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July 1975, Vol 32, No. 7 >
Article | July 1975

Sequence and Stages in Patterns of Adolescent Drug Use

Denise Kandel, PhD; Richard Faust, MA
[+] Author Affiliations

Accepted for publication Feb 24, 1975.

Reprint requests to Columbia University School of Public Health, 100 Haven Ave, New York, NY 10032 (Dr. Kandel).


Arch Gen Psychiatry. 1975;32(7):923-932. doi:10.1001/archpsyc.1975.01760250115013
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Comments

Two prospective longitudinal surveys based on New York State high school students indicate well-defined steps underlying adolescent progression and regression in drug use. At least four stages of involvement with drugs can be identified: (1) beer or wine; (2) cigarettes or hard liquor; (3) marijuana; and (4) other illicit drugs.

Two stages of legal drugs are necessary intermediates between nonuse and marijuana. Very few youths progress to other illicit drugs without prior experience with marijuana. This sequence is found in- each year of high school and in- the year following graduation. Progression to a higher-ranked drug is directly related to intensity of use at the prior stage. The identification of stages in drug behavior has implications regarding the optimum strategy for studying factors that predict, differentiate, or result from drug use.

REFERENCES

1 +
Goode E (ed): Marihuana . New York, Atherton Press, 1970;, p 66.
2 +
Kaplan J: Marihuana—The New Prohibition . New York, World Publishing Co, 1970;.
3 +
Grinspoon L: Marihuana Reconsidered . Cambridge, Mass, Harvard University Press, 1971;.
4 +
Johnson BD: Marihuana Users and Drug Subcultures . New York, John Wiley & Sons Inc, 1973;.
5 +
Zinberg NE, Robertson JA: Drugs and the Public . New York, Simon & Schuster, 1972;.
6 +
Nowlis HH:  Speaking of drugs and drug problems . Contemp Drug Probl 1:3-14, 1971;.
7 +
National Commission on Marihuana and Drug Abuse: Drug Use in America: Problems and Perspective. Washington, DC, US Government Printing Office, 1973.
8 +
Single E, Kandel D, Faust R:  Patterns of multiple drug use among adolescents . J Health Soc Behav 15:344-357, 1974;.
9 +
Goode E:  Trends in college drug use: Report from one campus , in Einstein S, Allen S (eds): Student Drug Surveys . Farmingdale, NY, Baywood Co, 1972;, pp 123-127.
10 +
Loiselle P, Whitehead PC:  Scaling drug use: An examination of the popular wisdom . Can J Behav Sci 3:347-356, 1971;.
11 +
Johnston L: Drugs and American Youth . Ann Arbor, Mich, Institute for Social Research, 1973;.
12 +
Johnston L:  Drug use during and after high school: Results of a national longitudinal study . J Am Pub Health Assoc 64 ( (suppl) ):29-37, 1974;.
13 +
Josephson E, Haberman P, Zanes A, et al:  Adolescent marihuana use: Report on a national survey , in Einstein S, Allen S (eds): Student Drug Surveys . Farmingdale, NY, Baywood Co, 1972;, pp 1-8.
