MOTIVATIONS FOR DRUG USE


In this chapter you will explore:

WHY DO PEOPLE USE DRUGS?

There is little agreement about what the drug problem is and even less agreement about an explanation of what may be the cause or the solution. Therefore, there is no single comprehensive theory to explain what motivates people to use abusable drugs. We differ immensely from one another and so do the motives for using psychoactive substances. Drugs used appropriately can provide relief from physical and mental problems. When they are used in moderation they can enhance the enjoyment of social interactions and heighten pleasurable sensations. When drugs, however, are used to the point of abuse the individual, family and society all feel the consequences.

Lack of Agreement

Part of the reason for the lack of agreement relating to causes and solutions is due to the complexity of human motivation that is associated with any behavior. The motivations for drug use varies greatly within society and with individuals. Some people smoke cigarettes because it helps them relieve stress, other people find it relaxing, and still others find it stimulating because they find any behavior that white authority figures (such as our parents) disapprove of exciting.

Motivations Change

Motivations for the use of abusable drugs change as a person ages, takes on different social roles, experiences different degrees of involvement with drugs, and deals with stress in continuously evolving ways. Many people need to take drugs legitimately to maintain their physical or mental health such as the mentally ill who may suffer from conditions such as schizophrenia, mania and anxiety or those who are terminally ill.

We are not born with a desire to use drugs. We often react to the first dose with distaste, nausea or dizziness. We learn to tolerate these side effects to obtain other benefits from the drug including relief from pain, a vehicle to help us socialize or a means to dampen the effects of stress. Why then, do drugs become so gratifying to us?

Specific Motivations

The Stress and Strain of Our Society and Culture

The reason people use drugs is related to the way society is organized, perceived and experienced by the individual. Part of the answer as to why we use drugs is associated with living in a complex society in which our values are less defined and reinforced. For example, a close knit family unit occurs less often in today's society which in the past identified and reinforced values. Social change is often disruptive to individuals and their families. These changes cause a loss of self-esteem and increase the possibility of self- destructive behaviors such as drug abuse. Rapid social change also causes us to lose our ties with the community's social, commercial, religious, economic and political groups. A great deal of change occurs at a time when teenagers and young adults need a stable environment and time to develop positive self-esteem. Sexual identity in terms of the roles males and females play is in a state of transition and is continually evolving. Teenagers and young adults often perceive change as something that is beyond their control. The use of drugs is often a way to deal with the stress that occurs because of adaptation, frustration and overload.

Individuals feel deprived because of their inability to receive enough meaningful stimulation in their lives. Communications and relationships are more impersonal because we can use mass communications instead of personal contact to communicate with one another. This often results in boredom, loneliness and depression.

People find the amount of input they have to cope with exceeds their ability to respond. Thus, overload is experienced on the job, school, families and social lives. Pressures may build until we cannot meet life's demands. Frustrations due to overcrowding, prejudice, social-economic problems and bureaucracies result in the inability to achieve desired goals. As a result of these factors we find it increasingly difficult to deal with physical and emotional pain, attain pleasurable states, and to find natural ways to stimulate ourselves. These factors combine in complex ways to produce irresponsible and self-destructive behaviors in our attempt to cope with the complexities of society.

Personality and Biology

Is there a personality characteristic, tendency, or inherited trait that renders you more likely to enter into the self-destructive involvement with drugs? Some research indicates that we inherit our temperament and compulsive personality. No clear cut addictive personality, however, has been found. Any individual can develop drug problems. Consistent personality differences between alcoholics and non-alcoholics suggests that alcoholics have a preoccupation with personal power, aggression, thrill-seeking and antisocial behavior. This theory with alcohol holds that alcoholics drink to feel more powerful. A personality weakness may make us thrill seekers who search for excitement including the use of drugs. For others, a personality weakness motivates them to use drugs and to self-medicate the symptoms of a behavioral disorder such as depression or anxiety. In typical people any abnormal sounds or images generate special brain waves called "P300s". Although the research is mixed, some shows that a deficiency in P300 waves tend to be missing in children of alcoholics and have been correlated with resulting deficits in perception and attention.9 There also may be an inherited tendency in some of us to generate higher levels of tetrahydroisoquinolines (THIQs). THIQs are created in the brain when dopamine is combined with acetaldehyde from alcohol metabolism. THIQs reduce pain and like other opiates are addictive. THIQs produce a craving during alcohol withdrawal which seems to induce a preference for alcohol.

