Abstract
François Lamy’s doctoral thesis is an extensive and ambitious work under the theme of polysubstance use. In an innovative way, Lamy uses interview data and computational social simulation to detail and analyse behavioural changes in the course of a recreational polysubstance user’s life. He aims to construct a better understanding about this complicated social phenomenon by focusing on non-problematic polysubstance use, which has remained an under-studied area.
In his study, Lamy criticises different approaches for unilateral explanations of (poly)substance use. He argues that the adjunction of neurosciences to social sciences has rarely been attempted due to the paradigmatic distance between the disciplines. For this reason, he aims to combine the different explanations concentrated on the drug (biological and neurological), the individual (psychological) and the social context (sociological) and to bridge the gap between these different approaches.
Lamy tries to reach the complexity of polysubstance use by using qualitative interviews conducted in France and Australia and by considering recreational polydrug use as a complex adaptive system (CAS). The interviews are analysed for sociological interpretations as well as to construct an agent-based model called SimUse. The social simulation model also aims to combine the different explanations of substance use at the levels of the drug, individual, network, context and society.
The ambitiousness of Lamy’s work lies in its great multidisciplinarity: sociological frameworks such as symbolic interactionism and social representations theory, biological viewpoints and the neurological basis of addiction, the history and theory of artificial intelligence, and social simulation models are all introduced.
For a social scientist, this diversity of different disciplines and the thoroughness in defining ideas and foreign concepts make the thesis a challenging read. In this short review, I will discuss some observations for a reader interested in the question of polysubstance use focusing on Lamy’s sociological analyses of the interview data.
Polysubstance use as intentional behaviour
One particularity of the thesis is its focus on recreational polysubstance use and socially integrated users in contrast to the majority of polydrug use research regarding problematic use. Lamy’s analyses sustain the idea that recreational polysubstance use is behaviour based on rational decisions of actors. Recreational users are non-compulsive and in control of their use, who intentionally mix substances to attain certain goals. Hence, the role of substances is instrumental. The targeted effects of using multiple substances follow the patterns of controlling long-lasting effects when ending a drug-use session, changing the effects of a substance with another substance, enhancing the effects of a substance with another, or pilling up more than one of the aforementioned instrumental functions. In order to maintain a balance between substance use and an integrated social life, recreational users apply rules and sanctions, or techniques of control. Polyconsumption as controlled behaviour does not lead to social exclusion, and the recreational polyusers interviewed for the study did not see themselves as targets of stigma or discrimination. Rather than the use of multiple substances, it was the level of control that the interviewees argued to determine whether substance use was perceived as problematic or stigmatised.
Polysubstance use as defined by Lamy is thus simultaneous use of at least one illicit substance together with another licit or illicit substance. It is intentional behaviour and a particular form of knowledge, which requires learning. Learning the right effects of different substance combinations, the right moments and the right dosages happens during the polysubstance-use career.
Polysubstance-use “career”
Based on the analyses from qualitative interviews, Lamy introduces three stages of a polysubstance-use career: starting and learning, instrumenting and switching, and slowing and selecting. At the first stage, users initiate use and experiment with different substances. Although simultaneous use of different substances does occur at this stage, Lamy calls this accidental polyconsumption as the mixing of substances is not intentional. Motivation for use is often described through because motives. At the second stage, polyconsumption is a more predominant feature. Users are choosing between different ways of consumption and are doing it in order to achieve certain (social and neurological) goals. In-order-to motives are characteristic of the second stage. At the third stage, drug use decreases due to increasing social obligations. During the career, the social representations users have of different substances and the perceptions of risk and techniques of control change.
The concept of career reminds a social scientist of the work of Erving Goffman, who has applied the term moral career in connection to stigmatised identities. Moral careers are descriptive of stigmatised minorities and rely on the stereotypes linked to these groups. In this sense, talking about a polysubstance-use career seems to be simplifying in suggesting a certain kind of prototypical (recreational) polysubstance user. Lamy addresses the question of flexibility within careers and defends using the concept as it allows for capturing different moments of a substance user’s life – in an intelligible order.
Characteristics of polysubstance use in late modernity
Lamy sees polysubstance use as descriptive of the drug-use context today. He goes as far as to make the claim that nearly all illicit drug users are polysubstance users. This claim is closely linked to what is introduced as the quasi-constant presence of alcohol. Analyses show that the majority of combinations used by recreational users include alcohol. Interviewees see alcohol as a basement or as essential to their use: it is a polyuse inducer. The centrality of alcohol can explain why, even in a situation where reports are declaring increased polydrug use, the number of problematic substance users stays rather stable.
Two characteristics driving polysubstance use in late modernity according to Lamy are hyper-availability and normalisation. Hyper-availability refers to traditional psychotropic substances being more constantly and extensively available than before. The drug market has seen a major rise of new psychoactive substances or designer drugs for which new formulas are continuously invented. Availability has also affected the normalisation of drug use: more people experiment with and use drugs, which leads to social and cultural accommodation.
Summing up
For a social scientist, the thesis gives interesting insights into polysubstance use in a Western cultural context in this time. A social simulation expert could find other merits and be better equipped to appreciate the originality of the different theoretical frameworks and interview data being integrated into the agent-based model. Social simulations, as Lamy points out, always consist of simplifying a social phenomenon, which creates a balancing between the diversity of the phenomenon of polysubstance use on one hand, and coming up with effective ways to capture and understand it on the other.
The interviewees in the study do not see multiple drug use as defining them as users, but construct their user identities in relation and opposition to compulsive users, participating in their dissocialisation. Because of the quasi-constant and essential role of alcohol in polydrug use, Lamy questions the usage of the concept of polysubstance use as a general category. Rather, he recommends concentrating on the different functions that simultaneous, intentional combining of substances have for people engaging in this activity.
Lamy can be given credit for having tackled a topical issue in this sought-after, extensive study. His work broadens our understanding of polysubstance use as not only problematic substance use, but also as a pattern of use common for recreational, socially integrated users. Naturally, the reality of polysubstance use even within this group is more diverse than is captured in these analyses.