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Marijuana has been adopted by a significant fraction
of the youthful subculture as a social drug. Despite
its central importance in understanding current
patterns of drug use, only limited information is
available, especially concerning its relation to the
use of other drugs. The present study was feasible
because the Haight-Ashbury Medical Clinic provided
access to a population in which marijuana and other
drugs were in wide use.
The Haight-Ashbury Clinic was established in San
Francisco in anticipation of the influx of persons
into that neighborhood during the summer of 1967,
and beginning June 6, 1967 began to provide free
care for acute medical problems as well as for
problems related to drug use. By the time of this
study the Clinic and its volunteer staff had gained
acceptance by the community and was providing care
for as many as 200 persons per day.
By September 1967, when our survey was conducted,
the well-publicized hippie group had been diluted by
a large number of transient youths who were
exploring rather than committed to the hip
philosophy. And to describe the people of the
neighborhood at that time as being "hippies" is to
deny the diversity of the people who come to the
Haight with differing backgrounds, motivations,
expectations, and degree of drug experience.
Furthermore, the community subsequently changed to
include a substantial proportion of compulsive
methamphetamine users, and the beginnings of that
group were evident at the time of our survey.
The availability of a favorable population and the
status of the Haight-Ashbury Clinic with that
population encouraged us to believe that accurate
data could be collected to test our subjective
impressions.
Methods
Members of the clinic staff, themselves
Haight-Ashbury residents and members of the
community, were trained to administer a
questionnaire designed to present Iimited and simple
choices and to be self-explanatory. The survey
included multiple choice questions providing
demographic and personal data, present employment,
past incidence of psychiatric counseling and
hospitalization, drug preferences and questions
detailing the respondents own use of marijuana, hard
liquor, beer and wine, other sedative-hypnotic
drugs, oral and intravenous, amphetamines, the
psychedelic drugs, heroin, cocaine and opium.
Four hundred and thirteen usable questionnaires were
completed during the month of September 1967,
sampling both from the Clinic population and from
other congregation areas and community agencies
within the 20 square block Haight-Ashbury
neighborhood. The sample, admittedly a sample of
opportunity, is as representative as possible of the
Haight-Ashbury "hippie" population present at the
time. The demographic data agrees well with the
findings of other investigators.1
Among the community there was a well-known mistrust
of the "straight" society and a history of a lack of
cooperation with other investigators who had
attempted even less comprehensive surveys. We
therefore decided that in addition to protecting the
anonymity of the respondent it would be necessary to
have members of the "New Community", as Clinic
personnel, administer the drug survey in order to
obtain adequate and truthful answers concerning drug
use. The reputation of the Clinic minimized any
suspicion that the information collected would be
used against the community or any individual.
Community leaders were assured that the data would
be published only after a reasonable interval. The
survey was well received by the community and the
refusal rate was less than one percent.
Data from the surveys were transferred onto IBM
cards, and several computer programs were written to
select and tabulate the information on selected
groups from the sample. The statistics are for the
most part expressed in percentage form, and an
analysis of variance applied to obtain the standard
error and confidence interval for the statistic
obtained. Where the percentage statistic of two
samples is to be compared and to test for the
equality of population means, a two-tailed Student’s
T test is applied to the hypothesis of the equality
of the means or percentages. In this study the
confidence interval expressed is 95%, or p ~ .05.
likewise for a difference to be labeled as
significant, a two-tailed test with a p= .05 or less
is required unless otherwise stated.
The characteristics of the population Iiving in the
Haight-Ashbury neighborhood have not been constant
over any but very brief periods. As the
drug-centered community has evolved, the relative
proportion of individuals who prefer one or another
drug or pattern of drug use has changed. At the time
of this survey the hippie influence was still
influential but waning, and the use of high dose,
intravenous methamphetamine was growing in
prominence. In order to follow changes in the
neighborhood and to test several hypotheses related
to sociological aspects of drug use, extensive
surveys have been carried out at two subsequent
times. Reports of the analysis of these later
surveys will be forthcoming as they are completed by
Dr. James Carey, Department of Criminology,
University of California at Berkeley.
The present paper will focus on the patterns of
marijuana use and its relationship to the abuse of
other drugs. We will briefly characterize the total
sample of respondents regardless of their pattern of
marijuana use and then discuss areas of difference
between various patterns of use.
The Community as Revealed by the Sample
The types of people who comprise this community vary
in proportion from one time to another. During the
summer and fall of 1967, the time interval which the
present study represents, the Haight-Ashbury could
be described as composed primarily of sons and
daughters of the white middle class, who often had
some college experience and who frequently
experimented with various drugs.
