Research Paper
The role of leisure and delinquency in frequent cannabis use and dependence trajectories among young adults

https://doi.org/10.1016/j.drugpo.2014.07.014Get rights and content

Highlights

  • Frequent cannabis users regulate their use to leisure time.

  • With normalised supply through coffee shops, frequent users might still feel stigmatised.

  • Frequent users often shift from DSM-IV dependence to non-dependence, and vice versa.

  • Frequent cannabis use and cannabis dependence are no homogeneous phenomena.

  • DSM-IV cannabis dependence does not equate to problematic use.

Abstract

Background

The link between leisure and cannabis use has been widely studied, but less so for young adults, and rarely with a focus on frequent cannabis use. Also, little is known about how changes in leisure develop over time and how they are related to transitions in cannabis use and dependence.

Method

As part of a 3-year longitudinal project, in a qualitative study 47 frequent male and female young adult cannabis users with (n = 23) and without (n = 24) dependence at baseline were interviewed in-depth after 1.5 and 3 years.

Results

Frequent cannabis users (at baseline ≥3 days per week in the past 12 months) are involved in similar leisure activities as the general young adult population and live rather conventional lives, generally away from a delinquent subculture. They mostly regulate their cannabis use to leisure time, to enhance other leisure activities, including socialising and video gaming. While they often give precedence to responsibilities (e.g. work and study), dependent and non-dependent users differed in whether they actively adapted their leisure activities to their cannabis use, or their cannabis use to their leisure time. Both types of and time spent on leisure activities were associated with transitions in use and dependence.

Conclusions

While our findings generally support the normalisation thesis, it is questionable whether frequent but non-problematic cannabis use is socially accepted in wider society. This study also questions the diagnostic dependence vs. non-dependence dichotomy, and adds finer distinctions to the concept of cannabis dependence. Implications for prevention and treatment include facilitating structured spending of leisure time (e.g. sports), and targeting frequent users who spent much leisure time video gaming at home.

Introduction

It has been argued that cannabis has become normalised, referring to the process of social and cultural accommodation of recreational drug use as becoming part of everyday life for young people, for both users and non-users (Parker et al., 1998, Parker, 2005). Normalisation has been defined by six indicators: higher access and availability; increased drug trying rates; increased regular use rates; a degree of cultural accommodation among adolescents; trying and use extending to the adult population; and more liberal policy shifts (Parker, 2005). Basically, these indicators can be reduced to two dimensions: (1) growth in drug demand and supply, and (2) increasing levels of social and cultural acceptability. In contrast to normalisation, a subcultural perspective focuses on social formations, where drug users belong to a certain social group not bound to conventional or mainstream society. From a subcultural perspective, cannabis use could be understood as part of political opposition or as signifier of rejecting mainstream values (cf. Pedersen, 2009, Sandberg, 2013). Alternatively, and in line with the normalisation perspective, Duff and Erickson (2014) argue that cannabis use, since it has become an accepted feature of mainstream adolescents and young adults, should be assessed in terms of lifestyle and leisure rather than subcultural connections.

Researchers from several countries found support for the normalisation thesis (e.g. Duff, 2003, Duff, 2005, Parker et al., 2002), showing that the choice to use cannabis is a rational consideration of costs and benefits and users do not belong to a deviant subculture; they are bound to mainstream society, and their lifestyles are rather conventional (Duff et al., 2012, Hathaway, 1997, Pearson, 2001, Shukla, 2006). Others criticised the normalisation thesis for simplifying youth’ choices about drug use (Shiner & Newburn, 1997) and underemphasising the role of the (wider) social context of drug use attitudes and choices (Measham and Shiner, 2009, Pennay and Moore, 2010). Hathaway, Comeau, and Erickson (2011) showed that, notwithstanding indicators of normalisation, Canadian adult users had internalised stigma and experienced a mainstream perspective about cannabis as deviant.

The normalisation thesis is also criticised for being too broad and relying on a too simplistic distinction between recreational and problematic drug use (Shildrick, 2002). Moreover, scholars recently called for attention to social and structural contexts of cannabis use (Duff et al., 2012, Measham and Shiner, 2009, Pennay and Moore, 2010). A recent follow-up of the sample that had been the basis for the original normalisation thesis (Parker et al., 1998) provided some revision (Aldridge, Measham, & Williams, 2011). The follow-up study showed that as participants aged, they continued using drugs, yet through considering costs and benefits fitting their use around their (new) responsibilities, including jobs and children. The authors concluded that normalisation continued, yet acknowledged some critics, e.g. the meaning attributed to drug experiences and the role of structural factors in rational choice. The lives of these young adults were more in common with moderate alcohol use than with dependent drug use. Many studies on normalisation have focused on recreational party drug use, and far less on frequent cannabis use (Järvinen & Ravn, 2014). The debate would thus benefit from further examinations of the normalisation of cannabis. This qualitative longitudinal study in frequent cannabis users focuses on two aspects: the extent to which cannabis use is regulated to leisure time, and to what extent frequent cannabis users live conventional lives, away from delinquent or otherwise deviant subcultures.

