Tattoo Designs among Drug Abusers
Borokhov, Alexander, Bastiaans, Roland, Lerner, Vladimir, The Israel Journal of Psychiatry and Related Sciences
Abstract: Forty-one males with drug abuse who had tattoos with designs related to drug use were selected from a larger sample of tattooed males in forensic psychiatric wards, prisons and military recruitment centers during the period 1986-2000 in the former Soviet Union. Two-thirds of the tattoo images were related to a specific drug, some served to hide signs of repeated drug use, others to identify ideal sites for injection. Knowledge of these details may be helpful to clinicians, although images may be influenced by current trends.
The word "tattoo" entered the English language as an Anglicized version of the Tahitian word "tatau" ("to mark"). Tattooing is conscious injuring of the skin by special tools, which inject color in the skin with the purpose of obtaining permanent, indelible images. On the one hand, tattooing thrived throughout antiquity in China, Japan and North Africa, and tattoos have been found on skins of Egyptian mummies dating from 4000 to 2000 B.C.E. On the other hand, tattooing has been condemned by several religions. For example in Leviticus 19:28, God spoke to Moses, prohibiting tattooing as idolatry: "You shall not make any cutting in your flesh nor imprint any marks on you." The Prophet Mohammed issued a similar injunction in the Koran as did Pope Adrian I at the Ecumenical Council at Nicaea in 787 (1,2).
The original aim of the tattoo was to serve as a nonverbal symbol for personal identification and for making one's status clear among the other members of society.
In modern society tattoo has some additional meanings. For example, tattoos may express individualism, defiance, affection, risk-taking, alliance, sexual preference, beauty, fantasies, freedom, etc. (3-5). For many young individuals the tattoo is a quest for identity through which he/she is able to make clear to the world who he/she is, with the expectation of being accepted as such. The tattoo has also a major function in proclaiming one's allegiance to a specific group or subculture with its own intrinsic rules, but at the same time also it stresses difference from other groups. Hence, the tattoo itself and its meaning may reflect the inner world of an individual and his/her relationship with the outside world (6, 7). Moreover, according to some authors, the high rate of tattoo found among drug abusers may reflect their lack of social adaptability as well as an obstacle to the process of rehabilitation (8).
In spite of the abundant literature on tattoo (historical, ethnographical and cosmetic aspects, technique, and the art of tattooing itself), there are few medical studies on this topic. Most medical investigations concerning tattoos are devoted to personal hygiene, infectious diseases (hepatitis C and HIV) and to dermatological problems inherent to tattoodrawing itself (9-12). Since tattooing in jail or prison is generally performed by using non-sterile improvised "prickers" such as nails, needles, syringe needles, guitar strings and so on, it is not surprising that this practice increases the risk of infection (13). As mentioned above, psychiatric reports on tattoos and their relationship to mental disturbances are rare and, if at all, they are usually related to antisocial personality (14, 15).
The current study is to our knowledge the first report which makes an attempt to describe different images concerned with drug use.
The aim of our study was to investigate tattoos and describe their locations as found on the bodies of substance abusers and to find a possible relationship between these images and abuse or dependence on various kinds of drugs.
Subjects and Methods
During the period 1986-2000 we examined 1,440 subjects in Russia, Kazakhstan, Uzbekistan and the Ukraine. The examination was carried out in five forensic psychiatric wards, three prisons and two military recruitment centers: 318 prisoners, 255 psychiatric inpatients and 867 conscripts. Among all the examined subjects, 351 persons had 787 tattoos: 236 (74. …