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However, the order of tobacco and liquor was somewhat ambiguous: Among those students who had used both drugs, the same proportion reported having used each first. Intentions for future use followed the hierarchical pattern of use with "the more unusual drugs... most often ... desired only after acquaintance with the more common substances" (p. 26). From the longitudinal data available in their study, the authors presented only the proportion of each class of users who progressed or regressed along the assumed hierarchy of drugs over the four years of college, with no specification of the particular drugs used.
As we noted earlier, longitudinal data are required for a definite test of developmental stages in drug behavior. In the absence of other contradictory evidence, the longitudinal analyses of patterns of drug behavior over time that we have conducted and the inferential data provided by other investigators constitute to date strong evidence for the existence of stages in drug use.
STAGE-SPECIFIC PREDICTORS OF
Further evidence for the existence of stages is provided by the findings that different social psychological factors predict adolescent initiation into different stages of drug use. We have combined the notion that adolescent drug use involves sequential stages with a longitudinal research design in which the population at risk for initiation into each of the stages could be clearly identified. This has allowed us to assess the relative importance of various factors to predict initial transitions into various types of drug behaviors. The socialpsychological antecedents of entry into three sequential stages of adolescent drug use--hard liquor, marijuana, and other illicit drugs-were examined in a two-wave panel sample of New York State public secondary students and subsamples of matched adolescent-parent and adolescent-best-school friend dyads (Kandel et al. 1978). Each of four clusters of predictor variables--parental influences, peer influences, adolescent involvement in various behaviors, and adolescent beliefs and values--and single predictors within each cluster assume differential importance for each stage of drug behavior. (See figure 2.) Prior involvements in a variety of activities, such as minor delinquency and use of cigarettes, beer, and wine, are most important for predicting hard liquor use. Adolescents' beliefs and values favorable to the use of marijuana and association with marijuana-using peers are the strongest predictors of initiation into marijuana. Poor relations with parents, feelings of depression, and exposure to drug-using peers are most important for predicting initiation into illicit drugs other than marijuana.
Thus, at the earliest levels of involvement, adolescents who have engaged in a number of minor delinquent or deviant activities, who enjoy high levels of sociability with their peers, and who are exposed to peers and parents who drink start to drink themselves. The relationship with parental use of hard liquor suggests that these youths learn drinking patterns from their parents. The use of marijuana is preceded by acceptance of a cluster of beliefs and values that are favorable to marijuana use and in opposition to many standards upheld by adults, by involvement in a peer environment in which marijuana is used, and by participation in the same minor forms of deviant behavior
FIGURE 2.-Percentage of explained variance accounted
for by each successive cluster
Reprinted with permission from D. B. Kandel, R. C. Kessler, and R. Z. Margulies, 'Antecedents of Adolescent Initiation into Stages of Drug Use: A Developmental Analysis,' in Longitudinal Research on Drug Use: Empirical Findings and Methodological issues, ed. D. B. Kandel (Washington, D. C.: Hemisphere, 1978). Copyright © 1978 by Hemisphere Publishing Corporation.
that precede the use of hard liquor. By comparison use of illicit drugs other than marijuana is preceded by poor relationships with parents, by exposure to parents and to peers who themselves use a variety of legal, medical, and illegal drugs, by psychological distress, and by a series of personal characteristics somewhat more deviant than those that characterize the novice marijuana or hard liquor user.
At this time in history in the United States, adolescents' involvement in drugs appears to follow certain paths. Beer and wine are the first substances used by youth. Tobacco and hard liquor are used next. The use of marijuana rarely takes place without prior use of liquor or tobacco, or both. Similarly, the use of illicit drugs other than marijuana rarely takes place in the absence of prior experimentation with marijuana.
The documentation that different factors are important for different drugs provides additional support for the claim, developed on the basis of Guttman scale analysis, that drug involvement proceeds through discrete stages. The notion of "stage" itself allows a more fruitful specification of the role and structure of different causal factors at different stages of involvement.
For example, as regards interpersonal influences, we find at different stages not only differences in source of influence but also differences in the aspects of interpersonal influences that are important. In the early stage of drug use, parental behavior seems to be critical in leading the youth to experiment with hard liquor. In later phases of initiation, the quality of the parent-child relationship becomes important, with closeness to parents shielding adolescents from involvement in the most serious forms of drug use. Similarly, there is evidence that a generalized peer influence, which is important in predicting initiation to legal drugs and marijuana, is partially supplanted by the influence of a single best friend in leading to the initiation of other illicit drugs. Findings of this kind point to the importance of examining profiles of interpersonal influences over a series of behaviors, values, and attitudes in order to understand better their dynamic nature. Thus, if one accepts the notion that progressively more serious involvement in drugs underlies the stages we have outlined, the data suggest that the more serious the behavior, the greater the relative importance of the specific role model provided by one friend in contrast to the same behavior of the whole group.