Our sample consisted of 413 respondents, 222 males
and 191 females. Our analysis confirms this
impression that the population was drawn largely
from families of the middle class. The occupation of
the head of the household served as an index of
socioeconomic class and 51 .6 ± 4.8% (213) of their
fathers have occupations in the professions,
managerial or sales categories, and one-half (44.3 ±
4.8% of the fathers have some college education. Of
the entire sample of 413 respondents, 79.90 ± 3.9%
identified themselves as single, and 10.7 ± 2.9%
were married. 86.20 ± 3.3% of the sample identified
themselves as Caucasian; there were less than 1% of
the sample who were Negro and the sample included 16
American Indians. This mean age of the respondents
was 20.65 ± 1.5 years, and 51 .82 ± 4.8 % had had at
least some college experience. For 43.34 ± 4.8%
(179) of the respondents, it had been three years or
more since they had lived with their parents.
It is remarkable that about half of the respondents
were from areas other than California. Only 16.22±
3.5% had been raised in the Bay Area of San
Francisco, 34.14 ± 4.6% had been raised in another
large metropolitan area such as New York City, Los
Angeles, or Chicago, and 41.40.± 4.7% had spent most
of their life and were raised in cities of less than
200,000 or in rural areas. One hundred eighty-one
(43.83 ± 4.8% were living outside of California
before they began to participate in the
Haight-Ashbury scene, whereas only 128 (30.99.±
4.5%) were then living in the Bay Area.
The use of marijuana was practically universal in
this population. It was generally used as a social
drug, much as the parents of the respondents use
alcohol. In answer to the question “Have you ever
used marijuana?” 94.59 ± 2.9% (210) of the males and
188 or 98.43 ± 1.8% of the females said “yes”.
90.80 ± 2.8% (375) of the total sample of 413 had
used the drug in the Haight-Ashbury, though not
necessarily exclusively there as we shall discuss
later. Three hundred eighty-one or 92.35 ± 2.6% had
used marijuana within a month prior to the time of
the survey (September 1967), and 86.97.± 3.3% of the
413 had used LSD or a similar hallucinogenic drug at
least once.
It is important to emphasize that this population
has a particularly high level of acquaintance with
various drugs. 87.22 ± 3.2% have used hard liquor,
54-.57±4.1% have used other drugs of the
sedative-hypnotic category, not to mention the 96%
who have tried marijuana. One-fourth (25.19± 4.3%)
of the sample of 413 has tried heroin (though not
necessarily intravenously), although there were only
8 persons presently abusing that narcotic. 58.33 ±
4.9 have tried smoking opium, or what was thought
to be opium which is an important distinction when
discussing “street drugs”. 86.97 ± 3.3% have tried
one of the various psychedelics, most frequently
LSD. 35.43 ± 4.7% have tried intravenous
amphetamine; 74.87 ± 4.4% have tried the oral
amphetamines; and 35.99 ± 4.8% admit some personal
experience with cocaine. Thus it differs from other
drug-using populations in several aspects, and the
results should not necessarily be construed as
applying to other drug-using subcultures.
Patterns of Marijuana Use by the Respondents
A: Frequency of use and present age - It is
difficult to speak of the abuse of marijuana in the
United States, due to the low concentration of
active ingredients in the “grass” arriving or grown
in the United States and due to its inherent low
potential for abuse. Certainly our questions were
not sensitive enough to identify the rare person
whose functioning was interfered with by his use of
marijuana. For the purposes of this analysis we
differentiated three groups of marijuana users,
namely the occasional user, the regular user, and
the “habitual” user. Our sample consisted of 51
occasional users, 161 regular users and 177 habitual
users of the drug. The occasional user was defined
as the individual choosing an answer on the
questionnaire indicating use up to 4 times in the
month preceding the time of the questionnaire. A
regular user indicated use 4-30 times and a habitual
user more than 30 times during the prior month.
Questions regarding the amount of drug used on each
occasion were, unfortunately, often regarded as
ambiguous by respondents and were not used unless
gross differences appeared. The loss of data is not
great since the variable potency of the product and
varying techniques of smoking could not have been
evaluated in any case. The use of certain drugs was
found to differ in some respects between the two
sexes/ and we believe that their motivations to drug
use often are dissimilar. So for the most part the
analysis is made on males and females as separate
groups and the statistics compared. Our sample of
413 respondents, 222 males and 191 females, had a
mean age of 20.65 ± .15 and a range of 9 to 37
years. The ages of the various groups of marijuana
users is detailed in Table I. The mean age of all of
the males was 21.04 ± .2 (range 15-34 years), which
is significantly older than all of the females (20.2
± .23 (range 9-37 years)). (Table I) The mean age of
the female habitual user of marijuana is
significantly younger than either her male habitual
user counterpart (20.99 ± .3) or the females as a
whole (20.2 ± .2). And this same finding is
reflected in the significantly increased number of
female habitual users in the 16 to 20 year old age
bracket. Furthermore, there was a statistically
significant higher percentage of single females in
either the occasional or regular user category.
