More on Drugs

The issue of “drugs” and “drug abuse” has not disappeared from the public consciousness, certainly not the way other apparently crucial issues have—often they streak across the American scene and are considered old hat after being discussed on a few talk shows and highlighted in the press for a season or two. But for nearly a decade now, a whole range of “experts” have talked about and argued over and tried to make sense of “drugs.” Who takes them and why? The books keep coming out, and as befits an issue that has staying power, a presidential commission was appointed to go over the subject and report back as soon as possible. This it has done in Marihuana: A Signal of Misunderstanding.

I doubt that either The Natural Mind by Andrew Weil (Houghton Mifflin, $5.95) or Drugs and the Public by Norman E. Zinberg and John A. Robertson (Simon and Schuster, $8.95) could have come out a few years ago. The authors (along with just about everyone else) then felt more at sea about knowing what to believe concerning the dangers and possible value of certain drugs. And in the middle sixties a presidential commission would have been unthinkable—the plain fact being that once one is set up, enough has already happened to make some kind of change virtually certain.

Neither Dr. Weil’s ideas nor those of Dr. Zinberg and Mr. Robertson ought to be dismissed as just more of the same. For one thing, Drs. Weil and Zinberg, two thoroughly respectable Boston physicians, one interested in pharmacology, the other a first-rate psychoanalyst with an established reputation in his field, have been with this problem for a good long spell, and have in the past done some important studies of the psychological and physiological effects of marijuana. Each of them, in different ways, and from different perspectives, tells about that research in his book, and the difficulties they encountered help to explain the “misunderstanding” mentioned in the title of the report given to President Nixon this spring. For example, access to the drug was not easy—which ought to remind us that many people, including some high in the government, don’t necessarily want the “facts.”

In essence, the doctors found that marijuana isn’t all that powerful a drug; what it “did” for their subjects really depended on what their subjects wanted it to do. The “setting” (the conditions under which marijuana is used) makes a big difference, as does the state of mind a particular user possesses as he or she goes about drawing on a reefer. Nor does that apply solely to marijuana; other drugs, even heroin, vary in their effect, Dr. Zinberg emphasizes. For certain youths, strong-minded and gregarious, inclined not to be suspicious or anxious, marijuana in moderate doses can offer a pleasant and satisfying experience. For others, worried and fearful, maybe headed, anyway, for the psychiatrist’s office, or maybe just growing up and having a hard time of it, a reefer or two, or an LSD tablet, can exert a decisive influence—an already shaky “personality structure” begins to fall apart. Nor does such a turn of events distinguish “drugs” from alcohol; those of us who have worked with troubled youths know how they can take to drink, then begin to deteriorate psychologically. Does a “problem” prompt the interest in alcohol, in LSD, or does the particular individual merely stumble into a dangerous set of circumstances, then find himself or herself vulnerable indeed? Questions like these are easier asked than answered; each young person’s life has its own history, its own determinants and store of experiences, so generalizations about which is the horse and which is the cart probably come most easily from ideologues of various kinds. And as Drs. Weil and Zinberg keep insisting, the issue of drugs has received attention from plenty of those ideologues: moralistic defenders of the social and political status quo, who summon forth all the considerable rhetoric at their command against anyone who dares question the old values; angry radicals, fed up completely with the evils they see about them at home, and the awful, murderous things they believe this country is doing abroad, and anxious to find our last hope in certain young men and women of the “counterculture”; and in between, plenty of ordinary men and women (parents, teachers, and not rarely, psychiatrists) who feel confronted, brought up short, puzzled, envious of or angry at “them,” who of course turn out to be millions of our own children now become grown up.

The authors of Drugs and the Public have no interest in ideology. They don’t exhort and they don’t promise “solutions.” They write as social observers and social critics, and they do so with a sense of history. The result is a book that is rich with descriptions of our contemporary social and cultural situation, to the point where the reader (maybe for the first time) is able to understand how, in one swift decade, millions of a particular generation have come to be so very involved with substances once considered exotic or the consuming interest of “special groups” —musicians, people in urban ghettos, the psychiatrically “ill.” “We are experiencing a social upheaval,” write Zinberg and Robertson, “of which the so-called drug problem is merely the part on which many older people choose to center their fears. We may even be facing a change in the nature of consciousness, induced by our technology and brought into every house by television.”