Alcoholics have lower levels of a genetically determined enzyme called monoamine oxidase (MAO) that relates to mood. Low levels of MAO leads to a tendency to be easily bored. The neurotransmitter serotonin that regulates mood and eating behavior has been found to be lower in alcoholics. This may explain why alcoholics self-medicate with alcohol in an attempt to increase their serotonin levels and avoid depression. Certain serotonin uptake inhibitors such as Prozac fight depression by blocking the depletion of this neurotransmitter.

It is extremely difficult to tell whether the drug abuse is the result of, or the cause of, the behavior disorder or if these personality traits have specific biological markers. The relationship between personality type and alcohol and other drug use is statistical and exists within specific populations. So it is difficult to apply these findings universally to individual cases.

Drugs act as reinforcers. Some theorists suggest that drugs are rewarding because these drugs stimulate neurons that inform the central nervous system that we are performing behaviors that lead to natural rewards or pleasurable sensations such as food, sex, warmth and security. People who are forced to wait for long periods of time between naturally reinforcing activities may engage in a variety of associated behaviors including drugs when these support activities are missing. For example, sports figures and students who experience long delays between reinforcements including athletic contests and academic exams may take drugs when the stimulus obtained from these activities is missed. Whether or not this is caused by inheriting low levels of dopamine or serotonin still needs to be researched before concrete conclusions can be drawn.

Changing Consciousness Levels

We all have a normal level of functioning in which we feel comfortable, in control, feel at home; where we have the most confidence, can adapt and perform; and where we can create a feeling of safety for ourselves. Most people enjoy and seek alternate states of consciousness in their daily lives. Altering the level of consciousness can modify brain chemistry which can result in changing body chemistry. We naturally search for ways to alter our consciousness such as moving away from ordinary events, rapidly shifting our thinking, being entertained, and changing the meaning or significance of an event or our environment. Techniques used to alter consciousness have also been proven to effectively alter the course of diseases such as cancer by reducing bodily symptoms of the diseases such as pain. We often become aware of our consciousness level when it changes. This is very evident to us when we become angry, depressed, drunk, sad, or overly stimulated. Changing our consciousness level alters brain chemistry and the release of neurotransmitters including dopamine, endorphins and serotonin, which contributes to our ability to move away from our busy ordinary level of functioning.

Drugs temporarily alter our state of consciousness quickly and effectively with relatively little skill or mental effort on the part of the user. Altering consciousness levels is one common element in almost all motives given for drug use. Changing consciousness is a shift out of a frame of mind that we feel is troublesome, boring or not growth producing. When we change our state of consciousness we can increase or decrease the degree of stimulation as we desire producing a state of arousal or relaxation. We often wish to shift to low stimulus activities when we are uncomfortable with being overstimulated. Some examples of low stimulus activities include warm baths, meditation, muscle relaxation, message and use of depressant drugs. When we want to feel more stimulated, we can choose activities such as exercise, bunge jumping, sky diving, rock concerts, reading, writing, problem solving or the use of stimulant and psychedelic drugs.

Altering our consciousness levels should not be just a game or be viewed as a toy to be played with. Changing consciousness levels can marketedly improve a person's life when it is used in a deliberate, goal--producing way. We label a change in consciousness as being beneficial when it improves a person's coping ability, induces greater acceptance of others, causes physical and mental improvement in functioning, creates joy, or relaxation.

