first route for 41 percent, but it

was the usual mode for only 26 percent;

similarly, 42 percent mainlined the first

time they used heroin, but 64 percent usually

did so. Only 14 percent began by smoking

heroin, and 9 percent indicated that this

was the usual mode. In short, if a man

continued use of heroin, he tended toward

intravenous injection.

In Table 6.2 there are differences between

heroin and the other opiates. Sniffing and

mainlining were the major routes of administration of heroin even for experimenters, and

they were by far the most frequently reported

routes for other users. In contrast, these

were relatively unimportant modes for users

of other opiates, who reported oral administration and smoking. In the analysis of

the first and usual routes of opiate use,
these differences were again observed; almost

equal percentages began and continued with

oral use or smoking, and there was no hint of

a shift toward mainlining with continued use,

as was the case with heroin.

It would be easy to assume, because of their

identical pharmacological effects, that use

of heroin and of the other opiates were

essentially similar, and that the choice of

the drug depended on accidental factors such

as availability. However, the sizable

difference in the way the drugs were used

suggests that the meaning, purpose and context

of use may have been different.

Finally, cocaine tended to be used by sniffing

both at first and usually, although there is

a slight trend toward mainlining among other

than experimental users. Of the experimental

users, 4 percent began with mainlining, and

it was the usual route for 5 percent; 12

percent of the other users began by mainlining,

and it was the usual route for 20 percent.

Reasons for Use and Nonuse of Drugs

Two series of questions were included in the

interview, one for nonusers and those who

used a drug less than 10 times, and another

for all users. The first set contained eight

possible reasons for not using a drug, and

the question was, "Why did you never use these

drugs, or use them less than 10 times? Was

that at least in part because . . . ? How

about (Drug)?" The second set contained

nine possible reasons for use, and the question was: "We're interested in the reasons

people have for using these drugs. At any

time have the following been fairly important

reasons for your using them? How about . .

. ?" In both series, each reason was asked

about each drug to which it applied; that is,

the first set was asked about each drug

not used, or used less than 10 times, and

the second set about each drug ever used,

regardless of the extent of use.

The percentages of men who reported reasons

for not using or using less than 10 times

are shown separately in Table 6.3; it seems

reasonable to treat the latter as reasons

for discontinuing use. A glance at the table

shows that multiple reasons were given,

although more for not using than using less

than 10 times. Only in the third set of rows,

relating to the availability of drugs, did

users report the reason more often than

nonusers, and then only for heroin, opiates

and cocaine.

The pattern of reasons is similar across drugs,

and for both those who never used the drug

and those who tried it only a few times.

Possible bad effects on health as well as

dislike or an expectation of undesirable

effects were the two most common reasons for

all drugs. Effects on health were the most

commonly noted reason. The single exception

was marihuana; effects on health ranked

third for those who had used it. This might

be a learning effect, either from personal

experience with the drug or exposure to the

values of more regular users, or both.

At the other extreme, lack of availability

or cost of the drug was the least frequently

reported reason for avoiding use, for all

drugs except heroin and cocaine. Religious

or moral reasons for not using drugs were

mentioned by only about 40 percent of the

nonusers. The percentages for alcohol and

marihuana were higher, but they were based

on small parts of the sample; for the majority

of the sample, who used these two drugs,

such reasons were inoperative or ineffective.

Fear of becoming dependent on the drug was

mentioned relatively often as a reason for

avoiding sedatives, heroin, opiates, stimulants and cocaine. Fear of losing control

over oneself may tap essentially the same

thing, since its ranking in frequency of

mention is usually close to fear of becoming

dependent, and it is chosen over the latter

as a major reason for avoiding psychedelics.

Fear of trouble with the police was mentioned

by more than half of those who never used

the drugs and by less than half of those who

did.

Despite these differences, there is a considerable degree of regularity exhibited in the

data. While there is considerable variation

across reasons for each drug, there is less

variation across drugs for each reason,

especially for the experimenters. This

fact suggests that the reasons given for not

using drugs reflect general normative

tendencies and attitudes toward drugs in

general, rather than drug-specific rationales.

The more frequently stated reasons for not

using drugs were practical and expedient ones--

effect on health, did not like it, might

cause trouble with the police--rather than

expressions of moral convictions (religious

or moral reasons), or commitment to conformity

(family or friends would not approve). This

could mean only that young men are more

comfortable with practical than moral explanations of their behavior.

The reasons given for use by users of each

drug are shown in Table 6.4. The numbers

of experimental users are the same as the

numbers of those who used less than 10 times

in the previous table, except for stimulants,

65
Table 6.3. Reasons for Not Using Drugs, or Using Them Less Than Ten Times (Percentages)
Table 6.4. Reasons for Drug Use, for Experimenters and Other Users of Each Drug (Percentages)
sedatives and opiates; the quasi-medical

users of these drugs have been excluded. The

vast majority of the quasi-medical users had

used these drugs less than 10 times.

Multiple reasons could be given for each

drug, and they tended to be given for all

except experimental use of alcohol. With a

few exceptions all reasons were endorsed

more often by those who used the drug more

than experimentally; continued use may

produce additional reasons for use. Indeed,

for heroin and cocaine any reason seems to

have served those who used the drug 10 times

or more, and this is almost as true for

several of the other drugs. Thus, for

marihuana, stimulants and opiates, eight of

the nine reasons were endorsed by at least

10 percent of those who were more than

experimental users. The suggested generalization of motives for use may account, in

part, for some unexpected findings, such as

the facts that a few men said they used

sedatives to stay awake or alert and that

heightening the senses was a goal in use of

all drugs. When these responses were first

noted, it was suspected that they might

represent coding or punching errors or

inaccurate replies by respondents. These

possibilities still need to be examined, but

it appears from the patterns of responses

that a plausible alternative is that some

regular users came to see the drugs as

serving any purpose an interviewer mentioned.

There is more variation in the reasons for

use than in the reasons for not using a drug;

this is true both for the apparent importance

of reasons for using different drugs and in

the difference between experimental and

other users. One exception to this variation

is use in order to get high, which was the

most important reason given by both experimental and other users for use of all drugs

except alcohol and stimulants. With respect

to alcohol, it was not the primary reason

for use by the experimenters, who more frequently said they used alcohol because it

was expected of them, and the primary purpose

of stimulant use was to help stay awake or

alert. This use of stimulants, incidentally,

as well as the high ranking of getting to

sleep or relaxing as a reason for use of

sedatives and opiates, suggests that a fair

amount of use was for instrumental, rather

than recreational purposes.

Use "from force of habit" ranked low for the

experimental users of all drugs, but this

was also true for other users, except in

the case of heroin, for which it was the

second most frequently cited reason for use.

"To get through the work day" also ranked

low for most drugs; the sole exception was

the stimulants, and again this suggests

instrumental use.

The other six reasons ranked high for some

drugs and low for others. "To sleep or

relax" ranked high for sedatives and opiates,

in the high to middle range for alcohol,

marihuana and heroin, but low for all other

drugs. "To forget worries or troubles"

ranked as high as third for regular users of

heroin and sedatives, as low as eighth for

regular users of stimulants, and fluctuated

between these extremes for all users of

other drugs.

Among experimental users, the perception

that use was expected in the situation ranked

first for alcohol, second for marihuana and

no lower than fifth for any drug. This is

clearly important in the explanation of the

onset of drug use, not only because so many

men gave this reason for use, but also because

it was a major reason for use of alcohol and

marihuana, the drugs with which most users

begin.

"To stay awake or alert" showed the widest

variation; it ranked first in frequency of

mention for the stimulants and fourth for

cocaine, but low for most drugs. "To get

high or stoned" has already been mentioned

as the primary reason for use of all drugs,

but it is worth emphasizing that it was a

reason for use for almost 100 percent of

those who used psychedelics, heroin and

cocaine more than experimentally; this was

also the case for 93 percent of such users

of marihuana and for at least 65 percent of

such users of all other drugs.

"To heighten the senses" ranked second in

mention for psychedelics and cocaine, fourth

for marihuana and stimulants and sixth to

eighth for all other drugs for both categories

of users. Use due to boredom ranked about

as high as "because it was expected in the

situation"; both are exceeded only by "to

get high."

For five of the drugs, the experimental users

in Table 6.4 are the same men as those shown

as using less than 10 times in Table 6.3.

For stimulants, sedatives and opiates the

difference is accounted for by the quasimedical users, who are not included in Table

6.4. If they were included in this table,

the probable effect would be to make "to get

to sleep or relax" the highest, rather than

second highest percentage for sedatives and

opiates, and for stimulants it might make

getting through the work day rank second

rather than third in the number of times it

was mentioned. The tables can, therefore,

be treated together, and give the reasons why

68
the experimenters tried the drugs and why they

did not continue.

For all of the drugs except alcohol, "to get

high" was the most common or second most

common reason cited for use by experimental

users. Use because it was expected in the

situation was the most common reason why

experimenters used alcohol; this also ranked

high for marihuana, and it was mentioned

by about one-fifth of those who experimented

with other drugs. The other reasons were

mentioned by only a few men, or for only a

few drugs; for example, to stay awake and to

get through the work day were mentioned for

stimulants, to sleep or relax was noted for

sedatives, and to heighten senses was a reason

for use of psychedelics, stimulants and cocaine.

These, then, were the reasons why some men

tried the drugs. The reasons given by the

same men for discontinuing use were fear of

effects on their health and dislike of the

drug or its effects. These are only superficially satisfying explanations why they

did not continue to use the drugs. The

question becomes: Why did they dislike the

drugs or have these fears when other men liked

them sufficiently and handled their fears well

enough to continue?

One possible explanation has been advanced

by Becker (1953) with respect to marihuana,

and there is no reason why it could not be

generalized to other drugs. That is, one

learns to like the drug and to deal with the

reasons against its use in the process of

using the drug; the teachers are the users

with whom one associates. In this study data

were obtained about friends who were using

the drug when the respondent started to use

it. This extension of Becker's explanation

would be supported if it were found that the

experimenters reported fewer such friends

than those who continued to use a drug.

Therefore, the experimenters were compared

with those who had used the drugs more extensively, and the findings--in terms of the

percentages who reported they had only a few

friends or no friends using the drug when

they began its use--are presented with the

figures for experimenters first and others

second. The percentages were: marihuana,

45 and 25; psychedelics, 53 and 46; stimulants,

51 and 41; sedatives, 56 and 49; heroin, 81

and 51; opiates, 68 and 54; and cocaine, 70

and 56.

Some of these percentage differences are not

large, but the difference for heroin is 30

and for marihuana 20 percentage points. Even

more important, all of the differences are in

the same direction. This is clear support

for Becker's hypothesis; there is reason to

suspect that if more detailed data were

available--for example, the respondents'

emotional attachment to these friends or how

much time was spent with them--the support

would be even stronger.

Another question in the interview concerned

use of drugs by current friends. The responses

indicated that the experimental users had

even less contact with drug-using friends

when interviewed than when they first tried

the drugs. In contrast, the data on other

users suggest approximately the same degree

of contact with drug-using friends at

initial use and at the time of the interview.

Even more revealing are the facts that emerge

when these more than experimental users are

divided into former and current users. Like

the experimenters, the former users reported

less current contact with drug-using friends

than when they began use; current users, on

the other hand, reported more contact with

drug-using friends at the time of the interview.

In short, those who began use but stopped

after a few times had fewer friends who used

the drug when they began, and this number

decreased from first use to the time of the

interview. Those who continued use had more

friends using when they began and generally

maintained or increased contact with such

friends. The men need not, however, be seen

as passive objects, whose drug use was

determined by the contacts they happened to

have. Undoubtedly their friendship pattern

reflects choices of associates on their part,

and the effect of associates only partially

explains continuation of drug use.

Nevertheless, it appears to be a highly

plausible partial explanation; when men first

tried the various drugs many of them had

qualms, misgivings and fears about them. When

they were supported by friends, many were

able to handle these obstacles. Others, who

did not have the same degree of support

(and who may well have differed in other ways),

discontinued use and are classified as

experimental users or former users.

The reasons reported in Table 6.4 reflect the

variety of nonmedical uses of the drugs

covered in this study. As was argued in

Chapter 2, some of the use of stimulants,

sedatives and opiates appears to have been

quasi-medical. Some of it, especially of the

stimulants and sedatives, appears to have

been instrumental and quite possibly functional

in that the drugs were used to facilitate

work or rest. Some of the drug use seems to

reflect dependence, as well as an effort to

cope with life, and some was to expand

69
Table 6.5. Expectations for Future Use of Each Drug (Percentages)

CHANCE OF USE THREE YEARS AFTER INTERVIEW

No Slight Good Very Good

A. Total Sample (2510) Chance Chance Chance Chance

Tobacco 34 19 21 26

Alcohol 10 17 33 41

Marihuana 61 17 11 10

Psychedelics 91 6 1 1

Stimulants 84 11 3 1

Sedatives 86 11 2 1

Heroin 97 2 * *

Opiates 86 11 2 1

Cocaine 90 7 2 1

B. Expectations of at Least "A Slight Chance" of Future Use by Experience With Each Drug'

Tobacco

Alcohol

Never Used Former Users 1974-75 Users

(n) Percent (n) Percent (n) Percent

(766) 30 (248) 25 (1494) 92

(76) 7 (130) 29 (2301) 97

Marihuana (1128) 4 (421) 22 (960) 87

Psychedelics (1960) 2 (362) 15 (186) 67

Stimulants (1821) 4 (390) 26 (295) 73

Sedatives (2002) 4 (282) 29 (224) 73

Heroin (2362) 1 (100) 12 (46) 50

Opiates (1731) 1 (518) 30 (255) 61

Cocaine (2158) 2 (173) 34 (178) 74

*Less than half of one percent.

1

Sums of n's in each row fall short of 2510 by from 1 to 6 cases, due to

unknowns.

70
consciousness. In any event it is clear that

the most common reasons for use fall under

the general rubric of recreational use or

use for the effect of the drug itself.

Expectations for Future Use

For some years, in studies of cigarette

smoking an inquiry about the respondents'

estimation of the probability that they will

be cigarette smokers in the future has been

included. In general, respondents seem to

underestimate the probability of future use

when their expressed estimates are compared

with use as reported in later surveys. In

this study, the following question was asked

for each drug: "What would you say the

chances are that you will be using each drug,

even occasionally, three years from now?"

The four response categories were those shown

in Panel A of Table 6.5.

The sum of the percentages who chose an

answer other than "no chance" is close to the

percentage of current users of each drug,

but tends to be slightly lower for most drugs.

The percentages who estimated there was at

least a slight chance of future use are

shown in Panel B of Table 6.5 in terms of

experience with each drug. Most of the

current users thought there was at least

some chance they would continue use. Among

former users, fairly sizable minorities--averaging about 25 percent--thought they might

resume use. Even among those who have never

used the drugs, there are a few who thought

they might begin to use the drugs in the

future.

Marihuana may be used as an example. If one

accepted the percentages in Panel B as

estimates of future use, the number of users

three years in the future would be slightly

larger than the number of current users.

This would also be true for the other drugs,

including heroin and cocaine. There is no

basis to accept as accurate the respondents'

estimates of future use, but certainly there

is nothing to suggest that a decrease in use

is likely.

Drug Use Among Current Friends

Respondents were asked: "As far as you know,

how many of your current friends and acquaintances use each drug?" Five answer categories

were used, as displayed in Table 6.6. In

Panel B the responses are presented in terms

of the respondents' experience with the

drugs.

With the exception of the opiates, nearly all

of the current users reported at least a few

friends using the drug. The percentages

among the former users were lower than among

the current users, and the difference was

substantial for heroin. Even among the

nonusers the proportion who had friends who

used the drugs was far from negligible.

Indeed, the percentage was surprisingly high

for heroin. While only 2 percent of the

sample reported current use of heroin, 12

percent of the nonusers said that they knew

at least a few current users of heroin.

One possible explanation is that the nonusers

of drugs incorrectly suspected use in

friends or acquaintances or had reason to

believe that they were using some drug and

interpreted this as use of several drugs.

Another explanation is that nonusers may have

had good reason to suspect past use of a

drug by a friend and assumed that the use was

current.

The latter explanation is plausible because

of the answers to two questions: the nonusers

were asked whether they had ever been present

when the drug was being used and whether the

drug had ever been offered to them. In the

first case the respondent would know from his

own observation that his friends were using,

and he would have their own statements as to

what it was they were using. In the second

case (probably but not necessarily the same

occasion), it would be a fair inference that

the person who offered the drug was using it.

In answer to the first question, 63 percent of

the nonusers of marihuana had been present

when marihuana was being used. The comparable

percentages for the other drugs were:

psychedelics, 30; stimulants, 38; sedatives,

35; heroin, 17; opiates, 16; and cocaine, 21.

Almost identical percentages responded

positively to the second question.

The respondents, therefore, had a good basis

for the statements about use by current

friends if they were thinking in terms of

known use at some time, but not necessarily

the present. The intent of the question was

to ascertain current use bv current friends.

but the word current was attached to "friends"

and not to "use." For nonusers, then, it

appears that the question may have elicited

answers about how many current friends had

ever used drugs, rather than the intended

answer in terms of current use.

If this happened with nonusers, it could have

happened with former users and current users.

With respect to these two groups, however,

there is less reason to question their statements that most of them had friends who were

using the drugs. Here the relevance of the

figures lies in the generally accepted belief

71
Table 6.6. Drug Use Among Current Friends of Respondents (Percentages)

PROPORTION OF CURRENT FRIENDS USING

All or About Less Than A Few None

A. Total Sample (2510) Most Half Half

Tobacco 43 35 9 11 2

Alcohol 67 20 4 7 2

Marihuana 19 18 11 30 23

Psychedelics 1 4 9 29 57

Stimulants 3 5 8 32 52

Sedatives 2 4 7 31 55

Heroin * 1 2 11 86

Opiates 1 2 3 18 76

Cocaine 2 3 3 18 74

B. At Least "A Few" Friends Are Current Users by Experience With Each

Drug1

Tobacco

Alcohol

Marihuana

Never Used Former Users 1974-75 Users

(n) Percent (n) Percent (n) Percent

(766) 98 (248) 96 (1494) 100

(76) 84 (130) 89 (2301) 99

(1128) 56 (421) 84 (960) 98

Psychedelics (1960) 32 (362) 77 (186) 94

Stimulants (1821) 36 (390) 72 (295) 93

Sedatives (2002) 36 (282) 69 (224) 88

Heroin (2362) 12 (100) 41 (46) 87

Opiates (1731) 12 (518) 43 (255) 67

Cocaine (2158) 17 (173) 63 (178) 87

*Less than half of one percent.

1

Sums of n's in each row fall short of 2510 by from 1 to 6 cases, due to

unknowns.

72
that the continuation of drug use, as well

as its onset, is facilitated and made more

probable by having friends who use drugs. It

may be presumed that if one has such friends,

this will work against cessation among current

users and toward the resumption of use among

former users; this is one more reason to doubt

that any sizable reduction in the number of

users will occur in the immediate future.

Vailability of Drugs

The respondents were asked: "Suppose you had

the money and wanted to get each of these

drugs now. How hard do you think it would be

for you to get some within a day?" The

see response categories are shown in Panel

A in Table 6.7. Half or more thought it

would be possible to get each drug within a

day, and one-fifth or more would find it

easy. The lowest percentage was for heroin,

but 17 percent of the sample said it would

be easy to obtain heroin.

In Panel B the responses of "easy" and

"difficult but possible" are combined. At

least two-thirds of the current and former

users reported it would be possible, albeit

perhaps difficult, to obtain any of the drugs.

It is significant that only for heroin,

opiates and cocaine would most nonusers find

it almost impossible to obtain the drug, and

the percentages are so close to 50 that

one can say that half or more of the sample

Table 6.7. Availability of Drugs (Percentages)

Difficult Almost

A. Total Sample (2510) Easy But Possible Impossible

Marihuana 70 19 10

Psychedelics 32 38 29

Stimulants 41 35 24

Sedatives 40 34 25

Heroin 17 28 53

Opiates 22 31 46

Cocaine 20 33 46

B. "Easy" or "Possible" by Experience With Each Drug1

Nonusers Former Users 1974-75 Users

(n) Percent (n) Percent (n) Percent

Marihuana (1128)

Psychedelics (1960)

Stimulants (1821)

Sedatives (2002)

Heroin (2362)

Opiates (1731)

Cocaine (2158)

82 (421) 94 (960) 97

66 (362) 83 (186) 90

70 (390) 91 (295) 93

71 (282) 85 (224) 92

45 (100) 69 (46) 83

46 (518) 64 (255) 80

49 (173) 68 (178) 87

1

Sums of n's in each row fall short of 2510 by from 1 to 6 cases, due to

unknowns.