14 +
Whitehead PC, Smart R, Laforest L:  Multiple drug use among marihuana smokers in eastern Canada . Int J Addict 7 ( (spring) ):179-190, 1972;.
15 +
Weppner RS, Agar MH:  Immediate precursors to heroin addiction . J Health Soc Behav 12:10-17, 1971;.
16 +
Wolfson EA, Lavenhar MA, Blum R, et al:  Survey of drug abuse in six New Jersey high schools: I. Methodology and general findings , in Einstein S, Allen S (eds): Student Drug Surveys . Farmingdale, NY, Baywood Co, 1972;, pp 9-32.
17 +
Goldstein J, Gleason TC, Korn JH, et al: Whither the Epidemic? Psychoactive Drug Use Career Patterns of College Students , report No. 74-2. Pittsburgh, Carnegie-Mellon University, 1974;.
18 +
Judd LL, Gunderson E, Alexander MA, et al:  Youth drug use survey , in Marihuana: A Signal of Misunderstanding . Washington, DC, National Commission on Marihuana and Drug Abuse, 1972;, vol 1, appendix, pp 367-421.
19 +
Robins L, Darvish HS, Murphy GE:  The long-term outcome for adolescent drug users: A follow-up study of 76 users and 146 nonusers , in Zubin J, Freedman AM (eds): The Psychopathology of Adolescence . New York, Grune & Stratton Inc, 1970;, pp 159-178.
20 +
Groves EW:  Patterns of college student drug use and lifestyles , in Josephson E, Carroll EE (eds): Drug Use: Epidemiological and Sociological Approaches . Washington, DC, Hemisphere Publishing Co, 1974;, pp 241-275.
21 +
Jessor R, Jessor SL, Finney J:  A social psychology of marihuana use: Longitudinal studies of high school and college youth . J Pers Soc Psychol 26:1-15, 1973;.
22 +
Josephson E, Elinson J, Zanes A:  Trends in adolescent marihuana use , in Josephson E, Carroll EE (eds): Drug Use: Epidemiological and Sociological Approaches . Washington DC, Hemisphere Publishing Co, 1974;, pp 177-205.
23 +
Manheimer DI, Kleman MT, Balter MD, et al: Use of mood changing drugs among American adults. Read before the 39th International Congress on Alcoholism and Drug Dependence, Amsterdam, 1972.
24 +
Smith GM, Fogg CP: Early precursors of teenage drug use. Read before the 36th meeting of the Committee on Problems of Drug Dependence, National Academy of Sciences, National Research Council, Mexico City, 1974.
25 +
Kandel D:  Adolescent marihuana use: Role of parents and peers . Science 181:1067-1070, 1973;.
26 +
Single E, Kandel D, Johnson B:  The validity and reliability of drug use responses in a large scale longitudinal survey . J Drug Issues , to be published.
27 +
Jellinek EM:  Phases of alcohol addiction . Q J Stud Alcohol 13:673-684, 1952;.
28 +
Alksne H, Lieberman L, Brill L:  A conceptual model of the life cycle of addiction . Int J Addict 2:221-240, 1967;.
29 +
Chein I, Gerard DL, Lee RS, et al: The Road to H . New York, Basic Books Inc, 1964;.
30 +
Wickler A:  On the nature of addiction and habituation . Br J Addict 57:73-79, 1961;.

