Social context and human meaning

If there is anything distinctive about the sociological perspective, it is its emphasis on social context. It might appear that this concept seeped into the public consciousness long ago, that it is a banality. But if this were so, the blunders committed every day by commentators on the drug scene would not occur. If the concept really were understood, a large part of the drug problem would also be understood. Social context refers to the setting in which drug use takes place. In a religious or ceremonial setting (as with eating the peyote cactus among members of the Native American Church), a drug will have certain effects, and the user will have certain subjective experiences under the influence of the drug. Taking that same drug to get high—for recreational, not religious, reasons—will induce quite different effects and experiences in the user. Being administered a drug in a laboratory or a hospital by researchers or technicians will yield behavioral, pharmacological, and subjective changes that may not be matched under different conditions—say, taking the same drug with friends in the comfort of one's living room. The social context within which drug use occurs is a powerful determinant of what the drug is and does to the user. To extrapolate from drug use in one setting to that in another is a risky enterprise, and often altogether invalid.

The social context of use influences or determines at least four central aspects of the drug reality, aspects that traditionally have been presumed to grow directly out of the chemical and pharmacological properties of the drugs themselves. These four aspects are drug definitions, drug effects, drug related behavior, and the drug experience.) Whether a given drug is defined as good or bad, socially acceptable or undesirable, conventional or "deviant," is not a simple outgrowth of the properties or objective characteristics of the drug itself, but is in no small measure a result of the history of its use, what social strata of society use it, for what purposes, the publicity surrounding its use, and so on. In short, how a drug is regarded—by the public, the law, its users, and even the medical profession—depends as much on irrational cultural factors as on its objective properties. Likewise, what a drug does to Looking at Drugs the human mind and body, what people do subsequent to ingesting it, and what subjective experiences they have under its influence, are all at least in part a function of how, under what circumstances, and for what purposes it is taken. Generally, the more "objective" the effects in question are, the less prominent the role played by social context; the more "subjective" the effects are, the more influential this factor is. However, even "objective" effects, such as heartbeat rate, pupillary dilation, blood sugar level, and so on, can be influenced by sociological factors, as we will see throughout this book. And the "subjective" effects of drugs, the drug experience itself— whether the effects are experienced as pleasurable (euphoric) or unpleasant (dysphoric), weak or intense, hedonistic or depressing, hallucinatory or mundane, serene or exciting—are largely a function of sociological factors. We must turn our attention away from a simple examination of the drug itself to just how that drug is taken to understand the phenomenon of drug use.

The sociological perspective stands in direct opposition to what might be called the chemicalistic fallacy, what I called earlier fetishism or the fallacy of misplaced concreteness—the view that drug A automatically and inevitably causes effects X through Z, that what we see as behavior and effects associated with a given drug are solely, or even mainly a function of the biochemical and pharmacological properties of that drug. Drug effects and drug-associated behavior are enormously complicated, highly variable, and contingent on many things, one of which is social and contextual in nature. Humans are infinitely more intelligent and difficult to study than animals, which makes automatic translations from the effects a drug has on animals in cages to those it has on humans in their natural settings suspect. This is why social context is so important.

One of the central dimensions of all human experience is meaning. No object or event has meaning in the abstract, in a natural state. Rather, meaning is imposed, socially fabricated—in short, symbolic. Meaning has two features: it is both internal and external. Meaning is assigned externally to objects or behavior in the process of human collaboration or interaction. But it also resides within the individual: It is arrived at as a result of a private act of choosing on the individual's part. In order for an observer to grasp that internal meaning, he or she must view the world from the subject's perspective, which inevitably involves empathy.

The same behavior, the same phenomenon, the same material reality, can mean completely different things to different people or to the same person in different contexts. Meaning is an ascription. It is superimposed on a phenomenon, a reality. It does not arise naturally. Anything may have multiple meanings, depending on one's point of view. Human action is suffused with meaning—just about everything we do is evaluated, thought about, mulled over, judged, interpreted.

Take anything—an object, an act, a thought. Put into two different settings, it will mean radically different things to us—perhaps contradictory things—simply because of our variability in interpretations. It is not the thing, the act, the thought, we are reacting to. The same thing quite simply "means" different things; the thing does not generate the meaning—we put it there. Consider two scenes: one the boudoir, husband and wife alone, engaging in foreplay; the other the examining room of a gynecologist's office, the physician, a man, examining a patient for breast cancer. In both cases, a woman's breasts are being felt. But in one, the behavior is linked with a "script" we refer to as lovemaking. In the second, it is linked with a different script: a medical examination . Though the specific acts involved are almost identical in a sheerly physical sense, they "mean" radically different things, and the participants act and react, think and feel, differently as a consequence. Thus they are in fact totally different acts, not because they differ externally but because different interpretations have been brought to them.

A large proportion of all assertions about social reality are ideologically imperialistic in nature—that is, an external meaning is imposed on a reality that should be investigated from an internal perspective. For example, many people equate long hair on men with feminization, without first asking what long hair actually means to the person growing it. Their point of view is that of an external observer who thinks that long hair should mean something definite and unvarying. A few generations ago anthropologists, armed with psychoanalytic insights, invaded non-Western civilizations and imposed their interpretations on what they saw. Snakes were interpreted as phallic symbols, regardless of what snakes actually meant to the particular cultures involved. Nakedness was given a sexual meaning, though in some societies nakedness has the overwhelming meaning of poverty, and not at all of sexuality. Today many of these biases have been eliminated from most analyses of other civilizations, but they are depressingly routine when it comes to our own.