B: Age at introduction to use - The entire sample
had first tried marijuana at a mean age of 17 .07 ±
.2 years of age (range 5-35 years). The age for
first trying the drug was the same for both the
males and the females in any use pattern, although
the age for the first trying marijuana did tend to
vary with the level of use within each sex grouping.
That is, the occasional user had first tried
marijuana at a mean age of 18.6 ±. .7; the regular
user at the age of 17.4 ± .3; and the habitual user
at the age of 16.2± .3. The difference between the
age of first trying marijuana and the present age
indicated a trend within the groups of male users
that is not present among the females. The male
occasional user had first tried marijuana on the
average 2.9 years ago and the male regular user 3.4
years ago and the male habitual user 4.6 years ago.
These findings are summarized in Table II.
The older age group (25 to 30 years), average 27.4
years old, had the greatest percentage of
occasional users in contrast to the 17 year olds
(ages 16 to 20) who had the least number who were
occasional users. Furthermore, the percentage of
habitual users in the 25 to 30 year old age bracket
tended to be lower than the younger age groups.
(Table III).
Thus the data in Table II analyzed without other
data could lead to the conclusion that the longer
one used marijuana the greater becomes his use of
the drug. But this conclusion is not supported by
the data in Table III for the older age group has
one of the smallest percentages of habitual users
although they have been using the drug for the
greatest length of time. In fact, the greatest
percent of habitual users were found among the 16 to
20 year olds in both the male and female samples.
Our study supports the impression that in the past
few years marijuana has been reaching increasingly
younger persons. In the 25 to 30 year age bracket
(mean age 27.4 years) the age of trying marijuana
was about 21 while in the 16 to 20 year old bracket
(mean age 18.8 years) the age was significantly
younger about 16 years of age. And most of the 10
to 15 year olds in our sample had tried marijuana
within the year while the 25 to 30 year olds had
tried it on the average 7 years ago. (Table III)
Ninety to 95% of all groups of users agreed their
use would continue, and among the older groups the
agreement was unanimous.
C: Characteristics of the three groups - The
habitual user, besides using the drug more
frequently than the other users, also more
frequently uses greater amounts of the drug as one
might expect. There was a detectable difference
between the amount used each time by the females and
the males. There was a tendency (significant at the
90% level of confidence) for the females to use less
of the drug than the males each time they used it,
irrespective of their frequency of use.
One half (54.72 ± 4.8%) of the respondents had at
one time used or were now using marijuana habitually,
but it is interesting how often the habitual level
of use may be replaced by only occasional use. This
is reflected in the 15.71.±. 9.9% of the occasional
users (8/51) who had at one time had a peak habitual
use of marijuana and the one quarter (23.60 ± 6.5%)
of the regular users (38/161) who at one time had
used the drug habitually. It is rare to find such
decreases in level of use among the users of drugs
with more abuse potential, e. g. intravenous
methamphetamine, and certainly such findings reflect
the low abuse potential for the marijuana found
circulating in the United States.
The occasional user differs from the regular and
habitual user in several important attitudes about
his continued use of marijuana. Only three-quarters
(74.51% or 38/51) of the occasional users admitted
that they stilI used the drug. Furthermore, a
significantly lower number of the occasional users
(77 .1%) admitted that they planned to continue
using the drug. The persons in the regular-habitual
use patterns were almost unanimous (95-99%) about
their intention to continue. And finaIly, only 13.3%
of the females and 20.1% of
the males of the total sample admitted that they had
ever worried about their marijuana use. Only 10.7 ±
3.0% of the sample had ever refrained from using any
drug because of the dangerous drug or narcotic drug
laws.
An analysis of the relationship of the demographic
data to the level of marijuana was remarkable in
that no trends were apparent. For instance, there
was no correlation between the population of the
area in which the user was raised and his level of
use. Socioeconomic level, the occupation of the head
of the household serving as the index, had no
detectable relationship to the level of marijuana
use, although the sample from the upper-manual and
lower-manual classes was small. Fifty percent of the
sample had an educational background of at least
some college education or more. And a detailed
analysis of the level of schooling achieved and the
present level of marijuana use gave no hint of a
relationship. It was apparent however that there was
a particularly high concentration of people with
some graduate education who were also occasional
users of marijuana. Otherwise marijuana use appeared
independent of the educational level achieved in our
population.
