Le's Site: Drug Information: Set & Setting

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“In my last severe depression I took coca again and a small dose lifted me to the heights in a wonderful fashion.”
- Sigmund Freud

What do all drugs have in common? * Abstinence * Addiction * Effects on behavior
Excessive dosages * Interactions * Personal & fetal health * Set & setting
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SET & SETTING
The objective of this section of my website is to raise awareness about risks inherent in all drugs, including chemicals that most people don’t consider drugs. Author and alternative medical practitioner Andrew Weil, M.D. discussed similar ideas in his book From Chocolate to Morphine. He is also a co-developer of the set and setting theory regarding drug experiences. The theory places emphasis not on the dosage, route of administration, legality, or even the type of chemical used. Rather, set and setting refers to the person taking the drug as well as the context in which the drug is taken, citing both as unique influences on how the mind and body will perceive and handle the experience. Below are factors that make up the set and setting.
Person (the Set)

Physical factors such as body weight, sex, race, current health conditions, illnesses or diseases, medication intake, and genetic makeup.

Level of experience with the exact drug, drugs of the same type, drugs in general, or using drugs within certain contexts.

Tolerance level of specific drug, usually influenced by level of experience and physical factors, especially body weight and genetic makeup.

Current emotional and mental state, such as depression, anger, stress, recent trauma, or psychological disorders.

Type and level of drug education received

Expectations (or lack of), as well as intentions, regarding pending drug use, how the effects should feel, and what the experience will be like.

Personality, ideological opinions, and things of interest, often influences intentions and expectations.

Predisposition to physical addiction, likely influenced by genetics, personality, and tolerance.

Context (the Setting)

Place (i.e. at home, at a party, at the doctor’s office, on the streets, at work, etc).

Characteristics of environment, including the presence of music or other sounds, weather conditions, type of area (i.e. suburbs, industrial district, inner city, woods, beach, etc), whether it’s indoor/outdoor, and perimeter or tightness of setting.

Time, such as day or night, which season, day of the week, etc.

Amount of surrounding people (if any), plus types of individuals, crowdedness, and whether communication, interaction, or recreation takes place among group.

Culture, such as age group, ideology, race, common activities, and even the country of use.

Reason for drug experience (i.e. to undergo surgery, as medicine, to relax, for therapy, for recreation, as religious practice, to stay up or get work done, as a subject of research, unexpectedly/unwittingly, without consent, etc).

Both these set of factors combine to form very different experiences for different people in different places, even if they’re taking the same amount of the exact same chemical through the same route of administration. The following charts lay out examples by drug, set, setting, and finally the resulting experience, some of which are based on real situations I have observed:
DRUG: ECSTASY

Set Setting Experience

Example I
Teenage female who has only taken ecstasy at house parties and raves. Also takes other stimulants and psychedelics for recreational purposes. Enjoys dressing colorfully and socializing with fellow young partygoers. Saturday night, local event center. All-night dance party featuring loud music, laser lights, and fluorescent decorations. Crowded capacity full of youths dancing, many of whom are also on ecstasy. Music is enhanced, environment is euphoric, and inhibitions are lowered. Talking to and hugging people become a joy. Dancing is also stimulating.

Example II
40-yr-old woman, divorced, no children. Was raped about 10 years ago. Heavy drinker and smoker, but doesn’t take any other drugs recreationally. Also takes anti-depressants regularly. Counseling office with new therapist. Quiet and moderately lit. Inhibitions are lowered, begins to trust therapist. Communication and confrontation of problems eased. Becomes more forgiving and acceptant of people. Has the highest level of self-confidence and self-acceptance she’s ever had in her life.

Example III
Young man with low self-esteem and perception of sexual inadequacies, despite girlfriend’s contentment. Often gets drunk or takes methamphetamine to lower sexual inhibitions and boost drive and confidence. Wants to take ecstasy as another outlet for enhancing sexual performance and pleasure. Vacation time, hotel room, returning from nightclub downstairs. He and the girlfriend take ecstasy together and begin to make love. Ecstasy inhibits his ability to become erect as it does with many males. Relaxation and empathy as usual. But sensitive mood exists as sorrow, self-pity, and embarrassment. Falls into a deep state of depression and confusion. Obsesses over inadequacy and flawed performance in bed.

