Drug, Set, Setting

        There are many reasons as to why people take drugs. Many theories have been put forward such as people take drugs to escape, to rebel against their parents and other authorities, in response to tensions over foreign wars, in imitation of their elders and so on (Weil, 1). There is never one valid explanation but these reasons do have one concept in common. Drug, set and setting is a concept introduced by Norman Zinberg and has been widely accepted by many researchers who study drug use. Set is the mindset of a person and setting is the environment that the person is in when the drug is being given to them. It is believed that the set and setting can have an influence the experience a person who will take drugs. So, whether the person drinks alcohol to escape reality or a person becomes addicted to heroin due to them being in a foreign war, the idea of set and setting never fails to appear. Zinberg and many other researchers have concluded “drug, set and setting” as an alternative approach to drug use policies and an importance to the effects of a user’s drug use.

        “I contended, first, that in order to understand what impels someone to use an illicit drug and how that drug affects the user, three determinants must be considered: drug (the pharmacologic action of the substance itself), set (the attitude of a person at the time of the use, including his personality structure), and setting (the influence of the physical and social setting within which the use occurs) (Zinberg, 2).” Zinberg uses these three determinants to explain the actions behind why people use drugs. Among these three, he believes that setting is the least recognized and should be the focus of the investigation. In a setting, there are social sanctions and rituals that can or cannot aid the control of the drug use. These social controls give an understanding to most individuals that “drug use should always be moderate and that behavior should always be socially acceptable (Zinberg, 3).”

In his article, he talks about the Vietnam war in which 35% of the enlisted men tried heroin while in Vietnam and 54% of these became addicted to it. Although, there were many treatment centers available in Vietnam for the addicts and even a slogan to stop the addiction, those programs were still total failures. However, studies did show that when people left Vietnam and returned to the United States, only 12% relapsed. Most people would wonder why it was so hard for a someone in the war to stop using it. “Apparently, it was the abhorrent social setting of Vietnam that led men who ordinarily would not have considered using heroin to use it and often to become addicted to it (Zinberg, 4).” This shows that the setting was essential as to why men turned to heroin. In Vietnam, heroin was attractive to these soldiers because of the availability, inexpensiveness and the method of administration. Instead of injecting the drug, which is normally the primary way, they were able to smoke it. Not only was the setting an influence but the mindset of the soldier should be noted as well. These soldiers could have been emotionally stressed because they were alone and smoking heroin might have filled up the void they had in them. So, when these soldiers returned back home, the drug became less appealing to use. Some might have had support and love from their family and friends so turning to the drug could have been pointless. Moreover, the drug was illegal, smoking heroin was impractical and since it was illegal, prices were higher.  

        In the article “Reducing the risks of drug use: The case for set and setting,” Phil Dalgarno and David Shewan concluded that “the role of set and setting are of fundamental importance in ensuring that the effects of that drug are as intended for and expected by the user.” The central proposition of this article is that if people set limits for themselves and are knowledgeable, it is possible that using drugs is not dangerous. They used three terms: controlled, recreational and unobtrusive. Controlled drug use includes the prescribing regime and research studies that use drugs such as cocaine and heroin. If a doctor was to sign off on multiple prescriptions everytime their patient shows symptoms of a certain disorder, then yes, the patient will soon become addicted. If a non-problematic drug user participates in using addictive or illegal drugs, they would have to think about the consequences and the availability or purity of the drug. The second type of non-problematic drug use is recreational. Drugs like ecstasy are known to be used only in a particular setting such as raves while the use of heroin seems to be used with “monotonous regularity through necessity.” This means that a person might not get addicted to using ecstasy because they are not at a party but a person could get addicted to heroin because they see it as a drug that can be used any time of the day. In both controlled and recreational drug use, the mindset and setting of a person is a dominant factor in whether they will get addicted to the drug.

        The term that Dalgarno and Shewan comes up with to cover non-problematic drug use is unobtrusive drug use. They discussed that even though some drugs are widely available and the effects can be desirable to people, they are not widely used. Plants such as Deadly Nightshade, Henbane and Mandrake were commonly used in the European tradition. These plants induced a state of total oblivion accompanied by audio-visual hallucinations. The plants were also abundant and can be obtained free of charge. It sounds interesting to most but the drug use was not widespread because people who wanted to try it, were informed of its fearsome reputation. Fly Agaric, a mushroom that is used for visionary purposes and is known as the oldest hallucinogen is another substance that was not widely used because it was hard to find and just like the plants, Fly Agaric had intense effects on an individual. These are just some of the substances that Dalgarno and Shewan mentioned that shows drug use can be unobtrusive to individuals. With the drugs being unobtrusive, it relates to the concept, “drug, set and setting.” With Fly Agaric being scarce, it reduced the use of it and since people were advised of the plants having a fearsome reputation, it was not widely used.  

        In the article, “The Destructive Influence of Imaginary Peers,” Tina Rosenberg mentions the idea of social norming. Students at most universities like Northern Illinois University in Dekalb had a problem with heavy drinking. The coordinator, Michael Haines tried to cut down the student use of alcohol by campaigning about the consequences of heavy drinking and instead of the activity decreasing, it increased even more. Therefore, Haines had to try something new which was campaigning that, “most students drink moderately.” He did this because most students believed that their peers around them drank heavy but instead, they really just drink less than five drinks at a party. Results from the campaign showed that drinking and heavy drinking decreased amongst students. “…Bad behavior is the social norm. Telling people to go against their peer groups never works. A better strategy is the reverse: give people credible evident that among their peers, good behavior is the social norm (Rosenberg, 2).” Instead of telling someone to not drink, telling them that the people around you are not drinking as much, can have an impact on the person. The concept, social norming incorporates “set” as a factor to why students were heavy drinking because the students had this “imaginary” mindset that their friends were heavily drinking so they felt like they had to do the same. When Haines pointed out that not many were heavily drinking, the students changed their minds and cut down their drinking habits. “In reality, the strongest influence on our decisions is the example of the people around us – even, oddly enough, when they are imaginary (Rosenberg, 1).”