Ira H. Cisin

Addict careers. II. The first ten years.

The varying life-styles of narcotic addicts in Baltimore during the first decade of their addictive careers are examined with respect to the following: (1) periods of addiction, (2) transitions from addiction, (3) periods of nonaddiction. Emphasis is upon the relationship between aspects of the life-styles and the characterization of addicts according to a typology based on the concepts of opportunity and motivation to use narcotics. What emerges is a general hypothesis linking social class, associated competencies, and pattern of addiction.

An ecological analysis of the interrelationships among drug abuse and other indices of social pathology

In a study of the interrelationships among 12 separate indices of social pathology, including drug abuse, in which census tracts were the units of analysis, moderate to high intercorrelations among all indices were observed. A subsequent components-types factor analysis revealed only a single eigenvalue greater than unity, suggesting that the interrelationships among the several indices may be most parsimoniously explained in terms of a single underlying construct-generalized social pathology. Exact factor scores on this construct were computed for each tract, and those may be viewed as estimates of the degree of social upheaval present.

Addict Careers. I. A New Typology

The notion that narcotic addicts constitute a homogeneous class has little utility for research on etiology, prevention, and intervention. Historically, various classification schemes have been suggested, tailored to particular applications. In this paper a new typology of addict careers is developed, based on the concepts of opportunity and motivation to use narcotics. The question addressed is: During the first decade of addiction, how much time is occupied by (1) narcotic addiction, (2) incarceration, (3) nonaddiction in the community? Preaddiction correlates of the typology are examined in a sample of addicts who became known to police during the past quarter century.

Evaluating a household survey measure of psychic distress

This paper describes a study to assess the validity of a brief household survey measure of psychic distress (PSYDIS). The measure classifies persons according to their pattern of scores on four dimensions, including anxiety and depression. Study subjects were interviewed first as respondents from the general population in a cross-sectional household survey. Then, according to their ratings on PSYDIS, subsamples were selected for psychiatric evaluation in a clinic a few weeks later. The survey ratings of 287 persons were compared with evaluations of the same persons by experienced psychiatrists. Overall levels of concordance ranged from 76% to 80%, depending on the psychiatric criterion used. Concordance was very high for women; it was lower for men and for persons classified as High on PSYDIS. We than applied two analytic strategies for increasing agreement between the clinical judgements and the clinical ratings. Strategy number I augmented the symptom checklist data with additional survey data on the subjects history of episodes of distress. Strategy II revised procedures for constructing the PSYDIS typology by (1) using more rigorous cutting point scores on the component scales, and (2) using a non-typological method of classification. The first strategy improved agreement between the clinic and survey measures; the second did not. The paper also compares PSYDIS with other brief symptom checklist measures.

Addict Careers. III. Trends across Time

A study of Baltimore narcotic addicts who have come to the attention of authorities during a 25-year period provides the basis for an analysis of changes across time in the personal characteristics and life-style attributes of the addict population. Trends are presented wih respect to (1) racial composition, (2) social status, (3) residential stability, (4) educational attainment, (5) occupational stability, (6) juvenile delinquency, (7) criminality, (8) age at onset of addiction, and (9) drug of choice. Also examined are changes in the distributional composition of a typology of addict careers based on concepts of opportunity and motivation to use narcotics.

Drinking Behavior and Drinking Problems in the United States

Anyone interested in assessing drinking practices and the epidemiology of drinking problems must take into account the values and attitudes prevailing among major subgroups in America, for such values and attitudes play a very large role in determining the direction and persistence of drinking behavior. As just one of many possible illustrations, Jews in America have a very high proportion of persons who drink at least a little but a very low proportion who get into trouble over their drinking, while the Irish-Americans have a lower proportion of drinkers but a fairly high proportion who get into trouble (Glad, 1947). Such subgroup differences in drinking practices seem to be due not so much to stress as to deep-seated cultural and environmental influences. Thus, the history and present state of American values and attitudes about drinking are not merely of antiquarian or humanistic interest, but are central to understanding the dynamics of American drinking behavior and current social and health problems related to alcohol.

Crime as a source of income for narcotic addicts.

Although it has been well documented that narcotic addicts derive the bulk of their income from criminal activities and that there are major differences between black and white addicts, interview data presented in this paper show little difference between the two races with respect to the degree of dependence on criminal income. However, the results also highlight the diversity among narcotic addicts in that there are some individuals who derive none of their funds from illegal sources, thus suggesting that not all addicts should be treated in the same manner.

MARIJUANA USE AMONG ADULTS IN A LARGE CITY AND SUBURB

This is a report on some of the data emerging from two sample surveys SUPported by the Psychopharmacology Research Branch of the National Institute of Mental Health, Bethesda, Maryland. These studies, based on personal interviews with adults, were mainly concerned with the use and acquisition of psychotherapeutic drugs stimulants, sedatives, hypnotics, and tranquilizers. Questions about the use of marijuana were introduced toward the end of the interview after rapport had been established by more than an hour of other questioning. One study was conducted among adults in San Francisco during late 1967 and early 1968. Personal interviews were held with 1,028 men and women between the ages of 18 and 74. Stratified probability sampling was employed in order to obtain a representative cross-section of San Francisco’s adult population. The completion rate was 85%. A trained interviewer first asked some general questions about physical and mental health and the ways in which respondents had handled various health problems. Increasingly sensitive questions about the use of psychotherapeutic drugs were introduced, concluding with: “Aside from all the pills that we’ve talked about so far, are there any other pills, drugs, or anything else that you have ever taken in order to improve your mood, or to gain insight, or to learn how they affect people, or just to get some kicks?” If marijuana was not mentioned, the respondent was asked directly if he ever tried marijuana. The second study, which made use of similar interview procedures, was conducted in 1969 in an upper-middle class suburban section of central Contra Costa County, many of whose residents commute to work in Oakland or across the bay in San Francisco. The Contra Costa study included 1,164 randomly selected adults representing a completion rate of 85%. Unexpectedly, the proportion of adults reporting they had used marijuana at least once was almost identical for the two communities 14% in San Francisco and 12% in the Contra Costa suburbs. In both locales, about half of the young men aged 18 to 24 and about one-third of the young women in the same age range reported having used marijuana at some time. In both locales, the use rate among persons 18 to 34 years old was 29%. The major correlates of marijuana use among people 18 to 34 years old in the San Francisco Bay Area, as found in these studies, have been reported elsewhere but are summarized here.l.2 The discussion is limited to persons 18 to 34 years of age since the great majority of people who had used marijuana were in that age range. Age and sex were found to be highly related to reported marijuana use. At every age level, and in suburb and city alike, men were more likely than women to have used marijuana. The proportion of people who had used marijuana