D: The possible hazard of residence in an
environment of high use - We looked particularly at
the respondent's time in the Haight-Ashbury and his
present level of marijuana use. Do those who stay
longer have higher levels of use due to increased
availability, associations made in the area, and the
like? Conclusive evidence is difficult to gain from
our questionnaire, since so few had arrived before
1967 (only 70 (16.95%) respondents had come to the
Haight before 1967). We are awaiting more data from
the surveys conducted in 1968 to conclusively deal
with this question. At this time it can be said,
however, that there was no statistically significant
difference in the frequency of the levels of
marijuana use between those who arrived in the
summer of 1967 and those who had arrived earlier in
1967.
The individuals experience with marijuana was by no
means entirely in the Haight-Ashbury, and their
first introduction to the drug was usually outside
the community. This is evidenced by a difference of
at least two years between the age of first trying
marijuana and their age when they arrived in the
Haight. (Table II) Many users (73.6 ± 4.3%) had come
to the Haight-Ashbury during the first nine months
of 1967. In addition; a full
17.7 ± 10.5% of the occasional users and 3.1 ± 2.7%
of the regular users had never used Marijuana in the
Haight, and over one-half were at the time of the
study Haight-Ashbury residents. A significantly
lower percentage of the 25 to 30 year olds had used
marijuana in the Haight-Ashbury, perhaps reflecting
a greater mobility and diversity of experience and
acquaintances.
The Use of Marijuana and the Abuse of Other
Drugs.
A: Alcohol-Marijuana correlates. The use of
the legal ethyl alcohol-containing drugs by this
population is particularly interesting, especially
when comparing and contrasting the use of marijuana
to the use of alcohol. Evidence has been presented
that marijuana may be similar in its pharmacologic
action to alcohol -- that it is a member of the
sedative- hypnotic class of drugs. It was our
impression that within this community marijuana was
being used as an alcohol substitute. Fifty-two of
the total sample (12.8%) had never tried hard liquor
while only about 2% (8) had never tried marijuana.
Only 65.62% ± of the entire group of respondents had
used any form of ethanol in the Haight-Ashbury,
while 90.8% ± 2.8 had used marijuana there. The
average age of the sample was 20.65 years, and
almost half were of the legal age to use and
purchase alcoholic beverages.
The abuse of hard liquor in this sample was quite
small when compared to the abuse of other drugs,
notably the psychedelics and intravenous
amphetamines. Only about 3% (12/413, 2.9± 1.6%) of
the 413 were dependent drinkers of hard liquor and
only about half of them were assuredly abusing the
drug in terms of the amount they consumed on each
occasion. So at first glance, among a population
which has a very high level of marijuana use, as
well as much experience with the psychedelic drugs,
where 50% habitually use marijuana and 15% abuse the
psychedelic drugs, by contrast only about 3% (3.25 ±
1.7) abuse the ethyl alcohol-containing drugs, hard
liquor, beer and wine, in terms of number of times
and amount consumed on each occasion.
The males in the survey had first tried hard liquor
at about the same age of 13 years, independent of
their present age, yet there was a difference among
the females. The younger females, 16 to 20 years of
age, had first tried hard liquor at a significantly
earlier age than their 25 to 30 year old
counterparts. The younger females had begun at age
12 to 13, about the same age as all age groups of
the males. Perhaps this reflects a change in social
attitude toward the use of liquor by females in our
society.
But we were concerned with a relationship between
the use of marijuana and the use of alcohol and so
examined in detail the peak and present levels of
the use of both drugs. Our questionnaire
distinguished between two types of ethanol use.
There were questions concerning the respondents use
of hard liquor and his pattern of use of beer and
wine. Again we determined who in each group was
abusing the drug, applying our previously stated
definition for abuse. First the respondents use of
hard Liquor was compared to his use of marijuana.
Because there was a small sample of hard Liquor
abusers (12), it was difficult to show any
statistical trend about the abuser's use of
marijuana. However, a few isolated trends stood out
which began to confirm our impression that in this
population a high level of marijuana use is
associated with a low level of hard liquor use. For
instance, among the female occasional user of
marijuana, a significantly higher percentage (20 .0
± 15.7) used hard liquor in an abusive pattern than
in any other groups of marijuana users, the regular
or habitual user. And among the female habitual
users of marijuana, their use of hard liquor was
quite low. The lowest percentage of hard liquor
abuse was among the habitual users of marijuana,
although because of the small sample, this was only
a trend.