Sometimes people go stale on things that have formerly gotten them high such as a lover, a close relationship, or a drug that was used to trigger a pleasing state of consciousness. Some people try to regain or orchestrate their highs or periods of tranquility by mixing drugs or increasing dosages.

The quality of a drug experience in its ability to alter consciousness depends on a number of individual factors. These include our general state of health (especially our emotional well-being), mood (called our mental set), motivations, expectations, personality and the environment (called the setting). Drug use acts like a trigger that helps us center and focus our attention. This drug effect is a key element in a drug being able to induce arousal or to maintain tranquility. However, when a drug is taken in too strong or too weak a dose or we do not experience the desired effect from the drug, the result can result in frustrations and disappointments.

When we alter our consciousness levels through our active involvement, as we do through choosing to read, exercise, dance, problem solve, we learn to take action and to be creative in changing our consciousness levels. As a result, we can grow as an individual and we can develop positive self-esteem. But when we take a drug to alter our consciousness level, we put ourselves in a reactive state in which we have little control over the experience.

Once the drug is introduced into the body it becomes a responsive event in which we are along for the ride---seeing, feeling and experiencing the drug. We remain in this drug--altered state until we metabolize the drug. In a drug induced situation experiencing the moment becomes all important. Drug taking temporarily dampens active thoughts about our everyday problems although problems still exist and will continue to stress our bodies and minds after the drug is metabolized.

When drug taking is chosen as the preferred way to obtain pleasurable sensations, relax, socialize, escape the unpleasantries of life or escape from problem solving, we forego developing the coping skills that will be necessary to manage life's problems.

For some individuals coffee or smoking a cigarette or marijuana is an adjunct to arousal. For others a cup of coffee relaxes them. Drug use under a physician's care can improve the quality of life but irresponsible drug use that compromizes your health or functioning in society can have lasting personal and societal effects. Irresponsible drug use may also impair your ability to focus your attention and develop natural states of arousal or relaxation which motivate your goal setting. Drugs can be used to alter consciousness but only at the lowest possible dose levels so you can appreciate the effects without experiencing extreme or negative side effects. Once we learn to take charge of ourselves and learn to alter our consciousness at will, we may find that fooling with drugs won't be worth the effort.

ALTERING YOUR STATES OF CONSCIOUSNESS
Drug induced states of consciousness Non--Drug induced states of consciousness

Do you include alternate states of consciousness in your typical day? Divide circle one into segments and list the activity that represents drug induced alternate states of consciousness ( e.g. a party with alcohol that produces relaxation and exhilaration) that were either positive or negative in the last week. Describe the feeling you experienced next to the activity. Divide circle two focusing on non-drug alternate states of consciousness that were positive or negative. When you have finished, examine the circles. Which alternates states of consciousness were most pleasing to you; the drug induced or the naturally induced activities? Did the drug or the non-drug activities leave you with an increased skill level, improved self-esteem or the ability to deal with similar experiences should they occur again?


Internal and External Locus of Control

Our motivation to use drugs is also related to what is called our locus of control. The degree that we are internally or externally motivated can relate to our potential to use drugs. Inner-directed people believe achieving rewards are due in large part to their own behavior. This behavior is learned values from authorities, such as their parents, and inner-directed people have seldom looked to see it these values suit them or their lifestyles. These individuals are motivated from within by values, satisfactions, self-discipline, desire to achieve goals and their ability to tolerate frustration. This strong internal control compels them to take personal charge of life situations. Internal locus of control can be a resistance to drug use if the personal has developed these traits from there own values or the internal locus of control can increase the susceptibility of drug use if these values are forced on you by authorities and parents.

People who are other-directed are motivated to believe that the rewards they receive are controlled by outside forces. These forces include their family, school and peer groups. Thus, they are driven to adopt the values that will endear them to a certain group. They perform to meet the needs, expectations and values of others. Individuals who are other-directed can resist drugs when the groups that influence them value health-enhancing activities or can become more susceptible to drug use if these influential groups practice health-compromising behaviors such as drug use.

