"Social and Epidemiological Aspects of Marijuana Use" was presented at the National Symposium on Psychedelic Drugs and Marijuana, under the auspices of the Illinois State Medical Society, on April 11, 1968, and was published in the Journal of Psychedelic Drugs 2, no. 1 (Fall 1968): 67-77. Copyright © 1968 by David E. Smith, M.D. Reprinted with minor changes by permission of the publisher and the author.
To a sociologist, the marijuana picture today borders on the surrealistic. Much discussion concerns the pharmacological properties of marijuana and the consequences—short- and long-term—of its use. Additional debate centers about the adequacy and/or fairness of legal sanctions and judicial dispositions for marijuana offences. Both of these items, however, beg the central issue regarding marijuana use today, an issue that is fundamentally social and epidemiological: it is the fact that respected and respectable people are themselves smoking marijuana or are facing the fact that their children do so or are likely to do so.
It matters not much, I think, whether marijuana will prove to be somewhat more or somewhat less harmful than we now believe it to be. There are things much more dangerous than marijuana that remain well beyond the reach of the criminal law. It may be noted, for instance, that overindulgence in food presents considerably more serious problems for the well-being of our society than use of marijuana. Overweight people kill themselves prematurely, make poor soldiers, and waste valuable commodities. Yet nobody seriously proposes the creation of new crimes, labeled first- and second-degree obesity, or the establishment of an S.S. corps (for Supermarket Surveillance), or restrictions on the import of Israeli halvah, Swiss chocolate, or Italian spaghetti—commodities that poison the bloodstream and make us vulnerable targets for a foreign takeover.
What does matter, excruciatingly so, is that marijuana is becoming embedded as part of the way of life of obviously responsible, obviously otherwise conforming persons. The implications of the epidemiological situation pose problems regarding tactical withdrawal from an entrenched moral position. Our problem with marijuana is not unlike the long-standing problem of our official position in Vietnam (if a political aside may be permitted). It is not by chance alone, in this respect, that congressional attention has to be drawn in recent months to the supposedly high rate of marijuana use among American troops in Vietnam. Like sex indulged in under the banner of tomorrow-we-die-on-the-battlefield, marijuana use by combat troops raises delicate questions of a "moral armistice" in the manner that terminal cancer patients are permitted to have as much morphine or LSD as is necessary for their comfort. Presumably, as graduate students are drafted in large numbers into the armed forces, the marijuana problem will become aggravated; perhaps films such as "The Menace of Marijuana" will replace those on venereal disease as leading candidates for military cinema oscars.
How Things Went to Pot
It hardly needs saying that the precise parameters of marijuana usage are very difficult to locate. The well-publicized episode of a 58-year-old elementary school principal in a northern California town, who recently told a legislative committee that it had been her habit for the past 18 years to come home from the classroom to a puff of pot, illustrates what is undoubtedly a widespread phenomenon of regular and undetected marijuana usage. In the same vein is the story of a California law school dean who suggested that the statutes against marijuana would undoubtedly be repealed within the next ten years. It was his understanding that a large number of his students were currently using marijuana, and his presumption that many of these persons would be elected to the state legislature in coming years.
Anecdotal material does not, however, provide adequate fare for an epidemiological inventory regarding marijuana. Such an inventory might begin by noting that Chinese and Indian sources have reported on the presence of marijuana as far back as the 1300s. The drug was adopted in literary, intellectual, and artistic circles in Europe about 1800. It then made its way to Latin America and Mexico, but was virtually unknown in the United States until the 1920s.
Enactment of the Marijuana Tax Act in 1937 clearly set the ground rules for official handling of the drug. In 1930, when the Federal Bureau of Narcotics was established, only 16 states had outlawed marijuana, and theirs were relatively mild proscriptions, rarely enforced.1 In 1933 the ill-fated Volstead Act and prohibition were abandoned, though by 1937 virtually all states had declared marijuana illegal. The congressional hearings in that year on the Marijuana Tax Act represent illustrations of the federal legislative process at its poorest; with single-minded dedication committee members moved from an untenable set of original postulates to a fallacious set of preordained conclusions, making certain to push aside any refractory material along the way.2
Fundamental to passage of the Marijuana Tax Act and to state laws was an unstated linkage between marijuana and the behavior and reputation of groups then using the drug in the United States. As we shall see, acts viewed as unattractive, family behavior patterns viewed as unappetizing, and similar conditions believed to be unesthetic, items that were indigenous to Negro and Spanish-speaking groups, were implicitly related to the presence of marijuana. It was the same process by which the idiosyncracies of the aberrant in other times and other places have been tied to such things as their style of dress, their heresies, and their ceremonies. Today, in similar manner, campaigns against crime in the streets often represent camouflaged methods for retaliatory tactics against minority group members, who most often commit such crimes, but against whom frontal assaults are no longer fashionable.
