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|Major Studies of Drugs and Drug Policy|
|Canadian Senate Special Committee on Illegal Drugs|
|Volume I - General Orientation|
Chapter 6 - Users and uses: form, practice, context
Factors related to use
Following logically from what we saw
in the previous section, studies on factors that could explain the use of
drugs, and cannabis in particular, deal primarily with initiation or
The INSERM report examines a set of
studies on factors that could explain cannabis use: the influence of the family
environment (use by parents, socialization, parental teaching methods, quality
of the parent-child relationship, parental models), peers (symbolic values of
use, norms) and educational and social environments.<![if !supportFootnotes]><![endif]> There is no clear conclusion, but
the report notes that the studies manage either poorly or not at all to take
into account the user’s role in social situations and consequently the
incremental impact on use arising from the variability of social stresses as
well as the methods of integration. We would also add that these studies do not
reflect trajectories of use.
First of all, along with DrugScope, we note that the
epidemiological approach to analysis of drug use, cannabis in particular, is
based on a medical model of analysis of the prevalence of disease, whereas the
reasons (which are not necessarily the causes) for drug use can very easily lie
outside the medical field and, in a broader sense, outside the psychosocial
model. Attributing dependence – understood here in terms of a disease – to
factors pertaining to the relationship between the locus of control and the
environment has consequences for the understanding of the phenomenon as well as
for public policy. The report by this British body contains a table of the
explanations of drug use we feel it useful to reprint here.
Attribution Explanations of Drug Use <![if !supportFootnotes]><![endif]>
In fact, we must not forget that,
with regard to psychoactive substances, the medical model of disease is still a
dominant model for comprehension and forms the other part of the public
response along with the penal model.<![if !supportFootnotes]><![endif]> As we were told several times,
drugs, and cannabis in particular, are not dangerous because they are illegal,
they are illegal because they are dangerous. We will have occasion to comment
on this statement in greater detail in the following chapters.
For now it is enough to remember
that attempts to explain drug use most often involve looking for defects in
personality or the environment rather than trying to understand the choices
made by users.
Among the factors related to the
locus of control, studies identify primarily:
Among the factors related to the
environment, studies mention:
According to the report Monitoring the Future, there is no doubt
that young people’s perceptions of drugs and their attitudes towards them
determine the levels of use, which in return must determine public policy:
Early in the decade of the 1990s we noted an increase in the use of a number of illicit drugs among secondary students and some important changes among the students in terms of certain key attitudes and beliefs related to drug use. (…) Specifically, the proportions seeing great risk in using drugs began to decline, as did the proportions saying they disapproved of use. As we predicted, those reversals indeed presaged “an end to the improvements in the drug situation that the nation may be taking for granted.” The use of illicit drugs rose sharply in all three grade levels after 1992, as negative attitudes and beliefs about drugs continued to erode. This pattern continued for some years. <![if !supportFootnotes]><![endif]>
And further on:
We can summarize the findings on trends as follows: over more than a decade – from late 1970s to the early 1990s – there were very appreciable declines in use of several illicit drugs among twelfth-grade students, and even larger declines in their use among college students and young adults. These substantial improvements – which seem largely explainable in terms of changes in attitudes about drug use, beliefs about the risks of drug use, and peer norms against drug use – have some extremely important policy implications. One is that these various substance-using behaviours among American young people are malleable – they can be changed. It has been done before. The second is that demand-side factors appear to have been pivotal in bringing about those changes. The reported levels of availability of marijuana, as reported by high school seniors, has held fairly steady throughout the life of the study. (Moreover, both abstainers and quitters rank availability and price very low on their list of reasons for not using.). And in fact the perceived availability of cocaine actually was rising during the beginning of the sharp decline in cocaine and crack use, which occurred when the risks associated with that drug suddenly rose sharply. (…) Over the years, this study has demonstrated that changes in perceived risk and disapproval have been important causes of change in the use of several drugs. These beliefs and attitudes surely are influenced by the amount and nature of public attention paid to the drug issue in the historical period during which young people are growing up. A substantial decline in attention to this issue in the early 1990s very likely helps to explain why the increases in perceived risk and disapproval among students ceased and began to backslide. <![if !supportFootnotes]><![endif]>
other words, social disapproval – through government information campaigns, for
example – can generate attitudes that reject drug use and will be reinforced by
actions likely to increase the risks associated with use (the risk of arrest,
A study conducted in Newfoundland
and Labrador involving a sample of 3,293 people is an example of this approach
applied in Canada.<![if !supportFootnotes]><![endif]> The questionnaire included
questions about activities (family activities, housework, extracurricular
activities, school work, sports, work, religious life), the availability of
cannabis, use by parents, peers and the individual, parental and peer norms
regarding cannabis, personal preferences and norms regarding cannabis. Analysis
of variance dealt with the interaction of these various variables to explain
personal use of cannabis. Overall, the model explains only 57% of use in the
provincial sample, 65% for boys and 54% for girls. The results show that peer
use is the main factor related to personal use (29% of variance), followed by
personal preferences (themselves influenced by peer norms), personal norms and
having to do chores around the home. Availability is not directly related to
use and works through peer norms and use. Parental use is strongly linked to
perceived availability. The authors conclude that this model has clear
implications for interventions to prevent cannabis use:
In the province wide sample, Peer Use, Peer Norms, Availability, Own Preferences and Own Norms together account for 56% of the 57% of Own Use predicted by the model. Peer Norms and Availability work though Peer Use, so important targets for intervention should be Own Norms, Own Preferences and Peer Use. Of these variables, Own Preferences and Peer Use contribute the most to prediction of Own Use, together accounting for 48.8% of the variance. It is of interest that a large part of availability is predicted by Parental Use, suggesting Peer Use arises from possible supplies of the marijuana/hashish from parental sources. This ought to be a target for intervention strategies as well. The model suggests sources of influence on target variables that ought to be considered in any intervention strategies. <![if !supportFootnotes]><![endif]>
into consideration the limits of the model as well as the differentiation
between the sexes and provincial health districts with respect to the relative weight
of the independent variables, we have to wonder if this type of analysis is a
true reflection of use, including initial use. Furthermore, in the light of
international trends in use on the one hand, and studies on users on the other,
we wonder about the postulates of this type of mechanical model based on the
rationality of the actors.