There was much suggestion in the data to show that
people who had abused hard liquor previously were
now at a low level of liquor use but presently
sustained a high level of marijuana use. A specific
example is among a sample of males who had abused
liquor at a previous peak use period. Of these 26
males, 20 or 76.9 ± 16.1 percent had a very minimal
use of hard liquor during the month that this survey
was conducted while their use of marijuana in the
same time period was almost completely (95%) in the
regular-habitual use level. All of the 20 had used
the psychedelic drugs. These 20 who were not at a
low level of hard liquor use did, on the rare
occasions when they did use hard liquor, use the
drug in excessive quantities; that is, two-thirds
(66.7%) used it to get drunk, sick, or passed out
with the drug on these occasions. Three quarters of
these past abusers of hard liquor state that they
didn't plan to continue using hard liquor, all
planned to continue using marijuana, and practically
all (17 or 85%) attribute the change in their hard
liquor use to having taken marijuana and/or LSD.
There were 309 of the total sample of 413 who had
decreased or stopped their hard liquor use. 79.3 ±
4.5% attributed this change to their having taken
marijuana and/or LSD. Again (90.4%) were regular or
habitual users of marijuana, among a community which
condones marijuana use much as the middle class does
alcohol. Certainly it is dangerous to allude to a
cause and effect relationship between taking
marijuana and decreasing alcohol consumption, and to
underscore this point we would point out that when
asked about their preferred drug, or drug of choice
so to speak, 61.8% of these 269 preferred the
psychedelics and not marijuana as first choice;
however, marijuana as a second choice drug was quite
commonly preferred (56.6%).
B: Marijuana-LSD correlates. There is a high
degree of association in our sample between the use
of the psychedelics and the use of marijuana. And it
is our impression, supported by statistics from this
survey and in agreement with the impressions of
others, that in this community in the summer and
fall of 1967 the use of LSD and the use of marijuana
were practically inseparable. One must remember that
in the summer of 1967 this community consisted of
people who primarily used the psychedelics and
marijuana. In fact the ”hippie ethic” and the New
Community had part of its basis in the use of the
psychedelics and only secondarily used marijuana.
Unwilling to accept established conceptions about
drugs and for other reasons, this population
experiments a great deal with a variety of drugs.
And as we began to look at the abusers of each
drug included in our survey, it became clear that the
abuse of one drug was often associated with the
abuse of another drug, often within the same time
period.
We were able to distinguish an "abuser group" as
well as a group who used drugs but infrequently
abused them. This second group of users use
primarily the psychedelics and marijuana.
There were the experimenters, only 27.4 ± 4.3% of
the total sample who have presently no significant
use of any of the illegal drugs but only 14.5 ± 3.4%
of others who never have had more than an occasional
use of any illegal drug, except marijuana. Then
there are the persons who regularly use marijuana
and one or another of the psychedelics but have no
abusive pattern of use of any drug (amphetamines,
heroin, liquor, psychedelics) and these persons make
up one-third (35.4 ± 4.6% of the sample) of the
community. Among the marijuana-LSD users only 9.0%
had abused another drug during the same time period
while among the abuser group a full 31.77 ± 11.8%
had abused another drug. Finally there are those who
are drug abusers, (19.4-± 3.8% of the sample) most
commonly of the psychedelics, and whose use of other
drugs is commonly in the abusive levels. This we may
know as the abuser group. Our analysis of these
three groups of users will be expanded upon in other
papers dealing with patterns of the use of the
amphetamines and the psychedelics, but a few
pertinent statistics should be given to support
these observations.
The drug most commonly used in the Haight-Ashbury
aside from the almost universal use of marijuana, is
the class of psychedelics. And it is the drug most
commonly abused. 84.0 ± 3.5% of the total sample has
tried one of the psychedelics at least once
(usually, 96.8%, LSD) and 66.8 ± 4.5% had used the
drugs at least once during the month of September
1967. It is the drug most commonly abused. 74.1 ±
9.5% of those who have abused any illegal drug
except marijuana have abused LSD, or another of the
psychedelics. By contrast only 9.9± 6.5% of this
group abuse heroin. The next most commonly abused
drug is the intravenous amphetamines, commonly
methamphetamine. A significant 44.4 ± 10.8% of the
sample of abusers abuse only the psychedelics, and
these persons have an associated habitual use (86%)
of marijuana. And of the persons who only used the
psychedelics but did not abuse them, 75% abused no
other drug, although marijuana was used by one-half
habitually.
The habitual use of marijuana was significantly more
frequently associated with the abuse of the
psychedelics than with the abuse of any other drug
(Table IV.) 85.0% of the psychedelic abusers also
use marijuana habitually and this is significantly
higher (p=.05) than the frequency of habitual
marijuana use in any other of the abuser groups. By
contrast, among the regular users of the
psychedelics, that is those who use the psychedelics
and marijuana almost exclusively, only 52.0 ± 7.4%
used marijuana habitually. The abuse of the
intravenous amphetamines was negligible in this
group of regular LSD users; only 11 of 175 or 7% had
abused the intravenous amphetamines. But among
abusers of the psychedelics, 23.3 ± 10.7% also
abused methedrine i.v. in the same time period as
their abuse of LSD.