Classic studies demonstrated cannabis users are not a homogeneous group; most use recreationally and have various motivations to use (Becker, 1963, Goode, 1970). They choose when and where to use (Erickson, 1989, Hathaway, 2003, Zimmerman and Weider, 1977): mostly in private venues, with peers or partners and in suitable situations and moods, applying informal rules for regulation (Reinarman & Cohen, 2007). Rather than the leisure activity itself, the social setting (i.e. persons sharing leisure time) is associated with changes in cannabis use (Schaub, Gmel, Annaheim, Mueller, & Schwappach, 2010). Adolescents who regularly use cannabis have more selective lifestyles than occasional users, spending more time at a friends’ place, concerts or clubs (Miller and Plant, 2002, Peretti-Watel and Lorente, 2004). Although an association between going out and occasional rather than regular cannabis has been reported (Peretti-Watel & Lorente, 2004), a partying lifestyle has commonly been linked to increased adolescent cannabis use (Ciairano et al., 2008, Thorlindsson and Bernburg, 2006). Frequent users holidaying in Ibiza were more likely to increase than diminish their frequency of use (Bellis et al., 2000, Briggs and Turner, 2012). In contrast, sports participation relates to less cannabis use (Lisha and Sussman, 2010, Terry-McElrath and O‘Malley, 2011, Thorlindsson and Bernburg, 2006), although not in all studies (Peretti-Watel & Lorente, 2004).

Only few recent qualitative studies devoted attention to why and when adults frequently use cannabis, particularly to changes in use. Hathaway (2004) showed that long-term frequent cannabis users predominantly use to relax, feel good and enjoy music or television. Increased use was often associated with more personal freedom, and decreased use with more responsibilities. Users generally considered positive aspects to outweigh negative aspects of their use (Hathaway, 2003). This was corroborated in a study among regular cannabis using adults (Osborne & Fogel, 2008). Respondents used cannabis while engaged in various leisure activities (e.g. socialising, watching movies, doing sports, and playing computer games); they did not report dependence problems or compulsive use, and rational decisions to use were generally accompanied by moderate use. Cannabis was used to enhance “leisure activities and manage the challenges and demands of living in contemporary modern society” (Osborne & Fogel, 2008: p. 562). Similarly, other studies concluded that cannabis is not a central aspect in the lifestyle of adult frequent users, and users are generally not part of a ‘drug subculture’ (Pearson, 2001, Shukla, 2006). Instead, cannabis use was largely a leisure time activity to disengage from daily stress, and is generally subordinate to other roles and responsibilities. Moreover, the majority is not involved in criminal behaviour apart from acquiring and using cannabis. Previous studies reporting a link between regular cannabis use and criminal offences and convictions (Bennett et al., 2008, Derzon and Lipsey, 1999, Fergusson et al., 2002) are hampered by the illegality of the drug, as it is suggested that most offences are related to possession and use (Fergusson et al., 2003, Pedersen and Skardhamar, 2010). The more lenient Dutch policy allows deeper investigation of this association, as use is not liable to prosecution and the possession and sale of cannabis in so-called coffee shops for personal use are tolerated (Wouters, Benschop, & Korf, 2010).

The link between leisure and young adult cannabis use has received some attention, and although changes in cannabis use have been found to be associated with to changes in life circumstances (Hathaway, 2004, Shukla, 2006), it is largely unknown how changes in leisure develop over time and how they are related to transitions in cannabis dependence, as most studies are retrospective, have been limited to adolescence, focused on use and not dependence, or generated quantitative data. This study aims to contribute to the existing literature on normalisation and the relationship between frequent cannabis use, dependence and leisure over time. More specifically, this study will gain insights in the extent to which frequent cannabis use is socially accepted in a country known for its liberal cannabis policy (i.e. the Netherlands), and is stripped of subcultural and deviant associations. The existence of coffee shops makes cannabis readily available. This offers a great opportunity to assess whether easy supply (being part of the first dimension of normalisation) also implies that cannabis use (in our case: frequent cannabis use) is socially and culturally accepted in wider society (the second dimension of normalisation), comparable to alcohol use for example.

We prospectively studied the course of cannabis use and dependence in 47 young adult frequent users over 3 years using qualitative in-depth interviews. First, we explore how frequent users construct their leisure time and how changes in cannabis use interact with changes in leisure, and vice versa. We also assess the centrality of cannabis in their lives, and the absence of (subcultural) delinquency, which would be expected from the nominalisation thesis. Dutch coffee shops allow users to easily acquire cannabis without any specific knowledge or subcultural affiliations. However, the cultivation of cannabis has neither de jure nor de facto been legalised in the Netherlands (albeit that growing up to five marihuana plants for personal use is tolerated). Moreover, successfully growing cannabis, either as a small-scale activity for own use or for large-scale purposes, requires specific knowledge and expertise that is gathered and shared through connections with other growers (Decorte, Potter, & Bouchard, 2011).