73
Table 6.8. Attitudes and Opinions About Selected Drugs by Use of Those Drugs (Percentages Responding "True")
felt they could obtain any drug within a

day. Lack of availability of a drug must be

a minor reason for abstaining from its use;

indeed, only 10 to 17 percent of the nonusers

gave this as a reason when they were asked

the question directly. (Table 6.3)

Attitudes and Opinions

In one of the two self-administered questionnaires completed during the interview, the

respondents were asked to check true or

false for each of the seven statements shown

in Table 6.8; this was done separately for

alcohol, marihuana and heroin. The answers

are presented for each drug according to the

respondent's experience with that drug.

The first three items refer to presumbly

problematic effects of the drugs. There was

general agreement, regardless of use, that

alcohol was likely to produce such effects.

Only for loss of will to work did current

users of alcohol differ from former users and

nonusers to an appreciable extent, and even

among current users the majority endorsed

the statement. With respect to marihuana,

the pattern of responses was quite different;

nonusers were more likely to endorse the

statements than former users and much more

likely to do so than current users.

For heroin, this pattern also appeared for

two of the three items but was reversed for

loss of will to work. The users of heroin

were somewhat more likely to endorse this

statement than nonusers. With respect to

these three specific problems, alcohol was

clearly seen as most likely to produce two

of them, heroin as most likely to produce

loss of will to work, and marihuana was seen

as least likely to have any of these

effects.

The differences in terms of experience with

the three drugs were marked for the other

four opinions or attitudes. Current users

were more likely to perceive users as

similar to themselves, to believe that laws

controlling use should be less strict, and

to agree that it is all right to use the

drug whenever one feels like it, They were

least likely to agree that use of the drug

makes people want to try other drugs.

If one compares the drugs in terms of these

items, marihuana users were perceived as

least different, and heroin users as most

different from the respondent, even within

categories of experience with the drug.

Heroin and marihuana were perceived as more

likely to make people want to try other drugs

than was alcohol. The statement about making

the laws less strict has a clear meaning

for marihuana and heroin, as specific

proposals of decriminalization have been

widely publicized; its meaning for alcohol

is less clear. Yet, the pattern was the

same for the three drugs; current users were

most likely to endorse the statement. Only

a third of the current users of alcohol and

heroin endorsed it. It was only for marihuana that support for the statement was

high, and even among the nonusers 28 percent

endorsed it.

The respondents' endorsement of the statement

is politically significant. The men who

endorsed less punitive marihuana laws comprised

slightly more than half of the entire sample.

Finally, the statement asserting that it is

all right to use the drug whenever one feels

like it showed the same pattern; it was least

endorsed by nonusers and most frequently

endorsed by users. Again, only a minority

of the users of heroin endorsed it.

75
7 Problems and Benefits

Attributed to Drug Abuse

This chapter is restricted to the problems

and benefits the respondents perceived to

be due to their use of the different drugs.

Four types of questions on these topics were

asked in the interview. First, each respondent was given a card on which the drugs he

said he had used were circled, and the

following question was asked:

Now we're interested in any problems

your drug use may have caused you. Did

your use of any of the drugs circled on

your list ever cause you:

a) any health problems or injuries?

b) to have problems at work?

c) 1. to have problems with a wife or

girlfriend,

2. your parents,

3. friends or other people you lived

with?

d) to have problems with the law?

e) any problems besides those mentioned?

If the answer to any of these questions was

positive, the respondent was asked to name

the drug(s) that caused the problem. This

was followed by a set of questions regarding

each drug named; the respondent was asked in

what year the drug first caused problems

of the type under discussion, in what year

it last caused problems and what was the most

serious problem that it caused.

Because of the way these questions were

phrased, it is not possible to infer that a

respondent regarded as serious any problem

he reported. He was asked to report any

problems; only after he identified a problem

in an area was he asked what was the most

serious one of that type. Thus, a respondent

could answer the first question in the

affirmative with only minor problems in mind;

in this case, his next answer cannot be

taken to mean he perceived it as a serious

problem, It is apparent that some of the

respondents did, in fact, describe some

relatively minor problems.

From the respondent's description it was

sometimes possible to determine that he perceived the problem as a serious or a trivial

one. The utility of this classification has

not been assessed, but it is apparent that

in many cases the data are insufficient for

reliable coding, as, for example, when the

complete description was, "I got drunk, fell,

and my arm went through a window and was

cut." For present purposes, the seriousness

of the problems reported must be taken as an

unknown, and the point of major interest is

the denial of problems.

A second set of questions, again with reference

to those drugs the man had used, dealt with

other consequences directly attributable to

drug use. For all of the drugs he had used,

the man was asked if he ever:

a) had any bad trips from using any of

them?

b) got into a physical fight as a result

of using any of them?

c) stayed up or high on any of them for

more than a day at a time?

d) found that he couldn't remember what

had happened to him as a result of

using any of them?

e) had been physically or psychologically

dependent on any of them?

A third approach was qualitatively different

and deliberately lacked specificity. After

the "problem" questions, the interviewer

continued:

We have been talking only about problems.

Did your use of any of the drugs circled

76
on your list help or benefit you in any

way?

If the answer was positive, the interviewer

probed for a complete list of drugs that

were perceived as having benefited the man.

Then, for each drug, the question was asked:

"In what ways did (Drug) benefit you?";

these answers have not been analyzed as yet.

Finally, the respondent was asked: "How

would you rate the effects your use of each

drug has had on your life? How about for

(Drug)?" The respondent was given a card

containing the answers "very bad," "more

bad than good," "more good than bad," and

"very good." A fifth response, "no effect,"

was recorded by the interviewer only if the

respondent volunteered it and refused to

make a choice among the responses on the

card.

PROBLEMS OF SPECIFIED TYPES

The data in Table 7.1 show the prevalence of

certain types of problems by drug class for

men in the age range of 20 to 30. With the

total sample as a base, only 14 percent of

the men reported one or more problems due

to marihuana use. Alcohol was clearly the

drug most productive of problems; 40 percent

of the total sample reported one or more

problems resulting from their use of it. In

terms of the total sample, few of the men

reported problems due to their use of drugs

other than alcohol or marihuana.

An examination of the row for alcohol in

Table 7.1 reveals that problems with the law

and problems with parents were mentioned by

18 percent of the men in the sample, while

19 percent reported problems with a wife or

girlfriend resulting from their use of

alcohol. The percentages for marihuana were

considerably lower; only 5 or 6 percent of

the men reported these legal or interpersonal

problems.

The percentages in Table 7.1 are based on

the total number in the sample, and most of

the men had not used most of the drugs;

consequently, the drugs could not have

caused problems for them. The percentages in

Table 7.2 are based on the number of men who

had used each drug. Of necessity, the

percentages of men who reported no problems

are lower than when the total sample was

the base. However, only 20 percent of the

users of psychedelics reported one or more

problems associated with their use. The

comparable percentages for stimulants,

sedatives, opiates and cocaine were relatively

low. Although not shown in tabular form,

the percentages remained low even among those

Table 7.1. Problems of Specified Types and No Problems Reported: Percent

of Total Sample (n = 2510)

No Problems of Specified Types

Problems Wife or

Reported Health Work Law Girlfriend Parent(s) Friend(s)

Alcohol 60

Marihuana 86

Psychedelics 96

Stimulants 95

Sedatives 96

Heroin 98

Opiates 98

Cocaine 98

10 5 18 19 18 8

2 2 5 5 6 1

1 1 1 2 1 1

2 1 1 2 1 1

1 1 1 2 1 1

1 1 1 1 1 1

* * * 1 1 1

* 0 * * 1

*

*Less than half of one percent.

77
who used the drugs more than experimentally.

In fact, only 32 percent of the men who had

used stimulants more than on an experimental

basis reported one or more problems, and the

percentages were low for comparable users

of sedatives, opiates and cocaine.

When those who had ever used heroin constituted

the base, 64 percent denied all of the

specified problems. When the experimental

users were excluded, only 34 percent denied

these problems. In fact, whether the base

is those who have ever used or those who

have used heroin more than experimentally,

the percentages who reported health, work,

law or one of the interpersonal problems

(wife or girlfriend, parents, friends) were

higher than for all the other drugs, except

alcohol. When one considers problems

resulting from extensive use, heroin produced

proportionately more problems than alcohol or

marihuana. Whereas the heroin users

constitute a small segment of the population

of young men, 97 percent of the men had used

alcohol, and 63 percent of the alcohol users

are classified in the heavy or heaviest

categories. This means that in terms of the

number of men who are affected alcohol is the

more problematic drug for society.

CONSEQUENCES OF DRUG USE

The percentages in Table 7.3 refer to consequences the respondents attributed to their

use of the drugs in response to specific

questions. First, four of every ten men who

had used psychedelics reported having bad

trips. Second, those who had used alcohol

were more likely to report fights as a

consequence than were users of the other drugs.

When only the heavy and heaviest users of

alcohol were examined, some 38 percent reported

fights resulting from their use of alcohol.

Third, use of psychedelics and stimulants

was clearly associated with staying high for

more than a day, as this experience was

reported by 27 and 40 percent, respectively,

of the users. Fourth, 39 percent of those

who had used alcohol found that on one or

more occasions they could not remember what

had happened to them as a result of their

alcohol consumption; the comparable figure

was 51 percent among the heavy and heaviest

users of alcohol. Fifth, 29 percent of those

who had ever used heroin reported having been

physically or psychologically dependent on

or addicted to the drug. For those who had

used heroin 10 or more times, 54 percent

reported dependence. For the other drugs

the percentages of men who reported dependence

were relatively low, even when use was more

than experimental.

Table 7.2. Percent of Users' Who Reported Specified Types of Problems

Problems of Specified Types

No Wife or

n Problems Health Work Law Girlfriend Parent(s) Friend(s)

Alcohol (2434) 58 11 5 19 20 18 8

Marihuana (1382) 74 3 3 9 9 12 3

Psychedelics (550) 80 4 4 4 10 6 3

Stimulants (581) 77 10 3 3 8 5 3

Sedatives (409) 79 8 3 5 10 8 4

Heroin (148) 64 12 10 14 22 17 16

Opiates (493) 92 1 1 1 3 3 1

Cocaine (352) 92 2 0 3 2 2 1

1For stimulants, sedatives, and opiates, quasi-medical use was defined as no use.

78
Table 7.3. Percent of Users1

 Reporting Bad Trips, Fights, Staying High More

Than a Day, Memory Lapses, and Dependence Due to a Given Drug

High More Couldn't

n Bad Trips Fights Than a Day Remember Dependence

Alcohol (2434) 16 28 9 39 5

Marihuana (1382) 8 2 8 8 5

Psychedelics (550) 41 3 27 13 2

Stimulants (581) 9 4 40 4 9

Sedatives (409) 9 11 6 17 5

Heroin (148) 18 5 15 9 29

Opiates (493) 5 1 3 3 2

Cocaine (352) 6 3 11 3 3

1For stimulants, sedatives, and opiates, quasi-medical use was excluded.

Table 7.4. Percent of Users1

 Who Perceived Benefits From Drug Use and Their

Perception of the Overall Effect Drug Usage has had on Their Life

Some Some Overall Life Effect

Problems Benefits Very Bad Very Good

n Reported Reported or Bad None or Good

Tobacco (2211) - - 66 22 12

Alcohol (2434) 42 22 46 21 33

Marihuana (1382) 27 32 33 22 45

Psychedelics (550) 26 54 12

(581) 36 48 13 39 Stimulants

21

23

35

Sedatives (409) 20 15 58 11 31

Heroin (148) 36 13

Opiates (493) 5 51 17

12

11

74 14

33

Cocaine (352) 8 11 43 18 39

1For stimulants, sedatives, and opiates, quasi-medical use was excluded.

79
BENEFITS PERCEIVED AND OVERALL

LIFE EFFECTS OF DRUG USE

While it is widely assumed that the use of

drugs can produce problems, the opposite

assumption is seldom made, that use may

produce benefits. The findings regarding

perceived benefits in contrast with problems

and the perceived overall life effects of

use are shown in Table 7.4.

The first finding deserving mention is that

for three drugs, alcohol, sedatives and heroin,

higher percentages reported problems than

perceived benefits. However, those who had

used these drugs more extensively reported more

benefits in comparison with all users; for

problems and benefits, respectively, the

figures are 27 and 22 percent for alcohol,

21 and 16 percent for sedatives and 22 and 11

percent for heroin. For the other six drugs

higher percentages of the men perceived

benefits than reported problems. Those who

used marihuana , psychedelics and stimulants

more than experimentally were somewhat more

likely to report benefits from their use

of these drugs.

With regard to the overall effects of drug

use on one's life, 74 percent of the heroin

users perceived the effects as bad or very

bad. It is interesting that tobacco ranked

second only to heroin in terms of the

perception of negative effects. In contrast,

only 33 percent of the users and 24 percent

of the moderate and heavy users of marihuana

described the overall effect of their use

in such negative terms. Between these

extremes the percentages reporting that the

effect had been bad or very bad were:

cocaine, 43; alcohol, 46; stimulants, 48;

opiates, 51; psychedelics, 54; and

sedatives, 58 percent.

Finally, an examination of the percentages

who perceived use of a drug as having a good

or very good overall effect on their life

reveals that only for heroin and tobacco

were the percentages low; 14 percent of

the heroin users and 12 percent of the tobacco

users rated the effects of these drugs

positively. The percentages for all of the

other drugs were, in fact, rather high. When

these percentages are calculated for those

whose use of these drugs had been more than

experimental, they were higher than for

experimental users. In fact, 66 percent of

the moderate and heavy users of marihuana

saw the overall life effect of their use as

good or very good. The comparable percentages

for more than experimental users of the

other drugs were: alcohol, 38; psychedelics,

48; stimulants, 45; sedatives, 36; heroin, 20;

opiates, 38; and cocaine, 49.

Marihuana differed from all of the other

drugs in one respect; it was the only one for

which more users reported the effect on their

lives as good or very good than reported it

as bad or very bad.

80
8 Drugs, Crime and Criminal Justice

Although the association between drug use

and criminality is widely recognized, there

is considerable disagreement concerning

the nature of the relationship. Earlier

studies, based largely on addicts hospitalized

for treatment, revealed that the relationship

between drug use and crime was neither a

simple nor a unidirectional one (Voss and

Stephens, 1973). A serious limitation of

earlier analyses has been reliance on

narcotic addicts for information (Voss

and Stephens, 1973; see also Inciardi

and Chambers, 1972; STASH Report No. 221,

19 74) . The point is not that narcotic

addicts may provide unreliable or invalid

information, but that their involvement

in crime may differ from that of users

of other drugs, or of narcotic users who

are not addicted, if for no other reason

than that addicts may have an expensive

"habit" to maintain.

The men in the sample were asked if they

had ever committed each of ten illegal acts

and, if so, the first and last year they did

so. In addition to these self-reports on

criminal activity, information was obtained

at other points in the interview concerning

whether they had ever sold drugs, stolen

drugs, purchased drugs from a friend or

dealer and whether drug use had caused the

respondent to have problems with the law.

A series of questions pertaining to contacts

with the criminal justice system were also

posed. These included inquiries about

arrests for traffic violations, driving

while intoxicated and other offenses;

age at first arrest; appearance in juvenile

court; commitment to a juvenile correctional

facility; conviction for a criminal offense;

jail, workhouse or prison sentence; and

the length of time served.

Self-Reported Criminal Acts

In Table 8.1 the number and percentage of

respondents who reported each of ten criminal

acts are shown in the first two columns.

Seventy percent of the men reported public

intoxication, and 60 percent admitted that

they had driven an automobile while intoxicated

The latter figure is noteworthy in view of

the hazard a drunken driver creates for other

travelers. Further, only 8 percent of the

men reported an arrest for driving while

intoxicated. The next most common of these

ten offenses was shoplifting; 44 percent of

the men reported this form of theft.

Also shown in Table 8.1 are the percentages

of men who reported each act according to

whether or not they had used marihuana or

other drugs, excluding tobacco, alcohol and

marihuana. Included in the category of

"other drugs" are psychedelics, stimulants,

sedatives, heroin, other opiates and cocaine.

There are sizable differences between the

users and nonusers of marihuana and also

between users and nonusers of the other drugs.

For example, 3 percent of the nonusers

reported that they had stolen an automobile,

while 8 percent of the marihuana users

and 11 percent of those who had used other

drugs admitted to auto theft.

With the exception of the first two acts,

for which consumption of alcohol to the point

of intoxication is a necessary condition,

users of marihuana were, in general, at least

two to three times more likely to have

committed each of these acts. Except for

shoplifting, similar or greater differences

appear between users and nonusers of other

drugs.

In Table 8.2 the information on self-reported

criminal acts is shown in relation to the

81
Table 8.1. Self-Reported Criminal Acts by Use of Marihuana and Other Drugs

(Percentages)

Number Percentage Other Drugs

Criminal Act Admitting of Marihuana (Marihuana

Act Sample Excluded)

Never Never

Used Used Used Used

(n) (2510) (1128) (1382) (1665) (845)

1. Public intoxication. 1754 70 54 83 62 86

2. Driving while intoxicated. 1512 60 45 73 53 75

3. Auto theft. 145 6 3 8 3 11

4. Breaking and entering. 314 13 6 18 7 24

5. Armed robbery. 36 1 * 2 1 3

6. Shoplifting. 1103 44 29 56 35 62

7. Stealing (face-to-face). 83 3 1 5 2 7

8. Illegal gambling. 74 3 1 4 2 4

9. Bad checks. 70 3 1 4 1 6

10. Forged prescriptions. 37 1 * 2 * 4

Table 8.2. Self-Reported Criminal Acts by Extent of Marihuana Use (Percentages)

EXTENT OF MARIHUANA USE

Criminal Act Total No Use Experimental

(n) (2510)

Light Medium Heavy

(1128) (423) (231) (227) (501)

1. Public intoxication. 70 54 78 86 84 87

2. Driving while intoxicated. 60 45 69 77 72 75

3. Auto theft. 6 3 4 6 9 12

4. Breaking and entering. 13 6 10 10 20 27

5. Armed robbery. 1 * 1 2 2 4

6. Shoplifting. 44 29 50 52 56 64

7. Stealing (face-to-face). 3 1 3 3 3 9

8. Illegal gambling. 3 1 4 2 5 6

9. Bad checks. 3 1 2 3 4 7

10. Forged prescriptions. 1 * * * 4 4

*Less than half of one percent.

82
Table 8.3. Self-Reported Criminal Acts by Extent of Alcohol Use (Percentages)
measure of extent of marihuana use. Whereas

the data in Table 8.1 show that commission

of these criminal acts is related to the use

of marihuana, it is apparent in Table 8.2

that involvement in each of these acts is

also related to the extent of marihuana use.

For example, 8 percent of the users reported

an auto theft, but among heavy users of

marihuana the percentage was 12. Similarly,

9 percent of the heavy users had committed

a robbery in comparison with 5 percent of all

users and 1 percent of the nonusers. In fact,

for each criminal act the percentage for

heavy users (Table 8.2) was higher than the

comparable figure for all users (Table 8.1).

Examination of the relationship between

alcohol use and the ten self-reported

criminal acts revealed a similar pattern;

the heavy and heaviest users of alcohol were

more likely to report each of the acts than

were men who were light or moderate drinkers

(Table 8.3). Among the 76 nonusers four

(5 percent) admitted to breaking and entering,

and 12 (16 percent) reported shoplifting;

they did not report any of the other criminal

acts. The extent of drinking was directly

related to public drunkenness and drunken

driving. Relatively few of the light drinkers

reported these acts, whereas among the

heaviest users of alcohol, 90 and 84 percent,

respectively, reported drunkenness in public

and driving while intoxicated. For the other

self-reported criminal acts the relationships,

although similar, were weaker than the ones

observed for marihuana use. For example,

9 percent of the heaviest drinkers reported

an auto theft in comparison with 12 percent

of the heavy marihuana users.

Each of the self-reported criminal acts was

classified on the basis of the first and last

year the respondent indicated it occurred.