Similar specification occurs with respect to the role of participation in deviant behaviors. Participation in various deviant behaviors is most relevant in starting to use alcohol, least for illicit drugs. The less serious the drug, the more its use or nonuse may depend on situational factors. By contrast, initiation into illicit drugs other than marijuana appears to be a conscious response to intrapsychic pressures of some sort or other.
Many theories of drug dependence offer some concept of individual pathology as a primary explanation, while others stress social factors. Each of these concepts may apply to different stages of the process of involvement in drug behavior, social factors playing a more important role in the early stages; psychological factors, in the later ones.
The identification of cumulative stages in drug behavior has important conceptual and methodological implications for identifying the factors that relate to drug use, either as causes or as consequences. In a longitudinal analytical framework, there should be decomposition of the panel sample into appropriate subsamples of individuals at a particular stage who are at risk for initiation into the next stage. Since each stage represents a cumulative pattern of use and contains fewer adolescents than the preceding stage in the sequence, comparisons of users and nonusers must be made among members of the restricted group that has already used the drugs at the preceding stage. Otherwise, the attributes identified as apparent characteristics of a particular class of drug users may actually reflect characteristics important for involvement in drugs at the preceding stage(s). The definition of stages allows one to define a population at risk and to isolate systematically, within that population, those individuals who succumb to this risk within a specific time interval.
The notion of stage itself is somewhat ambiguous (Wohlwill 1973). Among developmental psychologists, controversy exists about whether the notion of stages implies that development must necessarily occur in a hierarchical and fixed order, as Piaget, for example, proposes. However, the notion of invariance must be subjected to empirical test (Phillips and Kelly 1975). This is especially important for drug behavior. Indeed, as regards the notion of stages in drug use, two reservations must be kept in mind. To date, the stages have been identified in populations of American adolescents. The specific sequences are probably culturally and historically determined. Crosscultural studies are required in order to determine the extent to which the order that has been observed is in fact an invariant one. These studies would indicate whether or not involvement in illicit drugs is always preceded by use of legal drugs, as appears to be the case in the United States, or whether, in certain cultures, involvement in cigarettes, alcohol, and marijuana proceeds along parallel and nonoverlapping paths. Furthermore, while the data show a very clear-cut sequence in the use of various drugs, they do not prove that the use of a particular drug infallibly leads to the use of other drugs higher up in the sequence. Many youths stop at a particular stage without progressing any further. Nor can the findings be interpreted to show that there is something inherent in the pharmacological properties of the drugs themselves that leads inexorably from one to another.
The stage theory itself is a recent conceptualization of drug behavior and needs further testing and documentation.
Howard B. Kaplan, Ph.D.
Within the context of the general theory of deviant behavior presented below, opiate dependence as well as use/abuse of other illicit substances (hallucinogens, barbiturates, amphetamines, marijuana, alcohol) is regarded as an alternative deviant response to self-rejecting attitudes generated in the course of normative membership-group experiences which function more or less effectively to reduce the experiences of the subjectively distressful self-rejecting attitudes. As a theory of deviant behavior it would apply only to drug use/abuse patterns which do not conform to the normative expectations of the person's (predeviance) membership group(s) and which derive from the loss of a previous motivation to conform or from the development of a new motivation to deviate from normative expectations. The definition excludes behaviors which, although defined as deviant by other groups, are compatible with the normative expectations of the subject's membership/reference groups, as well as behaviors to which the person was motivated to conform but was incapable of so doing because of conflicting expectations or physical incapacity. The theory, thus, would not be applicable in situations where, for example, marijuana use was nearly universally observed and/or approved (as on a college campus relatively isolated from extracollege influences) or where the behavior was highly compatible with other values whether or not it was an already established pattern (as where experimentation with illicit drugs in a slum youth social network is congruent with the valued attributes of toughness and adventuresomeness). Normative socialization or social learning theories would be more appropriate to the explanation of illicit drug use/abuse in these situations.
The theory considers the common factors more or less directly influencing the adoption of any of a range of deviant patterns, the factors influencing the adoption of one rather than other deviant patterns (e.g., opiate versus hallucinogen use, drug use versus interpersonal violence, property crimes), and factors influencing the continuity of the deviant pattern.