Chapter 1: Drug Use: An Overview

Let's begin with a few key definitions of terms commonly used in discussing drugs and drug use:

Problem drug use may be described in different ways—it may be viewed as deviant or as misuse, abuse, or dependence.

Before you can evaluate the extent of a drug problem or propose possible solutions, you need a framework to analyze the situation.  Basic journalism questions can provide needed information.  Those questions are who, what, when, where, why, how, and how much. Specific answers to these questions can help differentiate drug use from drug misuse or abuse.

In addition to asking questions to analyze a possible drug problem, there are four basic principles of psychoactive drugs that are important to keep in mind:

1. Drugs, per se, are not good or bad.

2. Every drug has multiple effects.

3. Both the size and quality of a drug's effect depend on the amount the individual has taken.

4. The effect of any psychoactive drug depends on the individual's history and expectations.

It is important to note that drug use is not a new phenomenon.  Humans have used psychoactive drugs for thousands of years for therapeutic and recreational purposes. However, recent events have influenced our attitudes and behaviors regarding drugs and drug use.  The use of vaccines and antibiotics demonstrated the power of drugs to prevent and cure illnesses, while advances in psychopharmacology showed that drugs can affect emotions and perceptions.  The development of oral contraceptives showed that drugs can be used by healthy people to gain chemical control over their own bodies.

Attitudes toward drug use tend to change along with other cultural shifts.  In the 1960s, drug use was a common theme in popular culture, and despite President Nixon's declaration of a "war on drugs" in 1971, the 1970s were an era of greater tolerance for drug use.  The 1980s, on the other hand, were a more conservative period, and penalties for drug use were increased and broadened.  Key issues of the early twenty-first century are the spread of club drugs and the debate over medical marijuana.

Accurate statistics on drug use are difficult to come by, but two long-term studies that focus on drugs are the Monitoring the Future Project, which collects data on young people, and the National Survey on Drug Use and Health, which collects data on adults.  In general, researchers have found that drug use is higher during periods in which the perception of the risks of drug use is lower.

Researchers have also found it challenging to identify antecedents and correlates of drug use.  Aggressive behavior in children is one characteristic that does predict later drug use, and drug use is associated with other deviant behaviors such as fighting and stealing.  In general, adolescents who use illicit drugs are more likely to have academic problems and to know adults and peers who use drugs.

A typical progression of drug use starts with cigarettes and alcohol, which are sometimes called gateway drugs, followed by marijuana and then other drugs such as amphetamines. However, there is no evidence that using gateway drugs causes a person to escalate to illicit drugs.  People may use illicit drugs for many reasons.  They may be part of a deviant subculture, they may be signaling their rebellion, they may find the effects of the drugs to be reinforcing, or they may be seeking an altered state of consciousness.  Societal, community, and family factors play an important role in whether an individual tries a particular drug.  However, drug factors such as reinforcement and dependence play a greater role in whether an individual continues to use a drug.