DRUG: CAFFEINE

Set Setting Experience

Example I
Petite freshman college student who has never drank coffee before and seldom indulges in chocolate, candy, alcohol, or other drugs of any kind except for medicinal purposes. Suffers from frequent insomnia. Dorm room, day before midterm exams. Studying heavily with one cup of decaffeinated coffee. Weariness and disorientation build up gradually as hours pass. Despite exhaustion and completion of studying, unable to sleep at all and skips a night of rest before exam.

Example II
30-yr-old attorney who’s been drinking coffee since the age of 18. Received abstinence-based, anti-addiction education regarding illegal drugs and cigarettes. Also sees and hears anti-drunk driving messages frequently. Seldom receives information on risks of other legal drugs. Lunch hour from office where broken coffee maker was still being fixed. Inside crowded restaurant where she orders a cup of decaffeinated coffee. Feels nothing and continues to be agitated and tense due to nearly an entire morning without coffee. Demands waiter to immediately bring her a cup of regular coffee. Does not realize she is a drug addict experiencing withdrawal symptoms at the moment.

DRUG: KETAMINE

Set Setting Experience

Example I
Recreational drug user with fair amount of experience with LSD, psilocybin mushrooms, nitrous oxide, and other psychedelics and dissociatives. Wants to take ketamine to see how it compares to other drugs she’s taken, based on friends and peers saying how great it is. Friday night, small apartment. Intimate, new age style party with a group of close friends, most of whom are on one or more drugs, including ketamine. Initial relaxation and numbness, dissociation and out-of-body sensations, deep hallucinations during peak, fun enough to roughly meet what others said it would be like.

Example II
Middle-aged executive who, aside from beer and past marijuana use, has never taken drugs recreationally. Heavy sleeper, often gets up late, drives fast every morning to rush to work on time. Car accident scene. Person is crushed in own vehicle and severely injured. Crowded spectators, rush hour morning traffic, and rescuers form a noisy and condensed environment. Ambulance administer ketamine to person to suppress pain while they pull him out of the car. Initial relaxation and pain reduction. Dissociation from crowds and noise. Unexpected hallucinations and out-of-body sensations. Assuming pending death, perceived as afterlife experience. While spiritual, also very frightening and disorienting.

DRUG: MESCALINE

Set Setting Experience

Example I
Native American tribesman living in a Midwestern village. Experienced in traditional practices such as worshiping of animals and plants, including psilocybin mushrooms. Group ceremony practiced regularly by tribe members who take mescaline from the peyote cactus as a religious sacrament. Sense of environment coming to life. Value of air, trees, soil, and other surrounding elements enhanced. Belief that superior being, nature, and oneself are very close together.

Example II
Young man taking mescaline for the first time. Has done a number of other drugs before, but never any psychedelics or hallucinogens. Enjoys illustrating and relates many of his activities such as watching cartoons and taking photos to artwork. Cool, sunny Saturday afternoon with a few other friends who are also on mescaline. Walking and hanging out in downtown at a shopping, recreation, and entertainment plaza. Signs, billboard designs, and wall graffiti appear 3-dimensional. Colors are more vivid and buildings appear to be melting. Random trails, geometric patterns, and moving images surface. Everything perceived as profoundly beautiful, realistic, and inspiration for future illustrations.

Example III
Chinese woman who drinks alcohol and smokes cigarettes, but has never taken psychedelic drugs. Never been exposed to extensive drug education or cultures associated with mind-altering drugs. Crowded disco in Hong Kong. Saturday night. Typical mainstream crowd. Woman is with friends but none of them are taking mescaline with her. Mild hallucinations and body sensations perceived as weird and confusing. Disappointed due to a lack of stimulation or light-headedness common in getting drunk. Visuals, auditory changes, and other effects are somewhat uncomfortable and for the most part boring.

DRUG: MORPHINE

Set Setting Experience

Example I
19-yr-old male soldier in combat. Has drank alcohol and smoked marijuana recreationally. Also smokes cigarettes and has been given various stimulants throughout the war to stay awake on watches and walks. Was administered morphine one other time earlier in battle during a minor leg injury. 1940's, World War II, Germany. Battlefield with 100s of other soldiers fighting together. A bomb blasts the soldier apart from knee down and causes intense painful bleeding before fellow servicemen inject morphine and treat him. Immediate elimination of pain. Relaxation and euphoria. Requests stronger dosage to hold off pain without any particular thoughts about taking morphine again unless need be.