Loss of Self-Esteem

Self-esteem is the state of feeling good, competent and worthy about yourself. It involves the total of all the beliefs and attitudes that we have developed about ourselves. Self-esteem involves such values as achievement, strength, adequacy, independence and freedom. Esteem is also gained from others and involves such values as reputation, respect, status, recognition, attention and appreciation. Self--esteem consists of five components including security, competence, affiliation, mission and self-concept. These beliefs and attitudes are learned, not inherited, and they are modified everyday of their lives. Each component can be enhanced through well defined tasks and goals.

Many children grow up in environments that do not foster self-esteem. Many economic and social factors contribute to low self-esteem including broken homes, child care for working parents, teenage sexual activity, poverty, failure to complete high school and drugs.

Stanley Coopersmith, a child psychologist devoted a great deal of his professonal life to the study of self-image. One of his research goals was to determine what family conditions help promote high self-esteem. He found that self attitudes in people were formed by how parents or significant others saw them or by how children thought they were seen by parents or significant others. He also identified three critical common elements in the homes of individuals with high self-esteem.

First, the family expressed respect, concern and acceptance of the individual member's strengths and limitations. Second, the parents were not permissive and set clearly defined limits and expectations and as a result, children felt secure. Third, the family practiced a high degree of democracy which encouraged the communication of ideas and invited opinions for discussion.

Security involves a feeling of strong assuredness that comes from being comfortable, safe, knowing what is expected, being able to depend upon individuals, situations and understanding rules and limits. Security is the building block to all other components of self-esteem.

Competence is a feeling of success and accomplishment in things that the person regards important and valuable. Competence is also an awareness and acceptance of personal strengths and weaknesses.

Affiliation is a feeling of belonging, acceptance and relationship that are considered important to an individual. It is also feeling approved of, appreciated and respected by others.

Mission is a feeling of purpose and motivation in life. It is a feeling of self-empowerment that is attained through setting realistic and attainable goals and being ready to accept responsibility for the consequences of one's decisions.

Self-concept is an accurate self-description of a person's roles, attitudes and physical characteristics. It operates at a subconscious level and is developed from all the mental images and events you experience and gives you an accurate and realistic self-description of your attributes and physical characteristics. Self—concept is partially formed by the real events but can also be formed by imagined experiences. Each time we perform a task the self- concept plays back a positive or negative feeling of competence and security in dealing with a situation.

Self-concept cannot be eradicated but it can be revised. The pain and sadness that is associated with poor self--concept causes you to build barricades to protect yourself from those feelings. Some people try to block out the self-concept with drugs. Drug taking may be temporarily effective it does not allow the development of the self--esteem values listed above. Drug use cannot accurately change the self--image and it can create a barrier to wanting to change the events that allow people to modify their self--concept, improve their self--esteem and deal with the stresses of life.

Many of your achievements in life are directly related to our self- concept. Your self--concept is challenged each time you ask the question "What kind of person am I" "Can I perform this task?" or, "Should I use this drug?" The most important ingredient in developing a self--concept is the environment in which you experiment, grow and flourish. The environment needs to provide security, competence, affiliation, mission and self--concept. It should give the chance to share in decision making, gain a sense of control over your destiny, and make free choices. Such a positive environment provides the opportunity for you to take risks and to succeed at overcoming them.

The resistance to taking drugs remains high when your beliefs and attitudes about yourself are positive. The opposite is true when we have negative self--esteem. Environments that do not provide these opportunities make the individual more susceptible to drug misuse and abuse. Poverty, unemployment, minority status, and an inferior education can seriously hamper the development of positive self--esteem. This is important because how we behave in society is based on our perception of our environment and our self- concept. Therefore, positive self--esteem is essential to our ability to make responsible decisions about our drug involvement. Complete the following exercise to determine the present level of your self-esteem.