Some 60 to 70 percent of those who reported

an auto theft, breaking and entering or

shoplifting indicated that it occurred only

while the respondent was under 18 years of

age (Table 8.4). On the other hand, two-thirds

of those who admitted to public drunkenness

and armed robbery said it took place for the

first time after the age of 18, and approximately three-fourths of those who reported

driving while intoxicated, running numbers

and check forgery initially committed the

offense after attaining the age of 18.

Nearly all of the prescription violations

occurred after the respondents were 18. The

two alcohol-related offenses--public drunkenness and driving while intoxicated--were

not only the most commonly reported offenses

Table 8.4. Self-Reported Criminal Acts by Age (Percentages)

Act Reported as Occurring: Before 18 After 18 Before and After 18

1. Public intoxication. 4 66 30

2. Driving while intoxicated. 2 73 25

3. Auto theft. 67 25 8

4. Breaking and entering. 60 28 13

5. Armed robbery. 11 66 23

6. Shoplifting. 71 10 19

7. Stealing (face-to-face). 42 36 22

8. Illegal gambling. 15 74 11

9. Bad checks. 22 75 3

10. Forged prescriptions. 3 92 5

84
but were also most likely to be reported as

occurring both before and after the age of 18.

The median age at which the men in four age

groups (20-21, 22-24, 25-27, 28-30) indicated

they had first committed the ten self-reported

criminal acts was examined. For some of the

offenses, median ages of 21, 22 and 23 were

found in the two older age groups, and this

suggested that it was inappropriate to base

comparisons of the age groups on all of

the self-reported acts, as the men in the

youngest age group were only 20 or 21 years

old. In other words, their period of exposure

to the risk of criminality was considerably

less than was the case for the older men.

Therefore, the median age was calculated

only for those acts reported through the

age of 20, as shown in Table 8.5. These

medians are remarkably similar across the

four age categories. With two exceptions,

the fluctuations between adjacent categories

are only one year; more importantly, there

is no apparent trend for any offense. Thus,

for the alcohol-related offenses 18 is the

median age, regardless of year of birth, if

one excludes acts that take place after the

age of 20. Because the medians are so

similar across the age groups, it is appropriate to note that, overall, for five of

the ten acts the median is 18. The exceptions

are: shoplifting, 12; robbery, 15; auto

theft, 16; breaking and entering, 16; and

prescription forgery, 19.

The percentage who admitted each of the

self-reported offenses was also examined

within the age categories. When all of the

reported offenses were considered, there

was little difference for armed robbery and

robbery, but for the two alcohol-related

offenses, lower percentages of the younger

men reported these acts. The older men were

more likely to report that they had run

numbers or had a job involving illegal

gambling. The younger men were somewhat more

likely to report the other offenses.

To equalize the period of risk, the percentages

were again calculated only for the acts

reported through the age of 20 (Table 8.6).

For the two alcohol-related offenses the

percentages increased from the oldest to the

youngest age groups; when all of the acts

were examined, the trend was in the opposite

direction. By the age of 20 higher proportions

of the younger than of the older respondents

reported public drunkenness and driving while

intoxicated. For both of these offenses there

was a difference of 19 percentage points

between the oldest and youngest men. With

one exception, the percentage differences

were smaller for the other acts, but the

percentages were consistently higher for the

youngest men. Armed robbery was exceptional

in that 1 percent of the men in each age

category reported commission of that offense

by the age of 20. While the earlier analysis

of median ages revealed no salient differences

among the age groups, the younger men were

more likely to report that they had committed

each of the acts, other than armed robbery,

by the time they were 20 years of age (Table

8.6).

The percentages for the two older age groups

in Table 8.6 were quite similar, as were the

figures for the two youngest age groups.

Therefore, the data for the oldest groups

(ages 25-30) were combined to predict the

incidence of the ten self-reported criminal

acts that would have been observed among

the younger men (ages 20-24) if they had been

involved in these acts to the same extent as

the older respondents. As in the previous

analysis, only the acts reported through the

age of 20 were used.

In Table 8.7 the actual and predicted numbers

of the self-reported acts are shown and, for

the younger men, the ratio of the actual to

the predicted number in which the base is 100.

In other words, if the actual and predicted

numbers were the same, the ratio would be 100.

For the first seven acts the actual number

reported by the younger men was 20 to 40

percent higher than the number predicted on

the basis of the older respondents' reported

criminality. For the eighth and ninth acts,

running numbers and check forgery, the actual

number was double that expected, and for

prescription forgery it was almost five times

greater.

Comparable figures for use of cigarettes,

alcohol, marihuana and other drugs are also

shown in Table 8.7. The number of cigarette

smokers among the younger men was smaller

than expected, while the number of users of

alcohol was almost exactly what one would

predict on the basis of the older men's

behavior. However, for marihuana and other

drugs, there have been dramatic increases.

There were twice as many young users of the

other drugs and almost three times as many

young marihuana users as one would expect

on the basis of the experience of the older

men. These percentage increases are not the

result of a difference in the number of

younger and older men as this difference

was controlled in making the calculations

presented in Table 8.7.

However, it is a fact that the younger groups

are numerically larger. Taken in conjunction

with that fact, these data suggest that there

has been a "real" increase in drug use and in

crime. In other words, the increase reported

85
Table 8.5. Median Age for Initial Occurrence of Self-Reported Criminal Acts Admitted Through the Age

of 20
Table 8.6. Initial Occurrence of Self-Reported Criminal Acts Through Age 20 by Age Groups (Percentages)
in recent years on the basis of official

crime statistics is not solely a product of

improved records systems. While the younger

men did not appear to differ from their

older counterparts in terms of when they

became involved in criminal acts, there were

more young men due to the "baby boom" in

the early 1950s, and a higher proportion of

them were involved in criminal acts, insofar

as one can judge from the available data. On

the other hand, the limitations of these data

with reference to the nation's crime rate

must be recognized. Specifically, information

on only ten offenses is available, and the

frequency with which the respondents committed

these acts was not ascertained. Nor was the

occurrence of other common forms of crime

such as assault, homicide and forcible

rape assessed. Further, other types of

crime such as occupational, corporate and

organized crime were ignored.

It has been shown that use of marihuana and

other drugs and certain kinds of criminal

activity were more prevalent among the

younger men, but a caveat is in order. It

is essential to note that while the data

presented thus far show a statistical association between criminal activity and drug

use, no effort has been made to establish

a causal relationship. Preliminary efforts

to unravel the causal linkage, if any,

between crime and drugs will be deferred

until after the respondents' contacts with

the criminal justice system have been

described.

Table 8.7. Actual and Predicted Incidence of Criminal Acts and Drug Use by Age 20, and

Ratio of Actual to Predicted Number

YEAR OF BIRTH

1944-49 1950-54 Ratio or

Self-Reported Act** n = 1233 n = 1277 Actual to

Actual Actual Predicted Predicted

Percentage Number Percentage Number Number Number

1

2

3

4

5

6

7

8

9

10

Cigarettes 67

Alcohol 93

Marihuana 20

Other Drug Use 22

49

36

5

10

1

38

2

1

1

*

609 61

444

58

120

11

474

25

14

14

2

828

1144

250

267

49

6

14

1

46

3

2

2

1

63

95

56

44

784

630

76

172

14

585

36

28

28

14

805

1212

713

568

631 124

460 137

60 127

124 139

11 127

492 119

26 138

14 200

14 200

3 467

858 94

1186 102

259 275

277 205

*Less than half of one percent.

**See Table 8.6 for self-reported criminal act.

88
Contacts With the Criminal Justice System

Tabulations, which are not presented, show

that 66 percent of the men indicated that

they had been given a ticket or arrested

for a traffic violation; parking tickets

were excluded by the phrasing of the

question. The likelihood of receiving a

citation for a traffic violation is

undoubtedly related to the manner in which

one drives, but it is also related to how

much one drives and how long one has driven.

In the sample 55 percent of the men in the

three youngest age cohorts reported traffic

arrests, while 71 percent of the respondents

in the three oldest cohorts had been

arrested for traffic violations. There

was also a sizable difference in terms of

ethnicity; 69 percent of the whites and

59 percent of the men classified as Other

reported traffic citations in contrast

with only 46 percent of the black

respondents.

Overall, 8 percent of the men indicated that

they had been arrested for drunken driving,

but again there was a relation with age.

Ten percent of the men in the three oldest

cohorts reported such arrests in comparison

with 5 percent of the youngest men. By the

time the younger men reach their late 20s

presumably more of them will have been arrested

for driving while intoxicated. There are

also sizable ethnic differences for this

offense; arrests were reported by 8 percent

of the whites, 5 percent of the blacks, and

18 percent of those classified as Other.

In terms of the level of education completed

by the respondent there were few differences

in traffic arrests, but for arrests for

driving while intoxicated, there was a strong

inverse relationship with the respondents'

education. The percentages who reported

such arrests by educational level were:

less than high school, 16 percent; high school

graduate, 9 percent; some college, 6 percent;

and college graduate, 2 percent.

Table 8.8. Number of Respondents by Extent of Marihuana Use and Age Groups,

Ethnicity, and Education

AGE GROUP

MARIHUANA USE

Total No Use Experimental Light Medium Heavy

(25 10) (1128) (423) (231) (227) (501)

Year of Birth

1944-46

1947-49

1950-52

1953-54

541 328 97 52 23 41

692 320 125 74 54 119

740 267 119 62 99 193

537 213 82 43 51 148

ETHNICITY

White

Black

Other

2103 970 357 193 178 405

303 107 49 29 38 80

104 51 17 9 11 16

RESPONDENTS'

EDUCATION

Less Than High School 394 189 63 26 37 79

High School Graduate 933 428 158 82 87 178

Some College 713 281 115 76 60 181

College Graduate 470 230 87 47 43 63

89
The likelihood of arrest for driving while

intoxicated is related to car ownership;

9 percent of the men who owned cars reported

such arrests in comparison with 3 percent of

those who did not own cars. Car ownership

is also related to age and ethnicity. The

percentages of car owners by age were:

20-21, 82 percent; 22-24, 91 percent; 25-27,

95 percent; and 28-30, 96 percent. Similarly,

95 percent of the whites, 90 percent of those

classified as Other and 73 percent of the

blacks owned cars. Part of the explanation

for the differences in arrests for driving

while intoxicated involves access to an

automobile.

When the respondents are classified in terms

of the measure of extent of marihuana use

and by age groups, ethnicity and level of

education, there are relatively few men in

some of the cells, as may be seen in Table 8.8.

For example, there are only 26 men who did

not complete high school who are classified

as light users of marihuana. The numbers in

Table 8.8 serve as the bases for the percentages in Tables 8.9 through 8.12.

Overall, 31 percent of the respondents indicate

that they had been arrested for an offense

involving something other than a traffic

violation. As may be seen in Table 8.9, there

were only minimal differences among the age

groups while members of minority groups were

more likely to report arrests for criminal

offenses. In contrast with age, arrest is

strongly associated with the amount of

education a man has completed--three times

as many men who did not complete high school

were arrested than was the case for college

graduates. Although not shown in tabular

Table 8.9. Nontraffic Arrests by Extent of Marihuana Use and Age Groups, Ethnicity,

and Education (Percentages)"

MARIHUANA USE

Total No Use Experimental Light Medium Heavy

(n) (2510) (1128) (423) (231) (227) (501)

AGE GROUP

Year of Birth:

1944-46 541 29 21 31 39 57 61

1947-49 692 29 18 30 31 48 47

1950-52 740 34 15 29 34 49 53

1953-54 537 33 15 26 26 43 62

ETHNICITY

White 2103 30 17 30 32 45 54

Black 303 3 9 24 29 38 58 56

Other 104 35 22 18 33 73 69

RESPONDENTS'

EDUCATION

Less Than High School 394 53 36 51 65 65 86

High School Graduate 933 32 16 30 38 53 58

Some College 713 28 15 26 26 42 45

College Graduate 470 17 10 16 15 35 35

*For numbers in each cell see Table 8.8.

90
form, a slightly higher percentage of the

men who grew up in cities of 100,000 or more

were arrested than those who resided in

smaller places. Further, arrest is strongly

related to marihuana use (Table 8.9). There

are some fluctuations and minor reversals,

but there is, nevertheless, a definite trend

from the nonusers to the heavy users in the

percentages of men who were ever arrested.

Within each age group, ethnic category and

educational level many more heavy users than

nonusers reported an arrest for a criminal

offense.

Eight percent of the men appeared in juvenile

court. A larger proportion of the youngest

men were referred to juvenile court, but

the differences among the age groups were

not as great as the differences in terms of

extent of marihuana use (Table 8.10). The

percentages of blacks and whites who appeared

in juvenile court were almost identical,

and again extent of marihuana use was

associated with such an experience.

The differences according to the respondents'

education are dramatic. Few of the men who

eventually graduated from college appeared

in juvenile court, regardless of the extent

to which they used marihuana. For those who

dropped out of high school and used marihuana,

at least one-fifth appeared in juvenile court,

as did two-fifths of the dropouts who were

heavy marihuana users. Because it has not

as yet been determined how many of these men

used marihuana as juveniles, one cannot, on

the basis of these data, infer that appearance

in juvenile court was a result of marihuana use.

Table 8.10. Juvenile Court Appearance by Extent of Marihuana Use and Age Groups,

Ethnicity, and Education (Percentages)*

MARIHUANA USE

Total No Use Experimental Light Medium Heavy

(n) (2510) (1128) (423) (231) (227) (501)

AGE GROUP

Year of Birth:

1944-46 541 6 4 7 10 9 15

1947-49 692 8 4 9 11 11 12

1950-52 740 8 4 7 6 9 16

1953-54 537 11 4 9 9 20 20

ETHNICITY

White 2103 8 4 8 8 12 16

Black 303 9 3 8 14 11 16

Other 104 13 10 12 11 18 19

RESPONDENTS'

EDUCATION

Less Than High School 394 22 12 22 23 27 43

High School Graduate 933 8 4 7 12 11 13

Some College 713 5 2 5 4 8 11

College Graduate 470 2 ** 2 4 5 3

*For numbers in each cell see Table 8.8.

**Less than half of one percent.

91
There is also a relation between the size of

the city in which the respondents lived

most of the time as juveniles and appearance

in juvenile court; 13 percent of the men who

lived in cities of 500,000 or more went to

juvenile court in comparison with 6 percent

of the residents of rural areas.

Only 2 percent of the respondents were sent

to a juvenile correctional facility, and

detailed analysis of these men is not warranted.

It may be noted that commitment was directly

related to city size. Two percent of the

whites, 4 percent of the blacks and 7 percent

of the Others were committed. In terms of

the respondent's level of education, 9 percent

of those who did not complete high school

had experience in a juvenile facility. In

contrast, 2 percent of the high school

graduates, 1 percent of those who attended

college, and none of the college graduates

served time in an institution for juveniles.

Twelve percent of the men indicated that

they had been convicted of a crime (Table

8.11). The age groups did not differ in

terms of convictions even though the period

of risk was greater for the older respondents,

but there were differences between whites

(11 percent) and blacks (17 percent) and

Others (19 percent). The extent of marihuana

use was related to convictions--at least

one-fifth of the heavy users, regardless of

age or ethnic background, were convicted of

a criminal offense. Again, the respondent's

education was a variable that had an independent effect on convictions; 27 percent

of the high school dropouts and only 4

percent of the college graduates were convicted.

Regardless of marihuana use, those who

graduated from high school, the men who

eventually attended college and particularly

Table 8.11. Crime Conviction by Extent of Marihuana Use and Age Groups, Ethnicity,

and Education (Percentages)*

MARIHUANA USE

Total No Use Experimental Light Medium Heavy

(n) (2510) (1128) (423) (231) (227) (501)

AGE GROUP

Year of Birth:

1944-46 541

1947-49 692

1950-52 740

1953-54 537

ETHNICITY

White 2103

Black 303

Other 104

RESPONDENTS'

EDUCATION

Less Than High School 394

High School Graduate 933

Some College 713

College Graduate 470

13

11

12

13

11

17

19

27 16 24 35 41 47

11 4 11 16 18 24

10 5 8 9 20 16

4 3 5 4 5 10

5 11 12 15 22

9 12 21 29 24

12 0 22 64 31

7 14 20 35 32

6 9 12 20 25

5 11 13 15 20

6 9 9 22 22

*For numbers in each cell see Table 8.8.

92
those who graduated from college appeared to

be insulated from conviction in comparison

with the high school dropouts. In terms of

city size there was a relationship with

conviction; the percentage convicted ranged

from 10 percent among the rural residents to

15 percent for the men who grew up in cities

of one million or more.

Again, the men in the four age groups did

not differ in whether or not they served a

prison sentence (Table 8.12). Blacks and

Others were more likely than whites to serve

a prison sentence. Only 4 percent of the

whites served time, whereas 14 percent of

the blacks and 13 percent of the Others

served a prison sentence. Further, marihuana

use interacts with race, and among the minority-group members who were moderate or heavy

marihuana users, at least one-fifth served

a prison sentence. In terms of the respondent's

education, it was apparent that few of the

men who attended college or graduated from

college served prison terms; in fact, only

two men who served a prison term graduated

from college-- one did not use marihuana, and

the other man appears in the column for light

marihuana users. There is also a linear

relationship with city size; 4 percent of

the rural residents and 11 percent of those

who as juveniles resided in cities of one

million or more served prison sentences.

In the preceding description of the respondents'

contacts with the criminal justice system,

ranging from nontraffic arrests to juvenile

court appearances, juvenile correctional

commitments, crime convictions and serving

Table 8.12. Sentence Served by Extent of Marihuana Use and Age Groups, Ethnicity,

and Education (Percentages)*

MARIHUANA USE

Total No Use Experimental Light Medium Heavy

(n) (2510) (1128) (423) (231) (227) (501)

AGE GROUP

Year of Birth:

1944-46 541 6 3 6 8 17 17

1947-49 692 6

3 4 7 15 11

1950-52 740 4 2 3 3 5 8

1953-54 537 6 3 2 2 10 13

ETHNICITY

White 2103 4 2 3 3 4 9

Black 303 14 7 8 17 24 20

Other 104 13 4 0 11 55 25

RESPONDENTS'

EDUCATION

Less Than High School 394 18 11 10 23 32 34

High School Graduate 933 5 1 5 5 7 12

Some College 713 2 1 2 1 7 4

College Graduate 470 * * ** 0 2 0 0

*For numbers in each cell see Table 8.8.

**Less than half of one percent.

93
prison sentences, the temporal order of these

events and use of alcohol, marihuana and

other drugs has been ignored. On the basis

of these data, one cannot infer either that

drug use leads to contacts with the criminal

justice system or that involvement with lawenforcement agencies increases the likelihood

of drug use.

As noted in Table 8.1, there is a statistical

association between involvement in the ten

self-reported criminal acts and use of

marihuana and other drugs. To establish a

causal relationship it is necessary to show

not only that there is a statistical association, but also that the presumed cause

occurred before its effect, and that the

relationship is not spurious (Hirschi and

Selvin, 1973). There are at least three

conflicting hypotheses as well as some support

for each of them in the drug literature:

(1) drug use leads to crime; (2) involvement

in crime leads to drug use; and (3) both .

crime and drug use are the results of some

other factor(s). Little attention has been

directed toward the third hypothesis.

It may be recalled that the median age of

first use of marihuana and other drugs was

lower among the younger cohorts, and the

incidence of drug use was higher among these

younger men. The median age for the selfreported criminal acts reported by the age

of 20 has remained almost constant, but

there has been an increased incidence of these

acts among the younger cohorts. Consequently,

it is important to examine the variable of

age in considering the possibility of a causal

relation between drug use and criminal

behavior, regardless of the causal direction

that is postulated.

Three acts--shoplifting, auto theft and

prescription forgery--were selected because

they differed in the median age at which the

respondents indicated they first committed

them. To reiterate, the medians for these

offenses are: shoplifting, 12; auto theft,

16; and prescription forgery, 19. For these

offenses separate analyses were conducted

for four age groups (20-21, 22-24, 25-27, 28-

30). For each of these offenses, similar

patterns were observed within the age categories in the temporal order of the criminal

act and use of marihuana. Consequently,

differences among the cohorts may be ignored

in subsequent analyses of the temporal order

of criminal acts and drug use.

While age, defined in terms of cohort differences, may be ignored, this does not mean that

age is not an important variable. In the

initial analyses of the relation between the

year in which marihuana was first used and

the initial occurrence of the ten self-reported

criminal acts, there was no apparent pattern--

marihuana use was both preceded and followed

by the criminal acts. The respondents were

then divided according to whether they

used marihuana by the age of 16 or at an

older age, and a definite pattern emerged.