The authors are especially good as they talk about the relationship between television and child-rearing; most parents (in my experience, even the poorest of the poor, who can get cheap secondhand sets that barely work) find the television screen and its never-ending images the ultimate pacifier, the world within a world-or perhaps, the great and sustaining link their children have with the outside world. In the authors’ words: “Press the button and everything is there: turn on. tune in—and even relax and drop out for a while. The boundaries between inside and outside imperceptibly become diffuse. When a held or some other outside scene is shown on the small screen, a two year old tries to walk into it.” Is it any wonder that fifteen or twenty years later that person may find himself drawn to a substance that helps achieve a mood which has already become familiar?

Not that Dr. Zinberg wants to present yet another glib, psychologically reductionist “interpretation” of what he knows to be the complicated way that the mind comes to terms with the social and political forces that bear down on all of us, sometimes with as little awareness as we can mobilize with respect to other “forces” that psychiatrists seem to feel more comfortable talking about— the influence of a mother’s disposition or a father’s way of punishing his children. (“Neither do we believe that the turned-on generation found their electronic babysitter so gratifying that they seek to return to that early infantile experience.”) The hope is to attempt some suggestive hypotheses, an approach in sharp contrast to the assurance, if not outright dogmatism, one can find elsewhere: they are bad, these drug users, or sick, or sinful, evidence of a nation’s spiritual decline.

At one point the authors suggest that we need new kinds of research into the effects of various drugs on people. They say that the “narrower considerations” of pharmacological, biological, and even sociological studies simply will not do if we are to learn what it is that drug users experience and feel drawn to repeatedly. “Considerations of the high itself (the influence of consciousness, the relationship of positive or negative social setting) have been little explored,” they observe—perhaps because a society’s moral code, its sense of what is desirable or wrong affects, among others, those who do research, no matter how “objective” or “scientific” they regard themselves. Here one can link Drugs and the Public with The Natural Mind, even though the two books have quite different positions to present. Dr. Zinberg and Mr. Robertson want to argue that today’s laws regulating drug usage are self-defeating; that they do more harm than good and need to be supplanted by less categorical, more flexible and tentative ones. We are asked “to tolerate and accept a reasonable amount of drug use by those willing and able to make that decision,” perhaps through some “licensing system.” Obviously some would be disqualified; but we are definitely urged to respond to what has every appearance of being a significant shift in the nation’s social climate.

Forthright and bold one minute, the authors turn guarded the next; they respect the right of certain youths to use drugs as a means of finding both pleasure and self-awareness, but again and again they take note of the more dangerous and destructive side of the so-called drug scene, so they most certainly are not propagandists for it. Nor is Dr. Weil, really. If anything, he is against the use of drugs; he places great importance on the drug “high” that Dr. Zinberg and Mr. Robertson say needs more scrutiny, not because he advocates that we all get high with drugs, but out of a conviction (based on his work over the years in hospitals and clinics, as well as several research projects) that such a “high” is one way many people get closer to achieving the kind of “heightened consciousness” we all might achieve without drugs, were we allowed and encouraged to do so. Put somewhat differently, Dr. Weil thinks that the drug problem as it exists today is a phantom of sorts; youths crave drugs because they are trying in their own desperate way to learn much about themselves, and most specifically, to get closer to parts of their mind most of us are taught to seal off.

There is nothing modest or hesitant about Dr. Weil’s method of argument. He declares where others might speculate; he also ventures where others would hold off. We are offered no less than a whole new theory of child development: “Anyone who watches very young children without revealing his presence will find them regularly practicing techniques that induce striking changes in mental states. Threeand four-year-olds, for example, commonly whirl themselves into vertiginous stupors. They hyperventilate and have other children squeeze them around the chest until they faint. They also choke each other to produce loss of consciousness.”

Supposedly all that is done because children want to shed themselves of “waking consciousness.” Supposedly, too, children even find their way to chemicals of sorts for just that purpose-many of them “before the age of five,” Dr. Weil says. “The most common route to this knowledge,” he goes on, “is the discovery that inhalation of the fumes of volatile solvents in household products induces experiences similar to those caused by whirling or fainting.” As a child psychiatrist, I don’t know what to do with that kind of assertion. It is based on intuition and a particular person’s observations, not on conventional or systematic research. Is Dr. Weil right? I don’t know. Anyway, he keeps on asserting that people like me, practitioners of what he calls “allopathy,” are “straight,” meaning we rely on the intellect, we stick to rules of evidence, we are not in touch with the unconscious as are certain yogis and an increasing number of plain, ordinary Western youth, who more and more “want to open channels between the conscious and the unconscious minds.” Dr. Weil calls such people “stoned,” not because they use drugs (he hopes they don’t, or won’t) but because, presumably, they have those “channels” wide open—hence would go along with this assertion of his, meant to contrast the thinking of Western physicians (allopaths) with their own: “I mentioned earlier that essential hypertension is correlated with increased tone of the sympathetic nerves. Allopaths, seeing this correlate as a cause, cannot change the condition. The true cause is in the unconscious mind, which, denied access to consciousness, turns its energies downward.”