ANALYZE YOUR SELF-ESTEEM

Evaluation Scale:
5 =True most of the time
4 =Usually true
3 =True about half the time
2 =Sometimes true
1 =Rarely true

1. I enjoy college? _____
2. I am very popular with people my age? _____
3. I am lonely? _____
4. Other people think that I am a good student? _____
5. Other students are better liked than I am? _____
6. I find it difficult to stick at one project a long time? _____
7. I get discouraged at college? _____
8. I have a lot of self-control? _____
9. My instructors make me feel that I am not good enough? _____
10. I feel that work is easy for me? _____
11. I wish that I had more friends? _____
12. I would like to drop out of college? _____
13. I wish I were a different person? _____
14. Instructors expect too much of me? _____
15. I forget most of what I learn? _____
16. I don't seem to fit in at this college? _____
17. Other students are smarter than I am? _____
18. No one really cares about what happens to me? _____
19. I am satisfied with myself? _____
20. I am shy and self-conscious in social situations? _____
21. I have difficulty in accepting criticism? _____
22. I think that I am no good at all? _____
23. I enjoy going to this college? _____
24. There a lot of things about myself that I would change if I could? _____


Identity and Peer Pressure

The opinions of others are important to us. We identify ourselves as normal or deviant because of other peoples perceptions of us. Peer influence is a strong motivator for many individuals. The more attractive a group is to the individual the more influenced the individual can be by the group. Peer groups often have their own unique vocabulary, hairstyles and expectations of behavior. These characteristics help define the group and set it apart from established society.

Involvement with our peers helps us develop a positive or negative attitude toward drug taking behavior. Drug use is often learned during the initial interaction with others in a peer group. The most popular peers have higher prestige or status and can influence others in the group to join them in their actions. Within a peer group drug use is often the attempt to solve problems collectively. These primary groups share a high degree of intimacy and emotional bonding. Group members learn how to use a drug and how to discern its subjective effects within these groups.

There is also a learning sequence within peer groups. This learning sequence includes finding out from who and where the drug can be purchased, discovering how to maintain secrecy from authority figures and friends, and experiencing continuous group reinforcement that support the continued use of a drug. The peer group association helps maintain the frequency, duration, and importance of drug taking. Instead of coping with the demand for social conformity many people turn to drugs to enhance their identities, rebel or to decrease the stress they feel in life. Regardless of where drugs are first obtained, their initial and continued use usually occurs in the peer group setting.

Consider the peer groups you now involve yourself with. This may include a fraternity, sorority, athletic team, intramural program, or social club. What behaviors did you learn from the group relating to acceptable or expected use of drugs? What did you do as a result of learning what was expected of you? What decisions did you arrive at? Did you stay, conform, or leave the group?

Example of a peer group: Expectations of drug use My decision
_____________________ _________________________ ___________________
_____________________ _________________________ ___________________
_____________________ _________________________ ___________________

What conclusions can you draw about how peer groups influence your behavior and challenge your values? Use the space provided below to answer the question.









PERCEIVED RESISTANCE TO DRUG MOTIVATORS

Use a scale from 1 to 10 to rate how resistant you feel you are to the motivators of drug use discussed in this chapter.

Peer pressure/Identity
Societal Stress & Strain 0______________________________________10
Personality/Biology 0______________________________________10
Changing consciousness 0______________________________________10
Internal & External Control 0______________________________________10
Loss of self--esteem 0______________________________________10
0______________________________________10


PERSONAL MOTIVES FOR DRUG USE

Rank the following items according to the ones most appropriate to you. If you are a nonuser try to imagine what your answers might be. Once you have indicated the items that explain your motivations use the scale from 1 to 10 to indicate the importance of the motivator to you.