Among the men who admitted public drunkenness,

driving while intoxicated, auto theft,

breaking and entering or robbery as well as

use of marihuana one pattern was evident.

Most of the men who used marihuana by the age

of 16 reported that they committed the

criminal act for the first time in a year

later than the one in which they first used

marihuana; in contrast, for the men who first

used marihuana at the age of 17 or at an

older age, most of them had committed the

criminal act before they used marihuana.

For example, of those reporting both marihuana use and auto theft, 78 percent of the

men who used marihuana by the age of 16

stole a car in a year subsequent to the one

in which they used the drug, but of those

who used marihuana at the age of 17 or later,

89 percent had already stolen a car. Thus,

for five of the ten self-reported criminal

acts, the temporal ordering of marihuana use

and the criminal act appears to be a function

of the age at which marihuana is first used.

For armed robbery, running numbers and check

forgery, the same pattern was found for the

men who used marihuana by the age of 16;

however, for those who began use at a later

age, 50 to 70 percent reported that they

first committed the criminal act in the same

year or in a year subsequent to the one in

which they initially used marihuana. For

these three offenses, then, there is some

evidence that use of marihuana precedes the

criminal act; however, relatively few men

(1 to 3 percent) admitted these criminal

acts.

Among those who admitted shoplifting and use

of marihuana, 66 percent of those who used

marihuana by the age of 16 had shoplifted in

an earlier year, and 21 percent stated that

they had shoplifted for the first time in a

year subsequent to their initial use of

marihuana. Among those who had first used

marihuana when they were 17 or older, 92

percent had already shoplifted. Because the

median age for shoplifting was 12, this

offense usually preceded marihuana use,

regardless of the age at which marihuana use

first occurred.

Prescription forgery is a drug-related

offense, but only 37 of the men reported it.

Of these, one did not give complete time

data, and 5 did not use marihuana. Of the

remaining 31, 27 (87 percent) used marihuana

94
before they first forged a prescription, one

man forged a prescription before using

marihuana and 3 men reported both events as

occurring in the same year. For this offense,

the data support the marihuana-crime sequence,

although it must again be emphasized that

this is a relatively rare offense.

With the exceptions of shoplifting, prescription violation and, in part, three of the

other offenses, among the men who used

marihuana early and reported a criminal

offense, marihuana use generally preceded

the first occurrence of the criminal act--

evidence that drug use precedes crime.

However, for those who first used marihuana

at a later age, most of the other offenses

had already occurred for the first time--

evidence that criminal activity precedes the

use of marihuana. As the direction of the

relation is contingent on the age of first

marihuana use, there is almost equal support

for both possible temporal orderings.

This preliminary examination of the data

suggests that neither the hypothesis that

drug use leads to criminal activity nor the

one that criminal behavior leads to drug

use is unambiguously supported. While

additional analysis is required, it is also

essential to test whether a presumably causal

relationship is spurious. To this end three

test variables that were temporally prior to

the first occurrance of either marihuana

use or involvement in criminal activity were

introduced. The test variables were size

of city of residence to age 18, mother's

education and father's education.

In this analysis the two alcohol-related

offenses were combined, and shoplifting

was distinguished from the other self-reported

criminal acts. The test variables were then

used as controls in the relationships

between marihuana use and (1) the alcoholrelated offenses, (2) shoplifting and (3)

the other self-reported acts. Because none

of the partial relations were substantially

lower than the original relations, this

analysis did not provide any evidence that

the original relations were spurious. To

a limited extent, the relations are conditional on city size, father's education

and mother's education. The linkage between

the alcohol-related offenses and marihuana

use is somewhat lower for the men who resided

in cities of 500,000 or more, whereas for

the other self-reported offenses, excluding

shoplifting, the relation with marihuana use

is stronger among the men who lived in such

large cities as juveniles.

While further analysis is required to assess

the causal relation, if any, between drug

use and criminal activity, the answers to

one question shed some light on the extent of

legal difficulties the men experienced as a

result of their use of drugs. Each respondent

was given a card on which the drugs he said

he had used were circled, and the following

question was asked: "Except for tobacco, did

your use of any of the drugs circled on your

list cause you to have problems with the law?"

In subsequent analyses the responses in terms

of the first year drugs caused problems with

the law will be used in conjunction with the

dating of contacts with the criminal justice

system. As a preliminary step in this

direction, the data in Table 8.13 show the

responses to this question in relation to

criminal justice contacts. Obviously, some

of these contacts were not drug related, but

it is apparent that at each step there is a

relationship. Of the 204 men who said they

had been arrested for driving while intoxicated, 81 percent said they had had legal

problems due to their use of drugs. If the

respondents' usage of the term drugs included

alcohol, presumably this figure would be

100 percent, and the discrepancy undoubtedly

reflects the fact that some Americans do not

view alcohol as a drug.

Among those who were arrested, slightly more

than one-half saw drugs as having caused them

legal difficulties, For those who appeared

in juvenile court, served time in a juvenile

correctional facility, were convicted of a

crime or served a prison term, at least twothirds attributed some of their legal

difficulties to drugs. Among those who did

not have such contacts with the criminal

justice system, positive responses were

considerably less common, and the percentage

differences were consistently around 45 to 50

points. Nine percent of the men who were

never arrested indicated that they had had

legal difficulties due to drugs.

Although not shown in tabular form, it may

be noted that 580 of the respondents indicated

that they had had legal difficulties as a

consequence of their drug use. Of these men,

75 percent had been arrested, and 36 percent

had been convicted of a crime. The comparable

percentages for those who did not report legal

difficulties due to drug use were 18 and 5

percent, respectively, for arrest and conviction. Obviously, these low percentages were,

in part, due to the fact that some of these

men did not use drugs or used them only to a

limited extent.

Also shown in Table 8.13 are the self-reported

criminal acts and three drug offenses in

relation to contacts with the criminal justice

system. As in the previous analysis, the two

alcohol-related offenses are combined, and

95
Table 8.13. Law Problems Due to Drugs, Self-Reported Criminal Acts, and Drug Offenses by Contacs With the Criminal

Justice System (Percentages)
juvenile shoplifting is distinguished from

the other self-reported criminal acts. As

might be expected, nearly all of the men who

reported an arrest for driving while intoxicated indicated that they had either been

drunk in public or had driven an automobile

while intoxicated. While the percentages

of men within each type of criminal justice

contact who admit to one of the alcohol

offenses are consistently higher than for

those who did not have a similar contact,

the largest difference involves the percentages arrested for driving while intoxicated.

For the other types of contacts, there are

differences of 10 to 18 percentage points.

The pattern is similar for juvenile shoplifting although the percentage differences

are somewhat larger--those who report each

level or point of contact with the criminal

justice system are more likely to admit that

they had shoplifted as juveniles.

The men who appeared in juvenile court,

were committed to a juvenile correctional

institution, convicted of a crime or served

a prison sentence were considerably more

likely to report one or more of the other

criminal acts than those without such

experiences. For example, 78 percent of

the men sent to a juvenile institution

reported one or more of these acts in comparison with 19 percent of those with no

commitment as juveniles. The comparable

figures for those who did and did not serve

a prison sentence are 67 and 17, respectively.

For the three drug offenses, those who

reported any criminal justice contact were

more likely to indicate they had bought,

stolen or sold drugs. However, the acts

of buying and selling drugs were not confined

to men who have been arrested or incarcerated--

one-third of those with no arrest and twofifths of the men with no further official

contact had bought drugs. Relatively few

men had stolen drugs, but the ones who

reported such thefts were more likely to

indicate each type of contact with the

criminal justice system. Again, the reader

is cautioned that these data cannot be

interpreted to mean that drug use caused or

led to these contacts with the criminal

justice system.

In summary, the data in this chapter show

that there is a strong statistical association

between the extent of drug use, whether

measured in terms of use of alcohol or

marihuana, and self-reported criminal acts.

Further, there is an equally strong association between the extent of marihuana use and

contacts with the criminal justice system.

Problems with the law due to drugs, the

self-reported criminal acts, and buying,

selling and stealing drugs were reported more

frequently by the men who had each type of

contact with the criminal justice system.

The associations among these variables are

complicated by their relations with other

variables, notably education, age, ethnicity

and the size of the city in which the

respondents resided as juveniles. The

associations with age are particularly

important in considering the possibility of

a causal relation between drug use and

criminal behavior.

The preliminary analyses described in this

chapter do not provide clear support either

for the idea that drug use leads to crime

or that criminal activity leads to drug use.

With the exception of prescription forgery

and shoplifting, there appears to be no

consistent temporal relationship between

drug use and criminal activity on which an

argument for a causal link can be developed.

Rather, the temporal. order of marihuana use

and a number of the self-reported criminal

acts appears to be a function of the age at

which marihuana is first used. For several

of these offenses, among the men who admitted

them as well as use of marihuana, those who

used marihuana by the age of 16 reported that

they committed the criminal act for the

first time in a year later than the one in

which they first used marihuana; in contrast,

among the men who used marihuana at the age

of 17 or older, most of them had committed

the criminal act before they used marihuana.

While only preliminary analyses have been

conducted, the fact that drug use sometimes

occurs first and at other times criminal

behavior precedes use indicates that if there

is a causal connection between drug use and

criminal behavior, it is not a simple one.

97
9 Multiple Drug Use

In this chapter attention is focused on

multiple drug use or the reported use of at

least two of the drug classes examined in

this study. This is an initial report, and

the question whether use of one drug leads

to or "causes" use of another drug is not

addressed, but the data can be used to

establish the temporal order of usage.

USE OF PAIRS OF DRUGS

One tactic used by previous researchers to

study multiple drug use is to examine all of

the possible combinations of drug classes,

note how many cases are observed for each

combination and determine if some combinations

are observed more frequently than would be

expected by chance. As an example, one

possible pattern is that none of the nine

drug classes were used. It should be noted

that in this and later analyses in this

chapter, quasi-medical use of stimulants,

sedatives and opiates was treated as no use

of the drugs. In addition, there are nine

different patterns in which one, and only

one, drug class was used. If one adds the

patterns in which two, three or more of the

nine classes were used, the total number of

possible patterns is 512. Only 86 of the

512 patterns actually emerged. This clearly

established that it is not a matter of

chance which drugs are found together in

the drug histories of the men in the sample.

Some 78 percent of the respondents were

included in the ten pure scale types of

multiple drug use that are shown in Table

9.1. By far the most prevalent pattern,

including 33 percent of the respondents,

involved use of only alcohol and tobacco.

Another numerically prominent pattern involved

use of tobacco, alcohol and marihuana; 22

percent of the sample fitted this pattern.

Only 2 percent of the men reported no use of

any drug, while 4 percent reported use of

drugs in all nine categories.

A second tactic that has been used to study

multiple drug involvement is to examine

the percentage of persons who report use or

nonuse of one drug in terms of reported use

of another drug. However, before a detailed

analysis of the data in Table 9.2 is presented,

it is appropriate to offer a general interpretation. An examination of the pairs of

columns for each drug, in which users of

the drug are compared with nonusers, confirms

that use of any drug is associated with use

of all other drugs. This can be illustrated

by examining the data for users and nonusers

of tobacco and alcohol. Most tobacco users

have used alcohol but so have most nonusers;

so this finding means little. Some 59 percent

of the tobacco users report having used

marihuana, in comparison with 27 percent of

those who have never used tobacco. This

finding is interesting from two perspectives.

First, use of tobacco is correlated with

marihuana use. Second, approximately onefourth of those who have never used tobacco

report having used marihuana, and almost all

of them smoked marihuana. Thus, use of

tobacco is not a necessary precursor of

marihuana use.

Two points should be mentioned about the

users and nonusers of alcohol. Since

practically all of the respondents have used

alcohol, the percentages for nonusers are

based on a small number and are perhaps

unstable. It is also evident that use of

alcohol is associated with use of the other

drugs: 57 percent of alcohol users have

also used marihuana, 23 percent psychedelics,

24 percent stimulants, 17 percent sedatives,

6 percent heroin, 20 percent opiates and 14

percent cocaine, while nonusers of alcohol

rarely used any other drug, except tobacco.

98
Table 9.1. Number and Percent in Each of Ten Pure Scale Type Patterns of Ever-Never Use1
Table 9.2. Percent of Users and Nonusers of Each Drug Who Have Used the Other Drugs1
Further discussion of the data in Table 9.2

will focus on marihuana, heroin and cocaine.

An important inference is that marihuana may

be a key drug in understanding multiple drug

use. Evidence for this can be found in two

places in Table 9.2. The first is in the

column indicating the percentages of users

and nonusers of marihuana who reported using

the other drugs. The second location is in

the third row where the percentages of users

and nonusers of the other drugs who had also

used marihuana are shown; these percentages

are markedly different. Some 40 percent of

those who had used marihuana had used

psychedelics, while virtually none of the

nonusers reported psychedelic use. The

comparable figures for stimulants were 41

and 1 percent; for sedatives, 29 and 1 percent; for heroin, 11 percent and less than

1 percent; for opiates, 33 and 4 percent.

Finally, 25 percent of the marihuana users

reported having used cocaine in comparison

with almost none of those who have not used

marihuana. In three comparisons between

users and nonusers of marihuana, fewer than

1 percent of the nonusers had ever used

psychedelics, heroin or cocaine. If it can

be shown that use of marihuana predates use

of the other drugs, a plausible hypothesis

would be that use of marihuana, along with

a number of other factors, facilitates in

some way the movement of a person into use

of other substances.

An examination of the figures in row 3 of

Table 9.2 also suggests this conclusion,

though from a slightly different perspective.

Of those who had ever used psychedelics or

cocaine 100 percent had also used marihuana;

this was also true for 97 percent of those

who had used stimulants or sedatives, 91

percent who had used opiates, and 99 percent

of those who had used heroin. Among the

nonusers of these drugs, the percentages

reporting use of marihuana ranged from 42

to 52 percent.

There are several reasons for suggesting

marihuana rather than alcohol as a key to

the understanding of multiple drug use. All

users of marihuana used alcohol, and almost

all of them used tobacco. Thus, to know

that a man has used marihuana is to know

that he has used at least alcohol, and

probably tobacco; if these are accepted as

drugs, marihuana use means multiple drug use.

Second, while the associations of alcohol

use with use of other drugs are strong,

those of marihuana with other drugs are even

stronger. More importantly, marihuana use

is a more useful predictor of other drug

use than is alcohol use. For nonusers of

either drug, one can predict with a high

probability of being correct that they will

not have used other drugs. With respect to

alcohol, one is making a prediction about

3 percent of the sample, but with respect to

marihuana 45 percent of the men are involved.

This conclusion applies not only to the

associations based on the simple distinction

between having used and not having used a

drug, but also when the measures of extent

of use are examined; the associations of

marihuana use with the other drugs are

stronger than the associations of alcohol use

with them.

Finally, some drugs, for example, stimulants,

showed stronger associations with use of

other drugs than did alcohol and marihuana.

However, it will be shown that in terms of

temporal order, use of alcohol and marihuana

almost always preceded use of other drugs.

Because of the temporal order, it is appropriate to predict from marihuana use to use

of the other drugs, but it is only in a

statistical sense that one can predict

marihuana use from use of drugs such as the

stimulants.

Another conclusion suggested by the data in

Table 9.2 is that use of heroin signifies

the deepest involvement in the drug milieu.

Persons who had ever used heroin were likely

to have used all or most of the other drugs.

At least 99 percent of those who had used

heroin had also used tobacco, alcohol and

marihuana, and at least 80 percent had used

psychedelics, stimulants, sedatives, opiates

and cocaine. As indicated in Table 9.1,

99 respondents or 4 percent of the sample

had used all nine classes of drugs studied.

Thus, only 49 of the 148 persons who reported

having used heroin had not used all of the

other drugs. Stated differently, 67 percent

of the men who have ever used heroin have

also used all of the other drugs studied.

It is also apparent that those who had used

cocaine were likely to have used all of the

other drugs, except heroin. The data to

support this conclusion are found in the

last two columns and last row of Table 9.2.

First, the percentages of users of cocaine

who had also used tobacco and alcohol were

high although the percentages for nonusers

were almost as high. Second, 100 percent

of the users but only 48 percent of the

nonusers of cocaine had also used marihuana;

this is a ratio of two to one. Third, 89

percent of the cocaine users in comparison

with 11 percent of nonusers had tried psychedelics. Among those who had used cocaine,

at least 70 percent had also used stimulants,

sedatives and opiates, while the comparable

percentages for nonusers are approximately

101
10 percent. Fourth, only 39 percent of the

men who had used cocaine had also used heroin;

on the other hand, 90 percent of those who

had used heroin reported use of cocaine.

Several disclaimers are needed at this point.

First, these data do not show, nor are they

intended to suggest that use of marihuana or

any other drug automatically leads to subsequent use of other drugs. Second, the

data contained in Tables 9.1 and 9.2 utilize

only the crudest of measures. In subsequent

analyses of these data, lifetime extent of

use, frequency and amounts of use within

years and across years as well as patterns

of starting and stopping will be examined.

Third, in future reports an attempt will be

made to integrate the analysis of multiple

drug use and onset of use for pairs of drugs

with other events such as marriage and

education.

YEAR OF ONSET

In this section the temporal order of the use

of pairs of drugs is examined. One of the

major methodological weaknesses of most

studies of multiple drug use is the failure

to date the initial use of different drugs.

Goode (1974:319) clearly makes the point in

talking about whether marihuana leads to

the use of other drugs, particularly heroin:

We very rarely know in any of these

studies precisely when a given subject

uses marihuana for the first time,

begins using it regularly, and then

when he or she initiates heroin use.

From the bulk of the studies now available, all we know is that respondents

who use marihuana tend to also be those

who use heroin. Both could have

been initiated at the same time, or

either before the other. In order

to get a clearer picture of the

process of the progression from

cannabis to dangerous drugs, we would

have to have a detailed picture of

the natural history, or the drug

"career" of large numbers of users;

the drug "biography," in time

sequence, should be on the agenda

of any researcher exploring this

question.

The specific agenda items recommended by

Goode, natural history and time sequence of

drug use, were of central importance in this

study. Not only are the dates of first and

last use for each drug class available, but

frequency and quantity patterns were also

obtained for each year of use. In addition,

because drug use constitutes only one aspect

of a biography, the respondents were asked

to state the year in which they first ran

away from home, were suspended or expelled

from school, dropped out of school, owned a

car, had sexual intercourse and experienced

other events. Questions were also asked

about the respondent's involvement with and

attachment to parents, peers and school at

ages 13 and 16. In subsequent reports the

answers provided to these questions will be

brought to bear on such complex issues as

the natural history of drug use, multiple

drug use and the sequence of drug use. For

this initial report attention is focused on

the temporal order of initial use of pairs

of drugs.

For all men who ever used one of eight drug

classes, the year of first use was ascertained,

and for those who used any drug 10 or more

times, the month and year of initial use

were recorded. For tobacco, only the year

was noted.

The year of first use of each drug was

examined according to the year of first use

of all other drugs, except tobacco. The

men whose use of stimulants, sedatives and

opiates was quasi-medical were treated as

nonusers of these drugs. Whenever the

respondents indicated that the year of first

use for a pair of drugs was the same, a monthby-month table was constructed to eliminate

ties. For those who used one or both drugs

in a pair less than 10 times, the month of

June was arbitrarily assigned as the month

of onset, but there were few ties among the

experimental users.

It is clear that among the men who had ever

used alcohol and at least one of the other

drugs, alcohol was almost always the first

drug used (Table 9.3). For example, of the

men who had ever used alcohol and marihuana,

93 percent used alcohol first. The percentages

are even higher when initial use of alcohol

is compared with onset of use of the other

drugs. Therefore, it may be concluded that

use of alcohol precedes use of the other

drugs for almost all men who have ever used

alcohol and some other drug.

Some 80 percent of the men who had used both

marihuana and psychedelics used marihuana

first. Use of marihuana was antecedent to the

use of stimulants, sedatives and opiates for

at least 70 percent of the men who had used

marihuana and one or more of these drugs.

