Cultural factors in the choice of drugs.

The human animal has discovered a wide range of drugs, some of which are readily available products of nature, and has invented others by means of manufacture or processing. The meanings, uses, and associations that are attached to such drugs vary from one population to another and are often different for subgroups within a given population. Even the effects of drugs vary, demonstrating that they are not inherent in the substances or in the biochemical impact they have on the human organism. Meanings, uses, and associations often change over time as well. These facts, briefly illustrated with selected examples, demonstrate that culture is an important aspect of the environment--interacting with biological and psychological factors--in relation to choices individuals make about drugs, their uses, and the outcomes of use. The concept of culture has heuristic value in describing and analyzing beliefs and behavior, but it should not be construed as an etiologically powerful entity. Culture can be viewed as a metaphor, reflecting and incorporating social consensus and controls. Any serious attempt to change patterns of drug use must involve changes in the culture, and education promises to be the most likely way of altering both individual choices and cultural patterns. Whereas "the control model" of prevention unrealistically relies on formal legislative and regulatory controls, "the sociocultural model" emphasizes more powerful informal social controls.