So much for high blood pressure. A few years ago some of my colleagues in psychiatry began to give up talking about an X “personality structure” that seemed to be correlated with a Y disease; they worried that their statistics were inadequate, and wondered whether the presence of the disease might itself set in motion certain psychological attitudes and responses, rather than vice versa. It seems, though, that they should have gone further, maybe even abandoned their effort to be careful and precise, and taken up instead talk of “energies” going “downward” instead of “upward.” Once again, I can’t say that Dr. Weil is wrong—or right, either. He feels that there is a whole world of feeling and energy and power stored away back there in what he calls the “unconscious,” not to be confused with the unconscious that Freud tried to fathom. He claims that all sorts of diseases are caused by that unconscious, as it gets trapped or bottled up, or denied expression or turned in on itself—the imagery gets rather lavish, and if we ask for something more, a little clinical research, maybe, some facts and figures, then too bad for us: we are blind and deaf to so much, hence dumber than we will ever get to know. If the reader begins to detect an ideological flavor to all of this, I don’t think he or she will be far wrong, and I doubt Dr. Weil will object. It is his purpose to offer a wideranging, rather philosophical point of view—about those who shun drugs, those who take them, and those fortunate few (in his estimation) who are “beyond” both, and so really in touch with themselves, the north, south, east, and west of themselves, I guess it could be put, speaking no more metaphorically than Dr. Weil chooses to do.

Dr. Weil, however, is a first-rate and persuasive writer; he sets down lean, strong sentences and provocative ideas, the complexity of which the reader must meet up with himself, because I am surely biased against them. He is continuing his extraordinary studies—he has gone to South America to observe members of Indian tribes who have learned how to alter their “consciousness”—and no doubt he will keep trying to persuade more and more of us to take a second look at ourselves, and one hopes that he will keep an eye out for his own blind spots or prejudices. In the meantime, one can only be impressed by his courage and determination.

One assumes that the members of the President’s Commission on Marihuana and Drug Abuse are toughminded and practical men who did not expect to comment on the subject matter they have just studied without obtaining their fair share of insults. After a great deal of contemplation, after months of listening to witnesses and reading and arguing things out, they have come up with their first report, and by now much of the public knows their essential recommendation: that our legal system be rather decisively overhauled so far as the laws on marijuana go. We ought to have, the commission says, a uniform law, rather than dozens of them with astonishing and occasionally outrageous variations from state to state; and most significant, the possession or distribution in private of small amounts of marijuana ought not to be a state or local offense. Public possession or distribution is another matter—though again, small amounts so discovered would merely be subject to confiscation, whereas the discovery of amounts over one ounce would entail a fine of one hundred dollars. On the other hand, stiff penalties are recommended for those who go out and cultivate and buy and distribute the drug for profit; and antisocial offenses committed under its influence, as with alcohol, would by no means be condoned.

The report has been called everything good and bad, and is not intended, I believe, to satisfy those who have strong opinions, one way or the other, on the subject. A presidential commission of this kind aims to educate people, prepare the way for change that is all but certain to take place (though its exact nature is not yet certain), and help mobilize a confused nation around some action that will reduce the level of discord and suspicion—no mean achievement these days. I don’t think the members of the commission expect that the American people, through their elected representatives, will accede to every suggestion in their report. There are legal and maybe even constitutional issues to be settled. How, for instance, does one sanction possession but forbid sale without getting into trouble with the notion of “private property” and its various “rights”? In any event, the overall tone of the report is in keeping with what was intended: hysteria is shunned, propaganda avoided; a serious effort is made to acknowledge errors of the past. Most of all, we are nudged toward some common ground that millions of people can stand on with a reasonable chance of not getting at one another’s throats or seeing one’s children caught in the grips of irrational and out-of-date laws. As a citizen one must out of duty respond to such a report, written as it was for each and every one of us; and I will do so by saying thank you for what I believe to be a thoughtful and well-done job, a real beginning and a real help—if only regarded closely by those who make our laws.