Anthropological studies on how human beings use drugs have had major impact in at least eight areas:
1. They have extended the general understanding of how many different variants of drug use there are in the world.
2. They have conveyed the valuable message that the cultural context in which people use drugs helps to determine whether or not those who use suffer negative consequences.
3. They have developed paradigms for addressing questions of health and avoidance of harm related to drug use.
4. They have contributed mid-level theory about social process and structure in regional and transnational cities.
5. They have improved the precision of field interventions to prevent consequences of drug use through characterization of environments in which risk takes place.
6. They have built approaches to cognitive mapping of how drugs are perceived and how those perceptions are enacted.
7. They have analyzed the process of clinical interventions with an eye toward improvement of fit between cultural background of clientele and clinical approach.
8. They have offered methods for the study of covert behavior in urban contexts.
The impacts outlined above fall into three basic categories: descriptive, theoretical, and methodological. One cannot over-emphasize the importance of the descriptive impact. With all of their bewildering complexity and detail, it would seem that the thick descriptions contributed by Furst (1990), La Barre (1938a, 1938b), and Lowie (1919) were the antithesis of science, which seeks unifying and simplifying principles. Nevertheless, these descriptions ultimately will help to define the boundaries of human variation and provide the wherewithal for building theory. The works of Heath (1958, 1994) articulated the theory that ritual contexts provide protection against the harmful consequences of drug use, and La Barre's, Furst's, and Wilbert's work on peyote and tobacco supported this concept by characterizing the use of strong drugs in non-Western cultural contexts where they were not associated with health problems and addiction. Although this position remains controversial, it forces us to question the assumption that the use of drugs for mind-altering purposes ultimately visits harm upon users. Works by Page et al. (1990, Page & Salazar, 1999a), Gamella (1994), and Koester (1994) defined the nature of health risk among IDUs in terms of contextual factors, providing information necessary to improve interventions for preventing HIV infection. This contribution takes an approach to the relationship between drug use and its consequences that advocates for close examination of cultural context to determine the nature of risk.
Beyond theory specific to the consumption of drugs and its consequences, anthropological studies of drug use have analyzed the human condition in broad strokes, relating drug use to the general distribution of wealth (Waterston, 1993) and health care (Singer, Baer, & Susser, 1999). Trotter et al.'s (1995) conceptual struggle with networks among IDUs also has edified with implications for the structure of human relations.
The anthropology of drug use can trace its origins to some of the first descriptions of one people by another. It has grown into a thriving branch of the discipline populated by active scientists. Their contributions to the state of knowledge have been important not just to medical anthropology, but to anthropology as a whole. In a world where cultural traditions swirl together into complex recombinations, the study of drug use represents an exemplary application of the anthropological view. It is a behavior that has implications for many aspects of the human condition, and therefore it demands an holistic perspective in order to achieve adequate understanding of its impact. The anthropological works cited here demonstrate this principle clearly. Furthermore, the humanity of the people who use drugs comes through vividly in these writings, and this is perhaps their most important contribution.
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