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Citation: White, W. L. (1999). A history of adolescent , tobacco and other drug use in America. Student Assistance Journal, 11(5), 16-22. Posted at www.williamwhitepapers.com

A History of Adolescent Alcohol, Tobacco and Other Drug Use in America1

William L. White Emeritus Senior Research Consultant Chestnut Health Systems [email protected]

The approach of a new millennium Native children had cultural access to invites reflection into our past and such drugs only within the framework of speculations about our future. This paper such rituals. There is little early evidence will detail the evolution of adolescent of secular or recreational drug use or alcohol, tobacco, and other drug (ATOD) misuse among Native American tribes use in America and identify those factors until distilled alcohol came to be used that have and will likely continue to against them as a tool of economic, influence the rise and fall of adolescent political and sexual exploitation ATOD use. (MacAndrew and Edgerton, 1969; Mancall, 1995; Westermeyer, 1996). I. ATOD Use in Native and Colonial Europeans brought to the America Americas a taste for alcohol and a comparatively limited knowledge of At the time of European contact, Native psychoactive medicines. Alcohol was American tribes had an extremely the “Good Creature of God”--a gift from sophisticated knowledge of botanical the Almighty that was integrated into psychopharmacology and utilized a wide nearly every aspect of Colonial life. Men, spectrum of psychoactive drugs within women and children drank alcohol daily, Native medicinal and religious rituals. not so much from a desire for alcohol’s

1This research was supported by the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration under grant number Tl11320. The opinions expressed in this article are solely those of the author and do not represent official positions of CSAT or any other governmental agency. Comments or requests for reprints should be directed to the author at 720 West Chestnut, Bloomington, IL 61701. williamwhitepapers.com 1 intoxicating effects as it was the lack of community health and hospitality) gave alternative liquids. Contaminated water way to the urban saloon (a symbol of that could and did spread lethal disease drunkenness, vice, and political earned alcohol its designation as aqua corruption), and moderate drinking within vitae--the “water of life” (Vallee, 1998). a family context shifted to excessive Children (even infants) were provided drinking by unattached and socially warmed alcohol (usually in combination disruptive males. These alarming with bread or other food), and young changes incited a century-long boys entered taverns to be taught by their temperance movement whose goal was fathers the arts of storytelling and nothing short of completely banishing drinking (Rorabaugh, 1979; Steinsapir, alcohol’s threat to children, families, 1983). While alcohol was valued in communities, and the country Colonial America, drunkenness was (Cherrington, 1920; Lender and Martin, highly stigmatized as a sinful misuse of 1982; Rorabaugh 1979). this gift from God. While many pre- The temperance movement revolution laws were passed to prevent forced a cultural reassessment regarding drunkenness in the Colonies, there is children and adolescents’ access to little evidence of special concerns about alcohol and tobacco. Local and state limiting the age of access to alcohol. laws were passed in the second half of When age ordinances did begin, they the 19th century that required usually restricted access to alcohol for temperance education in all public those under the age of sixteen (Mosher, schools and prohibited the sale of alcohol 1980). Well into the late 1700s, drinking and tobacco to those under the age of by students and faculty was an accepted first 18 and later 21 (Mosher, 1980). and expected part of American campus Children and adolescents were enlisted life (Brown, 1966; Warner, 1970). in the temperance movement (the Slave Codes denied Americans of “Children’s Crusade”), and special African descent access to alcohol, but branches of temperance reform clubs many slave masters practiced a ritualized were organized for adolescents and degradation of slaves with alcohol during young adults experiencing alcohol- holidays. There is no evidence of drinking related problems (White, 1998). Not by slave children, and African slaves surprisingly, colleges and universities were as a whole such a sober people, began to alter their previous tolerance that they were long thought to be immune and promotion of alcohol on campus to the effects of alcohol (Douglas, 1855). (Warner, 1970). In spite of lurid journalistic tales of II. Growing Concerns about Juvenile children seduced into the doorways of ATOD Use in the Nineteenth Century opium dens, there is little evidence that adolescents were involved in any America went on an extended widespread drug experimentation during drunken binge in the post-Revolutionary the 19th century. There were, however, War decades. Annual per capita alcohol concerns about the growing exposure of consumption tripled, drinking tastes infants and children to drug-laced shifted from fermented alcohol to distilled medicines and tobacco. Opiate-laced alcohol, the colonial tavern (a symbol of preparations in products like Children's