Example II
Chemical researcher interested in how natural and synthesized substances interact with naturally occurring brain chemicals. Has taken hundreds of drugs before but has never taken plain morphine. Obtains pure extraction from opium and uses oneself as test subject, injects sample into arm. Weekday afternoon, quiet laboratory. Colleagues and fellow chemists doing own work in separate rooms, but close enough to supervise or assist if need be. Instant relaxation and euphoria noted. Backaches and other discomforts gone. Slight nausea and itchiness recorded as side effects. Slowed breathing observed as only risk at current dosage. Effects concluded as connected to depressants, tranquilizers, sedatives, opiates, and pain relievers.

Example III
Busy, middle-aged professional who receives rashes as an allergic reaction to ethanyl alcohol and doesn’t smoke due to heart problems. Occasionally injects extracted morphine for relaxation and stress-relief. 6pm, Thursday evening, just coming home from work. Quiet, middle-American home by himself. Wife and children are out. Relaxation and euphoria as usual. Contentment with life despite everyday problems. Desire to remain in mind state forever.

© 2004

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	Set	Setting	Experience
Example I	Teenage female who has only taken ecstasy at house parties and raves. Also takes other stimulants and psychedelics for recreational purposes. Enjoys dressing colorfully and socializing with fellow young partygoers.	Saturday night, local event center. All-night dance party featuring loud music, laser lights, and fluorescent decorations. Crowded capacity full of youths dancing, many of whom are also on ecstasy.	Music is enhanced, environment is euphoric, and inhibitions are lowered. Talking to and hugging people become a joy. Dancing is also stimulating.
Example II	40-yr-old woman, divorced, no children. Was raped about 10 years ago. Heavy drinker and smoker, but doesn’t take any other drugs recreationally. Also takes anti-depressants regularly.	Counseling office with new therapist. Quiet and moderately lit.	Inhibitions are lowered, begins to trust therapist. Communication and confrontation of problems eased. Becomes more forgiving and acceptant of people. Has the highest level of self-confidence and self-acceptance she’s ever had in her life.
Example III	Young man with low self-esteem and perception of sexual inadequacies, despite girlfriend’s contentment. Often gets drunk or takes methamphetamine to lower sexual inhibitions and boost drive and confidence. Wants to take ecstasy as another outlet for enhancing sexual performance and pleasure.	Vacation time, hotel room, returning from nightclub downstairs. He and the girlfriend take ecstasy together and begin to make love. Ecstasy inhibits his ability to become erect as it does with many males.	Relaxation and empathy as usual. But sensitive mood exists as sorrow, self-pity, and embarrassment. Falls into a deep state of depression and confusion. Obsesses over inadequacy and flawed performance in bed.

	Set	Setting	Experience
Example I	Petite freshman college student who has never drank coffee before and seldom indulges in chocolate, candy, alcohol, or other drugs of any kind except for medicinal purposes. Suffers from frequent insomnia.	Dorm room, day before midterm exams. Studying heavily with one cup of decaffeinated coffee.	Weariness and disorientation build up gradually as hours pass. Despite exhaustion and completion of studying, unable to sleep at all and skips a night of rest before exam.
Example II	30-yr-old attorney who’s been drinking coffee since the age of 18. Received abstinence-based, anti-addiction education regarding illegal drugs and cigarettes. Also sees and hears anti-drunk driving messages frequently. Seldom receives information on risks of other legal drugs.	Lunch hour from office where broken coffee maker was still being fixed. Inside crowded restaurant where she orders a cup of decaffeinated coffee.	Feels nothing and continues to be agitated and tense due to nearly an entire morning without coffee. Demands waiter to immediately bring her a cup of regular coffee. Does not realize she is a drug addict experiencing withdrawal symptoms at the moment.