It is interesting to compare the age for first
trying marijuana and hard liquor, between the
abusers and regular users of the psychedelics. The
mean age of the psychedelic abuser (19.8 ± 0.4
years) was significantly younger than the
LSD-marijuana user. likewise, among psychedelic
abusers, the mean age of first trying marijuana was
younger (15.2 ± 0.4 years) than among the
LSD-marijuana (regular LSD users) user group (16.8 ±
0.2 years).
But the difference between the mean ages of first
trying marijuana and their present age differs by
only one year. The mean age for first trying hard
liquor is significantly younger among the abuser
group than among the LSD-marijuana user group. We do
not believe that the age for first trying marijuana
and the level of use of drugs is causally related,
but the significantly younger age for trying hard
liquor and marijuana among abusers may reflect early
conditions which predispose one to abuse drugs.
Certainly the high level of abuse of one drug
associated with the abuse of other drugs supports
the multiple drug abuse theory.
C: Marijuana-Amphetamine Correlates. Because
a second paper will focus specifically upon the use
and abuse of the amphetamines in our population, we
will only briefly summarize the use of marijuana
among the abusers of the intravenous amphetamines.
34.1 ± 4.6% of the total sample of 413 respondents
had tried using amphetamines by intravenous
administration at least once. 21.3 ± 6.7% of these
(7.3 ± 2.5% of the total sample) were presently
abusing the drug. The intravenous amphetamines are
the second most commonly abused drug within our
sample. Among the various levels of marijuana use
(occasional, regular, habitual) there was no
significant differences between the percentages of
intravenous amphetamine abusers in each group: a
range of from five percent of the occasional users
to 11 % of the habitual marijuana users. However
among the habitual users of marijuana there was a
significantly greater frequency of
experimental and periodic use of intravenous
amphetamine than in the occasional or regular
marijuana
use categories. This simply reflects a greater
frequency of drug use among those who have extensive
acquaintance with drugs and who are frequently
experimenters with various drugs and routes of
administration.
Apparently the level of i.v. amphetamine use has no
relationship to the level of marijuana use, for the
percent distribution of the various levels of
marijuana use was statistically the same whether
among experimental, periodic, or abuser of the
intravenous amphetamines (Table V). From 8 to 13%
were occasional users of marijuana; 22-34% were
regular users of marijuana; and 56-63% were habitual
users of marijuana. The habitual level of marijuana
use is the most frequent pattern of use within the
various levels of i.v. amphetamine use and abuse as
it is among the total sample of 413. It is true that
habitual marijuana use is significantly more
frequent among respondents who presently have any
use of i.v. amphetamines at all than among the total
sample of 413. But other patterns of marijuana use,
namely occasional and regular use, are no more
frequent among users or abusers of i.v. amphetamines
than among the sample as a whole.
If we consider only the abusers of the various drugs
we find that the frequency of habitual marijuana use
is statistically significantly greater among the
abusers of the psychedelics than among any other
abuser group. Although the frequency of habitual
marijuana use is greater among the abusers of the
i.v. amphetamines than among the general population
of the Haight, it cannot be considered significantly
greater than the other abuser groups, namely oral
amphetamines or heroin, due to the small sample in
these groups.
Originally it was our impression that the frequency
of marijuana use among abusers of the i.v.
amphetamines would be quite high because of
observations that marijuana was being used to aid
the person who was coming down from i.v. amphetamine
intoxication, much as a sedative would be used.
Apparently this practice may account for the
significantly greater frequency of habitual
marijuana use among the i.v. amphetamine abusers
than among the sample as a whole.
It is, however, difficult to account for the high
association of habitual marijuana use and abuse of
the psychedelics except to explain that these are
the most “socially acceptable” drugs within this
subculture, and their association may simply reflect
the social preference. It may also be true that
marijuana is being used to modulate the psychedelic
experience either as a “downer” or in an attempt to
heighten the experience.
D: Summary of Drug Preference. Certain
questions in the survey concerned a respondent's
drug preferences. His drug of choice was that drug
which he considered to best fulfill the goals which
he associated with taking drugs. A unique feature of
this drug using subculture is their preference for
the psychedelics as their first choice. 46.8% of the
sample listed LSD as their first choice, and 25.5%
listed marijuana first. And although 8% of the
sample were abusing i.v. amphetamines only 3% listed
that drug as first choice. And the preference for
LSD as a drug of choice existed among practically
all groups of users and abusers within this
community. Marijuana was listed by 53.9% of the
respondents as second choice, and LSD was listed by
19.4% second.