And drugs. How do social definitions, interpretations, and meaning impinge on drugs, drug effects, and drug-related behavior? Are the same drug realities defined and interpreted in vastly different ways? How do contextual features change the relevant characteristics of drug use? For example, peyote taken by American Indians in a ceremony participated in by adherents of the Native American Church is legal and legitimate—even holy. Yet the same substance, taken by college students—even for the same purposes—is suddenly, magically, labeled a dangerous drug, debilitating and damaging to the user and a threat to society—and quite illegal. Another example: heroin and morphine. These two drugs are not very different pharmacologically and biochemically, except that pure heroin is several times more potent than morphine. (In fact, the morphine administered for therapeutic purposes in hospitals may be stronger than the heroin sold on the street, since black-market heroin is often considerably diluted.) An experienced drug addict would probably not be able to discern the difference between comparable doses of heroin and morphine, and a pharmacologist would have to look very, very closely to distinguish the laboratory effects of the two drugs. In short, by "objective" standards they are very nearly the same drug; they do more or less the same things to the tissues of the body. Nonetheless, heroin is declared to have no medical uses whatsoever. It is considered a menace, a killer. Morphine, on the other hand, is regarded as a boon to humankind. It has the stamp of approval from the medical fraternity; it is a valuable therapeutic tool. And yet the role and medical functions of the two drugs, and hence their social meanings, could easily be reversed. It is not the characteristics of drugs themselves, their pharmacological actions, that generate such contrasting interpretations; rather it is the meanings that have been more or less arbitrarily assigned to them. f The sociologist's view of drugs and drug use goes a good deal farther than merely recognizing that there are variable interpretations of similar drug realities and drug-related situations; It also emphasizes that the drug experience and drug effects will vary when different meanings are brought into the drug-taking situation. The one-dimensional, chemicalistic view of drug-taking is that humans are basically passive receptors for drug actions, and that when a certain drug is administered, a certain effect, or standard set of effects, takes place. This view has been discredited as a general model, but the comments of many drug experts indicate that it is still operative. It is not uncommon to encounter analyses that utilize such concepts as the "complete marihuana intoxication syndrome" , as if the effects of marijuana were a clinical entity with distinct configurations analogous to an H20 molecule or a cumulus cloud; or the notion that drug users are part of "an abnormal subculture" , as if this could be determined by means of objective, scientific examination. Naturally, some drug effects will be fairly distinct and will not vary a great deal, and there will be widespread agreement on their occurrence. In almost every case the whites of a person's eyes will become bloodshot after he or she has smoked a sizable quantity of marijuana. A person with a .2-percent blood-alcohol concentration in his or her bloodstream will not be able to operate a complex piece of machinery as well as he or she could when sober. Nearly everyone will go through some sort of withdrawal distress after long-term administration of a gram a day of barbiturates. But drug effects with such narrow variability are themselves limited in number; drug effects that are highly sensitive to external conditions and about which interpretations vary enormously are far more common, as well as far more important and interesting to most observers.

It is crucial to distinguish between drug effects and the drug experience. What happens in one's mind subsequent to taking a given drug is the outcome of many different factors, not solely a function of specific biochemical reactions. A number of changes take place in the body when a chemical is ingested, and not all these changes are automatically noticed and classified. The subject must be attuned to certain drug effects to be able to interpret and categorize them and thus place them within his or her experiential and conceptual realms. Otherwise, the effect of a drug may simply be sensed as a vague, unsettling, dizzyish sort of experience. A drug effect has to be interpreted and categorized in order to "happen" internally, in order to be part of one's experiencing of it. Out of many potential "effects" of drugs individuals and drug subcultures (as well as the general society) select several to pay special attention to. Very few hospital patients who are administered morphine experience it as euphoric or pleasurable, yet the illegal street user of morphine experiences euphoria and pleasure from it. Psychedelic drugs taken for religious purposes, after spiritual preparation and training, have often been felt as having a religious impact, yet people who take hallucinogenic drugs simply to get high do not usually report anything like a religious or a mystical experience. Drugs only potentiate certain experiences; they make them possible, but they do not produce them outright. It is the situation, the social definition surrounding use—not simply the drug's "objective" biochemical properties—that determines the experiential dimension. f Societies define not only the meaning of drugs but also the meaning of the drug experience these definitions differ radically among different societies and among subgroups and subcultures within the same society. Social groups and cultures define what kind of drug-taking is appropriate. They define which drugs are acceptable and which are not. They define who takes drugs and why. They decide what amounts of each drug are socially acceptable. They spell out which social situations are approved for drug use and which are not. They define what drugs do, what their actions and effects on people will be. Right or wrong, each of these social definitions and descriptions will have some degree of impact on actual people in actual drug-taking situations. Each will exert a powerful influence on what drugs actually do. That a fantastic power to enslave is attributed to heroin actually helps to give heroin the power to enslave; the "effect" does not rest completely within the biochemical properties of the drug . The effective role of placebos in medical therapy has been underscored in numerous discussions and research. That marijuana tends to have a negative and inhibitory effort on the sexual activity of caged rats and a positive and disinhibitory impact on sex in humans indicates the overwhelming role played by social expectations and definitions.