Although ceremonial alcohol use is widely appreciated, the ceremonial use of drugs is not so well known. Peyote buttons are a sacramental substance in the Native American Church (Bergman, 1971). Hallucinogen use for religious purposes still occurs among many South American ethnic groups (DuToit, 1977). Supernatural sanctions, both prescribing use within certain bounds and proscribing use outside these bounds, inveigh against abuse of these substances by devotees. Thus, ceremonial or religious use tends to be relatively safe. Examples of abuse do occur, however, such as the occasional Catholic priest who becomes alcoholic, beginning with abuse of sacramental wine.
Secular but social use of alcohol and drugs occurs in numerous quasi-ritual contexts. Drinking may occur at annual events, such as New Year or harvest ceremonies (e.g., Thanksgiving in the United States). Weddings, births, funerals, and other family rituals are occasions for alcohol or drug use in many cultures. Marking of friendships, business arrangements, or intergroup competitions can virtually require substance use in some groups. For example, the dutsen in German-speaking Central Europe is a brief ritual in which friends or associates agree to address each other by the informal du ("thou") rather than by the formal Sie ("you"). Participants, holding an alcoholic beverage in their right hands, link their right arms, toast each other, and drink with arms linked.
The use of betel-areca, pulque or cactus beer, coca leaf, and other intoxicants has accompanied group work tasks, such as harvests or community corvée obligations (e.g., maintaining roads, bridges, and irrigation ditches). Although substance use may be heavy at ceremonial events, even involving intoxication, the social control of the group over dosage and the brief duration of use augurs against chronic abuse (although problems related to acute abuse may occur). Problems can develop if the group's central rationale for existence rests on substance use (e.g., habitués of opium dens, taverns, and cocktail lounges). In these latter instances, group norms for alcohol or drug use may foster substance abuse rather than prevent it (Dumont, 1967).
Medicinal reasons for substance use have prevailed in one place or another with virtually all psychoactive substances, including alcohol, opium, cannabis, tobacco, the stimulants, and the hallucinogens (Hill, 1990). Insofar as substances are prescribed or administered solely by healers or physicians, abuse is rare or absent. For example, the prescribing of oral opium by Chinese physicians over many centuries had few or no adverse social consequences. On the other hand, self-prescribing for medicinal purposes carries risks. For example, certain Northern Europeans, Southeast Asians, and others use alcohol for insomnia, colds, pain, and other maladies—a practice that can and does lead to chronic alcohol abuse. Self-prescribing of opium by poppy farmers similarly antedates opium addiction in a majority of cases (Westermeyer, 1982). Thus, professional control over medicinal use has been relatively benign, whereas individual control over medicinal use of psychoactive compounds has often been problematic.
Dietary use of substances falls into two general categories: (1) the use of alcohol as a source of calories and (2) the use of cannabis and other herbal intoxicants to enhance taste. Fermentation of grains, tubers, and fruits into alcohol has been a convenient way of storing calories that would otherwise deteriorate. Unique tastes and eating experiences associated with beverage alcohol (e.g., various wines) have further fostered their use, especially at ritual, ceremonial, or social meals. Cannabis has also been used from the Middle East to the Malay Archipelago as a means of enhancing soups, teas, pastries, and other sweets. Opium and other substances have been served at South Asian ceremonies (e.g., weddings) as a postprandial "dessert."
Recreational use can presumably occur in either social or individual settings. Much substance use today occurs in recreational or "party" settings that have some psychosocial rationales (e.g., social "time-out" and meeting friends) but minimal or no ritual or ceremonial aspects. So-called recreational substance use in these social contexts may in fact be quasi-medicinal (i.e., to reduce symptoms associated with social phobia, low self-esteem, boredom, or chronic dysphoria). Even solitary psychoactive substance use can be recreational (i.e., to enhance an enjoyable event) or medicinal (i.e., to relieve loneliness, insomnia, or pain).
Other purposes exist but are not as widespread as those described earlier. In the 19th century, young European women took belladonna before social events in order to give themselves a ruddy, blushing complexion. A particular substance or pattern of use can represent a social or ethnic identity (Carstairs, 1954). Children may inhale household or industrial solvents as a means of mimicking adult intoxication (Kaufman, 1973). Intoxication may simply serve as a means for continuing social behaviors, such as fights or homicide, that existed previously without intoxication (Levy & Kunitz, 1969). Particular patterns of alcohol-drug production or use may represent rebellion by disenfranchised groups (Connell, 1961; Lurie, 1970).
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