Wayne M. Harding

A Study of Social Regulatory Mechanisms in Controlled Illicit Drug Users

An ongoing study of controlled marihuana, psychedelic, and opiate users shows that long-term, moderate illicit drug use is primarily supported by rituals and social sanctions. These guidelines for use, developed by segments of the drug subculture, militate against compulsive use. This work demonstrates the necessity of viewing quality of drug use as a function of sociocultural as well as pharmacological and psychological factors. Findings suggest that a system of social controls similar to that operating for alcohol use could be a more reasonable means of preventing compulsive use than the present prohibition of any and all illicit drug use.

PATTERNS OF HEROIN USE

Since 1962 many researchers have become accustomed to thinking of drug use as a socially evolving process. In the case of heroin, however, little coherent or consistent work has been done t o delineate the patterns of use which have been evolving. This neglect results from two factors: the intransigent view that there is no choice between abstinence, on the one hand, and compulsive use, on the other; and, perhaps even more important, the lack of sound theoretical postulates to explain how an individual can exercise control over use of this powerful, psychologically and physiologically addictive intoxicant. Theoretical postulates regarding control that have been developed during studies of controlled opiate users* will be described briefly, followed by several broad patterns of heroin use uncovered during interviews with heroin users. Thirdly, recent literature on occasional use of heroin will be reviewed. Finally, questions raised by this investigation of heroin use and the need to resolve them through long-term longitudinal studies will be discussed.

DWI prevention: profiles of drinkers who use designated drivers

The effectiveness of designated driver (DD) use in preventing driving while intoxicated (DWI) depends on whether drinkers at risk for DWI use DDs. Bivariate and logistic regression analyses conducted on data from 1,391 Computer-Assisted Telephone Interviews (CATIs) and from 902 barroom patron surveys showed that DD users, compared to nonusers, tended to be at-risk, heavier drinkers. For example, logistic regression using the CATI sample indicated that DD users were more likely to drink more often outside the home, to achieve higher blood alcohol concentrations (BACs) when drinking outside the home, to ride with intoxicated drivers (RID), and to be heavy drinkers on D. Cahalan et al.s (1969) Quantity-Frequency-Variability (QFV) index. Similarly, logistic regression using the barroom sample showed that DD users tended to be heavy drinkers on the QFV index, and were more likely to drive after drinking and to ride with intoxicated drivers. Additional analyses showed that DD users also were more likely than nonusers to engage in other behavior to avoid DWI, such as drinking less, waiting to drive until the effects of alcohol diminish, walking home, and staying overnight. These results are consistent with other findings from a related study by the current authors which showed that at-risk drinkers also used free safe (taxi) rides to avoid DWI, however were still more likely to report DWI and RID behavior (B. D. Caudill, W. M. Harding, & B. Moore, in press). Consequently, DWI prevention efforts may be improved by future research aimed at learning why such at-risk drinkers sometimes take steps to avoid DWI and sometimes do not.

DWI prevention: profiles of drinkers who serve as designated drivers

This study was designed to profile drinkers who serve as designated drivers (DDs) and to determine if drinkers who are at risk for driving while intoxicated (DWI) serve as DDs. Bivariate and logistic regression analyses on data from 1,393 computer-assisted telephone interviews (CATIs) and 913 bar-room surveys showed that DDs, relative to non-DDs, tend to be at-risk, heavier drinkers. Logistic regression using CATI data showed that DDs were more often heavy drinkers and reported higher levels of driving after drinking and riding with intoxicated drivers (RID). Logistic regression using bar-room data showed that DDs reported more driving after drinking, in spite of drinking less often outside the home. DDs were also much more likely to have used a DD. These findings are consistent with those from several related studies that showed that drinkers who used DDs or free safe (taxi) rides tended to be heavier drinkers who reported more DWI and RID (B. D. Caudill, W. M. Harding, & B. Moore, in press-a, in press-b). Future research may benefit from examining why at-risk drinkers take steps to avoid DWI on some occasions but not others.

Avoiding DWI Among Bar-room Drinkers: Strategies and Predictors

We examined the prevalence and predictors of 11strategies to avoid driving when feeling intoxicated among 561 bar-room patrons in two medium-sized Maryland communities. Logistic regression analyses identified demographic, behavioral, and attitudinal predictors of avoidance strategies and interactions among predictors. Overall, 89% reported one or more DWI avoidance actions in the past year, and 38% reported driving intoxicated during that time. Average frequencies of avoidance behavior and intoxicated driving increased significantly as drinking level increased. However, the higher the drinking level, the smaller the ratio of avoidance actions to DWI experiences, highlighting the vulnerability of heavy drinkers who had driven intoxicated. Using a sober driver or one who allegedly drank less than the respondent were the most popular and frequent strategies, but paying for a cab, walking, and using a bus or free cab were relatively unpopular. Higher drinking levels predicted significantly higher odds of using avoidance approaches, as did intoxicated driving. Confidence in driving safely when intoxicated was positively related to drinking level and intoxicated driving, but it tended to predict lower odds of avoidance actions. Similarly, marital status, age, gender, and location influenced the odds of avoidance behaviors. Interventions should be strategically tailored to exploit or counter drinker predilections among avoidance options.