williamwhitepapers.com 2 Comfort and Mother Bailey's Quieting norms all played roles in the rise of early Syrup were so popular for calming infants 20th century juvenile narcotic use. Drug and children that warnings began to use became ritualized within newly appear about the deadly possibilities that emerging drug cultures that offered a could accompany their use (Haller, 1989; haven to youth who, whether by choice Pollard, 1858). By the late 1900s, reports or exclusion, had become detached from of neonatal narcotic addiction also began the broader culture (Courtwright, 1982). to appear that were the result of maternal Following the repeal of the opium use during pregnancy and while Eighteenth Amendment in 1933, alcohol nursing (Fischer, 1894; Mattison, 1896). and tobacco were destigmatized and then glamorized--in fact, ceased being III. Juvenile Narcotic Addiction and viewed as “drugs,” while use of other Alcohol/Drug Experimentation during drugs became increasingly criminalized. the Prohibition Years The wounded anti-alcohol and anti- tobacco movements retained only The 20th century opened with the enough power to pass age limits on culmination of decades of anti-alcohol alcohol and tobacco--an effort that and other anti-drug movements. These succeeded in part by arguing that there now mature movements used the was a direct link between tobacco and vulnerability of youth as an ideological early alcohol use and juvenile platform to support a ban on the non- delinquency (Gehman, 1943). The late medical use of narcotics and cocaine 1920s and 1930s saw new youth- (1914) and the non-medical and non- oriented anti-drug campaigns launched religious use of alcohol (1919). Following that led, in 1937, to marihuana being implementation of these laws, illicit added to America’s list of prohibited alcohol and drug cultures emerged. drugs. Youthful experimentation with alcohol, The marijuana plant had long tobacco and other drugs became a sign been used in America for its fiber, and of chicness and independence within tinctured in alcohol had been these cultures. Particularly alarming was used in 19th and early 20th century the first significant episodes of juvenile medicine--even as an adjunct in the narcotic addiction. treatment of alcoholism and narcotic The 19th century profile of opiate addiction. Its use as an intoxicant in the addiction--that of women addicted to U.S. was introduced by a young school opium or morphine as a consequence of teacher, Fitzhugh Ludlow, who wrote of medical treatment--gave way in the early his experiments with the drug in his 1857 20th century to young males seeking not book, The Hasheesh Eater. While there relief from pain but pleasure from a newly followed periodic journalistic exposés of released narcotic, heroin. Heroin use “ houses” in the 1870s, the drug rose among the children of first remained relatively invisible until its use generation white immigrants who were rose during the 1920s. It was in this crowded within the slums of America’s period that marijuana became linked to largest cities. Explosive immigration, Mexican migrant workers at a time of urban poverty, and the breakdown of growing racial and class conflict in country-of-origin cultural and family Southwestern United States. The anti- williamwhitepapers.com 3 marihuana campaign of the 1920s and 1953). There was also a marked a 1930 linked the drug to crime, violence change in the ethnic composition of and insanity and portrayed young people America’s young addicts. The incidence as exceptionally vulnerable to the drug’s of heroin addiction among young African effects (Anslinger and Cooper, 1937; Americans and Latinos exploded in the Rowell, 1937, 1939). There is little 1950s as minority neighborhoods--the evidence of widespread youthful same neighborhoods that witnessed marijuana experimentation during the white ethnic narcotic addiction at the turn 1920s and 1930s, but the prohibition of of the century--were flooded with cheap Marijuana in 1937 would eventually have heroin (Helmer, 1975). Concerns about an enormous effect on young people in the growing heroin epidemic triggered America. As a newly classified “narcotic” harsh new anti-drug laws whose under federal statute, all subsequent provisions included the potential for life laws that increased the penalties for sentences or the death penalty for possession of narcotics were applicable anyone selling drugs to a minor. to marijuana. This led to a situation In perhaps the first roots of a rising where many young people in the early polydrug phenomenon, the 1950s also 1960s found themselves facing saw the first reports of youthful inhalation draconian sentences that in some states of volatile solvents for purposes of included the possibility of life intoxication (Clinger and Johnson, 1951) imprisonment for possession of small and the first reports of a rebellious clique amounts of marijuana (Bonnie and of young chain-smoking, hard-drinking Whitebread, 1970; Musto, 1972). artists and writers (known