	Set	Setting	Experience
Example I	Recreational drug user with fair amount of experience with LSD, psilocybin mushrooms, nitrous oxide, and other psychedelics and dissociatives. Wants to take ketamine to see how it compares to other drugs she’s taken, based on friends and peers saying how great it is.	Friday night, small apartment. Intimate, new age style party with a group of close friends, most of whom are on one or more drugs, including ketamine.	Initial relaxation and numbness, dissociation and out-of-body sensations, deep hallucinations during peak, fun enough to roughly meet what others said it would be like.
Example II	Middle-aged executive who, aside from beer and past marijuana use, has never taken drugs recreationally. Heavy sleeper, often gets up late, drives fast every morning to rush to work on time.	Car accident scene. Person is crushed in own vehicle and severely injured. Crowded spectators, rush hour morning traffic, and rescuers form a noisy and condensed environment. Ambulance administer ketamine to person to suppress pain while they pull him out of the car.	Initial relaxation and pain reduction. Dissociation from crowds and noise. Unexpected hallucinations and out-of-body sensations. Assuming pending death, perceived as afterlife experience. While spiritual, also very frightening and disorienting.

	Set	Setting	Experience
Example I	Native American tribesman living in a Midwestern village. Experienced in traditional practices such as worshiping of animals and plants, including psilocybin mushrooms.	Group ceremony practiced regularly by tribe members who take mescaline from the peyote cactus as a religious sacrament.	Sense of environment coming to life. Value of air, trees, soil, and other surrounding elements enhanced. Belief that superior being, nature, and oneself are very close together.
Example II	Young man taking mescaline for the first time. Has done a number of other drugs before, but never any psychedelics or hallucinogens. Enjoys illustrating and relates many of his activities such as watching cartoons and taking photos to artwork.	Cool, sunny Saturday afternoon with a few other friends who are also on mescaline. Walking and hanging out in downtown at a shopping, recreation, and entertainment plaza.	Signs, billboard designs, and wall graffiti appear 3-dimensional. Colors are more vivid and buildings appear to be melting. Random trails, geometric patterns, and moving images surface. Everything perceived as profoundly beautiful, realistic, and inspiration for future illustrations.
Example III	Chinese woman who drinks alcohol and smokes cigarettes, but has never taken psychedelic drugs. Never been exposed to extensive drug education or cultures associated with mind-altering drugs.	Crowded disco in Hong Kong. Saturday night. Typical mainstream crowd. Woman is with friends but none of them are taking mescaline with her.	Mild hallucinations and body sensations perceived as weird and confusing. Disappointed due to a lack of stimulation or light-headedness common in getting drunk. Visuals, auditory changes, and other effects are somewhat uncomfortable and for the most part boring.

	Set	Setting	Experience
Example I	19-yr-old male soldier in combat. Has drank alcohol and smoked marijuana recreationally. Also smokes cigarettes and has been given various stimulants throughout the war to stay awake on watches and walks. Was administered morphine one other time earlier in battle during a minor leg injury.	1940's, World War II, Germany. Battlefield with 100s of other soldiers fighting together. A bomb blasts the soldier apart from knee down and causes intense painful bleeding before fellow servicemen inject morphine and treat him.	Immediate elimination of pain. Relaxation and euphoria. Requests stronger dosage to hold off pain without any particular thoughts about taking morphine again unless need be.
Example II	Chemical researcher interested in how natural and synthesized substances interact with naturally occurring brain chemicals. Has taken hundreds of drugs before but has never taken plain morphine. Obtains pure extraction from opium and uses oneself as test subject, injects sample into arm.	Weekday afternoon, quiet laboratory. Colleagues and fellow chemists doing own work in separate rooms, but close enough to supervise or assist if need be.	Instant relaxation and euphoria noted. Backaches and other discomforts gone. Slight nausea and itchiness recorded as side effects. Slowed breathing observed as only risk at current dosage. Effects concluded as connected to depressants, tranquilizers, sedatives, opiates, and pain relievers.
Example III	Busy, middle-aged professional who receives rashes as an allergic reaction to ethanyl alcohol and doesn’t smoke due to heart problems. Occasionally injects extracted morphine for relaxation and stress-relief.	6pm, Thursday evening, just coming home from work. Quiet, middle-American home by himself. Wife and children are out.	Relaxation and euphoria as usual. Contentment with life despite everyday problems. Desire to remain in mind state forever.