Discussion:
A few concepts and definitions must be reviewed
before discussing the problems of multiple drug use
and the inverse or direct relation between the use
of one drug and another. Why, for example, was the
inverse relationship between hard liquor use and
marijuana use just described in this population not
repeated when the use of beer and wine by the
marijuana users was considered? '
Classification of drugs subject to misuse. -
Psychoactive drugs may be classified into several
groups according to their mode of action. We have
discussed hard liquor which is a sedative-hypnotic
drug. Other members of this general classification
of sedative drugs include the other
ethanol-containing drugs ( in our survey beer and
wine), the barbiturates, and drugs formerly termed
“minor tranquilizers” but now known to be sedatives,
such as meprobamate (Miltown), chlordiazepoxide
(Librium) and diazepam (Valium). Furthermore, there
is evidence to classify marijuana as a sedative
drug.2 A second group of drugs is the opiate
derivatives: heroin, morphine, crude opium, and
narcotic synthetics. It is generally agreed that
marijuana is not a member of this class of drugs. A
third group of drugs are those with selective
central nervous system stimulating properties,
conveniently termed the psychedelic or
hallucinogenic type drugs, such as LSD-25, STP (DaM),
MDA, mescaline, psylocybin, etc. Marijuana is said
by some to be a “mild hallucinogen” and was compared
in some studies to peyote or mescaline in its
effects, 3 implying its inclusion in this class of
drugs. It must be remembered that the occurrence of
hallucinations or what has been termed
pseudo-hallucinations4 with a particular drug does
not automatically place it in the class of
psychedelic drugs. Nitrous oxide, ethanol, and
amphetamine may produce hallucinations at certain
stages of intoxication or withdrawal. The authors of
this paper prefer its classification as a sedative
and have assembled evidence in support of this
hypothesis.2 A fourth group of drugs are the
general central nervous system stimulants, drugs of
the amphetamine type, including oral and intravenous
amphetamine ("speed"), and nicotine and caffeine. In
passing we should note how similar are the
psychedelic drugs and the amphetamines in
pharmacologic action and chemical structure, and
differentiation of these 2 groups may be culturally
rather than pharmacologically determined by the
"psychedelic community."
Multiple drug abuse - There are several theories
about drug abuse and the drug abuser, but a
particularly useful one, and one which is supported
by our data from this drug centered community, is
the "multiple drug abuse theory." The person who has
an abusive pattern of use of one drug is more likely
to abuse another drug, either concomitantly or when
the first drug is not as available. This theory
implies an "abuser personality" who is prone to
abuse any drug used, although one drug may be said
to be preferred over another for its effect, lack of
side effects, etc. Such a theory should not be
applied to the social or ritual use of drugs - e.
g., marijuana by the youthful subculture or LSD by
an indoctrinated hippie - nor should its emphasis on
individual susceptibility obscure group factors that
are acting.
The multipIe drug abuse theory assumes that abuse of
drugs by a person may extend beyond a single class
of drugs, for instance the amphetamines, into
another group with different properties such as
alcohol, a sedative drug. This type of abuse - abuse
of drugs in differing classes - may be known as
horizontal abuse. An example would be the speed
(amphetamine) abuser who also abuses the psychedelic
type drugs, or the narcotics such as heroin. A
different pattern of abuse may be known as vertical
abuse, that is the abuse of different drugs within
the same drug classification. An example of this
form of abuse would be the alcoholic who also abuses
another drug which is a sedative, for instance,
meprobamate.
The use of drugs within the same class may lead to
an additive effect of the two drugs being used
together in the same time period; that is, the
effect of one drug adds its effect to the effect of
the other drug. This result is twice that of other
drugs used alone in the same dosage.
Interchangeable use of marijuana and alcohol - Now
these concepts may be applied to our study, in
particular to the use of beer and wine and marijuana
by this population. We noted that our data tended to
support our impression that marijuana is being used
as an alcohol substitute within this subculture, and
that the use of alcohol has declined for many of the
respondents while their use of marijuana is quite
high. To suggest any cause for such a change or the
exact nature of that cause would be highly
speculative, but we should mention that 80 to 90% of
a given sample attribute their decrease in alcohol
consumption to their having taken marijuana and/or
LSD, and agree with the implication in the question
that their use of marijuana and LSD came before the
decline in their use of alcohol. The role LSD has
played in such a change is difficult to evaluate,
but certainly a greater percentage prefer LSD to
marijuana as a drug of choice.