as the “beats”) The anti-marihuana campaign of whose challenges to conventional the 1930s gave way to good news in the society sometimes included marijuana 1940sBa dramatic decline in narcotic experimentation. The Beats were a addiction during World War II. While this cultural marker of things to come. decline precipitated predictions that The 1960s and 1970s witnessed America’s drug problems were on the America’s first widespread youthful verge of being solved, events in the early polydrug epidemic. Marihuana, and to a 1950s quickly dashed those hopes lesser extent LSD, became sacraments (Musto, 1974). within a drug-experimenting youth subculture that by the 1970s usually V. Mid-Twentieth Century Polydrug involved alcohol, cannabis and an Use: 1950-1980 assortment of newly popular hallucinogens (PCP), stimulants, As illicit trade routes were re- barbiturates, and “look-alike” drugs. This established following World War II, a new period was marked by an increased epidemic of juvenile narcotic addiction perception of marihuana as a relatively unfolded (Chein, 1956). Admissions of benign drug, a growing acceptance of person under age 21 to the two federal marihuana use, and proposals for narcotics hospitals rose from 22 in 1947 decriminalization of marihuana coming to 440 in 1950 while juvenile narcotic from the highest levels of government. arrests in New York City rose from 33 in The year 1979 was the high-water mark 1946 to 775 in 1951 (Conferences, for 20th century adolescent illicit drug use williamwhitepapers.com 4 with 30.9% of 12-17 year old youth and overshadowed by what some called a 60.4% of high school seniors reporting new era of temperance in America. having used marihuana sometime in their A second period emerged when life (Monitoring, 1996). Masked within the decline in overall drug this illicit drug experimentation were experimentation began to reverse itself in changes in youthful licit drug 1992 and rose significantly until 1996 and consumption. Concern about illicit drugs then reached plateaus in 1997 and 1998. gave smoking and drinking a benign While middle and upper class cocaine mask that triggered as much parental use leveled off, there was growing relief (that their kids weren’t using concern that crack cocaine use was “drugs”) as alarm. Hidden behind becoming endemic within America’s headlines about new and exotic drugs most disempowered communities. was the cold reality that an inordinate and There was also resurgence in polydrug growing number of young people were use (marihuana, hallucinogens, solvents, killing themselves and others in alcohol- amphetamines), and a rise in heroin use related traffic fatalities and were not triggered in part by increased heroin heading the warnings about tobacco to purity and a resulting shift in method of which there their parents were beginning ingestion from injection use to intranasal to take notice. use (Monitoring, 1998; White and Webber, 1999). Resurging adolescent VI. Late Twentieth Century ATOD Use drug use is likely to once again capture, Trends at least briefly, the attention a nation that is weary from a century of drug There are two discernable epidemics to which there seems to be no changes in adolescent ATOD use in the end and no solution. closing decades of the 20th century. The first period from 1981 to 1991 was VI. Adolescent ATOD Trends: The Big marked by declining daily, monthly and Picture lifetime illicit drug use by adolescents at all grade levels surveyed, a parental Let’s see if we can step back from backlash against drug tolerance, this briefest of sketches to explore in intensified prevention campaigns more depth what the most important targeting marihuana, a repeal of many themes are within the evolving history of early marijuana de-criminalization adolescent ATOD use in America. The experiments, and a growing stigma menu presented to associated with illicit drug use. While the adolescents has continued to increase in overall pool of illicit drug consumers was number and variety of drugs. Illicit drugs shrinking, there were concerns about have become more potent and more changing patterns of use. Great alarm accessible to adolescents. Drug choices was expressed over the rise in cocaine have continued to evolve with alcohol, use during the 1980s and, in particular, tobacco and marijuana being the modern the use of crack cocaine by adolescents. baseline drugs of choice for young drug There were also concerns about the users. The price-per-unit of some drugs lowered age of onset of alcohol, tobacco has recently changed in ways that and other drug use. But all of this was increased their accessibility to young williamwhitepapers.com 5 people, e.g., crack cocaine. Most drugs as a socially or politically symbolic adolescents today are more likely to act. The social setting of use has shifted procure drugs from another adolescent from the family to one’s generational than an adult. Adolescents today are peers. This century generated a highly more likely to be prescribed psychoactive organized youth-oriented drug culture drugs by a physician/psychiatrist than at with its own language, values, rituals, any previous period in American