THEORIES ON DRUG ABUSE Selected Contemporary Perspectives Editors: DAN J. LETTIERI, Ph.D. MOLLIE SAYERS HELEN WALLENSTEIN PEARSON NIDA Research Monograph 30 March 1980 DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Alcohol, Drug Abuse, and Mental Health Administration National Institute on Drug Abuse Division of Research 5600 Fishers Lane Rockville, Maryland 20857 For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, D.C. 20402 The NIDA Research Monograph series is prepared by the Division of Research of the National Institute on Drug Abuse. Its primary objective is to provide critical re- views of research problem areas and techniques, the content of state-of-the-art conferences, integrative research reviews and significant original research. Its dual publication emphasis is rapid and targeted dissemination to the scientific and professional community. Editorial Advisory Board Avram Goldstein, M.D. Addiction Research Foundation Palo Alto, California Jerome Jaffe, M.D. College of Physicians and Surgeons Columbia University, New York Reese T. Jones, M.D. Langley Porter Neuropsychiatric lnstitute University of California San Francisco, California William McGlothlin, Ph.D. Department of Psychology, UCLA Los Angeles, California Jack Mendelson, M.D. Alcohol and Drug Abuse Research Center Harvard Medical School McLean Hospital Belmont, Massachusetts Helen Nowlis, Ph.D. Office of Drug Education, DHEW Washington, D.C. Lee Robins, Ph.D. Washington University School of Medicine St. Louis, Missouri NIDA Research Monograph series William Pollin, M.D. DIRECTOR, NIDA Marvin Snyder, Ph.D. DIRECTOR, DIVISION OF RESEARCH, NIDA Robert C. Petersen, Ph.D. EDITOR-IN-CHIEF Eleanor W. Waldrop MANAGING EDITOR Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857 THEORIES ON DRUG ABUSE Selected Contemporary Perspectives The National Institute on Drug Abuse has obtained permission from the copyright holders to reproduce certain previously published material as noted in the text. Further reproduction of this material is prohibited without specific permission of the copyright holders. All other material, except short quoted passages from copyrighted sources, is in the public domain and may be used and reprinted without permission. Citation as to source is appreciated. The U.S. Government does not endorse or favor any specific commercial product or commodity. Trade or proprietary names appearing in this publication are used only because they are considered essential in the context of the studies reported herein. Library of Congress catalog card number 80-600058 DHHS publication number (ADM) 80-967 Printed 1980 NIDA Research Monographs are indexed in the Index Medicus. They are selectively included in the coverage of Biosciences Information Service, Chemical Abstracts, Psychological Abstracts, and Psychopharmacology Abstracts. Publication development services provided by METROTEC, Inc., under contract No. 271-79-3625 with the National Institute on Drug Abuse. Cover art by Wendelin Astra Davidson, used with permission of the artist. iv Contents FOREWORD xi A GUIDE TO THE VOLUME xiii Part 1 THEORETICAL PERSPECTIVES AND OVERVIEWS Theories on One’s Relationship to Self AN INTERACTIONAL APPROACH TO NARCOTIC ADDICTION David P. Ausubel 4 THE CAP CONTROL THEORY OF DRUG ABUSE Steven R. Gold 8 THE BAD-HABIT THEORY OF DRUG ABUSE Donald W. Goodwin 12 INTERACTIVE MODELS OF NONMEDICAL DRUG USE Richard L. Gorsuch 18 AN EXISTENTIAL THEORY OF DRUG DEPENDENCE George B. Greaves 24 AN EGO/SELF THEORY OF SUBSTANCE DEPENDENCE: A CONTEMPORARY PSYCHOANALYTIC PERSPECTIVE Edward J. Khantzian 29 A GENERAL THEORY OF ADDICTION TO OPIATE-TYPE DRUGS Alfred R. Lindesmith 34 THEORY OF DRUG USE Harvey Milkman and William Frosch 38 v CONTENTS (Continued) AN AVAILABILITY-PRONENESS THEORY OF ILLICIT DRUG ABUSE Reginald G. Smart 46 PERCEIVED EFFECTS OF SUBSTANCE USE: A GENERAL THEORY Gene M. Smith 50 A LIFE-THEME THEORY OF CHRONIC DRUG ABUSE James V. Spotts and Franklin C. Shontz 59 DRUG USE AS A PROTECTIVE SYSTEM Leon Wurmser 71 Theories on One’s Relationship to Others PSYCHOLOGICAL, SOCIAL, AND EPIDEMIOLOGICAL FACTORS IN JUVENILE DRUG USE lsidor Chein 76 INCOMPLETE MOURNING AND ADDICT/ FAMILY TRANSACTIONS: A THEORY FOR UNDERSTANDING HEROIN ABUSE Sandra B. Coleman 83 THE SOCIAL DEVIANT AND INITIAL ADDICTION TO NARCOTICS AND ALCOHOL Harris E. Hill 90 FRAMEWORK FOR AN INTERACTIVE THEORY OF DRUG USE George J. Huba, Joseph A. Wingard, and Peter M. Bentler 95 A SOCIAL-PSYCHOLOGICAL FRAMEWORK FOR STUDYING DRUG USE Richard Jessor and Shirley Jessor 102 TOWARD A THEORY OF DRUG SUBCULTURES Bruce D. Johnson 110 DEVELOPMENTAL STAGES IN ADOLESCENT DRUG INVOLVEMENT Denise B. Kandel 120 SELF-ESTEEM AND SELF-DEROGATION THEORY OF DRUG ABUSE Howard B. Kaplan 