The Little Flower and Pot
Mayor Fiorello LaGuardia of New York City, while serving in the House of Representatives, had been impressed by testimony that use of marijuana among U.S. troops in Panama posed no serious problem either to mental health or discipline. Given this background, LaGuardia tended to doubt the horror stories regarding marijuana; he therefore arranged for a medically-supervised investigation of the drug. The subsequent report of the work of the mayor's committee, begun in 1939 and published in 1944, provides by far the best epidemiological material we have on marijuana for the 1930-40 period.
Field work for the sociological segment of the mayor's committee report was undertaken, oddly enough, by six officers from the narcotic squad of the police department. Their investigation was directed toward answering six questions. The first two concerned the extent of marijuana use in New York and the method by which marijuana was distributed. They found that use of the drug was heaviest in Harlem and secondarily in one section of midtown Manhattan, although marijuana was used to some extent in other areas of the city as well. Most of the users were either Negro or Latin American, in their twenties, and unemployed. There were an estimated 500 peddlers in Harlem, and about 500 "tea-pads" where marijuana was consumed on the premises.
The third question dealt with how users viewed marijuana. The smokers felt that it made them feel better and that it was not harmful in any way. Persons would voluntarily cease using marijuana for long periods without signs of discomfort. Finally, it did not appear that marijuana served as a stepping stone to heroin or other addictive drugs.
Because of claims that marijuana use was responsible for sexual degeneracy and sex crimes, the field workers looked for possible relationships between marijuana and eroticism. They found none. The evidence also failed to substantiate the existence of a causal relationship between marijuana use and crime. In cases where an individual both smoked marijuana and engaged in crime, it appeared that the criminal activity came first. Finally, the study looked into the relationship between marijuana use and juveniles. It found very little marijuana use in the New York City high schools or junior high schools, and no tendency for juvenile delinquency to develop out of the little use there was. The report on the sociological part of the study concluded that "the publicity concerning the catastrophic effects of marijuana smoking in New York City is unfounded." 3
Issued almost midway through the second world war, the sound and sophisticated material in the mayor's committee report has never received the careful attention it merits, though its conclusions regarding the nonaddictive qualities of marijuana are widely known.
Both support for and perversion of the approach of the mayor's committee is, however, nicely illustrated by a number of wartime studies of marijuana use by military personnel. All the studies, for instance, note a disproportionate number of Negroes among marijuana users referred to neuropsychiatric services. In a study of patients at Fort McClellan, Alabama, 55 were Negroes, one white;4 all but one of the 35 marijuana cases at March Air Field Base in California were Negroes,5 and 95 percent of the marijuana cases among servicemen in India were also Negroes.6
The Fort McClellan study illustrates as well as anything might the often feudal and futile process of generalizing from a sample whose characteristics are not measured by adequate sampling or control techniques. Thus the Fort McClellan researchers concluded that "the preponderance of Negroes is due, we believe, to the peculiar need marijuana serves for them." Marijuana, they felt, "enables the Negro addict to feel a sense of mastery denied him by his color," 7 a conclusion made somewhat less than prescient by the spread of use today to persons who possess an obvious sense of mastery of both themselves and the world about them.8 In addition, the Fort McClellan study went on to detail a past history of personal horrors among the users that, three decades later, sounds like nothing more than a description of life and its consequences for a large part of the population of the Negro ghetto.
The LaGuardia report and the clinical material from the military doctors have been further supplemented by studies of marijuana use among jazz musicians, members of an occupational group that perhaps more than any other has traditionally been associated with a pattern of heavy recourse to drugs.
