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Drug use as a social ritual : functionality, symbolism and determinants of self-regulation

Publication Date
  • Hiv
  • New York
  • Rotterdam
  • Cocaine
  • Crack
  • Drug Injecting
  • Drug Policy Research
  • Drug Use Ritual
  • Frontloading
  • Group-Mediated-Drug-Sharing
  • Harm Reduction
  • Heroin
  • Heroin Smoking
  • Needle/Syringe Exchange
  • Overdose
  • Peer Interventions
  • Self-Regulation
  • Biology
  • Ecology
  • Geography
  • Medicine
  • Pharmacology
  • Psychology


abstractThis dissertation brings together results of my NWO-funded ethnography --into the drug taking rituals of regular users of heroin, cocaine and other psychoactive substances--, resulting studies and some twenty years of puzzlement and subsequent pondering. The NWO study was initiated in the former Erasmus University Institute for Preventive and Social Psychiatry (IPSP) by professor Charles D. Kaplan and the late institute director professor Kees Trimbos. The work was completed within the walls of the new-born lnstituut voor Verslavingsonderzoek (IVO), Addiction Research Institute, and the safety of my home. The assumed failure of users of illicit drugs to conform with common standards of socially appropriate conduct is directly associated with the use of a substance which supposedly renders them powerless. This image is not only part of popular wisdom, but, in different forms also recognized in several scientific theories.' Many theories emphasize the powerful pharmacological properties of psychoactive drugs. others relate (problematic) substance use to f.e. deficient personality structures, ego problems, impaired psychological development, acute distress or psychiatric problems. Again other theories associate drug use with environmental deficits, such as poverty. All of these factors may, indeed, explain part of the phenomenon, but the frequent emphasis on only one aspect, be it a pharmacological, psychological or social factor, is in my opinion erroneous. Until now, none of these schools has produced specific correlations between cause and effect. A number of recent studies have questioned these (rather) mono-causal explanations and emphasized the multi· dimensionality of drug taking behaviors.text

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