Some 96 percent of those who have used cocaine

and marihuana used marihuana first, while 90

percent of those who have used both heroin

and marihuana used marihuana prior to their

use of heroin. Use of marihuana did not

precede stimulant and opiate use as often

as it did use of psychedelics, sedatives,

102
Table 9.3. Users Across Pairs of Drugs and Time Order of Usage (Percentages)1

Number Who Percent Who Percent Who Percent Who FIRST Percent Where

Have Used Used Drug in Used Other Used Both Drugs Time Order

Each Pair of Capital Letters Drugs at in the Same Month of Usage is

Drugs (n=2510) at Left, FIRST Left, FIRST Not Known

ALCOHOL and

Marihuana

Psychedelics

Stimulants

Sedatives

Heroin

Opiates

Cocaine

MARIHUANA and

Psychedelics

Stimulants

Sedatives

Heroin

Opiates

Cocaine

PSYCHEDELICS and

Stimulants

Sedatives

Heroin

Opiates

Cocaine

STIMULANTS and

Sedatives

Heroin

Opiates

Cocaine

SEDATIVES and

Heroin

Opiates

Cocaine

HEROIN and

Opiates

Cocaine

OPIATES and

Cocaine

1377 93 5 1 1

548 98 2 * *

578 98 2 0 *

407 97 2 0 *

147 97 3 0 0

491 94 6 0 *

351 99 1 * 0

546 80 14 5 1

562 73 21 6 1

394 84 12 4 1

146 90 7 3 0

449 77 20 3 *

350 96 1 2 1

409 36 46 17 1

326 48 34 16 2

134 66 26 7 0

353 50 33 16 1

314 77 13 9 1

334 50 29 19 1

125 73 21 5 2

345 56 34 10 1

301 75 17 7 0

116 63 27 9 2

296 45 38 14 3

254 67 22 10 1

133 29 50 19 2

132 52 32 14 2

276 63 20 16 1

1For stimulants, sedatives, and opiates, quasi-medical use was defined as no use.

*Less than half of one percent.

103
heroin and cocaine. While these data do

not show that use of marihuana leads to use

of heroin or cocaine, it is apparent that

use of the one drug usually preceded the

other in time. This fact suggests that use

of marihuana cannot be dismissed as a

possible, perhaps even probable, cause of

use of other drugs , particularly heroin and

cocaine.

The temporal order of initial use of psychedelics and the other drugs varies. Only

for heroin and cocaine was the likelihood

high that use of psychedelics was antecedent.

Of the men who had used psychedelics and

stimulants, 46 percent used stimulants first

in comparison with 36 percent who used

psychedelics first. Among the men who had

used psychedelics as well as stimulants,

sedatives or opiates, almost one-fifth used

psychedelics and these other drugs for the

first time in the same month.

Initial use of stimulants was antecedent to

use of heroin or cocaine for about three of

four men who had used these drugs. Use

of stimulants also tends to antedate first

use of sedatives and opiates, but not to

the same extent that it precedes heroin and

cocaine. Some 19 percent of the men who

had used both stimulants and sedatives used

both for the first time in the same month.

The data do not include sufficient detail

to determine if the figure of 19 percent

represents use of one of these drugs to

counteract the effects of the other or

reflects a period of intensive experimentation

with stimulants and sedatives.

Sedatives were initially used before heroin

and cocaine by 63 and 67 percent, respectively,

of the men who had used these drugs and

sedatives. Neither sedatives nor opiates

can easily be classified as antecedent to

the other, as 45 percent used sedatives

first and 38 percent used opiates before

sedatives. For 14 percent of the men who

used sedatives and opiates, initial use of

both drugs occurred in the same month.

Use of opiates was antecedent to initial

use of heroin for 50 percent of the men who

had used both drugs, while 19 percent first

used these drugs in the same month. Use of

opiates was clearly antecedent to cocaine

for most of the men who had used both drugs.

Figures on the initial use of heroin and

cocaine indicate that heroin was more likely

to be the first drug used in that pair.

In summary, several findings deserve special

attention. First, the data in Table 9.1

show that the largest number of persons who

had used more than one drug had used only

alcohol and tobacco; they comprise 33 percent

of the total sample. Twenty-two percent of

the respondents used only alcohol, tobacco

and marihuana. Only 99 (4 percent) of the

respondents have used all nine of the drugs

studied.

Second, more than 90 percent of the men who

had used cocaine, opiates, heroin, sedatives,

stimulants or psychedelics had also used

marihuana. When users of marihuana are

compared with nonusers, higher percentages

of the users have used the other drugs.

Third, nine of ten men who had used heroin

had also used cocaine, but only 38 percent

of the men who had used cocaine had used

heroin. This lends support to the idea

that heroin signifies the deepest involvement

in the drug milieu.

Fourth, in terms of the temporal order of

use of pairs of drugs, alcohol was antecedent

to use of all the other drugs, including

marihuana. For men who have used marihuana

and any one of the other drugs, use of marihuana usually occurred first.

Fifth, it was not a rare occurrence for men

to begin use of pairs of drugs--psychedelicsstimulants, psychedelics-sedatives, psychedelics-opiates, stimulants-sedatives, sedativesopiates, heroin-opiates and opiates-cocaine--

in the same month.

Finally, it should be repeated that these

data do not show that use of any drug causes

use of any other drug. However, it is possible

that, along with a number of other factors,

use of marihuana may have facilitated the

movement of persons into use of the other

drugs.

104
10 A Total Drug Use Index

One of the barriers to an adequate understanding of the causes, correlates and effects

of drug use is essentially methodological.

The problem is one of contructing a realistic

overall index of drug use that would allow

a researcher to compare persons who have

used various drugs to a different extent and

with different intensities in either

frequency or amount consumed.

This barrier was faced in this study. In

Chapter 2 data were presented on the lifetime prevalence of use of nine drug classes.

Because the difference between never having

used a drug and having used it at least once

provides a crude index, more refined measures

of the extent of use of the various drug

classes were developed. For tobacco,

psychedelics, heroin and cocaine, the extent

of use was measured simply by the number

of times the drugs were used. For alcohol,

marihuana, stimulants, sedatives and opiates,

the measures were based on the total number

of times the drug had been used and whether

it was ever used in large amounts. For the

latter three drugs, criteria were used to

distinguish quasi-medical from other use.

The relationships between these measures of

the extent of use and educational attainment,

race, age, marital status and employment

have been examined; the analysis and interpretation have been based on the consistency

of the findings across drug classes. In

this chapter an overall drug use index is

developed in an effort to eliminate the need

to consider each drug class separately and

to permit statistical rather than judgmental

decisions about the significance of the

findings.

The procedure for constructing the Total

Drug Use Index (hereafter referred to as TDU)

was developed by K. H. Lu and was described

in 1974 in The International Journal of the

Addictions. The index is constructed by

assigning weights to the categories of extent

of use of each drug. These weights are not

assigned arbitrarily; rather, they are

determined by the proportion of cases in the

total sample that are found in the various

categories. Essentially, the weights reflect

the frequency or rarity of a given level of

drug use in relation to the frequency of

lower and higher levels of use in the sample.

The set of weights is designed so that the

mean score for the sample is .5, and its

variance .0833 for each drug class. In the

development of the TDU scores, tobacco use

was ignored; the scores for each man in the

sample on the other eight drug classes were

summed and then divided by eight. The TDU

score, therefore, also has a mean of .5;

its variance is .0242. The score for each

individual is determined by the extent to

which he has used each class of drugs in

relation to the extent that the same drugs

were used by the entire sample.

An alternative way of constructing a TDU

index would have been to assign weights to

the categories of extent of use of each

drug as the combined judgment of the investigators suggested. This would be arbitrary

and might reflect biases and misjudgments as

easily as judgments; one advantage of Lu's

procedure is that it allows the data to

determine the weights.

If the investigators had assigned weights,

there would certainly have been wider

differences between the categories than those

produced by Lu's procedure. The weights

on which the TDU scores are based are shown

in Table 10.1. For alcohol and marihuana

the weights differ considerably from one

category to the next and reflect the kinds

of differences intuition would suggest for

105
Table 10.1. Index Scores for Each Category of Extent of Use for Eight Drugs Used in Construction of Total Drug

Use Index1
all drugs. However, it may be observed that

for the other drugs the Lu procedure assigns

the greatest difference in weights to the

step from no use to quasi-medical use or to

experimental use; from that point on increases

in the amount of use produce relatively small

differences in the weights.

The researchers still have reservations about

the index as it pertains to stimulants,

sedatives and opiates. There is a clear

case for regarding quasi-medical use of

these drugs as equivalent to no use. It

is planned to rescore these drugs under the

Lu procedure to determine if it makes any

difference. Meanwhile, the findings based

on the TDU scores, using the weights shown

in Table 10.1, are so striking that it is

difficult to believe that any great improvement can be achieved.

It may be seen in Table 10.1 that for a man

who had not used any of the eight drugs the

scores would add to 2.638 or a TDU score

of .330. Similarly, a man who had used

each drug extensively enough to fall into

the highest category would receive a TDU

score of .957.

Parsimony is the value of an overall score.

It eliminates the need to note, for example,

that the frequency with which psychedelics

are used by even the heaviest users is far

less than the frequency of alcohol or

marihuana use. The drugs are usually taken

by different routes, have different pharmacological effects and differ in availability,

cost and in other ways. Relevant questions

are: Does the Total Drug Use Index somehow

fuse these facets of drug use without

glossing over such differences? Is the

Total Drug Use Index a valid and useful

measure?

The TDU scores were first grouped into ten

categories; the cutting points were chosen

to provide an adequate number of respondents

in each category. In Table 10.2 the percentages who have ever used each drug within

specified categories of TDU scores are shown;

these results are exactly what one would

expect if the TDU index is measuring what it

is intended to measure. For each drug class

the percentage figures increase as one moves

from low to high TDU scores. Thus, in the

lowest TDU category there were no men who

had used marihuana. As the TDU scores

increase, the percentage of marihuana users

increases; all of the men in the two highest

TDU categories have used marihuana. The

shifts are even more dramatic when all

categories of the extent of use index for

marihuana are used. Further, as the TDU

scores increase, additional drugs are seen

to have been used, and the percentage

who used them increases.

The row for heroin deserves comment. As the

data in Table 10.2 indicate, only 59 percent

of those in the 800+ TDU category have used

heroin. There are only 148 users of heroin

in the total sample, and only 76 of these

have used heroin beyond the experimental level.

There are 117 (199 x .59) heroin users in

the 800+ category or 79 percent of all heroin

users in the sample.

Another strategy for assessment of the

validity of the TDU index involves comparison

with other drug-related experiences. In

Table 10.3 the percentages refer to those

who mentioned that they had experienced one

or more consequences of drug use (bad trips,

fights, couldn't remember, high more than

a day, or dependent on or addicted to a

drug); that they had one or more problems

(health, work, law, wife or girl friend,

parents, friends) as a result of their drug

use; that they had sold one or more drugs;

and that they had turned others on to one

or more drugs. There are fairly steady

progressions as one moves from the lowest

TDU category to the highest. The reversals

in the order of the percentages are few and

of minor importance. The TDU index, therefore,

appears to be a valid measure of the involvement of these men with the eight drug classes.

TDU Scores and Correlates of Drug Use

In this section the TDU scores will not be

grouped into ten categories; rather, the

differences in mean TDU scores are examined

for various groupings of the respondents

on a number of variables. There are several

advantages in using the mean TDU scores to

compare groups that would be expected to

differ on drug use. First, it is possible

to assess the findings reported in earlier

chapters on the basis of an examination of

each of the drug classes separately. Differences in the mean TDU scores by the respondents'

birth year, race, education and other

variables provide an opportunity to compare

groups known to differ in certain ways in

their use of specific drug classes. Second,

use of the mean TDU scores provides an

opportunity to move beyond reliance on

percentage differences and a descriptive

analytical strategy and thus to demonstrate

the utility of the index. Included in

Chapter 10 will be two statistical tests.

When the sample is divided into two groups,

a t test score will be used. The t test

value indicates whether the mean TDU scores

for the two groups differ significantly. For

example, when the mean TDU scores for those

who have ever been married are compared with

107
Table 10.2. Use of Specific Drugs and Total Drug Use Index (Percentages)
Table 10.3. Total Drug Use and Problems, Consequences, Selling, and Turning Others On
those who have never been married, the value

of t is 9.36. If there were really no

difference between these groups, a value

this large would be observed in less than

one of a thousand random samples. In short,

it is almost certain that the drug use

of the men who have ever married differs

substantially from those of 20 to 30 year

old men who have never married.

An extension of the t test to more than two

groups is provided by analysis of variance.

In an analysis of variance the mean scores

for more than two groups of respondents are

examined, and an F test determines whether

there is a significant difference among the

groups. The t and F tests permit one to

verify or temper interpretations based

primarily on the observation of consistent

relationships between a variable and drug

use across the classes of drugs. A third

advantage of the mean TDU scores within

groups is that it provides an opportunity

to present information in a succinct manner

about variables not mentioned previously in

this report.

The data presented in Table 10.4 generally

support the conclusions reached in Chapters

2 and 5. The mean TDU values indicate that

those born in 1950 and 1953 have been more

involved with drugs than those in any of the

other cohorts. There is a tendency for the

mean TDU scores to increase from the 1944

cohort to a plateau for the men born in

1950-53. While the progression is not

perfect, birth year and Total Drug Use seem

to be linearly related. When the birth years

are translated into ages and combined into

four groups, the relationship is clarified.

The mean TDU scores by age group are: 28-30,

.459; 25-27, .491; 22-24, .526; and 20-21,

.516. The mean TDU score of the 20-21 year

Table 10.4. Birth Year, Race, Residence and Total Drug Use

Value of Significance

n Percent Mean F Level

Birth Year

1944 174 7 .450 7.61 .001

45 171 7 .458

46 196 8 .468

47 254 10 .480

48 223 9 .499

49 215 9 .495

1950 234 9 .531

51 245 10 .525

52 261 10 .524

53 247 10 .531

54 290 12 .504

Race

White 2103 84 .499 2.45

Black 303 12 .514

Other 104 4 .476

Residence to Age 18

1 million or more 187 7 .550 9.32

500,000 or more 183 7 .522

100,000 or more 427 17 .518

50,000 or more 201 8 .496

25,000 or more 265 11 .509

2,500 or more 730 29 .496

Less than 2,500 456 18 .464

Outside the U.S. 61 2 .444

N.S.

.001

1

In this and subsequent tables, N.S. means Not Significant.

110
old men was higher than that for men who were

25 to 30 years old at the time of the interview. This suggests that, in terms of Total

Drug Use, the men in the two youngest cohorts

may eventually equal or surpass the men in

the 22-24 year old group. This possibility

is consistent with the data presented in

Chapter 2 regarding lifetime prevalence and

in Chapter 5 with respect to the drug

epidemic and age at first use.

The mean TDU values for the three ethnic

categories suggest that the idea that

significantly more blacks use drugs may be

incorrect. The value of F is not statistically significant. There are several

plausible explanations for the discrepancy

between this finding and the results of

previous studies. First, in most of the

studies in which drug use by ethnic groups

has been analyzed, the samples have not been

representative of the total population.

The blacks in most of these studies have been

disproportionately selected from ghetto areas

in metropolitan cities in selected regions

of the country. Often they have been

incarcerated offenders.

A second explanation is that the age range

covered in this study may be too restricted

for significant ethnic differences to emerge.

If this sample were representative of men

20 to 40 years old instead of 20 to 30, previous studies would suggest that the TDU

scores among blacks would be substantially

higher than would be observed for whites or

men from other ethnic categories. Whatever

the reason, it must be concluded from these

data that there is no significant ethnic

difference in Total Drug Use among men who

were 20 to 30 years old in 1974. This

does not, however, conflict with the interpretation offered in Chapter 2 that the lack

of difference reflects two opposite relations

of drug use with age, namely an increase

among younger whites and a decrease among

younger blacks.

The data on the relationship of size of city

of residence to age 18 and Total Drug Use

indicate that there is a significant difference

in drug use depending on the milieu in which

one is raised. In general, men who lived in

the largest cities were more likely to have

used drugs and to have used them more extensively than were men who resided in smaller

cities. The mean TDU scores for men who

lived in cities with at least 100,000 population are considerably higher (.518 to .550)

than for those who lived in cities with less

than 100,000 population (.464 to .509).

Thus, the data in Table 10.4 confirm the

findings regarding city size and drug use

discussed in Chapter 2.

The variables related to Total Drug Use in

Table 10.5 reflect maturation and the transition of the men in this sample into conventional adult roles in society. Because

these variables represent statuses achieved

after adolescence, the differences in drug

use that emerge may indicate the operation of

countervailing demands for commitment to

conformity and choices made by these men

about life styles and career goals.

The mean TDU scores confirm another finding

on the relation between education and drug

use discussed earlier in this report. Men

with "some college" had more experience with

drugs than men who did not graduate from

high school; the means were .516 and .504,

respectively. The means for high school

and college graduates were even lower, .499

and .474, respectively. The value of F

indicates that the differences between the

groups are statistically significant. Stated

differently, the amount of drug use differs

significantly by education.

The relationship of employment status to

Total Drug Use confirms the findings mentioned

earlier. The mean TDU score for the unemployed

(.579) is higher than for those who worked

less than 30 hours a week (.545), those who

were students (.507) and those who were

working 30 or more hours a week (.488). The

differences suggest that a regular job may

serve as a restraining influence on the

extent to which men use drugs, or that drug

users are less likely to seek or find fulltime employment.

The data in Table 10.5 that deal with the

relationship of marital status to Total

Drug Use confirm the conclusions reached

earlier in the report when each of the various

classes of drugs was examined separately.

Total Drug Use among the men who have never

married is significantly higher than for the

men who have been married. Another comparison

can be made between those who have ever lived

with a woman for six months or more without

being married (coupled) and those who have

never coupled. The mean TDU score for those

who have ever coupled is .613; in comparison,

it is only .476 for those who have never

coupled. These data suggest that marriage,

a conventional form of behavior, may also

act as a significant restraining factor on

drug use. It is also apparent that it is the

fact of marriage and not simply the influence

of living with a woman that is the key

variable. The willingness to live with a

woman for six months or more without being

married may reflect a general tendency to be

unconventional and use of drugs may be

another indicator of unconventionality.

111
In terms of current family status, the

"coupled" category is not restricted to those

who had lived with a woman for 6 months or

more; rather, it means that the man was, at

the time of the interview, living with a

woman to whom he was not married. Only 5

percent or 120 respondents were currently

coupled. The mean TDU score for the men

who were currently coupled was much higher

(.632) than Eor men who were single and

living away from parents (.547), single men

who were still living with their parents

(.468) or men who were currently married

(.466). The value of F indicates that Total

Drug Use was significantly different for the

men in these four categories. Emancipation

from parents and the lack of the restraining

influence of marriage may be productive of

a greater tendency toward drug use. On the

other hand, drug use may be conducive to

living in an unconventional heterosexual

relationship. Another possibility is that

there is a general tendency to be unconventional, and the use of drugs and coupling

may be indicators of this tendency.

Criminal Activities and Total Drug Use

The relationship of reported involvement in

various criminal activities to Total Drug

Use is presented in Table 10.6. Those who

reported each of the criminal activities

are compared with those who denied them.

The differences in the mean TDU scores

support the conclusions reached in Chapter 8,

in which the focus was on the relationships

Table 10.5. Education, Employment, Marital Status, Current Family Status and Total Drug Use

Value of Significance

n Percent Mean F or t Level

Education

Less than high school

High school graduate

Some college

College graduate

394 16 .504 6.96 (F) .001

933 37 .499

713 28 .516

470 19 .474

Employment

Working 30 hours or more a week 1715 68 .488 23.50 (F) .001

Students, except those working over 30 hours 282 11 .507

Working less than 30 hours, not a student 35 1 .545

Unemployed 213 8 .579

Marital History

Ever married

Never married

1477 59 .476 9.36 (t) .001

1033 41 .534

Cohabitation History

Ever coupled

Never coupled

444 18 .613 17.91 (t) .001

2066 82 .476

Current Family Status

Married 1309 52 .466 85.43 (F) .001

Coupled 120 5 .632

Independent 796 32 .547

Living with parents 285 11 .468

112
Table 10.6. Total Drug Use and Criminal Activities

Value

n Percent Mean o f Significance

t Level

Been drunk or intoxicated Yes 1754 70 .538

in a public place? No 756 30 .413

Driven a car while drunk? Yes 1512 60 .542

No 998 40 .437

Stolen a car? Yes 145 6 .638

No 2365 94 ,492

Broken into a house, school, Yes 314 13 .624

or place of business? No 2196 87 .482

Been armed with or used a

weapon of any kind while

committing a theft or

robbery?