128 vi CONTENTS (Continued) THE IOWA THEORY OF SUBSTANCE ABUSE AMONG HYPERACTIVE ADOLESCENTS Jan Loney 132 REINFORCEMENT AND THE COMBINATION OF EFFECTS: SUMMARY OF A THEORY OF OPIATE ADDICTION William E. McAuliffe and Robert A. Gordon 137 ADDICTION TO AN EXPERIENCE: A SOCIAL- PSYCHOLOGICAL-PHARMACOLOGICAL THEORY OF ADDICTION Stanton Peele 142 A FAMILY THEORY OF DRUG ABUSE M. Duncan Stanton 147 SELF-ESTEEM THEORY OF DRUG ABUSE R.A. Steffenhagen 157 BIOLOGICAL, PSYCHOGENIC, AND SOCIOGENIC FACTORS IN DRUG DEPENDENCE W.K. van Dijk 164 A THEORY OF OPIOID DEPENDENCE Abraham Wikler 174 Theories on One’s Relationship to Society THE SOCIAL BASES OF DRUG-INDUCED EXPERIENCES Howard S. Becker 180 DRUG ABUSE AS LEARNED BEHAVIOR Calvin J. Frederick 191 PSYCHOSOCIAL THEORY OF DRUG ABUSE: A PSYCHODYNAMIC APPROACH Herbert Hendin 195 TOWARD A SOCIOLOGY OF DRUG USE Irving F. Lukoff 201 ACHIEVEMENT, ANXIETY, AND ADDICTION Rajendra K. Misra 212 THE NATURAL HISTORY OF DRUG ABUSE Lee N. Robins 215 vii CONTENTS (Continued) A THEORY OF DRUG DEPENDENCE BASED ON ROLE, ACCESS TO, AND ATTITUDES TOWARD DRUGS Charles Winick 225 THE SOCIAL SETTING AS A CONTROL MECHANISM IN INTOXICANT USE Norman E. Zinberg 236 Theories on One’s Relationship to Nature ADDICTION TO PLEASURE: A BIOLOGICAL AND SOCIAL-PSYCHOLOGICAL THEORY OF ADDICTION Nils Bejerot 246 METHADONE MAINTENANCE: A THEORETICAL PERSPECTIVE Vincent P. Dole and Marie E. Nyswander 256 A CHRONOBIOLOGICAL CONTROL THEORY Mark Hochhauser 262 A BIOANTHROPOLOGICAL OVERVIEW OF ADDICTION Doris F. Jonas and A. David Jonas 269 EMERGING CONCEPTS CONCERNING DRUG ABUSE William R. Martin 278 SOMATOSENSORY AFFECTIONAL DEPRIVATION (SAD) THEORY OF DRUG AND ALCOHOL USE James W. Prescott 286 A THEORY OF ALCOHOL AND DRUG ABUSE: A GENETIC APPROACH Marc A. Schuckit 297 OPIATE RECEPTORS AND THEIR IMPLICATIONS FOR DRUG ADDICTION Eric J. Simon 303 viii CONTENTS (Continued) Part 2 THEORY COMPONENTS CONTENTS--PART 2 310 INITIATION 313 CONTINUATION 336 TRANSITION: USE TO ABUSE 357 CESSATION 378 RELAPSE 402 REFERENCES 421 ix Foreword One of the more striking aspects of drug research over the last few years is the relative upsurge of various models and theories explaining, wholly or in part, the problems of drug abuse. In fact, this rapid growth has signaled the need for a single, concise, and widely available volume which would allow interested researchers to discover the exist- ence, diversity, convergence, and complexity of the array of contempo- rary explanatory perspectives. Undertaking the preparation of such a compendium was carefully con- sidered. It was our intent to present as many theories as practicable, in an open, nonjudgmental, noncritical manner, and to allow each theorist to speak for his or her own theory. The volume contains 43 theoretical perspectives representing the work of more than 50 theorists. I trust the reader will find this collection of ideas stimulating and will be encouraged to generate future research aimed at hypothesis and theory testing. Marvin Snyder, Ph.D. Director, Division of Research National Institute on Drug Abuse xi A Guide to the Volume One of the early indications that a social problem research domain has come of age is the quantity and quality of the theoretical explanations for it. Over the last several years interest in research on the problems of drug dependence has grown dramatically. What is particularly striking is that each of a wide array of scientific disciplines has explored the problem. Drug dependence is a complex contemporary social problem. Its complexity derives in part from the impact it has on the individual user psychologically, socially, and biologically, and in part from its effects on society, law, economics, and politics. The primary intent of this volume is to present a representative selec- tion of contemporary theoretical orientations and perspectives in the drug abuse research field, derived from the social and biomedical sciences. Among our secondary aims and intents were these: (1) to produce a major reference volume for research scientists and other interested readers, (2) to afford theorists a forum in which to present their views, and (3) to allow readers to compare and contrast the diverse range of theories on drug abuse. In designing this volume, it was necessary to assure that each contribut- ing theorist would have sufficient latitude in style of presentation and textual development, and yet that the reader would find comparable discussions of formalized issues so that convergences and divergences among and between the theories could be easily discerned. The solution to these apparently disparate aims was to divide the volume into two distinct parts. Part 1 of the volume contains 43 separate theoretical overviews, one