I use drugs because: IMPORTANCE
_____ 1. Drugs allow me to escape or avoid an annoying world. 0________10
_____ 2. Drugs help me to alter my state of consciousness; I like the feelings I get from using drugs. 0________10
_____ 3. Drugs allow me to meet and create a closer bond with people. 0________10
_____ 4. I'm not afraid of life when I'm using drugs. 0________10
_____ 5. Drugs are part of my culture, they're socially acceptable. 0________10
_____ 6. Drug use allows me to feel good about myself. 0________10
_____ 7. Drugs help me to be a more spiritual person. 0________10
_____ 8. Limit drug use to prescription drugs needed to fight infections or disease. 0________10
_____ 9. My drug use is a social protest against the system. 0________10
_____ 10. Drugs help me gain and maintain status with my peers. 0________10
_____ 11. Drugs enhance my enjoyment; they're fun and provide a degree of excitement 0________10
_____ 12. My drugs are really food (e.g., beer, wine tea, coffee, etc.) 0________10
_____ 13. My peers put pressure on me to use drugs. 0________10
_____ 14. Drugs keep me going: they get me through my classes or job. 0________10
_____ 15. Drugs help me to experience new things in a very special way, and I can't duplicate this without drugs. 0________10
_____ 16. Drugs are a source of relief from tension. 0________10
_____ 17. Drugs allow me to be more social and outgoing. 0________10
_____ 18. Make up for the lack of control in my life. 0________10
_____ 19. Drugs keep me motivated. 0________10
_____ 20. Drugs fill a void; they are something to do when I feel bored. 0________10
_____ 21. Drugs build my confidence. 0________10
_____ 22. Drugs allow me to enjoy social events and concerts. 0________10
_____ 23. Drugs enhance my senses; make music more entertaining, friends funnier. 0________10
_____ 24. Drugs make me more creative. 0________10
_____ 25. Drugs are part of my everyday life. 0________10
_____ 26. Drugs are a reward for accomplishing or enduring something. 0________10
_____ 27. I use drugs to prevent pregnancy (birth control). 0________10
_____ 28. I use drugs to enhance my performance. 0________10
Add you own reasons:
_____ 29. __________________________________________________ 0________10
_____ 30. __________________________________________________ 0________10
_____ 31. _________________________________________________ 0________10
_____ 32. _________________________________________________ 0________10


REDUCING THE MOTIVATION TO USE DRUGS

Ridiculing people for their motives for using drugs doesn't give them options to change their behavior. If we wish to reduce the motivations for drug use it is important to offer options that meet the same needs and provide the same experiences that drugs do.

One suggestion involves substituting a positive addiction for the negative drug addiction. Positive addictions have specific criteria: they are noncompetitive and are chosen freely by a person; they are easy to perform; they don't take a great deal of mental effort; you can do it by yourself without depending upon others; they have some physical, mental, or spiritual value for the person; they should provide an opportunity for you to improve in some area of your life and lastly, and you should be able to perform the activity without criticizing yourself.

Use the following space to create a list of activities that will meet the criteria for a positive addiction. Review the drug motives exercise above. What motivations do you find in the Personal Motives for Drug Use exercise that can also be obtained in the non-drug activities you list below?

Needs met by "drug" use. Possible non-drug activities that can meet the same needs met by drugs.
_____________________________ ___________________
_____________________________ ___________________
_____________________________ ___________________


FACTORS THAT INTERACT TO INFLUENCE OUR MOTIVATIONS

When we analyze the motivation for drug use we need an approach that will recognize the essential nature of the drug problem. A public health model offers such an approach and analyzes drug abuse in terms of the host, agent and environment. The host is the person along with their biological and psychological susceptibilities to drug use, their personal knowledge and attitudes about drug use that influence their drug use patterns. The agent is the drug of choice, its characteristics, distribution methods and availability. The environment is the setting in which drug use occurs and the community ideals that shape drug use practices.

This association between a host, an agent, and the environment and acute illness has long been recognized. Many infectious diseases such as polio have been eradicated by interrupting the ties between the host, agent and environment. This same concept can be applied to chronic progressive diseases such as drug abuse.