Yes 36 1 .706

No 2474 99 .497

Shoplifted something from Yes 1103 44 .557

a store? No 1407 56 .455

Stolen anything from a Yes 83 3 .676

person--face-to-face? No 2427 97 .494

Run numbers, or had a job

which involved illegal

gambling?

Yes 74 3 .590

No 2436 97 .497

Forged, or passed bad Yes 69 3 .673

checks? No 2441 97 .495

Forged prescriptions or

passed scrip?

Sold one or more drugs?

Yes 37 1 .728

No 2473 99 .497

Yes 478 19 .691

No 2032 81 .455

Turned others on for their Yes 504 20 .649

first time? No 2006 80 .463

19.80

17.41

11.25

15.90

8.13

17.38

10.74

5.06

9.56

9.14

37.19

27.40

.001

.001

.001

.001

.001

.001

.001

.001

.001

.001

.001

.001

among crime, drugs and criminal justice

outcomes.

An examination of the mean TDU scores in

Table 10.6 reveals that for those who said

they had not been involved in each of the

criminal activities, the range is narrow;

it is .413 for public drunkenness and .497

for armed robbery. The mean TDU scores for

those who report a criminal act range from

.538 to .728. Other than the offenses involving intoxication, the only criminal act

that is drug-related, forging prescriptions,

has the highest mean TDU score. In short,

those who report involvement in any one of

these criminal activities are significantly

more likely to have a high mean TDU score

than those who do not.

The men were asked if they had ever sold

drugs illegally and if they had ever "turned

on" anyone to drugs. Those who answered

positively to either of these items were

distinguished from others by greater differences in TDU scores than were observed for

most of the criminal offenses.

Activities of Friends at Age 16 and Total

Drug Use

The respondents were asked: "Think about

your friends, the people you spent time with

113
Table 10.7. Total Drug Use and Peer Activities at Age 16

Value

n Percent Mean of Significance

Level

When you were 16, were

at least some of your

friends:

Sometimes in trouble

at school?

Sometimes in trouble

with the police?

Arguing a lot or

getting on badly with

their parents?

Drink beer, wine, or

liquor at times?

Smoking marihuana?

Using other drugs?

People your parents

didn't approve of?

Yes 1670 67 .520

No 840 33 .461

Yes 781 31 .563

No 1729 69 .472

Yes 909 36 .539

No 1601 64 .478

Yes 1917 76 .519

No 593 24 .439

Yes 561 22 .604

No 1949 78 .470

Yes 342 14 .641

No 2168 86 .478

Yes 878 35 .551

No 1632 65 .472

9.15

14.14

9.60

.001

.001

.001

11.11 .001

19.23 .001

19.37 .001

12.51 .001

and did things with at these same two times.

When you were 13, and then when you were 16,

were at least some of your friends (a)

sometimes in trouble at school?" (see Table

10.7). Age 13 was chosen because it was

expected that most of the men in this sample

would have used few, if any, drugs before

that time, except perhaps tobacco or alcohol.

It was anticipated that age 16 might

constitute the age of entry into the population

at risk for marihuana use as well as other

drugs. This expectation was confirmed by

the data presented in Chapters 2 and 5; therefore, the data in Table 10.7 refer only to

the activities of friends of the respondents

when they were 16. Thus, these peer activities were temporally prior to most of the

respondents' drug use.

Twenty-two percent of the men reported that

some of their friends were using marihuana,

76 percent reported some were using alcohol

and 14 percent reported some were using other

drugs when the respondents were 16 years old.

The value of t for the difference between

the mean TDU scores is statistically

significant for all of these activities.

Stated differently, the mean TDU score for

the men who report that some of their friends

were doing these things is consistently

higher than for men who reported they did not

have friends involved in such activities.

Countercultural Involvement and Total

Drug Use

One of the most valuable aspects of this

study is that the eleven birth cohorts were

adolescents or young adults when some of the

most tumultuous events in modern American

history occurred. The oldest men in this

sample were 19 when John F. Kennedy was

assassinated, 24 when riots occurred at the

Democratic national convention and 28 when

Richard Nixon was elected to his second term

in office. When these events took place,

the youngest men were between 9 and 18 years

of age.

The young men in the sample have witnessed

the Civil Rights movement, political assassinations, urban riots, the war in Vietnam,

the hippie movement, a sexual revolution, the

appearance of women's and Gay liberation

movements, the drug epidemic and many other

far-reaching social changes. Much of the

114
behavior exhibited by young people during

this period of time was labeled countercultural and received considerable attention

in the press and by social scientists

interested in the study of alternative life

styles.

To assess involvement in countercultural

activities, the respondents were asked if

they had ever done the things listed in

Table 10.8. Except for registering to vote

and political campaigning, a positive answer

may be considered representative of a

countercultural type of activity. In

every instance the mean TDU score for those

who had participated in a countercultural

activity was significantly higher than for

those who had not. The mean TDU scores for

those who had participated in a countercultural activity ranged from a low of .574

(attended an outdoor rock concert or festival)

to a high of .662 (lived in a commune). For

those who did not report these activities,

the mean TDU scores ranged from a low of .435

to a high of .491, for the same two activities.

The data presented in Table 10.8 confirm that

participation in unconventional activities

is related to drug use. It should be noted

that temporal order has not been examined;

Table 10.8. Total Drug Use and Countercultural Involvement

Value

n Percent Mean of Significance

Level

RAVE YOU EVER:

Lived in a commune?

Attended an outdoor rock

concert or festival?

Meditated, or explored

an eastern religion or

philosophy?

Joined a street gang?

Registered to vote?

Followed a vegetarian,

macrobiotic, or organic

diet?

Campaigned or worked

for a political

candidate, issue, or

cause?

Taken part in a political

demonstration?

Studied astrology, ESP

or the occult?

Bummed around the United

States or elsewhere?

Thought pretty seriously

about committing suicide?

Yes 129

No 2381

Yes 1173

No 1337

Yes 393

No 2117

Yes 273

No 2237

Yes 1795

No 715

Yes 200

No 2310

Yes 553

No 1957

5 .662

95 .491

47 .574

53 .435

16 .598

84 .482

11 .584

89 .490

72 .496

28 .509

8 .643

92 .488

22 .531

78 .491

Yes 368 15 .592

No 2142 85 .484

Yes 406 16 .590

No 2104 84 .483

Yes 399 16 .631

No 2111 84 .475

Yes 211 8 .627

No 2299 92 .488

12.55

24.88

14.12

9.57

1.93

14.11

5.26

12.67

13.21

19.68

12.80

.001

.001

.001

.001

.05

.001

.001

.001

.001

.001

.001

115
Table 10.9. Attitudes Toward Unconventional Behaviors and Total Drug Use

All Right A Little Pretty Very Don't Know

or Bit Bad Bad Bad Good No Response

HOW BAD IS IT IF:

A person drives over the

speed limit?

A person doesn't work

steadily when he could?

A man has sex relations

with several women when

he's single?

A person gets into

fights?

A man has sex relations

with other women after

he's married?

A person cheats on his

income tax?

A person bets on the

numbers or some other

gambling that's illegal?

A man has sex relations

with another man?

A man refuses to be

drafted into the armed

forces?

A person lives or acts

in a way that could

damage his health?

Mean .541

n 195

Percent 8

Mean .583

n 166

Percent 7

Mean .535

n 1621

Percent 65

Mean .538

n 59

Percent 2

Mean .588

n 192

Percent 8

Mean .583

n 271

Percent 11

Mean .580

n 496

Percent 20

Mean .597

n 252

Percent 10

Mean .584

n 672

Percent 27

Mean .601

n 129

Percent 5

.508 .486

1382 588

55 23

.548 .491

502 976

20 39

.459 .409

487 223

19 9

.497 .497

491 1023

20 41

.553 .501

532 769

21 31

.527 .486

735 738

29 29

.516 .462

946 573

38 23

.561 .513

185 318

7 13

.519 .466

456 482

18 19

.550 .494

380 801

15 32

.467 .506

339 6

14 *

.466 .506

859 7

34 *

.408 .450

170 9

7 *

.502 .491

927 10 37 *

.455 .515

1007 10

40 *

.458 .511

761 5

30 *

.434 .511

490 5

20 *

.477 .578

1745 10

70 *

.445 .459

887 13

35 1

.477 .532

1191 9

47 *

*Less than one-half of one percent.

116
these relationships do not reveal anything

about cause and effect.

In view of the fact that the answers were

given by a nationwide random probability

sample of young men 20 to 30 years old, the

percentages who reported having ever taken

part in unconventional activities are of

interest. For example, only 5 percent had

ever lived in a commune, a figure which

may seem low, given the publicity about

communes in the late 1960s. Two of the

items indicate that a substantial proportion

of these young men were legitimate participants in the electoral process; 72 percent

had registered to vote and 22 percent had

campaigned for an issue, candidate or cause

of their choice. Some 15 percent of these

young men had taken part in a political

demonstration. This item was worded neutrally;

thus, the response could refer to violent

or nonviolent protests or merely attendance

at a political rally. Two of the items

were "meditated, or explored an eastern

religion or philosophy," and "studied

astrology, ESP or the occult." Each was

endorsed by 16 percent of the sample.

Sixteen percent of the 2,510 men in this

sample have "bummed around the United States

or elsewhere," and 8 percent or 211 have

"thought pretty seriously about committing

suicide."

Attitudes Toward Unconventional Behavior

and Total Drug Use

The respondents were asked to evaluate ten

types of unconventional behavior in terms

of the response categories shown in Table

10.9. For those who endorsed the items

as "all right or good," the mean TDU scores

ranged from .535 for "a man has sex relations

with several women when he's single" to .601

for "a person lives or acts in a way that

could damage his health." As would be

expected, the mean TDU scores were substantially lower for those who said these unconventional behaviors are "very bad." For

all of the items, the mean TDU scores declined

as the response alternatives became more

conventional.

Other noteworthy findings pertain to the

percentages who said the unconventional

behavior was all right or good. Twenty-seven

percent of the men endorsed refusal to be

drafted, 20 percent endorsed illegal

gambling, and 11 percent endorsed cheating

on one's income tax. Eight percent endorsed

extramarital relations and driving over the

speed limit, as did 10 percent with respect

to homosexuality. The most widely endorsed

form of unconventional behavior was premarital sex. The item of most relevance

to drug use deals with potential damage to

one's health. Use of drugs is a form of

risk-taking, both in terms of potential

encounters with the law and the effects of

the drug itself. The men who endorsed

this item had the highest mean TDU score

of any group on any of the ten items.

In sociological and psychological research

attitudes are generally treated as predictors

of behavior or as predispositions to act in

a certain way under appropriate circumstances.

Attitudes of the kind described in this

section could be combined into a measure

of conventionality; if conventionality were

shown to pre-date drug use, one could

confidently predict that the more conventional

men would show less drug use. One could

then argue that conventionality "insulates"

a man against drug use.

It seems likely that the men who said most

of the acts in Table 10.9 are "pretty bad"

or "very bad" have held these attitudes for

a long time, and probably before any choices

had to be made about using or not using

drugs. However, for those who answered "all

right or good," it is possible and indeed

probable that their expressed attitudes

represent a change from their original

attitudes, and this change might be attributed

to their drug use and other unconventional

behavior. For both groups the attitudes

were expressed on the date of the interview,

but for the first group they probably

represent long-standing attitudes, which

were among the causes of their lesser drug

use, while for the second they might represent

effects of their experiences with drugs. It

would, therefore, be incorrect to treat

these attitudes either as dependent or

independent variables in relation to drug

use; they presumably include both causes and

effects of drug use. Later analyses will

attempt to study the effects of conventionality

on drug use by means of dated measures such

as those in Table 10.7.

117
11 Drug Use and Military Service

A question of major interest in recent years

has been the extent to which drug use was

related to military service and particularly

to overseas service in Vietnam. In The

Vietnam Drug User Returns, Robins (1974)

reported that, in the time period she studied,

almost half of the men used some narcotic

in Vietnam. About one-third of the men

tried heroin and one-third opium, but there

was considerable overlap between these groups.

For most of the men, use was continued over

a considerable period of time, and use of

marihuana was even more frequent. About

one-quarter used barbiturates or amphetamines,

and these also overlapped with the opiate

users.

When the Vietnam veterans returned to the

United States, their levels of drug use

declined to their pre-service rates, and

even among users addiction was infrequent.

This was true when they were interviewed

eight to 12 months after return from Vietnam.

Their overall rates of use continued to be

low in another follow-up two years later.

No other rigorous studies of drug use in

other military settings are known to the

writers, but the news media have regularly

stated or implied that rates of drug use

have been high among men in the military,

expecially those serving overseas.

The expectation was that in this sample

military service would be related to lifetime

prevalence, though not necessarily to current

use. Thirty-four percent of the sample

(864 men) had had military service, and these

were divided fairly evenly among those with

no overseas service, those who had served

overseas but not in Vietnam, and those who

served in Vietnam.

The expectation of a relationship between

military service and drug use is consistent

with the opinions of the veterans themselves

34 of the 294 men who did not serve overseas,

61 of the 250 who did and 101 of the 320

who served in Vietnam said that there were

drugs they would not have used if they had

not been in service. Among the Vietnam

veterans 46 attributed their use of marihuana,

21 their use of heroin and 41 their use of

opiates to their military service. Smaller

numbers attributed use of all of the other

drugs to their military service.

If these opinions were taken at face value

and if the 320 Vietnam veterans had not been

in service, their percentages of lifetime

use would have been 47 percent for marihuana,

3 percent for heroin, and 20 percent for

opiates. These figures are all well below

the percentages of use reported by the men

who had no military service. It is, therefore,

difficult to accept them as reasonable

estimates; it seems plausible to regard

these as cases in which use began in the

service, and thus it seemed reasonable to the

men to attribute their drug use to their

service experience. Yet, all of the other

data suggest that many of them would have

used these drugs whether or not they had

been in service.

The expected relationship was not found in

terms of the Total Drug Use index. The men

with no military service had a mean score of

.496; the comparable scores were: for men

with service but not overseas, .497; for men

with overseas service but not in Vietnam,

.506; and for men with Vietnam experience,

.519. If one treats the four categories of

service as an ordinal variable, there is a

linear progression, and the highest scores

are found among Vietnam veterans. However,

the association is not a statistically

significant one; the value of F is only 2.07.

118
Table 11.1. Drug Use and Military Service

A. Lifetime Use of Drugs (Percentages)

Overseas, but Vietnam

Total None No Overseas Not Vietnam Service

(2510) (1646) (294) (250) (320)

Tobacco 88 86 91 92 92

Alcohol 97 96 98 98 99

Marihuana 55 54 51 56 61

Psychedelics 22 22 20 23 21

Stimulants 27 28 28 27 27

Sedatives 20 20 20 20 21

Heroin 6 5 4 7 10

Opiates 31 30 33 33 33

Cocaine 14 14 12 11 16

B. Current (1974-75) Use (Percentages)

Overseas, but Vietnam

Total None No Overseas Not Vietnam Service

(2510) (1646) (294) (250) (320)

Cigarettes 60 55 64 69 71

Alcohol 92 91 93 92 93

Marihuana 38 40 32 37 38

Psychedelics 7 8 7 8 5

Stimulants 12 12 9 11 12

Sedatives 9 9 9 8 10

Heroin 2 2 2 2 1

Opiates 10 10 13 11 8

Cocaine 7 8 6 7 6

119
In terms of the TDU index, the tentative

conclusion is that military service had no

effect on lifetime drug use.

This can be checked against the use of the

nine classes of drugs, for current (1974-75)

and lifetime use (Table 11.1). As shown

in Panel B, there is some indication of

increased use of cigarettes among men with

military experience. There is no sign of

any effect of military service, overseas

service or Vietnam service on current use of

other drugs, except possibly a minor increase

in alcohol use, but this is of dubious

statistical significance. For all of the

other drugs, current use was as high or

higher among men with no military service as

it was among those in the three categories

of military service.

The picture is not as clear for lifetime use,

which is shown in Panel A. Yet, the impact

of military service cannot be great. With

the possible exceptions of tobacco and alcohol,

the percentage of users of all other drugs

among men with no service equaled or exceeded

the percentage for at least one of the

military groups; opiates were an exception,

but the difference was small. The data offer

no support for the hypothesis that military

service or overseas service had any appreciable effect on drug use. Vietnam veterans

did, however, show slightly higher percentages of use of marihuana and heroin than

other groups.

In view of the fact that use of marihuana

and heroin in Vietnam is known to have been

high, the relevant question is: Why are the

percentages not higher for these drugs? In

a table not included in this report these

two drugs were examined, with controls for

race and age. Of the four age groups, those

born in 1953-54 included only three men with

Vietnam service, and there were only 41

blacks of all ages with such service. These

numbers are inadequate to calculate stable

percentages. Among whites the Vietnam

veterans showed the highest percentage of

marihuana use in each of the three older

age groups, but only those born in 1950-52

showed an appreciably higher percentage for

heroin use. This pattern suggested that the

Vietnam veterans in this sample served there

before the use of drugs became widespread.

Table 11.2 was prepared to assess this

possibility.

The dates of service in Vietnam were not

obtained in the interview, but the dates of

Table 11.2. Vietnam Service and Drug Use

A. Year Military Service Ended, by Year of Birth (Percentages)

YEAR OF BIRTH

Year Service Total 1944-46 1947-49 1950-52 1953-54

Ended (320) (112) (155) (50) (3)

Before 1968 9 26 1 0 0

1968-69 32 38 39 0 33

1970-71 33 21 37 52 0

After 1971 18 10 16 44 33

Unknown 7 6 7 4 33

B. Drug Use, by Year Service Ended (Percentages)

Date Before

Total Unknown 1968 1968-69

(320) (21) (30) (103)

Marihuana 61 48 47 60

After

1970-71 1971

(107) (59)

62 75

Heroin 10 5 3 1 13 25

120
entry into the service and discharge were

noted. Thus, limits can be set on when service in Vietnam occurred, except for those

men still in the service. The data in Panel

A in Table 11.2 suggest that most of the men

were draftees, whose service ended when they

were in their early twenties. Of the oldest

group almost two-thirds had left Vietnam in

1969 or earlier, and this was true for 40

percent of the next age group. This means

that many of them had left before drug use,

especially heroin use, had become common in

Vietnam. The figures in Panel B clearly

establish that the somewhat higher percentages

of marihuana and heroin use among Vietnam

veterans are accounted for by those whose

service was in recent years, not the early

years of the Vietnam war. For heroin, in

particular, high percentages of use were

found only for men whose Vietnam service

could have been in 1970 or later, and about

half of the men in this sample had left

Vietnam before 1970.

These findings can be reconciled with those

of Robins, who reported higher rates of heroin

use among Vietnam veterans. Her sample was

drawn from men who left Vietnam in September,

1971, a date chosen precisely because it was

in the summer and fall of 1971 that drug use

in Vietnam reached epidemic proportions.

Robins (1974:25) herself states:

While a long tour of duty in the 1970-71

era might increase exposure to heroin,

it is not clear that an earlier tour

in Vietnam would have this effect, since

it was believed (Baker) that before

1969 there was relatively little heroin

in Vietnam.

Another factor to be considered is that among

the draftees in Robins' sample, the group

that most closely resembles the Vietnam

veterans in this sample, 71 percent were born

in 1949 or 1950. These men correspond in

age to only two of the eleven cohorts in

this study. The possibility, therefore,

exists that there was a "Vietnam effect" on

drug use in a few cohorts in this sample, but

that this is concealed when the sample as a

whole is considered.

In Table 11.3 the data on lifetime use of

heroin in the sample are presented in Panel

A for the four categories of military service

and for each of the eleven birth cohorts.

The data are presented in terms of the percentage who used heroin, except that in each

case where the percentage for one of the

three military groups is higher than the

percentage for the nonveterans, the number of

users and the number of men in the cell are

shown. Thus, for Vietnam veterans born in

1945, instead of an entry of 3 percent, the

figures show that this percentage reflects

one man of the 34 in the cell.

If percentages alone were shown, the column

for Vietnam veterans would show low figures

for heroin use--5 percent is the highest--for

the 1944 through 1948 cohorts. There is then

a steady increase: 1949, 10 percent; 1950,

36 percent; 1950 and 1951, 50 percent; 1953,

100 percent; and 1954, zero percent. However,

the 1944 through 1948 cohorts include 227

(71 percent) of the 320 men in the sample who

served in Vietnam. Only 7 of the 227 had a

history of heroin use. Thus, in these five

cohorts 3 percent of the Vietnam veterans

had used heroin; the comparable figure for

nonveterans was 4 percent. For most of the

men who served in Vietnam, therefore, there

is no indication that this led to increased

use of heroin.

