The Drug, The Person, and The Setting

To understand how a health disturbance occurs when taking a psychoactive substance, it is important to understand what factors can contribute to this. In 1984, American psychoanalyst and psychiatrist Norman Zinberg, described these factors that contribute to a person’s wellbeing in his book: ‘Drug, Set, and Setting’.

For this training a slight alteration of the original model is used as described below.

The word ‘wellbeing’ in the model is interchangeable for ‘health disturbance’ to give insights into the factors that can contribute to a health disturbance occurring.

The Drug

The Drug refers to factors within the taken drug. This component of the experience concerns those factors that are dictated by the substance itself. Factors are foundational to the experience, and health outcome of the substance experience.


Examples are:

  • Chosen drug (and whether the substance is what you intended to consume)

  • Poly-use (combining multiple drugs)

  • Frequency of use

  • Amount used

  • Legality of use

  • Quality of drug

  • Route of consumption

The Person

The Person refers to factors within a person. This component of the experience concerns those factors that are internal to the person- either physiological factors or mental/ learned factors.  

Examples are:

  • Mindset

  • Physiology of person                 

  • General health

  • State of being               

  • Hydration/hunger

  • Culture/History

  • Experience with drug

  • Knowledge of drug

  • Motivation for use

The SETTING

The Setting refers to external factors that can influence a persons wellbeing. They are outside, often situational inputs which affect the way the experience occurs.

 

Examples are:

  • Location of the experience

  • Intensity of stimuli

  • Control over stimuli

  • Social group person is with

  • Temperature

  • Humidity

  • Affinity with location

  • Presence and intensity of law enforcement

  • Societal & Cultural contexts