Finally, Aquatias et al., conducted
a study on cannabis use among youth in the suburbs of Paris.<![if !supportFootnotes]><![endif]> The authors make a particularly interesting
distinction between forms of use based on user characteristics and the
ideological representations of cannabis use. They demonstrate in particular (1)
that there exist “hard” uses of soft drugs and (2) that the traditional
distinction between the festive, socially integrated and group-regulated forms
of use among middle class youth, and the excessive and socially unregulated
uses of disadvantaged youth does not hold. Depending on factors related to
their environment, both groups can have regulated and unregulated forms of use.
Factors traditionally associated
with unregulated use such as social disenfranchisement, poor living conditions
in the suburbs and the lack of professional integration, are only part of the
picture. Other factors related to tensions arising in the environment (for
example family-related problems or being in conflict with the law) and the
capacity to remain autonomous from their social milieu also play an important
role in the trajectories of these cannabis users.
In trying to understand what factors determined these different forms of
cannabis use among these youths, we have obviously noted the importance of
factors related to social dislocation: difficulties in social integration and a
lack of financial resources capable of fostering their autonomy from the living
facing similar difficulties to get a job and socio-economic resources, some
smoke cannabis without any excess, some not at all and others smoke
considerably. Even within the group of youth who have a job, some smoke high
potency cannabis intensively while others have more regulated forms of use and
dislocation is obviously a factor explaining the different forms of use just as
integration in the job market serves to regulate these practices. But these
complementary factors only constitute the more general context to these
behaviours of intensive and prolonged use of cannabis.
those who experience social dislocation the most, those who smoke cannabis in
an intensive and prolonged manner also experience the strongest social tensions
such as problems with their local reputation, being in conflict with the law or
family related problems… (…).
Conversely, those who have a more regulated use are both better integrated in their environment and at the same time more autonomous with respect to local social life. <![if !supportFootnotes]><![endif]>
The authors propose a classification
of forms of use which we reproduce since it has, in part, inspired our own
Finally, the authors distinguish
between four levels of use:
From an analysis of the life stories
of users and their “trajectories”, we have learned primarily that, for a
proportion of experimenters, which varies between 15% and 20% of the
population, who will become regular users, the circumstances and patterns of
their “career” as a user vary considerably but that for a significant
proportion of these long-term users, use is integrated into their social and
Further, contrary to some studies,
uses of cannabis are not determined only by a series of psychological or
environmental factors. In all cases, it seems that specific events, elements of
one’s particular life story, can trigger unregulated forms of uses,
characterized in particular by intensive and solitary use. While such
unregulated uses appear to be temporary, we did not come across any study that
examined the trajectories of these users.
We also note that negative social
attitudes and the characteristic of the cannabis market appear to have little
impact on patterns of use.
Finally, we note that regular use
does not necessarily mean problem use. At the same time, we have learned that
early onset and rapid progression towards regular use are factors in problem
use. In other words, and this will be important for choosing public policy and
interventions, initiation at a young age (under age 16) and rapid progression
towards regular use (under age 20) are markers that should be used to identify
and prevent heavy use. Chapter 7 will discuss this issue in greater detail.
<![if !supportEmptyParas]> <![endif]>
<![if !supportFootnotes]><![endif]> INSERM (2001) op. cit., pages 28-50.
DrugScope (2001) United Kingdom.
Drug Situation 2000. Report to the EMCDDA, page: 19.
On this subject, see for example the work of Bergeron, H. (1996) Soigner la toxicomanie. Les
dispositifs de soin entre idéologie et action. Paris: L’Harmattan; and Barré, M.D., M.L. Pottier
et S. Delaître (2001) Toxicomaie, police,
justice: trajectoires pénales. Paris: OFDT.
Johnston, L.D., et al., (2001) op.
cit., page: 6.
Ibid., page 30.
<![if !supportFootnotes]><![endif]> Wasmeier, M., et al.,
(2000) Path analysis survey of substance
use among Newfoundland and Labrador Adolescents. Marijuana/haschish and Solvent
use. Memorial University of Newfoundland.
Ibid., page 15.
<![if !supportFootnotes]><![endif]> Aquatias, S., (1999) « Usages du cannabis et situations sociales. Réflexion sur les conditions sociales des différentes consommations possibles de cannabis. » in Faugeron, C. (éd.) Les drogues en France. Paris: Georg. Pour l’étude originale: Aquatias. S. et coll. (1997) L’usage dur des drogues douces, recherche sur la consommation de cannabis dans la banlieue parisienne. Paris: OFDT.
<![if !supportFootnotes]><![endif]> Aquatias, S. (1999) op. cit., pages 48-49.
Ibid., page 45.
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Marihuana, A Signal of Misunderstanding - The Report of the US National Commission on Marihuana and Drug Abuse
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