The number of Vietnam veterans in the 1949

and 1950 cohorts is sizable; consequently,

the percentages of 10 and 36 in those two

years may be considered reasonably accurate

estimates. In contrast, 5 and 3 percent,

respectively, of the nonveterans born in 1949

and 1950, used heroin. Therefore, it may be

concluded that Vietnam service increased

heroin use for the men in these two cohorts,

particularly those in the 1950 cohort.

For the younger cohorts the numbers in the

cells are so small that one would not usually

treat the percentages as meaningful. The 50

percent rates of heroin use for Vietnam

veterans born in 1951 and 1952 are based on

8 and 6 cases, respectively; the 100 percent

rate for 1953 represents one case, and the

zero percent for 1954 is based on two cases.

Whether or not one accepts the percentages

for these four cohorts as an indication that

rates of heroin use associated with Vietnam

service were high, one would still conclude

that they would have no impact on overall

rates of heroin use because the number of men

with Vietnam service is so small.

For practical purposes, the fact that 10

percent of all Vietnam veterans in the sample

used heroin, in contrast with 5 percent among

those with no military service, is almost

entirely accounted for by the 1949 and 1950

birth cohorts. This is precisely the age

group that constituted the majority of Robins'

sample of Vietnam veterans.

The same kind of analysis can be applied to

the other two columns in Panel A in Table 11.3.

Military service as such clearly did not

increase heroin use; men with stateside service

only showed a lower percentage of use than

men with no service. Men with overseas service

121
Table 11.3. Lifetime Use of Heroin and Marihuana by Military Service

and Birth Cohort

A. Lifetime Use of Heroin (Percentages or Fractions)

MILITARY SERVICE

Year of Total None No Overseas Overseas Vietnam

Birth (2510) (1646) (294) (250) (320)

1944 2 2

45 1 0

46 6 8

47 4 4

48 5 5

49 4 5

1950 10 3

51 9 7

52 9 7

53 9 8

1954 4 4

3

(3/28)

7

(2/19)

(1/18)

(1/23)

0

3

0

(3/23)

0

(5/18)

4

(4/22)

(1/8)

(2/18)

0

(1/34)

4

3

5

(4/40)

(13/36)

(4/8)

(3/6)

(1/1)

0

Total 6 5 4 7 10

B. Lifetime Use of Marihuana (Percentages)

MILITARY SERVICE

Year of Total None No Overseas Overseas Vietnam

Birth (2510) (1646) (294) (250) (320)

1944 39 40 33 43 39

45 34 33 32 33 38

46 44 45 33 32 58

47 49 44 45 50 58

48 57 53 56 61 68

49 56 53 51 58 68

1950 66 60 66 83 83

51 62 61 61 67 87

52 64 62 56 82 100

53 62 58 84 100 100

1954 59 60 50 56 50

Total 55 54 51 56 61

122

0

(1/22)

4

(2/31)

0

0
in places other than Vietnam showed a slightly

higher percentage--7 in contrast to 5. The

numbers are small, but it may be noted that

it again is the 1950 cohort that contributes

the largest number of heroin users.

The data on marihuana use are presented in

Panel B in Table 11.3, and a stronger Vietnam

effect is suggested. The 1946 through 1950

cohorts show percentages which exceed those

for nonveterans by 13 to 23 points, and the

differences are not a result of small cell

size. The higher percentages in the younger

Vietnam cohorts are, of course, based on the

same small numbers previously discussed with

regard to heroin.

The veterans with no overseas service showed

a lower percentage of marihuana use than the

nonveterans, and the percentage for those

with overseas service was negligibly larger.

Therefore, it appears that military service

as such did not increase marihuana use, but

that Vietnam service had some effect, primarily

in the 1946-50 cohorts. It should be

emphasized that all that has been shown is an

association between having been in Vietnam

and having used drugs; no evidence has been

presented that any of the use of the drugs

began or even occurred while the men were

in Vietnam.

The dates of Vietnam service were not obtained

in the interview. The dates of service were

obtained, as were the dates of onset of drug

use. These were used to determine when drug

use began in relation to military service

(Table 11.4). When the month of entering

or leaving service was the same as the month

of initial drug use, it is not known which

occurred first. Therefore, there are five

categories in the table; in three of them

the onset of use was clearly before, during

or after service, and in two categories it

was in the same month that the man entered or

left the service.

Of the Vietnam veterans who used marihuana at

least one-fifth, and possibly three-tenths,

had used it before they entered the service.

At least half, and possibly two-thirds, began

its use while in service. Only 10 to 15

percent began after leaving the military.

The picture is similar for heroin. From 6 to

15 percent had used it before entering

service, 64 to 85 percent began while in

service, and 6 to 18 percent initially used

it after leaving the service. It seems

plausible to assume, but it is only an

assumption, that much of the marihuana and

heroin use that began in the service began in

Vietnam.

In summary, the data show no association

between military service and current drug

use. Lifetime drug use seems to have been

unaffected by military service or by overseas

service, unless that service was in Vietnam.

Specifically, Vietnam veterans show slightly

higher percentages of marihuana and heroin

use. However, the increase in heroin use

was concentrated among the men born in 1949

and 1950, and the increase in marihuana use

was concentrated among the men born in 1946

through 1950. If one looks at the sample

as a whole, military service apparently had

little effect on drug use.

Included in this sample are precisely those

men who were exposed to the last decade of

the military draft as well as those who were

exposed to service in Vietnam. Men with

Table 11.4. Onset of Drug Use, Relative to Dates of Entering and Leaving

Service (Percentages)

Marihuana Heroin

Onset of Drug Use (197) (33)

Before entering service 22 6

Immediately before or after 9 9

entering service

While in service 53 64

Immediately before or after 5 12

leaving service

After leaving service 11 6

Unknown 1 3

123
military service constitute a third of the

sample; yet, all of their drug use, when added

to that of those with no military service,

increased the percentages of use for the total

sample by no more than one percentage point

in Table 11.1. This is not inconsistent with

the fact that drug use was heavy in Vietnam,

but heroin use seems to have been heavy for

a relatively short time; it affected only

those men who were there in the last years

of the war, and they constitute a minority of

the men who served in Vietnam.

Presumably there were many factors that

operated to produce the increase in drug use

among young men in the late 1960s and early

1970s; military service was not important,

and Vietnam service was of relatively minor

importance among those factors. Those who

were exposed to drug use in the military or

in Vietnam may have begun to use drugs earlier

than they otherwise would have done, but not

many more began to use than would have been

expected to do so without experience in the

military. When the focus is on men who were

in Vietnam in 1970 and 1971, drug use rates

are high. However, when the focus is

broadened to encompass all of the young men

in the sample, the effects of military service

on drug use are invisible, and the effect of

service in Vietnam is little more than a

ripple in a stream.

124
12 Treatment for Drug Use

An important concomitant of society's

definition of drug use as a social problem

has been an extensive effort in recent years

to provide treatment and rehabilitation

opportunities for the drug user. Considerable

sums of money have been invested to expand

Federal as well as state and local facilities

to provide a wide variety of treatment

modalities. Because of the general interest

in treatment as it relates to drug use, all

men in the sample who reported any use of any

drug, including tobacco, were asked a series

of questions about their treatment experiences.

Obviously, the number of men reporting such

experiences will be small in a random sample

of the population of young men. Although

small in absolute terms, this number is

highly significant when it is considered in

relation to the extent of drug use. Reported

in this chapter are the findings regarding

the number of men who were ever treated,

the number of times they were treated and

the drugs for which they were treated.

The number of times the respondents were ever

treated is shown in Table 12.1. As expected,

Table 12.1. Number of Times Treated, All Drugs

Number of Times

Treated Frequency % Total

0 2,442 97.3

1 45 1.8

2 13 .5

3 3 *

4 2 *

5 1 *

6 3 *

7 0 -

8 1 *

Total Number of Men Treated 68

*Less than one-half of one percent.

125
treatment was a rare event in the sample

under study. Only 68 (3 percent) of the men

reported one or more treatment experiences in

response to the questions: "Have you ever

undergone treatment of any kind for your

use of any drugs, including alcohol and

tobacco?"; "Altogether, how many times have

you been in treatment?" Of the 68 men who

were treated, two-thirds had been in treatment only once; the remaining 23 men experienced from two to eight periods of treatment.

While the number of men who received treatment is small, these men are, nevertheless,

clustered in terms of the drugs for which they

were treated (Table 12.2). Tobacco is not

included in this tabulation. Because some

men were treated for more than one drug, the

sum of the entries in this table is greater

than 68. Clearly, use of alcohol and heroin

resulted in greater absolute numbers of men

treated; however, relative to the number of

users, heroin was the drug most likely to

lead to treatment. Of the 148 heroin users

14 percent were treated one or more times.

Treatment for Heroin Use

Twelve of the light and heavy users of heroin

were treated; these men comprise 34 percent

of the light and heavy heroin users. Of the

18 heavy users of heroin, one-half received

treatment for their use of this drug. If

daily use of heroin is taken as an indicator

of involvement with this opiate, 16 (34

percent) of the 47 who at some time used the

drug daily reported one or more treatment

experiences. Naming heroin, 43 men responded

positively to the question, "Have you ever

been physically or psychologically dependent

on any drug, or addicted to any?" Of these

men 15 or 35 percent indicated that they had

been in treatment for heroin use.

Although a relatively small proportion of

the heroin users received some kind of therapy

(albeit a much larger proportion than for any

other drug), it appears that a significant

proportion of the men who used heroin to an

extent that they required treatment did, in

fact, receive treatment.

Whether or not treatment was successful is a

question that will require further analysis of

the data on cessation of use and abstinence.

At this point, it may be noted that 15 of the

20 men treated for heroin use indicated that

they either reduced their use of heroin or

stopped using it after their first experience

in treatment. However, half of these men who

were treated reduced or stopped their use of

heroin for less than one month; of the remaining

ten men, seven did so for no more than four

months and only three for more than six months.

Selected data on the first period of treatment

for these 20 men are presented in Table 12.3.

For 13 of them, this was the only treatment

Table 12.2. Number of Men Receiving Treatment for Specific

Drugs

DRUG NUMBER % OF USERS

Alcohol 27 1.1

Marihuana 5 *

Psychedelics 7 1.3

Stimulants 8 1.2

Sedatives 4 *

Heroin 20 13.5

Opiates

Cocaine

3 *

2 *

*Less than one percent.

126
Table 12.3. Selected Characteristics of First Treatment Experience of Those Treated for

Heroin Use

A. Place where treated

Doctor's private

practice

Therapeutic community

Prison or jail

Military clinic or

hospital

Other clinic or hosp.

Other

B. Type of treatment

Individual

Group

Both

C. Voluntary program?

Yes

No

D. Inpatient-outpatient?

Inpatient

Outpatient

Freq. Percent

2 10

0 0

1 5

6 30

10

1

20

50

5

100

7 35

8 40

5 25

20 100

19

1

20

95

5

100

12

8

20

60

40

100

E. Methadone used in treatment?

Yes

No

12

7

19a

63

37

100

F. Type of methadone treat- Freq. Percent

ment

Detoxification

Maintenance

G. Length of time in treatment

Under 1 month

1-2 months

3-4 months

5-6 months

7-11 months

1 year or more

Unknown

H. Length of time cut down

or stopped using

Under 1 month

1-2 months

3-4 months

5-6 months

7-11 months

1 year or more

9 75

3 25

12 100

2 10

3 15

1 5

2 10

3 15

4 20

5 25

20 100

10 50

5 25

2 10

0 0

1 5

2 10

55 100

aOne case missing because of incomplete information.

127
they received. The remainder were treated

from two to four times; however, the later

periods of treatment differed little from

the first one in terms of the variables shown

in Table 12.3.

Most of the men were treated in military

clinics or in other clinics or hospitals.

The type of treatment was almost equally

divided between individual and group therapy,

and nearly all of the men entered the treatment programs voluntarily. Methadone was

used in 63 percent of the treatments. In 9

of these 12 instances, it was used in a

detoxification program; only three men were

in methadone maintenance programs. The

length of time in treatment ranged from under

one month to a year or more.

In Table 12.4 the 20 treated heroin users

are compared with the remaining 128 untreated

users on four characteristics. In Panel A in

this table it is shown that the treated men

tended to be slightly younger than those who

were not treated in terms of when they first

used heroin. The average number of years of

heroin use was 4.7 among those who were treated

in comparison with 4.0 in the untreated group.

These findings are consistent with the figures

on extent of use. Taken together, they suggest

greater involvement with heroin in the case of

the users who received treatment.

Racial differences and differences in social

class origin, as measured by father's education, were negligible. A major difference

concerned current use of heroin; 65 percent

Table 12.4. Selected Characteristics of Treated and Non-Treated

Heroin Users

A. Age at first heroin use

Under 18

18 - 22

Over 22

B. Race

White

Black

Other

C. Father's education

Less than high school

High school graduate

Some college

D. Most recent use of heroin

Before 1974

1974-75

Treated

(n=20)a

% n

25 (5)

65 (13)

10 (2)

100 (20)

70 (14)

30 (6)

0 (0)

100 (20)

39 (7)

39 (7)

22 (4)

100 (18)

35 (7)

65 (13)

100 (20)

Untreated

(n=128)a

% n

17 (22)

69 (87)

13 (17)

99 (126)

67 (86)

28 (36)

5 (6)

100 (128)

37 (42)

38 (43)

25 (28)

100 (113)

73 (93)

27 (33)

100 (126)

aDiscrepancies between these figures and subtotals for certain

variables result from missing information on these variables.

128
Table 12.5. Reasons for and Problems Associated With Heroin

Use: Treated and Untreated Heroin Users

Treated Untreated

A. Reason for use (n=20) (n=128)

% n % n

To forget troubles 80 (16) 27 (35)

To relax 75 (15) 25 (32)

It was expected 45 (9) 20 (26)

To get high 95 (19)

From force of habit 65 (13)

86 (110)

25 (32)

To heighten senses 35 (7) 13 (16)

To pass the time 65 (13) 29 (37)

To get through the day

B. Problems

75 (15)

Treated

(n=20)

9 (12)

Untreated

(n=128)

% n % n

Health

Work

50 (10) 6 (8)

40 (8) 5 (6)

With wife 16 (21)

55 (11) 9 (11)

50 (10)

With parents

With friends 35 (7) 11 (14)

With the Law 35 (7) 11 (14)

of the men who had been treated for heroin

use were currently using it, in contrast with

27 percent of the men who had never been

treated for use of heroin. These data suggest

that users who enter treatment comprise those

least likely to succeed in terminating the

use of heroin.

Finally, comparisons of the treated and

untreated users are presented in Table 12.5

in terms of their reasons for use and problems

reported in connection with their use of

heroin. Without exception there was greater

endorsement of each of the reasons for heroin

use among the treated men. Differences

between the treated and untreated men were

greatest for the reasons that are more likely

to reflect addiction, such as to forget

troubles, to relax, from force of habit and

to get through the day. "To get high" was a

reason given by almost all of the treated

men, but it was also endorsed by the majority

of the untreated men.

At Least half of the men who had been treated

for their use of heroin reported problems

with their parents, wife or with their health.

All of the problems were reported more

frequently by the treated than the untreated

users of heroin.

In summary, relatively few users of any drug

received treatment for drug use. In this

connection it must be remembered that the

sample is restricted to young men, and drug

use tended to be more prevalent and more

extensive among the youngest of them. It may

be assumed that use of a drug must extend

129
over a considerable period of time before it

troubles the user sufficiently that he seeks

treatment or before it brings him to the

attention of others who pressure him to seek

treatment; as a result, the low incidence of

treatment in this sample may be a function

of the age of the respondents and the fact

that they have been using drugs a relatively

short time. Among those who continue to use

some of these drugs, it is likely that the

percentages who eventually are treated will be

higher. This speculation is supported by the

findings for heroin users. It is clearly

those who used heroin more extensively and who

were or came close to being addicts, rather

than the experimental users, who experienced

problems due to their use of heroin, and they

were most likely to be treated.

130
13 Regional Variations in Use

Data on the Locations where men were Living

at the time of the interview became available

late in the process of preparing this report.

The computer tape has not been checked with

the interview schedules, but it is known that

the Location of one respondent is Listed

incorrectly. Consequently, data are available for 2,509 rather than 2,510 men. The

importance of the available data justify

inclusion of a brief discussion of regional

variations.

Data on the Lifetime use of all drugs except

tobacco and alcohol are presented in Table

13.1 in terms of the four regions and nine

major divisions of the United States. The

percentages for the regions are offset and

enclosed in parentheses to facilitate comparisons.

For five of the drugs the rank order of the

regions is the same; the West had the highest

percentage, and was followed by the Northeast,

North Central and the Southern regions.

This pattern was observed for marihuana,

psychedelics, stimulants and sedatives; it

also held for cocaine, as the apparent tie

between the North Central and Southern regions

disappeared when an extra decimal place was

used. A similar pattern appeared for heroin,

except that the position of the Southern

and North Central regions was reversed. The

only major exception was in use of the other

opiates; the highest percentage was found in

the North Central region, and it was followed

by the West, South and Northeast. There are

only minor differences among the Latter three

regions.

With the exception of the opiates, the percentages of use in the West were well above

the national averages. Without exception

the percentages for the South were below the

national averages, and only for opiates did

the percentage differ by less than 10 percent

of the national average. The Northeast tended

to be above and the North Central region

below the percentages for the total sample,

but the differences were usually small.

When divisions within the regions are examined,

some of the patterns are stable. The Pacific

division had the highest percentage for all

drugs except opiates, and even for opiates

the figure was not much below the percentage

in the total sample. This should not be

generalized too far; almost all of the

respondents in this division were in California.

The Mountain division also had high percentages

of use. It had the highest percentage for

opiates, and was second only to the Pacific

division for stimulants, heroin and cocaine.

All of the states in the division were

represented in the sample, but most of the

respondents resided in Arizona, Colorado and

Montana.

The East South Central division usually had

the lowest percentage of use; the exceptions

were heroin and cocaine, but even for these

drugs, the percentages in this division were

among the lowest and below the national

average. These are probably better estimates

than for most divisions. Kentucky, Tennessee

and Alabama were well represented, and only

Mississippi was noticeably underrepresented.

The West South Central division tended to have

the next lowest percentages. Texas accounted

for most of the cases, but there were a fair

number of respondents from Louisiana and

Oklahoma; only Arkansas was greatly underrepresented.

The findings were similar for current drug

use. The data in Table 13.2 again show that

the percentages of use were highest in the

West, except for opiates, but there was a tie

131
Table 13.1. Lifetime Drug Use by Regions and Divisions of U.S. in Which Respondents Lived at Time of Interview

(Percentages)
Table 13.2. Current (1974-75) Use of Drugs by Regions and Divisions of U.S. in Which Respondents Lived at Time

of Interview (Percentages)
with the Northeast for current marihuana use.

The South had the lowest percentages for

marihuana, stimulants, heroin and cocaine.

Its highest relative rankings were for

psychedelics and sedatives, and for these

drugs the South was tied for second place

with the North Central and Northeast regions,

respectively.

There was more variation among the nine

divisions for current than lifetime use.

The Pacific division ranked highest for

psychedelics, stimulants, heroin and cocaine;

it was tied for first place for sedatives,

and it was second highest--and almost equal

to the Northeast--for marihuana. However,

for opiate use it ranked eighth.

The percentages for lifetime use were high

in the Mountain division, but this region

was usually in the middle of the rankings

in terms of current use. Only for stimulants

and cocaine was it as high as second place.

As was the case for lifetime use, the East

South Central division had low percentages

of current use, but it was not clearly the

lowest. The West South Central division also

tended to have low percentages but was tied

for first place on sedative use.

Regional differences on current and lifetime

use are not identical; this can be seen by

examining the distribution of the highest and

second highest ranks of the seven drugs across

the nine geographical divisions. For lifetime use the Pacific division had 6 of these

14 high percentages, while the Mountain

division had 4, the Northeast 3, and the West

North Central 1. The Middle Atlantic division

also had 1, by virtue of a tie for second

place for sedatives. The other four divisions

had none of the first or second place rankings.

