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March 8, 1985

Drug, Set, and Setting: The Basis for Controlled Intoxicant Use

Author Affiliations

University of Southwestern Louisiana Lafayette

JAMA. 1985;253(10):1467. doi:10.1001/jama.1985.03350340121039

The distinction between occasional heroin use and addictive use is fundamental. Occasional use does not necessitate an urgent quest for contacts and money to procure the drug. Nor does it necessarily precipitate the changes in interests, mood, and leisure activities that characterize the addict's life.

Norman Zinberg, MD, is an internationally respected authority on the use of psychoactive substances. He is the director of psychiatric training at The Cambridge Hospital and a professor of psychiatry at the Harvard Medical School.

Zinberg contends that the use of any drug involves values and rules of conduct, which he calls social sanctions, as well as patterns of behavior, which he calls social rituals. Zinberg argues that American culture minimizes the importance of social mores that can enhance our capacity to control use. He is convinced that the term "drug abuse" must be dropped from our vocabulary if we are to understand why and

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