Drug Use Etiquette Can Harm Your Health

Etiquette is the set of rules indicating the proper and polite way to behave.  Often understood to represent behavior of upper social classes, and even specific actions which indicate a higher social class, you may be surprised to learn that etiquette applies to all social groups, including groups of drug users.  And although etiquette is intended to demonstrate caring for the comfort of others, etiquette can cause harm as well as comfort to those on the receiving end.

One of the ways that drug use etiquette can be harmful is through the sharing of objects which are in contact with the mouth.  While friendly gestures, such as passing joints, sharing crack pipes, and offering a swig of liquor or water, create bonding and promote feelings of acceptance and camaraderie among drug users, they raise the risk of passing infections, such as H1N1hepatitis B and C, and TB.  Protecting yourself from these infections involves basic good hygiene you should be practicing anyway, but may be neglected by drug users. And there are other risks from behaviors which apply specifically to drug users in social situations, that increase the risk of infection.

Research has shown that drug users engage in quite sophisticated rules of etiquette that support the drug using lifestyle, and help to avoid intrusion from outsiders.  These rules of etiquette have even been observed across different cultures.

  They include such actions as contributing money to group purchases of drugs, withdrawing to a polite distance from non drug users before taking drugs, sharing "tokes" or puffs on smoked drugs and portioning out drugs equally between members of the groups, and each drug user moderating their own level of intoxication.

These etiquette behaviors form parts of the ritual of drug ingestion, and have been recognized for decades.  They serve a variety of purposes to drug users.  Individuals can leave the ritual as intoxicated as they want to be, but avoid becoming incapacitated. Differences in equality of access to substances, for example, because of being underage, can be managed by the group, and consuming all of the drug within a group avoids having to keep a stash which could make them more vulnerable to arrest or theft by other users.

Needle sharing, of course, is well known to carry infection risks, most notably, HIV, which is rarely transmitted without very close contact with an infected person or infected blood, semen or other bodily substance.

Although drug users often consider themselves to be above social conventions, the acceptance they feel from their peers is perhaps even greater than non-users, and engaging in drug taking behaviors with other users enhances a feeling of belonging and community.

With this in mind, the “peer pressure” to share drugs and drug paraphernalia can be hard to resist. This is worsened by the rituals involved in drug use, which are a major part of the addictive process.

It is important to be aware of the increased risk not only of becoming infected with H1N1 “Swine Flu” if you are a drug user, but also the greater risk of becoming severely ill, due to having a compromised immune system, and resisting seeking help from the medical establishment.

However, immediate treatment is often key to your recovery from infectious diseases, so if you experience symptoms, go to see your family doctor or go to the emergency department of your nearest hospital immediately.


Ream, G., Johnson, B., Dunlap, E., & Benoit, E. "The role of marijuana use etiquette in avoiding targeted police enforcement." Drugs: Education, Prevention & Policy, 17: 6, 689-706. 2010.

Sterk-Elifson, C. & Elifson, K. "The social organization of crack cocaine use: The cycle in one type of base house." Journal of Drug Issues, 23: 3, 429-441. 1993.

Hunter, G.M., Donoghoe, M.C., Stimson, G.V., Rhodes, T., & Chalmers, C.P. "Changes in the injecting risk behaviour of injecting drug users in London, 1990-1993." AIDS (London, England) 9: 5, 493-501. 1995.

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