Nevertheless, if we look at the group of persons
whose use of hard liquor has decreased or stopped,
we find that while their use of beer and wine also
for the most part has decreased, significantly fewer
of these persons have discontinued their use of beer
and wine and more plan to continue their use of beer
and wine in the future. Only 22.98 ± 4.7% of this
sample of persons whose use of hard liquor has
decreased or stopped plan to continue their use of
hard liquor, but 57.9 ± 5.5% plan to continue their
use of beer and wine; however, objective evidence
indicates that it is usually at a lower level of
use.
There were 31 persons who had abused ethanol in any
form (hard liquor or beer and wine) and 9 had
discontinued their use of hard liquor altogether.
All were habitual users of marijuana and all had
continued their use of beer and wine but at a level
below an abusive pattern. Why don't attitudes and
practices of beer and wine follow the decreased use
of liquor among the marijuana users in this
population?
There are many possible explanations and probably
not any single explanation will suffice. But we have
on several occasions talked to members of this
community who spoke of their concurrent use of
marijuana and wine. A group would smoke several
"joints" of marijuana and then purchase and consume
a bottle of wine. They insisted that this practice
led to becoming much more “stoned", and the
experience of marijuana and wine together was
subjectively said to be better than the use of
either drug alone. Similarly one of the authors has
seen attempts in the Midwest at “curing” marijuana
in wine, presumably to try to reproduce such an
effect. The occurrence of such a practice would
explain the statistics; moreover, it would be an
example of the additive effect of two drugs being
used together. It is known that alcoholics will try
to get sedative drugs to decrease their consumption
of alcohol, and certainly this is the practice in
the medical treatment of alcoholic withdraw - to
substitute one safer, longer active sedative drug
for ethanol, a short-acting sedative with a low
therapeutic index. And if you consider marijuana a
sedative drug like ethanol or the barbiturates, then
this is an example of vertical abuse. Heroin abusers
at times will abuse a barbiturate in order to
decrease their heroin habit - an example of
horizontal abuse, and the contamination of LSD with
methedrine to increase the subjective effects aims
at a similar effect.
Marijuana use and the sequential theory of drug
abuse - The habitual use of marijuana is often
associated with the abuse of other drugs not in the
same pharmacologic class. The habitual use of
marijuana is frequently associated with the use of
the psychedelic drugs for example, which is an
example of vertical abuse if marijuana is considered
to be a psychedelic or an example of horizontal
abuse if it is considered a sedative. In any case
there are many examples of high levels of marijuana
use being associated with high levels of use or
abuse of other drugs within this community.
Marijuana is involved in both horizontal and
vertical use within this drug-using subculture as a
social drug, a spree drug, and a depressant to
antagonize stimulant drugs.
The sequential theory of drug abuse, that the use of
marijuana will lead to the abuse of heroin in
particular, has been the subject of debate in the
past. Most authorities now agree that there is
little basis in fact for such a statement. 3 And our
data supports its refutation.
Only 8 of the total sample of 415 respondents were
heroin abusers. However the percentage of heroin
abusers presently using marijuana habitually is
significantly lower than the high percentage of
habitual marijuana use among the abusers of the
psychedelics, and tends to be lower than the
frequency of habitual marijuana use among any other
abuser group. Only 50.0% of the heroin abusers are
habitually using marijuana, while 85.0% of the
abusers of the psychedelics are habitually using
marijuana. The levels of marijuana use among the
abusers of the various drugs is shown in Table IV.
The data of this survey suggests a surprisingly high
incidence of experience with opium. For reasons
mentioned below, we believe that the questions as
used did not provide a valid measure of the amount
of opium actually used. 58.3% of our sample admitted
to having tried opium at some time, and 36.3 ± 4.6%
stated that they had used opium while in the
Haight-Ashbury neighborhood.
However, more detailed interviews with residents and
dealers suggest that their answers were based on the
very doubtful assumption that they had used
"opium-cured grass" at one time or another. The
small amount of opium brought into the community in
the past was used in small amounts and in a group
very much as marijuana was used.
As alluded to above and as explained in other
papers6, the selling of drugs on the street in this
community involves what might be termed a "Madison
Avenue approach”. Drugs are being sold under
constantly changing guises, fantastic claims are
made about each drug, and the user has a
preconception about the expected effect of a
particular drug sold to him even before he has the
experience. Many drugs are billed as containing one
ingredient when in fact they contain something else.
There have been actual attempts at the "curing” of
marijuana in solutions of such drugs as DMT or
cocaine, but they are hardly frequent enough to
account for the often heard patter of the seller
about "opium, DMT, or cocaine-cured grass". The
differing effects one may experience with marijuana
purchased in the Haight is more rationally explained
in terms of the amount of active ingredient, rather
than attributing it to a contaminant in the
marijuana as the community often does. It is known
that attempts at curing marijuana in sugar have been
successful, and stories of DMT or opium curing
should not be dismissed as mere fiction.
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