Since all three elements of the public health model are interactive and interdependent, the most effective approach for dealing with drug motivations will be the one which deals with all three elements of the model. Both the agent and the host have characteristics that are fixed and others that can be altered. For example, the chemical makeup of cocaine is fixed, including its stimulating, addictive, and toxic properties that have a potential health impact. The form in which cocaine is made available to the user can be changed. In a similar fashion a person, or host, cannot change their inherited susceptibility to the addictive properties of alcohol, but they can change their individual patterns of use.

All environmental factors related to cocaine problems can be changed. It is a matter of effectively changing public policy or public actions. The environmental public policy approach seeks to create an environment that promotes the lowest possible level of drug abuse problems. We have also used the policy of changing the environment in which drug problems occur. These actions have included raising the purchasing age for alcohol, making cocaine purchases illegal, increasing the price of cigarettes, and requiring warning labels on alcohol and cigarettes.


STAGES OF DRUG USE

The drug scene includes the environment in which drugs are made available. Peers will influence the initial use of drugs and prove to be an important factor in the individual's choice to begin and to continue drug use. Personal values will be challenged and complicated by the fact that some drugs are legal and others are illegal to use. Certain drug characteristics (their ability to relieve pain, stimulate or relax the individual) and actual effects an individual experiences helps motivate a person to start and to continue using drugs.

Still other individuals may choose to withdraw into a lonely inner world. They lack a positive self-identity and wish to withdraw from a society they have problems coping with. These individuals may feel unfulfilled, frustrated, disappointed or apathetic toward the world around them.

The frequency of drug use increases as the individual progresses from curiosity about drugs to more complex motivations such as searching for the meaning of life, looking for alternatives to boredom, feeling a sense of belonging and looking for identity. Experimental drug use is often due to curiosity and desire for reinforcing experiences. When the motivation for using a drug relates to curiosity the individual is driven by the desire to feel different, look better, or experience the thrill of the unknown.

Social use infers that drug use is confined to special social settings or events. The experience is shared with friends and acquaintances.

Situational use is illustrated by the need to modify feelings that cannot be obtained through life experiences. We progress from situational use to intensified use when motivated by the desire to relieve inner stressors.

It is in the intensified stage that the individual begins to use a drug regularly and becomes dependent on the drug.

This continuum concludes with addictive use in which the central focus of the individual's life becomes the drug. The individual is motivated by persistent euphoria or the desire to avoid the discomfort of withdrawal. Drug use cannot be discontinued without psychological and or physical discomfort in the addictive stage.

If drug use progresses beyond the initial experimental stages people typically begin to change their peer group. They will have fewer non-using friends, increase their tolerance for drugs and begin to use more of the substance. It is generally believed that the most successful drug rehabilitation occurs in the beginning to middle stages of the drug continuum. Rehabilitation becomes increasingly more difficult in the intensified and compulsive stages. In these stages the individual becomes preoccupied with the next high, drops out of school, quits a job, loses friends and accepts excuses and alibis for his/her dependence. If the individual progresses to these later stages of drug dependence, professional treatment, in which physical and cognitive therapy is introduced may become necessary.


SUMMARY

The intense emotions surrounding the issue of drug use and abuse is partly due to the complexity of the causes influencing drug use and abuse. People use drugs at different ages and under different conditions. The theories that explain the motivations for drug use and abuse are evolving and there is little agreement about the nature of the problem and less agreement about any explanation of its cause.

Theories of drug use and abuse can be classified by placing emphasis on society and cultural strain, biology and personality, changing consciousness levels, internal and external locus of control, loss of self-esteem, peer pressure and identity, host, agent and environmental interactions and combinations of these variables. Perhaps a combination of these theories will provide a single theory that can explain the various aspects of drug use and abuse.


REVIEW QUESTIONS:


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Created By: Jonathan Sheldon