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Chapter 1

Drug Use: An Overview

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Our concern about the use of a substance depends on
Who is using it, how much is being used, and when, where, and why it is being used

Talking About Drug Use

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Image source: © Emma Lee/Life File/Getty Images

Image source: © Getty Images

Use is not abuse

Most users of any given substance do not use it in ways that can be defined as abuse or dependence

Every drug has multiple effects

Although a user might seek only one effect, drugs work at multiple sites in the brain and other organs

Amount matters

Larger doses, more frequent doses, or faster onset of effects can produce different effects compared to small doses

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General Principles of Drug Use

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User’s history and expectations affect drug-related effects

An experienced user may experience different effects compared to an inexperienced user

Expectations may make a drug effect more or less likely to occur

Drugs are not good or bad

Drugs are chemicals on a shelf that are inactive until they enter the body

Blaming the substance ignores all the factors that may lead to abuse

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General Principles of Drug Use

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Drug

Any substance, natural or artificial, other than food, that by its chemical nature alters structure or function in a living organism

Illicit drug

A drug that is unlawful to possess or use

Deviant drug use

Drug use that is not common within a social group and is disapproved of by the majority

Drug misuse

Use of drugs or chemicals in greater amounts than, or for purposes other than, those prescribed by a doctor

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Important Terms

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Drug abuse
Substance use in a manner, an amount, or in situations such that it causes social, occupational, psychological, or physical problems

Drug dependence
A more precise term than addiction
A state in which an individual uses a drug so frequently or consistently that it would be difficult for the person to stop
May or may not be physiological
Defined as a behavioral disorder

Important Terms

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Drug use is not new

Throughout history, drugs have been used for:

Enhancing spiritual experiences

Major economic roles

Treatment for illnesses

Developments in the past century

Rise of legal pharmaceuticals for a variety of purposes

Vaccines, birth control, mental health treatments

Rise of the “war on drugs”

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Have Things Really Changed?

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Not easy to get accurate and complete information on:

Number of drug users

How much of an illicit drug is imported and sold

Usage of legal drugs such as alcohol, tobacco, and prescription drugs

Nevertheless, we do get some information from survey questionnaires

Benefits: easy to use, inexpensive, efficient

Drawbacks:

Bias in student population (e.g., dropouts not counted)

Potential inaccuracy of self-reports (among both users and non-users)

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Extent of Drug Use

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Wide range of rates and amounts of use

Even within a substance-using population

This is true of all drugs of abuse

This range of users has important implications for:

Prevention efforts

Treatment efforts

Law enforcement

The nature of dependence

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Populations of Users

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Survey: Monitoring the Future Project (MTF)

Gathers data from students

8th–12th grade and college

Conducted annually for almost 40 years

Types of data collected

Prevalence of drug use

Perceived risk and availability of various drugs

Shows trends over time

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Trends in Drug Use

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Monitoring the Future

Source: Monitoring the Future Study, The University of Michigan.

Survey: National Survey on Drug Use and Health (NSDUH)

Gathers data from U.S. households (not just students)

Face-to-face interviews

Ages 12 and above

Conducted annually for over 40 years

Types of data collected

Prevalence of drug use

Frequency of drug use

Shows trends over time

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Trends in Drug Use

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NSDUH

Source: National Survey on Drug Use and Health.

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NSDUH

Source: National Survey on Drug Use and Health.

Data from MTF and NSDUH can be examined together

Finding similar patterns in two different studies, using different sampling techniques:

A stronger indication that these trends are real and reflect broad changes in American society over time

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National Surveys

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Correlate

A variable that is statistically related to another variable, such as drug use

Important: Correlates are not causes

Risk factors for adolescent drug use include:

Having friends who use drugs

Engaging in antisocial activities

Protective factors include:

Perception of strong sanctions against use

Having parents as social support

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Correlates of Drug Use

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Gender

Example: Men use more drugs than women

Race and ethnicity

Example: Whites are more likely to drink alcohol than African Americans

Level of education

Example: College graduates are less likely to smoke tobacco than high school graduates

Personality variables

Example: “Impulsive” individuals may use drugs at a higher rate

Genetics

Example: Genetics may play a role in who will develop a substance use disorder

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Correlates of Drug Use

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Antecedent

A factor that occurs before an event such as the initiation of drug use

Not necessarily causes of drug use

Examples of antecedents

Aggressiveness

Conduct problems

Poor academic performance

Attachment to a drug-using peer group

Parental and community norms that support drug use

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Antecedents of Drug Use

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Gateway

One of the first drugs used by a typical drug user

Alcohol and tobacco are sometimes considered gateway drugs

Gateway substances may not be the cause of future drug use

Gateway substances are perhaps best thought of as:

Early indicators of a basic pattern of deviant behavior resulting from a variety of risk factors

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Gateway Substances

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There are several influences of drug use

Identification with a deviant subculture

Rebelliousness

Fads and cultural trends

Reinforcing properties of drugs

Desire to experience an altered state

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Motives for Drug Use

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Influences on Drug Use

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