history- symbols, music and dress. This culture -drugs that can be potentially abused or may be as attractive to some adolescents diverted into the illicit drug market. as the drugs that can be found within that The characteristics of young drug culture. consumers have evolved throughout the Adolescent drug use has moved 20th century. Young men have become from a licit to an illicit activity within the more vulnerable to illicit narcotic use, and space of a single century. The resulting young women are more likely to be illicit drug culture has been recently involved with alcohol, tobacco, and illicit transformed under resurgence of non-narcotic drugs. Young people of cocaine use, leaving young people who color are much more vulnerable to the drawn to this culture more likely to be misuse of alcohol, narcotics and other both perpetrators and victims of drug- illicit drugs compared to a century ago related crime and violence. A final and when such use was virtually nonexistent. dramatic recent change in the context of By far the most significant change in drug use is the emergence of injection characteristic of drug consumers is the drug use and sexual contact with lowered age of onset of regular alcohol injection drug users as the primary risk and other drug exposure. For 150 years factors related to HIV transmission in (1820-1970) America successfully America. HIV/AIDS has fundamentally postponed the age of onset of regular changed the context of illicit drug use in ATOD exposure until after the biological the United States and the vulnerabilities changes of adolescence. Between 1970 adolescents face in experimenting with and 1990, that achievement was lost. A illicit drugs. majority of adolescents entering addiction treatment in the 1990s reported The Coming Century pre-adolescent onset--perhaps adding confirmation to the findings of a just- ATOD use has long had multiple completed study that found a direct effects upon, and meanings to, relationship between early onset of use adolescents. There are many factors that and increased risk of lifetime incidence of will continue to make adolescents addiction (Dennis, et. al., 1998). particularly vulnerable to the untoward The physical, psychological, effects of these substances: low tissue social and legal context of adolescent tolerance, inexperience and poor drug use has changed. The location of judgment, responsiveness to peer use has shifted from the home to the coercion, a propensity for impulsivity and wider community. The motivations for risk-taking, and a tendency to embrace drug use have also changed through this drug use as ritualized affirmation of the history from that of relief of physical pain transition from childhood to adulthood. to a search for pleasure and the use of williamwhitepapers.com 6 Juvenile drug use in America rose in history of American marijuana tandem with a weakened nuclear family prohibition, Virginia Law Review 56, structure, decreased contact between October, 971-1203. youth and extended families and kinship Brown, J. (1966). Early American networks, the dissipation of value- beverages. Rutland, Vermont: Charles E. homogenous neighborhoods, the Tuttle Company. emergence of peer-oriented surrogate Chein, I. (1956). Narcotic use family structures, and the targeting of among juveniles Social Work 1:50-60. young people by licit and illicit drug Cherrington, E. (1920). The industries. These ecological influences evolution of prohibition in the United will continue to exert an enormous States. Westerville, Ohio: The influence on adolescent drug use in the American Issue Press. 21st century. The coming century will Clinger, O. & Johnson, N. (1951). challenge us with new and more potent Purposeful inhalation of gasoline vapors. psychoactive drugs, drugs that enhance Psychiatric Quarterly, 25, 557-567. various aspects of human performance, Conferences on drug addiction more efficient methods of drug among adolescents. (The New York administration, and the emergence of Academy of Medicine) (1953). New York: drug cocktails (precisely mixed drug The Blakiston Company. combinations) that will challenge two Courtwright, D. (1982). Dark centuries of research and control policies paradise: Opiate addiction in America that focus on each drug in isolation. The before 1940. Cambridge, 20th century trend that will have the Massachusetts: Harvard University greatest impact on the 21st century will Press. be the dramatic lowering of age of onset Dennis, M., McGeary, K., French, of alcohol and other drug exposure. No M. & Hamilton, N. (1998). The need for change of the past 200 years has more more adolescent treatment and profound and potentially enduring treatment research. Submitted for effects. Publication. Our prevention and intervention Douglas, F. (1855). My bondage technologies must evolve in anticipation and my freedom. NY: Miller, Orton, & of, and in tandem with, changes in the Mulligan. psychoactive drug menu, changes in the Fischer, L. (1874). The opium characteristics of adolescent drug habit in children. Medical Record 45, consumers, and changes in the ecology 197-199. of adolescent drug use. Gehman, J. 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