A study by Charles Winick indicates that jazz musicians were heavy users of alcohol in the early years of this century, but moved toward marijuana during the 1930s. Following the second world war, however, heroin began to gain popularity. From interviews conducted during 1954 and 1955 with 357 jazz musicians, whose average age was 33, regarding the drug use habits of their colleagues, Winick estimated that 82 percent had used marijuana at least once, 54 percent were occasional users, and 23 percent were regular users. More than half had tried heroin, 24 percent used it occasionally, and 18 percent regularly. Though a majority of the musicians tended to believe that marijuana hindered rather than improved performing ability, a number pointed out that use of the drug seemed necessary for them to face the demands of their job; that without it they would be unable to perform at all. The study also indicated that marijuana may aid in buttressing occupational solidarity and insularity. If true, the story often told to Winick that a jazz band had performed such marijuana-euphemistic numbers as "Tea for Two" and "Tumbling Tumbleweed" at a police benefit dance must have been a source for great ingroup merriment.9
By using a similar group of subjects interspersed with marijuana users other than musicians, Howard Becker has contributed the view that continued recourse to marijuana depends upon a series of events, beginning with learning to smoke the drug in a manner that will produce real effects, then learning to enjoy the perceived sensations. "In short," Becker suggests "the marijuana user learns to answer 'Yes' to the question: 'Is it fun?"' The further direction that his drug experience will take then comes to depend upon intervening factors, including such things as moral judgments, availability of the drug, fear of arrest, and social reactions.10
Out of the Frying Pot
Since 1968 we have acquired adequate longitudinal information with which to examine the continuing careers of persons in the lower socioeconomic class, who have been the principal marijuana users until very recent times. This information comes from a St. Louis study by Lee Robins and George Murphy, which indicated more widespread use of marijuana than many persons had suspected, as well as a striking diminution of marijuana use with advancing age.
Study subjects were young Negro men who had been born in St. Louis between 1930 and 1934, had attended local elementary schools, and were residing in St. Louis in 1966. Of the 221 persons interviewed in the study, 109 had tried at least one of four drugs; 103 had used marijuana, 28 had used heroin, 37 had used amphetamines, and 32 had used barbiturates. It is noteworthy that all the heroin addicts, as distinguished from heroin experimenters, had arrest records, and that all addicts admitted their heroin use to study interviewers, who themselves were previously unaware of it. In regard to marijuana, only a very small percentage of either occasional or regular users had ever come to the attention of the police. It is notable that half of the marijuana users had never taken any other drug, that three out of four of the heroin users began with marijuana, and that one out of four of the marijuana users began using the drug before his sixteenth birthday. Sixty-nine percent had begun using marijuana by the time
they were 20 years old, and only nine percent from age 24 and afterwards."
During the year preceding that in which they were interviewed, 22 of the men ( about ten percent) reported that they had used drugs. Three had used heroin, and a fourth, then imprisoned, had been using heroin prior to his arrest.12
The drug-use rate uncovered by the St. Louis investigation may be slightly inflated by omission of rural and small town migrants, but it indicates nonetheless a quite pervasive pattern of marijuana use among a minority group in a midwestem city where drugs are not considered as notable a problem as they are in seaports and Mexican border cities.
Weed-Filled Recreation Sites
Marijuana use today has obviously moved from the lower socio-economic segments of our population into our demographic mainstream. The spread of marijuana to the middle and upper strata of the society is, however, a quite recent phenomenon, one that makes the most penetrating numeration outdated in short order. As a recent magazine recently put the matter: "Statistics on the problem are nonexistent, and its extent is tough to gauge. School officials normally ignore it or hush it up; students with first-hand knowledge are prone to boastful exaggeration; arrests are relatively rare." 13 Despite this situation, however, we do have some information regarding current marijuana use that provides a basis for observations about the direction in which such use is likely to proceed.
It is necessary, first, to continue to examine the lower socioeconomic groups, partly because they use the drug more than other groups, and partly because they provide the liaison to marijuana use in other segments of the society.
The clearest insight into present drug customs in deprived areas must certainly be that reported by Herbert Blumer and his colleagues in 1967. Blumer's work had been designed to induce youthful drug users to abstain from further usage, a mission in which it totally failed. "The real reason for the lack of success," project workers noted, "was the strong collective belief held by the youths that their use of drugs was not harmful and their ability to put up effective arguments, based usually on personal experience and observation, against claims of such harm. " 14
Frustrated as reformers, the project team decided to become researchers. As such, by their rather immodest appraisal, they were preeminently successful. "We believe," they write, "that we have penetrated more deeply and fully into an analysis of the world of youthful drug users than is true of any published accounts."
