Interim Report
In the recent addiction literature, emphasis has shifted
away from an exposure model, suggesting that drug (particularly opiate)
use engenders a powerful urge towards subsequent compulsive use, to
adaptive theories, proposing that drug use is an attempt to adapt to
chronic stress of whatever origin. This shift has been prompted by an
accumulation of evidence which cannot be accomodated within an e.@posure
model - the fact that casual use of opiates is relatively widespread,
that some heavily addicted groups (Vietnam veterans, e.g.) show only
moderate levels of recidivism after induction into civilian life, for
example. Metabolic theories, such as Goldstein's proposal of a
fundamental opiate avidity in mammals, or the recent claim that repeated
exposure to opiates might create a long-term incapacity of the body to
synthesise endorphins,their endogenous counterparts(Snyder, 1977), have
proved not to be viable. Nor have conditioning theories, the other
influential approach of this genre, whether these employ a simple
positive reinforcement or avoidance learning model, or more formally
developed models, such as Solomon and Corbit Is opponent-process
theory (Solomon, 1980), which integrates both elements.
Adaptive theories, which appear to violate conventional
wisdom about addiction, view drug use as a coping strategy, a means of
handling distress, whether this is due primarily to inadequate person-
ality, a need to reduce physiological or psychological pain,as a means
of dealing with social stress, or as a response to a violent or
hostile environment. Adaptive or coping mechanisms include opiate use,
smoking, drinking, over- and under-eating, 'Type Al behaviour,the
overuse of denial. Considerable evidence in the current literature
increasingly supports this view (cf. Alexander and Hadaway, 1982).
A similar theoretical shift is observable in the literature
dealing specifically with smoking, and, to a lesser extent, alcohol use.
Arousal modulation theories of smoiing maintenance propose that psycho-
active drugs such as nicotine are used to enhance performance when the
individual is bored or fatigued, and to promote 'psychological comfort'
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when he is anxious and/or stressed. There are indications that the
particular drug used is, to some extent, a function of the person's social
experience and expectations, drug availability, cultural sanctions on
drug use, and so forth. It seems a reasonable inference from this
that if an habitual user is cut off from his source of supply for
whatever reason, he will migrate to other, more readily available drugs.
which produce essentially the same effects, a finding which has been
recorded with heroin users (Wishnie, 1977, e.g.). C:>
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This is the background to the proposed research. A study by
the present author, with J. F.. Golding (in press, Behaviour Research
and Therapy Monographs) has reported a range of biological/psychological
variables predicting smoking prevalence rates amongst adolescents in
the age range 11 - 18 years. Subsidiary analyses, which were not
reported, suggested some tradeoff between smoking and other drug
(alcohol, solvents) use - although the exact nature of this was not
established - as a function of the 'steering' factors mentioned above.
Such migration was seen as an attempt to maintain d psychological
'steady state', this applying particularly to groups expressing high
levels of anxiety, psychosocial discord and stimulation seeking.
The present study attempts to test the polydrug hypothesis.
A questionnaire has been constructed, consisting of two sets of items,
which have already been pre-tested. The first set includes items which,
from the previous study, proved to be predictive of smoking and drinking
prevalence rates (anxiety, stimulation-seeking and so on). The second
set is concerned specifically with aspects of drug use - the range of
psychoactive drugs used, availability ( in part a function of age),
cultural/familial sanctions, perceived effects of drug use, effects of
health education programmes etc., i.e., with the whole gamut of factors
which appear, from the literature, to be relevant to a migration
hypothesis.
In the first phase of the study, these questionnaires will be
administered to groups of approximately 200 Ss (100 boys, 100 girls)
in the 14, 15, 16, 17 and 18 year old range. Multiple discriminant/
regression analyses will be computed, comparing the psychological
and sociocultural profiles of non-drug, single drug and multiple drug
users, the latter group including those single-drug use 'rs who have
emigrated'. From these analyses, it should be possible to isolate those
factors which are relevant to migration, given that such a phenomenon
occurs. Note that the non-drug group will be limited in size, since
it will function solely as a control group.
A microclinical study of selected Ss (approximately 100) is
proposed in the second phase of the investigation. These Ss will be
intensively interviewed about different aspects of psychoactive drug
use. The interview format and content have not yet been decided, as
these will depend to some extent on the resultb of the first phase.
in general, however, interest will focus on the nature, timing of, and the
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3
psychological and sociocultural factors relevant to any tradeoff
disclosed from first phase data.
The sample has been selected, the non-standardised items
pre-tested, and testing planned to begin in February, 1983, when schools
recommence.
November 29, 1982.
G. L. Mangan
U-4
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BATCo document for Province of British Columbia 13 April 1999