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1 +
Goode E (ed): Marihuana . New York, Atherton Press, 1970;, p 66.
2 +
Kaplan J: Marihuana—The New Prohibition . New York, World Publishing Co, 1970;.
3 +
Grinspoon L: Marihuana Reconsidered . Cambridge, Mass, Harvard University Press, 1971;.
4 +
Johnson BD: Marihuana Users and Drug Subcultures . New York, John Wiley & Sons Inc, 1973;.
5 +
Zinberg NE, Robertson JA: Drugs and the Public . New York, Simon & Schuster, 1972;.
6 +
Nowlis HH:  Speaking of drugs and drug problems . Contemp Drug Probl 1:3-14, 1971;.
7 +
National Commission on Marihuana and Drug Abuse: Drug Use in America: Problems and Perspective. Washington, DC, US Government Printing Office, 1973.
8 +
Single E, Kandel D, Faust R:  Patterns of multiple drug use among adolescents . J Health Soc Behav 15:344-357, 1974;.
9 +
Goode E:  Trends in college drug use: Report from one campus , in Einstein S, Allen S (eds): Student Drug Surveys . Farmingdale, NY, Baywood Co, 1972;, pp 123-127.
10 +
Loiselle P, Whitehead PC:  Scaling drug use: An examination of the popular wisdom . Can J Behav Sci 3:347-356, 1971;.
11 +
Johnston L: Drugs and American Youth . Ann Arbor, Mich, Institute for Social Research, 1973;.
12 +
Johnston L:  Drug use during and after high school: Results of a national longitudinal study . J Am Pub Health Assoc 64 ( (suppl) ):29-37, 1974;.
13 +
Josephson E, Haberman P, Zanes A, et al:  Adolescent marihuana use: Report on a national survey , in Einstein S, Allen S (eds): Student Drug Surveys . Farmingdale, NY, Baywood Co, 1972;, pp 1-8.
14 +
Whitehead PC, Smart R, Laforest L:  Multiple drug use among marihuana smokers in eastern Canada . Int J Addict 7 ( (spring) ):179-190, 1972;.
15 +
Weppner RS, Agar MH:  Immediate precursors to heroin addiction . J Health Soc Behav 12:10-17, 1971;.
16 +
Wolfson EA, Lavenhar MA, Blum R, et al:  Survey of drug abuse in six New Jersey high schools: I. Methodology and general findings , in Einstein S, Allen S (eds): Student Drug Surveys . Farmingdale, NY, Baywood Co, 1972;, pp 9-32.
17 +
Goldstein J, Gleason TC, Korn JH, et al: Whither the Epidemic? Psychoactive Drug Use Career Patterns of College Students , report No. 74-2. Pittsburgh, Carnegie-Mellon University, 1974;.
18 +
Judd LL, Gunderson E, Alexander MA, et al:  Youth drug use survey , in Marihuana: A Signal of Misunderstanding . Washington, DC, National Commission on Marihuana and Drug Abuse, 1972;, vol 1, appendix, pp 367-421.
19 +
Robins L, Darvish HS, Murphy GE:  The long-term outcome for adolescent drug users: A follow-up study of 76 users and 146 nonusers , in Zubin J, Freedman AM (eds): The Psychopathology of Adolescence . New York, Grune & Stratton Inc, 1970;, pp 159-178.
20 +
Groves EW:  Patterns of college student drug use and lifestyles , in Josephson E, Carroll EE (eds): Drug Use: Epidemiological and Sociological Approaches . Washington, DC, Hemisphere Publishing Co, 1974;, pp 241-275.
21 +
Jessor R, Jessor SL, Finney J:  A social psychology of marihuana use: Longitudinal studies of high school and college youth . J Pers Soc Psychol 26:1-15, 1973;.
22 +
Josephson E, Elinson J, Zanes A:  Trends in adolescent marihuana use , in Josephson E, Carroll EE (eds): Drug Use: Epidemiological and Sociological Approaches . Washington DC, Hemisphere Publishing Co, 1974;, pp 177-205.
23 +
Manheimer DI, Kleman MT, Balter MD, et al: Use of mood changing drugs among American adults. Read before the 39th International Congress on Alcoholism and Drug Dependence, Amsterdam, 1972.
24 +
Smith GM, Fogg CP: Early precursors of teenage drug use. Read before the 36th meeting of the Committee on Problems of Drug Dependence, National Academy of Sciences, National Research Council, Mexico City, 1974.
25 +
Kandel D:  Adolescent marihuana use: Role of parents and peers . Science 181:1067-1070, 1973;.
26 +
Single E, Kandel D, Johnson B:  The validity and reliability of drug use responses in a large scale longitudinal survey . J Drug Issues , to be published.
27 +
Jellinek EM:  Phases of alcohol addiction . Q J Stud Alcohol 13:673-684, 1952;.
28 +
Alksne H, Lieberman L, Brill L:  A conceptual model of the life cycle of addiction . Int J Addict 2:221-240, 1967;.
29 +
Chein I, Gerard DL, Lee RS, et al: The Road to H . New York, Basic Books Inc, 1964;.
30 +
Wickler A:  On the nature of addiction and habituation . Br J Addict 57:73-79, 1961;.

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