Two major types of drug users were identified among youths in the Oakland flatlands, an area populated primarily by lower-class Negroes and Mexican-Americans, where the project was run. These youths were labeled either as rowdy or as cool. Rowdies, a small minority, were aggressive and used any and all drugs but preferred alcohol. Cool youths fell into three types: pot heads ( or weed heads ), mellow dudes, and players. Mellow dudes, by far the most prevalent group, would "try anything once" but did not seek out drugs. Their orientation was hedonistic, their pleasures primarily sexual. They used pills and crystals ( methamphetamine hydrochloride or methedrine) as well as marijuana.
The Pot head, member of a sizeable group, is exclusively a user of marijuana. He has been described in the following terms:
He uses no drugs other than marijuana and may even prefer soda pop to drinking alcohol. He is respected by other adolescents, presenting an image of a calm, sensible, solitary figure, soft-spoken, personable, and thoroughly knowledgeable about what is "happening" in the adolescent world. He takes pride in his appearance, always wearing sharp slacks and sweaters, is interested in taking things easy, having a good time, and fostering relations with the opposite sex. He is likely to be involved in conventional life activities, participating in various school functions, athletics, and conventional work.15
The pot head is apt to smoke a joint when he awakens, and a second after breakfast, after he has "eaten his high away." A third cigarette might be used in the early afternoon and others in the evening, depending upon the social agenda. Like all youthful drug users, the pot head looks down on heroin addicts as persons who have "blown their cool."
Initiation into marijuana use by pot heads was regarded by the project researchers as something other than a fulfillment of a personality predisposition or a motivational syndrome. Various conditions were found to keep the neophyte from access to drugs, primarily conditions relating to others' estimates of his integrity and his "coolness." Many pot heads were "turned on" by older brothers, who were intent upon preventing them from "sniffing glue, drinking wine, or risking the chance of being arrested." 16
Finally, the Oakland study team assailed standard personality theories of drug use, which they found "ridiculous." It is "primarily the defining response of associates that leads to the formation of whatever motives may be attached to drug use," it was claimed. The study evidence was said to show "overwhelmingly that the great majority of youngsters become users not to escape reality but rather as a means of embracing reality" in a setting where drug use is extensive and deeply-rooted." It was the guess of the research team that most pot
heads would be assimilated into conventional life as adults, though their drug experience might lead a few of them into more serious narcotics involvement.
Further light has been shed on the subsequent careers of young users of dangerous drugs by a follow-up study of a selective group consisting of 866 persons under 18 arrested for the first time on a nonopiate drug charge during 1960 and 1961 by the Los Angeles police. Subsequent arrest records of each person were examined from the date of his initial apprehension through the following five years.
Of the 866 youths, 58 percent had no subsequent recorded arrest for drug involvement. Thirty percent were subsequently arrested on marijuana and/or dangerous drug charges only ( the same offense for which they had initially been apprehended). Only 12 percent of the youths were subsequently arrested for opiate involvement. These findings contradict the notion that later opiate use is necessarily a consequence of marijuana or dangerous drug involvement.18
Where the Grass Is Greener
Given the greater use of marijuana by the lower-classes in the past decade, it is likely that the striking recent increase in police seizures of marijuana's and the skyrocketing arrest rates for marijuana offenses represent in considerable measure the use of marijuana by middle- and upper-class citizens. These two groups present the major ideological challenge to marijuana laws and the major rebuff to traditional explanations of marijuana use.
A general overview of available epidemiological material by Stanley Yolles indicates that perhaps 20 percent of high school and college students have had some experience with marijuana. More men than women students report involvement, and of those students reporting use, 65 percent say they smoked marijuana fewer than ten times, with the most common response being "once or twice." It was noted as particularly interesting that fully 50 percent of the students who had tried marijuana indicated that they experience no effects from it. Four explanations were offered for the situation.
