This work uses classical sociological theory to demonstrate how the processes of rationalization and modernization have altered why, how, and how frequently people consume drugs. As cultural and structural changes increase heterogeneity and individuation, social controls over drug use weaken. Drug use therefore becomes increasingly widespread among the general population, a greater variety of drugs are used, drugs are used more frequently and drugs are used more for individualistic and profane reasons as opposed to communal and sacred reasons. Moreover, as the dimensions of stratification change over time, rules regulating who is permitted to use intoxicants change. Whereas drug consumption was once strongly patterned by ascribed statuses, it is more highly correlated with achieved statuses in modernized societies.

The theory can account for current cross-cultural patterns of drug consumption that indicate that rates of drug use are much higher in advanced industrial nations than in lesser-developed nations. In addition, the theory explains the variations in rates of drug use over time in the United States, Great Britain, Japan, Israel, and the former Soviet Republics. Finally, the theory explains the evolution of the drug subculture in the United States since 1940s.