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In this chapter you will explore:

Why there is a lack of agreement as to what motivates people to use and
abuse drugs
How the stress and strain of society contributes to drug abuse
How biology and personality affect drug taking behavior
How changing our consciousness levels relates to drug taking
How internal and external control affects drug use
The influence peer pressure and identity have on the motivation to use
The effect self-esteem and self-concept have on drug taking
How the Public Health Model relates to drug use and abuse
The groups most at risk of using or being affected by drug
The effect drug use has on society


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 selfdestructive 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 selfesteem. 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 selfdestructive 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

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.

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 healthcompromising 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 selfempowerment 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. Selfconcept is partially formed by the real events but can also
be formed by imagined experiences. Each time we perform a task the selfconcept 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 selfconcept 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.
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
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.


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
Changing consciousness
Internal & External Control
Loss of self--esteem



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:

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



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.


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.
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.
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.
1. Borba, Michele. Esteem Builders. Rolling Hills Estates California: Jamar
Press, 1989.
2. Bozarth, M.A. "The Role of Drugs in the Production of Schizophrenia
form Psychoses and Related Disorders." In H.Y. Meltzer,
Psychopharmacology: The third generation of progress. New York:
Raven Press, 1987.
3. Chasnoff, I.J. "Drug use in pregnancy: Parameters of risk." Pediatric
Clinics of North America 35: pp.1405-1408, 1988.
4. Davis, V.E., and Walsh, M.J. "Alcohol, Amines and Alkaloids: A
Possible Biochemical Basis for Alcohol Addiction." Science 167: 10051103, 1970.

5. Khantzian, E.J. "The self-medication hypothesis of addictive disorders;

focus on heroin and cocaine dependence." American Journal of
Psychiatry 142: 1258-1263, 1985.
6. Koob, G.F., Vaccarino, F. Amalric, M., & Bloom, F.E. "Positive
reinforcement properties of drugs: Search for butyl substrates." In J.
Engel, L. Oreland, D.H. Ingvar, B. Pernow, S. Roessner, & L.A. Pellborn
(Eds.) Brain reward systems and abuse. New York: Raven Press 5, 1987.
7. Tabakoff, B. , Hoffman, P.L. and Peterson, R.C. "Advances in
Neurochemistry: A Leading Edge of Alcohol Research." Alcohol
Research and Health World 14: 138-141, 1990.
8. The Office of Substance Abuse Prevention, 1991.
9. Volavka, J., Pollack, V., Gabrielli, W.F., and Mednick, S.A. "The EEG in
Persons at Risk for Alcoholism." In M. Galanter (ed.), Recent
Developments in Alcoholism. New York: Plenun Press, pp. 21-34, 1985.
10.Wise, R.A. "The Neurobiology of Craving: Implications for the
Understanding and Treatment of addiction." Journal of Abnormal
Psychology 97: 128-132, 1988.
11. Zuckerman, M. "Biological Connection Between Sensation Seeking and
Drug Abuse." In J. Engle, Oreland, D. H., Ingvar, B., Pernow, S.,
Roessner, and L.A. Pellborn (eds.) Brain Reward Systems and Abuse.
New York: Raven Press, 1987.

Created By: Jonathan Sheldon