1. The agent may not have been potent.
2. Frequently effects are experienced only after repeated use.
3. The expectation of the user has a significant effect on what he experiences.
4. The social setting in which use takes place has an effect on the response.20
More detailed information than that supplied by Yolles may be gained from surveys of drug-use patterns among high school students on either coast of the United States. In a study at two senior high schools in Great Neck, New York, an affluent suburb with a school system considered among the best in the nation, some 207 of 2,587 students (8 percent) reported they had smoked marijuana. Fifty-five had tried LSD.21 On the west coast, in a senior class of a high school in San Mateo County, California, more than 25 percent of 288 boys and almost ten percent of 220 girls reported that they had used marijuana at least once, with more than half of both groups indicating use on three or more occasions. It is interesting in this connection that the San Mateo survey made the following observations.
There is less accurate and less medical information about marijuana than any of the other dangerous drugs or narcotics.
Youths do not trust adults' information regarding marijuana.
Many youths maintain that the use of marijuana is no more harmful, and probably less harmful, than the use of alcoholic beverages.22
It is also interesting in connection with the high school surveys that a recent Harris Poll indicates that only five percent of the nation's parents report knowing a teenager who smokes marijuana, and that the smoking of marijuana is forbidden for their own children more than any other activity, with 85 percent of the parents saying that they would forbid marijuana, compared with 84 percent who would ban LSD, 70 percent who would rule out drinking hard liquor, and 66 percent who would object to a two-week trip taken by the youngster alone.23
It may be, although we have no definite information on the subject as yet, that a disproportionate number of the high school drug users do not matriculate. Among the heaviest users of drugs, some may migrate to such renowned citadels as the Haight-Ashbury district in San Francisco, where research has been undertaken to gain a profile of summer transients and permanent residents. Preliminary HaightAshbury reports, incidentally, indicate that the largest amount of marijuana use occurs among persons regularly using methedrine. Such persons use marijuana to put themselves in a more tranquil condition after recurrent methedrine experiences or, in their own terms, at the "end of a run." In Haight-Ashbury it is the methedrine group as well that reports the highest rate of personal problems, since such problems are measured by prior contact with or referral to psychiatric services,24 although it is possible, research logicians note, that the psychiatric experiences drove the youths to methedrine rather than that a pre-existing disordered state led both to psychiatric referral and to later drug use.
The sparse data available on marijuana use in colleges also indicates a dropping off from the rates among high school seniors at the surveyed schools. One news report has indicated that, on some basis, it was decided that 15 percent of the student body at the University of Miami had had some experience with marijuana and that 8 percent of the total group had used marijuana more than ten times.25 More useful is the result reported by William McGlothlin and Sidney Cohen of a questionnaire profile of 121 male graduate students responding to an advertisement for study subjects in January 1965. Thirteen of the respondents indicated some experience, generally of an infrequent nature, with marijuana. The advertisement, it should be noted, gave no indication that the experimenters were interested in drug issues, though it is still not unlikely that there could have been a significant under-reporting because of possible loss of the opportunity to acquire work. In either case, the current nature of our information on marijuana use by college students is clearly inadequate and obviously biased by the New York Times. Four years ago, write McGlothlin and Cohen, a Harvard student turned in his roommate to the authorities for smoking marijuana in order to save him. Today, "it would be embarrassing for a student to admit that he hadn't at least tried pot—just as it would be embarrassing to admit that he was a virgin." 26
Our analysis suggests that early and continued use by dispossessed elements in American society may have contributed to the present legal position of marijuana, just as it suggests that shifts in use patterns may be contributing to a reexamination of that position. It has not been our intention to reargue already well-argued polemical points regarding the proper position for the law, the medical profession, or the lay public to take regarding official policies on marijuana or personal use of the drug. Rather we have attempted to mar-shall what concrete data exists concerning the social and epidemiological nature of marijuana use, and to let that material speak for itself. Ultimately, of course, the attitude that society chooses to take regarding marijuana must emerge from a weighing of unquantifiable values. It is only worth noting, in concluding, that that attitude itself will then become, as it has been in the past, one of the most important items shaping the epidemiological patterns and the consequences of such patterns in regard to marijuana use.