On the other hand, for current use the

Pacific division again had 6 of the high

percentages, while the Mountain, Northeast,

West North Central and South Atlantic

divisions had 2 each, and the Middle Atlantic,

East North Central, South Atlantic and

West South Central had 1 each. Only one

division, the East South Central, did not

rank as high as second for any of the

drugs.

Part of this difference is an artifact.

There were more ties in the rankings of

current use; thus, there were more high

percentages to tabulate. The percentages

for current use fell within a narrower

range, and this increased the probability

of ties. The fact remains that more of the

divisions ranked high in terms of current

use of one of the drugs than was the case

for lifetime use.

While there were differences among the four

regions, it should also be emphasized that

even the region that showed the lowest

percentage for any drug, whether for

lifetime or current use, was never far below

the percentage for the nation as a whole.

The differences were greater among the nine

divisions, but the representativeness of the

sample for these divisions is questionable,

and sampling variation may explain most of

these differences. Further, regional differences have not yet been examined in connection

with other variables; if, for example, one

region or division included a high proportion

of respondents from large cities this would

inflate the rates of drug use in that area.

In later reports the data pertaining to regional

variations will be examined in greater

detail.

134
APPENDIX I

Quasi-Medical Use

A. Opiates

The criteria used for classifying some opiate use as quasi-medical use were

as follows:

Variable

Response accepted as Response regarded

consistent with quasi- as inconsistent with

medical use quasi-medical use

1. Reasons given To help get to sleep Any other response,

for use or relax; to enable e.g., to get high

one to get through the or stoned, boredom,

work day habit

2. Frequency and

amount of use

No more than once or Use almost every

twice a week, never in day or use of

large amounts large amounts

3. Source of drug

4. Route of

administration

5. Use in combination

with other drug(s)

because respondent

liked the effect

6. Spree use

7. Dependence

8. Treatment

9. Number of opiates No more than three

10. Attribution to

military service

11. Use of heroin

From own prescription, Any other response,

or by purchase or a e.g., stealing

gift the drug, obtaining

by forged prescriptions

Oral Use of needle,

smoking, sniffing

or snorting

Denial

Denial

Denial

Denial

Denial

Denial

135

Any such use of

combinations of

drugs

Stayed up or high on

an opiate for more

than a day at a time

Report of physical

or psychological

dependence on or

addiction to opiates

Any treatment for

use of opiates

Four or more

different opiates

used

Statement that

drug would not

have been used if

man had not been

in the service

Admitted
The criteria are not equally important, and there are arbitrary elements in

several of them. On the other hand, if a man stated he used opiates to get

high, stayed high for more than a day at a time or combined them with other

drugs because he liked the effect, such a single response would seem to

justify the conclusion that not all of his use of opiates was quasi-medical.

There were 286 users of opiates who met all of the eleven criteria. These

included: 199 of the 499 who had used less than 10 times; 80 of the 225 who

had used 10 to 99 times; 6 of the 42 who had used 100 to 999 times; and 1 of

the 13 who had used 1000 times or more. These 286 men are classified as

quasi-medical users.

The requirement that all of the criteria had to be met may seem too rigid;

perhaps those who met 9 or 10 of the 11 should also be regarded as quasimedical users. There were 129 men who failed to meet only one criterion.

Of these, 86 failed the first one; they stated, for example, that they had

used opiates to get high. An additional 12 men had used a route of administration other than oral, 11 attributed their opiate use to military service,

and 9 admitted a period of daily use or use of large amounts. Four men had

used opiates in combination with another drug because they liked the effect,

and four had obtained opiates by means other than purchase or gift. For

these cases there is reason to believe that some of the man's use of opiates

was not quasi-medical.

This leaves three cases, of whom one used more than three different opiates

and two used heroin. The decision not to classify these men as quasimedical users was arbitrary, but it makes little practical difference because

all three men are classified as experimental users.

There were 146 men who met all but two of the criteria, but 144 of these were

excluded on such grounds as the reasons given for use, frequency and amount

of use, source of the drug and the route of administration.

B. Stimulants

The same eleven criteria were used for the stimulants, except that use of

cocaine was substituted for use of heroin, "to stay awake or alert" was

substituted for "to help get to sleep or relax" and all-references to opiates

were changed to stimulants.

There were 108 users of stimulants who met all 11 criteria: 86 among the

293 who had used less than 10 times; 19 among the 261 who had used 10 to

99 times; 3 among the 102 who had used 100-999 times; and none among the 33

who had used 1000 times or more. These 108 men are classified as quasimedical.

There were an additional 157 men who failed to meet only one criterion. Of

these, 98 gave reasons for use such as to get high. An additional 18 men

had used cocaine, and 14 had stayed high on stimulants more than a day at

a time. Ten men had used stimulants in combination with other drugs, and

six attributed their use of stimulants to military service. Four men had

used on a daily basis or in large quantities, and four had used other than

oral routes of administration. Two said they had been dependent on stimulants, and one man had used more than three different stimulants. The first

four of these criteria were involved in 116 cases of the 119 who failed two

of the criteria.

The classification of the few cases who failed to meet one criterion again

makes little practical difference, since 14 of the 19 were experimental users,

and the remaining five had used 10-99 times. Again, therefore, only those

men who met all 11 criteria were classified as quasi-medical users.

136
C. Sedatives

The criteria were the same as those for opiates, except that use of heroin

was eliminated, and all references to opiates were changed to sedatives.

There were 99 men who met all 10 criteria: 86 among the 263 who had used

less than 10 times; 12 among the 170 who had used 10-99 times; 1 among the

59 who had used 100-999 times; and none among the 16 who had used 1000 times

or more. These 99 men are classified as quasi-medical users of sedatives.

There were an additional 174 men who failed to meet only one criterion. Of

these 158 gave reasons for use such as to get high. Five men said they would

not have used sedatives if they had not been in the military service, and

four had used sedatives in combination with other drugs. Three men had used

more than three different sedatives, and two had used them on a daily basis

or in large amounts. One man had stayed high on sedatives for more than a

day at a time, and one considered himself to have been dependent on sedatives.

Among the 92 men who failed two criteria, 85 did so by the reasons given for

use. As with opiates and sedatives the decision was made to classify as

quasi-medical users only those men who met all 10 criteria.

137
Used no psychedelics

" 1

" 2

" 3

" 4

" 5

" 6

" 7

" 8

" 9

Number used unknown

Total. users

Total sample

Used no stimulants

" 1

" 2

" 3

" 4

" 5

" 6

" 7

" 8

" 9

" 10

APPENDlX II

Specific Drugs Used Within Drug Classes

A. Psychedelics

(550 Users)

170

94

83

68

53

39

21

14

6

2

550

330

138

93

65

25

16

8

3

2

0

1960

550

2,510

Mescaline 395

LSD 382

THC 298

Peyote 157

Psilocybin 156

PCP 108

STP 70

DMT 64

MDA 21

Belladonna 7

Mushrooms 5

Morning Glory Seeds 4

DET 1

Other or Don't Know 23

B. Stimulants

(689 Users)

1821 Amphetamine 361

Benzedrine 327

Dexedrine 253

Methedrine 245

Dexamyl 68

Unknown 54

Ritalin 43

Preludin 39

"White Crosses" 35

"Black Beauties" 20

Desoxyn 6

" 11 1

Number used unknown %

"Uppers", "Pep Pills", etc 24

Total users 689 689

Total sample 2,510

138
C. Sedatives

(508 Users)

Used no sedatives 2002

" 1 203

" 2 98

" 3 73

" 4 33

" 5 25

" 6 26

" 7 15

" 8 14

" 9 7

" 10 3

" 11 4

" 12 2

Number used unknown 5

Total users 508 508

Toatal sample 2,510

Used no opiates 1731

" 1 418

" 2 172

" 3 64

" 4 42

" 5 28

" 6 17

" 7 12

" 8 14

" 9 6

" 10 6

Total users

Total sample

779 779

2,510

D. Opiates

(779 Users)

Valium 272

Seconal 254

Quaalude, Sopors 198

Librium, Libritabs 140

Tuinal 135

Phenobarbital 120

Nembutal 110

Amytal 31

Equanil or Miltown 24

Desbutal 16

Carbrital 15

Doriden 15

Placidyl 15

"Downers" 8

Valmid 8

Butisol 7

Luminal 3

Noludar 3

Veronal 2

Other or Don't Know 42

Codeine

Darvon

Opium

Opiated hashish

Demerol

Morphine

Paregoric

Methadone

Percodan

Talwin

Dilaudid

Laudanum

Hycodan

Other

482

375

209

208

101

74

65

62

35

31

18

5

3

6

139
E. Inhalants

(399 Users)

Used no inhalants

" 1

" 2

" 3

" 4

" 5

" 6

" 7

Total users

Total sample

2111

300

66

20

8

2

2

1

399 399

2,510

F. Other Drugs

Thorazine 104

Elavil 22

Millaril 22

Compazine 15

Stelazine 10

Tofranil 6

Sparine 3

Serpasil 3

Marplan 1

Airplane glue

Amyl Nitrite

Aerosol sprays

Nitrous oxide

Ether

Gasoline

Toluene

Thinners

Freon

Lighter fluid

Carbon Tetrachloride

Contact cement

Nail polish remover

Other

188

126

61

47

29

21

9

8

7

6

4

2

1

44

140
REFERENCES

Abelson, H. I., R. Cohen and D. Schrayer.

1972 "Public attitudes toward marihuana." Appendix II of the report

of the National Commission on Marihuana and Drug Abuse. Washington,

D.C.: Government Printing Office.

Becker, Howard S.

1953 "Becoming a marihuana user." American Journal of Sociology 59:

235-42.

DuPont, R. L. and M. H. Greene.

1973 "The dynamics of a heroin addiction epidemic." Science 181:716-

722.

Goode, Erich.

1974 "Marijuana use and the progression to dangerous drugs." Pp. 303-

338 in Loren L. Miller (ed.), Marijuana: Effects on Human

Behavior. New York: Academic Press.

Hirschi, Travis and Hanan C. Selvin.

1973 Principles of Survey Analysis. New York: Free Press.

Inciardi, James A. and Carl D. Chambers.

1972 "Unreported criminal involvement of narcotic addicts." Journal of

Drug Issues 2 (Spring):57-64.

Jaffe, Jerome.

1973 "A conversation about the drug epidemic with Jerome Jaffe conducted

by T. G. Harns." Psychology Today 7:68-79.

Lu, K. H.

1974 "The indexing and analysis of drug indulgence." The International

Jounral of the Addictions 9:785-804.

Robins, Lee N.

1974 The Vietnam Drug User Returns. Special Action Office Monograph,

Series A, Number 2, May.

STASH Report No. 221.

1974 Drugs and Crime: A STASH Literature Review. Madison, Wisconsin:

Stash Press.

Voss, Harwin L. and Richard C. Stephens.

1973 "Criminal history of narcotic addicts." Drug Forum 2 (Winter):

191-202.

141
INDEX

Note: Nine drug classes or specific drugs were included in the study; tobacco, alcohol,

marihuana, psychedelics, stimulants, sedatives, heroin, opiates and cocaine. These are not

listed in the index, because when any of them is mentioned all are normally discussed in the

text, so a general reference to drugs suffices to locate the nine classes. There are a few

exceptions, when only alcohol, marihuana or heroin are discussed, and these are listed.

Addiction (see Consequences of drug use)

Age (see also Birth cohorts)

and military service, 120-124

and Total drug use, 110-111

at first use of drugs, 51-57

by year of first use, 52-57

changes in, 52-57

at risk, 56-57, 59

correction for, in estimates, 43-47

of occurrence of self-reported criminal

acts, 84-88

of registration with Selective Service, 3

range in sample, 3, 8-11

Alcohol, use in general population, 1

Armed robbery (see Crime)

Arrests (see Criminal justice contacts)

Associations between use of pairs of drugs,

98-102

Attitudes of respondents, 73-75, 116-117

Auto theft (see Crime)

Availability of drugs (see also Reasons for

use), 60-61, 73, 75

Bad checks (see Crime)

Bad trips (see Consequences of drug use)

Benefits of drug use, 76-80

Birth cohorts (also see Age)

and current use, 35-36

and lifetime use, 14-15

and year of first use, 53-59

differences in size of, 51

differences in proportion of users, 51, 53

Boredom (see Reasons for use)

Breaking and entering (see Crime)

Buying drugs and Criminal justice contacts,

95-97

Cannabis. Included under "marihuana."

Cessation of use, 41, 68-69, 71

Chances of future use of drugs, 33, 59-60,

70-71

City size

of residence at interview, 38-39

of residence to age 18, 17-18

and ethnic groups, 18

and estimates, 43-47

Class, subjective identification, 23

College major

and current prevalence, 38

and lifetime prevalence, 21

Confidentiality

of Selective Service files, 4

of study data, 6-7

Consequences of drug use, 78-80, 107, 109

Conventionality, and lifetime use, 21-22

Conviction, of crime (see Criminal justice

contacts)

Cost of drugs (see Reasons)

Countercultural activities, 114-117

Credibility of data, 7-8

Crime, and drugs, 81-97, 112-113

Criminal justice contacts, 81, 89-97

Current employment

and current prevalence, 38

and lifetime prevalence, 22-23

Current family status, 21-22, 38-39, 111-112

Current student status, 20-21

Current use of drugs (see Prevalence, current)

Dealers (see Obtaining drugs)

Dependence on drugs (see Reasons for not using,

Consequences of drug use)

Disapproval of drug use (see Reasons for not

using)

Dislike of drug effects (see Reasons for not

using)

Driving while intoxicated (see Crime)

and extent of alcohol use, 25-27, 113

Drug classification, 13-14

Drug use (see Prevalence, current and lifetime)

among known users, 7

by friends, 60-61, 69, 71-73

effects on health (see Reasons for not

using)

expected in situation (see Reasons for

using)

number of times used (see Extent of use)

specific drugs used within classes, 138-140

among young men, 1-134

Earliest use of drugs, 55-57

Education of respondents

and college major, 21

and crime, 89-93

and current student status, 20-21

and current prevalence, 37-38

and ethnic groups, 18-21 .

and lifetime prevalence, 18-21

and Total drug use, 111-112

Effect of drug use (see Consequences of drug

use, Benefits, Problems)

on life of respondents, 77-80

Employment, current

and current prevalence, 38

and ethnic groups, 23

and lifetime prevalence, 22-23

and Total drug use, 111-112

Epidemic, drug, 48-61

Estimates, of drug use in population, 42-47

Ethnic groups

and birth cohorts, 18, 32

and crime, 89-93

142
Ethnic groups (cont.)

and current employment, 32

and current family status, 32

and current prevalence, 36-38

and current student status, 32

and education, 32

and lifetime prevalence, 15-16, 18

and marriage, 32

and size of city of residence to age 18,

32

and Total drug use, 110-111

"Ever" use of drugs (see Prevalence, lifetime)

Extent of alcohol use

and consequences of use, 26, 78

and crime, 26, 84-85

Extent of marihuana use

and availability of drugs, 59-61

and chances of future use of drugs, 59-61

and crime, 81-83, 89-93

and use of drugs by friends, 59-61

Extent of lifetime use, 23-31

alcohol, 25-27

cocaine, 27

heroin, 27

marihuana, 27-28

opiates, 27, 29-30

psychedelics, 27

sedatives, 27, 30

stimulants, 27, 30

tobacco, 27

Fights (see Consequences of drug use)

Follow-up studies,

of alcoholics, 1

of opiate users, 1, 118, 121

Forgery (see Crime)

Forget worries (see Reasons for use)

Gambling, illegal (see Crime)

Geographic variation in drug use (see Regional

variation)

Growing, as source of drugs (see Obtaining

drugs)

Habit (see Reasons for use)

Hashish, hashish oil. Included as marihuana.

Health (see Problems, Reasons for not using)

Heighten senses (see Reasons for using)

High (see Reasons for using)

Historical effect, 53-54, 56

Incidence of drug use, 48-59

peak years, 50-52, 56-57, 59

mechanisms of increase in, 51, 53

Injection (see Routes of drug administration)

Interview

completion rate, 8

schedule, 4-5

pretests, 5

Interviewers, 5-7

Involvement with drugs, 101

Intramuscular injection (see Routes of drug

administration)

Intravenous injection (see Routes of drug

administration)

Juvenile correctional facilities (see Criminal

justice contacts)

Juvenile court appearances (see Criminal

justice contacts)

Law, problems with the (see Problems,

and Criminal justice contacts, 95-97

Lifetime use (see Prevalence, lifetime)

Loss of control (see Reasons for not using)

Mainlining (see Routes of drug administration)

Marriage (see also Current family status)

and Total drug use, 111-112

Maturation effects on drug use, 48-59

Memory loss (see Consequences of drug use)

Military service and drug use, 118-124

Moral, religious factors (see Reasons for not

using)

Multiple drug use (see also Total drug use),

98-104

Natural history of drug use, 2

Needle (see Routes of drug administration)

Obtaining drugs, 62-64

Opinions (see Attitudes of respondents)

Oral use (see Routes of drug administration)

Overseas service (see Military service)

Patterns of drug use (see Multiple drug use,

Total drug use)

Payment to respondents, 5-6

Police (see Problems)

Prescriptions, as source of drugs (see

Obtaining drugs)

forged (see Crime)

Prevalence, annual, 59

Prevalence, current, 33-41

and birth cohorts, 35-36

and college major, 38

and current family status, 38-39

and education, 37-38

and current employment, 38

and ethnic groups, 36-37

and experimental use, 33-36

and lifetime prevalence, 40-41

and military service, 119-120

and regions of U.S., 131, 133-134

and size of city of current residence,

38-39, 41

defined, 33-36

Prevalence, lifetime, 13-32

and birth cohorts, 14-15

and college major, 21

and conventionality, 21-23

and current employment, 22-23

and current family status, 21-22

and current student status, 20-21

and current prevalence, 40-41

and education, 18-21

and ethnic groups, 15-16, 18

and extent of use, 13

and marriage, 21-22

and military service, 118-124

and regions of U.S., 131-134

and size of city of residence to age 18,

17-18

defined, 13

Problems (see also Consequences)

due to drugs, 78-80

due to heroin use, 129

and treatment, 129

143
Public Intoxication (see Crime)

and Criminal justice contacts, 95-97

Quasi-medical use of drugs, 27-31

Quitting drug use (see Cessation)

Race (see Ethnic groups)

Reasons for use and nonuse, 65-71

and treatment for heroin use, 126-129

Regional variations in use, 131-134

Relax (see Reasons)

Research objectives, 2-3

Residence (see Size of city, Regional

variations)

Routes of drug administration, 63-65

Sample

age range in, 2-3

comparison of interviewed with noninterviewed men, 8-11

New York City, 3, 7

registration years, 4

selection, 3-4

size, 2, 8-11

Scrip passing (see Crimes)

Selective Service, 2-4

Self-reported criminal acts (see Crime)

and Criminal justice contacts, 95-97

Selling drugs and Criminal justice contacts,

95-97

and Total drug use, 113

Sentence , prison (see Criminal justice

contacts)

Shoplifting (see Crime)

and Criminal justice contacts, 95-97

Size of city

of residence at time of interview, 38-39,

41

of residence to age 18, 8-11

of residence and crime, 89-93

and Total drug use, 110-111

Skinpopping (see Routes of drug administration)

Sleep (see Reasons)

Smoking (see Routes of drug administration)

not condition for marihuana use, 98, 100

Sniffing (see Routes of drug administration)

Social class (see Class)

Specific drugs used within drug classes,

138-140

Stealing (see Crime)

Subcutaneous injection (see Routes of drug

administration)

THC, classified as psychedelic, 13

Time order of drug use, 102-104

Total drug use (see also Prevalence, lifetime,

Multiple drug use), 105-117

and activities of peers, 113-114

and age, 110-111

and attitudes toward unconventional

behavior, 116-117

and cohabitation, 111-112

and consequences of drug use, 107, 109

and countercultural activities, 114-117

and crime, 112-113

and current family status, 111-112

and education, 111-112

and employment, 111-112

and ethnic groups, 110-111

and marriage, 111-112

and residence to age 18, 110-111

and use of drug classes, 107-108

construction of Index of, 105-107

validity of Index of, 107, 109

Traffic violations (see Criminal justice

contacts)

Transmission of drug use, 59-61

Treatment for drug use, 125-130

Trouble with the law (see Reasons, Problems)

Vietnam, service in (see Military service)

Work (see Employment, Problems)

Year of birth (see Age)

Year of first use (see Incidence)

 U.S. GOVERNMENT PRINTING OFFICE : 1976 634-161/217

144