Second, we distinguish dependent from non-dependent frequent cannabis users and investigate to what extent leisure activities and the importance of cannabis in their lives differ, and to what extent their leisure pursuit explains cannabis dependence transitions. Obviously, dependent users, by definition (see: Method), would be expected to neglect social and work-related activities in favour of cannabis use and experience reduced control over their use. The normalisation thesis understands cannabis use among youth as a rational choice, yet this only applies to recreational use (Aldridge et al., 2011). Problematic use is considered as non-recreational use, interfering with everyday functioning (cf. Kronbæk & Frank, 2013). From this rationale, while a cost–benefit consideration would apply to frequent non-dependent users, different considerations would be expected in the case of frequent dependent users. However, cannabis dependence is not a homogeneous condition (McBride, Teesson, Slade, & Baillie, 2010). Therefore, it is important to examine whether and how frequent dependent users differ in leisure from frequent but non-dependent users and trajectories. Furthermore, understanding the relationship between leisure and cannabis dependence trajectories helps target prevention and treatment specifically at frequent users at high risk of dependence, as most frequent users limit cannabis use to their leisure time (Liebregts et al., 2013a).

Section snippets

Method

In a qualitative study the dynamics underlying changes in cannabis use and transitions in cannabis dependence were investigated. Participants were selected from a cohort study with a quantitative approach including 600 frequent cannabis users (≥3 days cannabis use per week in the past 12 months) with follow-up assessments at 1.5 and 3 years (see for details Liebregts et al., 2011, van der Pol et al., 2011). Briefly, participants were recruited in coffee shops and through respondent-driven

Cannabis use: when, where and why

The amount of leisure time varied, but most interviewees had professional obligations (work/study) and cannabis use was mainly a leisure activity (Liebregts et al., 2013a). Most interviewees thus used cannabis only at the end of the day, when daily tasks were finished. Some said not to use late at night, because cannabis would bother their night's rest, whereas others believed they slept better ‘stoned’ or ‘high’.

All participants spoke about inappropriate settings for use and emphasised not to

Discussion and conclusion

The majority of frequent cannabis users in our study live a ‘conventional life’, including professional obligations, a social life, going out and participating in sports. While participants’ lives were not without delinquency, these included mainly minor delinquency. More important, delinquency was commonly not related to or induced by cannabis, and convictions were all except one not associated with cannabis use. These findings suggest support for the normalisation thesis. Moreover, while for

Funding

This work was supported by the Netherlands Organization for Health Research and Development (grant number 31160009).

Conflicts of interest

The authors declare that they have no conflicts of interest.

References (58)

  • M. Wouters et al.

    Local politics and retail cannabis markets: The case of the Dutch coffee shops

    International Journal of Drug Policy

    (2010)
  • J. Aldridge et al.

    Illegal leisure revisited: Changing patterns of alcohol and drug use in adolescents and young adults

    (2011)
  • American Psychiatric Association

    Diagnostic and statistical manual of mental disorders DSM-IV

    (1994)
  • H.S. Becker

    Outsiders: Studies in the sociology of deviance

    (1963)
  • D. Briggs et al.

    Understanding British youth behaviors on holiday in Ibiza

    International Journal of Culture, Tourism and Hospitality Research

    (2012)
  • M.S. Buchowski et al.

    Aerobic exercise training reduces cannabis craving and use in non-treatment seeking cannabis-dependent adults

    PLOS ONE

    (2011)
  • S. Ciairano et al.

    Adolescent substance use in two european countries: Relationships with psychosocial adjustment, peers, and activities

    International Journal of Clinical and Health Psychology

    (2008)
  • J.H. Derzon et al.

    A synthesis of the relationship of marijuana use with delinquent and problem behaviors

    School Psychology International

    (1999)
  • C. Duff

    Drugs and youth cultures: Is australia experiencing the ‘normalization’ of adolescent drug use?

    Journal of Youth Studies

    (2003)
  • C. Duff et al.

    A Canadian perspective on cannabis normalization among adults

    Addiction Research & Theory

    (2012)
  • C. Duff et al.

    Cannabis, risk and normalisation: Evidence from a Canadian study of socially integrated, adult cannabis users

    Health, Risk & Society

    (2014)
  • P. Erickson

    Living with prohibition: Regular cannabis users, legal sanctions, and informal controls

    International Journal of the Addictions

    (1989)
  • European Monitoring Centre for Drugs and Drug Addiction

    Annual report 2011: The state of the drugs problem in Europe

    (2011)
  • D.M. Fergusson et al.

    Cannabis use and psychosocial adjustment in adolescence and young adulthood

    Addiction

    (2002)
  • E. Goode

    The marijuana smokers

    (1970)
  • A.D. Hathaway

    Marijuana and lifestyle: Exploring tolerable deviance

    Deviant Behavior

    (1997)
  • A.D. Hathaway

    Cannabis effects and dependency concerns in long-term frequent users: A missing piece of the public health puzzle

    Addiction Research & Theory

    (2003)
  • A.D. Hathaway

    Cannabis careers reconsidered: Transitions and trajectories of committed long-term users

    Contemporary Drug Problems

    (2004)
  • Cited by (0)

    View full text