1 David Solomon, "Marihuana Myths," in Solomon, ed., The Marihuana Papers (Indianapolis: Bobbs-Merrill, 1966), p. xv.
2 U.S. House of Representatives, Committee on Ways and Means, Hearings on the Taxation of Marihuana, 75th Cong., 1st Sess., 1937. See also Joseph S. Oteri and Harvey A. Silverglate, "In the Marketplace of Free Ideas: A Look at the Passage of the Marihuana Tax Act," in J. L. Simmons, Marihuana: Myths and Realities (North Hollywood, Calif.: Brandon House, 1967 ), pp. 136-162; and Howard S. Becker, "The Marihuana Tax Act," in The Outsiders: Studies in the Sociology of Deviance (New York: Free Press, 1963), pp. 595-846.
3 See Dudley D. Shoenfeld, "The Sociological Study," in Mayor's Committee on Marihuana, New York City ( Lancaster, Pa.: Cattell Press, 1944), pp. 1-25. The summary of the report has been taken in large measure from the excellent presentation by David 0. Arnold, "The Meaning of the LaGuardia Report: The Effects of Marihuana," in Simmons, op. cit., pp. 111-35.
4 Sol Charen, and Luis Perelman, "Personality Studies of Marihuana Addicts," American Journal of Psychiatry 102 ( March 1946 ): 674-82.
5 Eli Marcovitz, and Henry J. Myers, "The Marihuana Addict in the Army," War Medicine 6 ( December 1944 ): 382-91.
6 Herbert S. Gaskill, "Marihuana, An Intoxicant," American Journal of Psychiatry 102 ( September 1945) : 202-94.
7 Charen and Perelman, "Personality Studies," p. 674.
8 "Fifteen percent of the students at Princeton admit smoking pot—two-thirds of them in the upper academic 20 percent, a third of them members of varsity athletic teams." Antoni Conan, "The Great Marihuana Problem," National Review 20,4 ( January 30,1968 ): 78.
9 Charles Winick, "The Use of Drugs by Jazz Musicians," Social Problems, Vol. 3 (winter 1959-1960), pp. 240-253; Winick, "Marihuana Use by Young People," in Ernest Harms, ed., Drug Addiction in Youth ( New York: Pergamon Press, 1965), pp. 19-35.
10 Howard S. Becker, "Becoming a Marihuana User," American Journal of Sociology 59 (November 1953): 235-42.
11 Lee Robins, and George E. Murphy, "Drug Use in a Normal Population of Young Negro Men," American Journal of Public Health 57 ( September 1967): 158-59.
12 Ibid., p. 158.
13 "The Pot Problem," Time Magazine, March 12, 1965, p. 49.
14 Herbert Blumer, Alan Sutter, Samir Ahmed, and Roger Smith, The World of Youthful Drug Use, Add Center Project Final Report, School of Criminology, University of California, Berkeley, January 1967.
15 Ibid., p. 79.
16 Ibid., p. 49.
17 Ibid., p. 59.
18 Dimitri Polonsky; George F. Davis; and Chester F. Roberts, Jr., A Follow-Up Study of the Juvenile Drug Offender ( Sacramento: Institute for the Study of Crime and Delinquency, October 1967 ), p. ix.
19 Bulk seizures of marijuana by federal enforcement authorities totaled 5,641 kilograms in 1965, as against 1,871 kilograms in 1960. President's Commission on Law Enforcement and Adminstration of Justice, Challenge of Crime in a Free Society ( Washington, D.C.: Government Printing Office, February 1967 ), p. 213.
20 Stanley F. Yolles, "Statement on LSD, Marihuana, and Other Dangerous Drugs," statement to U.S. Senate, Committee on the Judiciary, Subcommittee on Juvenile Delinquency, March 6, 1968, pp. 14-15.
21 United Press International, February 16, 1967.
22 Juvenile Justice Commission, Narcotics Inquiry Report for San Mateo County, November 16, 1967, p. 5.
23 Los Angeles Times, March 4, 1968.
24 David E. Smith and J. Fred E. Shick, "Marihuana and Its Relationship to Other Drug Practices," paper presented at National Marijuana Symposium, San Francisco, March 24, 1968.
25 Reuter's, March 18, 1968.
26 William H. McGlothlin and Sidney Cohen, "The Use of Hallucinogenic Drugs Among College Students," American Journal of Psychiatry 122 ( November 1965) : 572-74.