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This dissertation brings together results of my NWO-funded ethnography --into the \ndrug taking rituals of regular users of heroin, cocaine and other psychoactive \nsubstances--, resulting studies and some twenty years of puzzlement and subsequent \npondering. The NWO study was initiated in the former Erasmus University Institute for \nPreventive and Social Psychiatry (IPSP) by professor Charles D. Kaplan and the late \ninstitute director professor Kees Trimbos. The work was completed within the walls of \nthe new-born lnstituut voor Verslavingsonderzoek (IVO), Addiction Research Institute, \nand the safety of my home. \nThe assumed failure of users of illicit drugs to conform with common standards of \nsocially appropriate conduct is directly associated with the use of a substance which \nsupposedly renders them powerless. This image is not only part of popular wisdom, \nbut, in different forms also recognized in several scientific theories.' Many theories \nemphasize the powerful pharmacological properties of psychoactive drugs. others \nrelate (problematic) substance use to f.e. deficient personality structures, ego \nproblems, impaired psychological development, acute distress or psychiatric problems. \nAgain other theories associate drug use with environmental deficits, such as poverty. \nAll of these factors may, indeed, explain part of the phenomenon, but the frequent \nemphasis on only one aspect, be it a pharmacological, psychological or social factor, \nis in my opinion erroneous. Until now, none of these schools has produced specific \ncorrelations between cause and effect. A number of recent studies have \nquestioned these (rather) mono-causal explanations and emphasized the multi· \ndimensionality of drug taking behaviors.
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