Stanton's review in the American Psychological Association review journal Contemporary Psychology of a book that counteracted the cocaine hysteria of the 1980s. Surveying cocaine users in a nonclinical, community study, Addiction Research Foundation researchers found that most users do not develop problems. Even more critically, those who do develop problems respond typically by cutting back (!) or quitting cocaine use without treatment. The book presents a radical, and at the same time commonsensical, perspective on drug use: People generally avoid problems and change on their own when they encounter them.
Contemporary Psychology, 33:144-145, 1988
How Strong Is the Steel Trap?
Review of 'The Steel Drug: Cocaine in Perspective' by Patricia G. Erickson, Edward M. Adlaf, Glenn F. Murray, and Reginald G. Smart, Lexington, MA: Lexington Books, 1987
Review by Stanton Peele
Patricia G. Erickson, head of drug policy research at the Addiction Research Foundation (Toronto, Ontario, Canada) and lecturer in the Criminology Program at the University of Toronto, is author of Cannabis Criminals. Edward M. Adlaf is a scientist at the Addiction Research Foundation and a doctoral student in the Department of Sociology at York University (Toronto). Glenn F. Murray is a doctoral candidate in the Department of Sociology at York University and author of a chapter in Illicit Drugs in Canada. Reginald G. Smart, director of the Prevention Studies Department at the Addiction Research Foundation, is author of Forbidden Highs: The Nature, Treatment, and Prevention of Illicit Drug Abuse and of The New Drinkers: Teenage Use and Abuse of Alcohol. Stanton Peele, visiting scientist at the Alcohol Research Group (Berkeley, California) and the Institute of Epidemiology and Behavioral Medicine in the Medical Research Institute (San Francisco), is author of The Meaning of Addiction: Compulsive Experience and Its Interpretation.
The Steel Drug is an evenhanded historical, epidemiological, and clinical account of cocaine use. Between 1970 and 1985, cocaine first was glamorized, then was overused by some, and finally was universally denounced. As the authors indicate, this process replicated the course of cocaine use in North America from 1880 to 1910. Today, no concerned professional speaks favorably about cocaine, as Freud and a number of other physicians of his era did. Nonetheless, cocaine's presence in popular turn-of-the-century patent medicines and soft drinks meant many Americans consumed the drug more frequently 75 years ago than any but the heaviest users do today.
Although the media present cocaine in a consistently lurid light—describing only compulsive use of the drug—epidemiological data that the authors explore indicate that the large majority of those exposed to cocaine have used it infrequently. The few studies of regular cocaine users other than clinical patients find that a majority maintain controlled use, while even fairly heavy users only infrequently report addictive symptoms. Cocaine use is associated with use of other drugs and alcohol, and many of the traits (e.g., unemployment) that characterize clinical cocaine abusers also apply to alcoholism inpatients (although those in treatment for cocaine use are younger).
In order to compensate for an overemphasis on users in treatment, the authors conducted a community-based study of cocaine users in Toronto. Subjects answered ads or were located through personal referrals (the "snowball" technique). As in other such studies, most drug users did not report negative consequences. Typical problems for the remaining subjects were acute insomnia and nasal disorders. Twenty percent of the subjects reported uncontrollable urges to continue use. Yet, in the case descriptions of problem users, nearly all had quit or cut back without actually receiving treatment for cocaine addiction!
As David Musto summarizes in the foreword, "laws by themselves are weak compared to individual decisions" to stop drug abuse, both for individual cases of remission and in combating the problem overall. Recent data indicate a sharp downturn in middle-class cocaine use, while abuse and addiction predominate in ghettos and among minorities. Musto opined in a New York Times article (Kerr, 1987):
The question we must be asking now is not why people take drugs, but why do people stop. In the inner city, the factors that counterbalance drug use . . . often are not there. It is harder for people with nothing to say no to drugs. (p. 1)
Cocaine abuse resembles many drug and other problems in the United States in infecting those with the fewest opportunities and options. Thus, rather than comprising a special drug menace, cocaine abuse and addiction reflect larger social and psychological vulnerabilities. As Musto reports in the foreword to this valuable, sensible volume: "If history is a guide, we should be concerned lest rational discussion be submerged in . . . denunciation of the drug" (p. xvi).
Reference
Kerr, P. (1987, August 30). Rich vs. poor: Drug patterns are diverging. New York Times, pp. 1, 28.
