Reasons Why People Use DrugsAnna Ciulla
Drug use has many connotations in American culture. It may be glamorized, minimized, accepted as part of everyday living, shunned, criticized, blamed for society’s ills, regarded as indicative of laziness, unwillingness to deal with life’s problems, associated with homelessness and criminal activity, and characteristic of addiction. Yet, drug addiction is a treatable, yet chronic, relapsing brain disease. It’s not a character fault, a sin, or exclusive to any demographic. Addiction can and does affect people of all ages, race, nationality, socioeconomic status, education, religion, sexual orientation and more. As for the reasons why people use drugs, there are many and varied, with much overlap and legitimacy (or not) for continuing drug use.
Initiation into drug use often begins with experimentation with alcohol and marijuana in early adolescence, usually in the presence of peers who encourage such use. The social pressure to fit in, to belong, to be part of the popular group, to overcome shyness and to rebel all factor into the compelling peer pressure to do drugs at a young age. The Foundation for a Drug-Free World also lists the desire to relax, relieve boredom, seem grown up, rebel and experiment as reasons why young people say they take drugs.
Such peer pressure to do drugs typically continues into high school and college. Indeed, for those young men and women who enter fraternities and sororities in college, the pressure to go along with the norms of Greek social life results in significantly higher rates of binge drinking and other drug use. Part of the culture involves bouts or contests involving rapid and excessive alcohol consumption, often during hazing and initiation rituals. A frightening statistic from the Journal on Studies of Alcohol and Drugs is that about 5,000 college students die each year from alcohol-related injuries. A Harvard University study found that 4 of 5 fraternity/sorority members engage in binge drinking. Further, 2 of 5 college students are regular binge drinkers. The risks of developing a substance use problem are highest for white male college students under the age of 25.
The National Institute on Drug Abuse (NIDA) reports that such substance abuse continues after college, with nearly half of fraternity members reporting symptoms of alcohol use disorder (AUD) at the age of 35. AUD is what most people call alcoholism. Former fraternity and sorority members also show significantly higher prevalence of marijuana use into their mid-30s. The original study, funded by NIDA and reported in the Journal of Adolescent Health found that increased substance use-related consequences was not limited to college, and is associated with higher long-term levels of AUD during early midlife.
Acute and chronic pain are valid reasons why people use drugs. As reported in The Journal of Pain, estimates of chronic pain in the U.S. range from 19-43 percent, around 116 million people. Yet this does not take into account high-impact chronic pain, affecting about 11 million people 4.8 percent of the adult U.S. population. This population experiences severe pain, and mental health and cognitive impairments.
A doctor may prescribe opiate pain relievers for acute pain resulting from an injury, accident or following surgery, although these are supposed to be only for short duration. Opiates are also prescribed for ongoing or chronic pain, particularly for individuals for whom non-opiate painkillers do not work or those with end-stage cancers and other medical diagnoses. In either case, acute or chronic pain, use may turn to misuse. Some people who take a prescription painkiller continue to take it even after their initial reason for taking it (acute pain) subsides. They may report feeling pain long after their symptoms disappear, or want to take it just in case the pain comes back.
The problem with long-term painkiller use is that it builds tolerance, requiring more of the drug in higher doses, and taken more frequently, and then dependence (physically needing the drug in order to function), and addiction (a compulsion to continue taking despite mounting negative consequences).
COPE WITH INTENSE EMOTIONS
Past trauma, sexual abuse, domestic violence, intense grief, and other emotions may prompt initiation of and continuing drug use. In fact, dealing with intense emotions often requires professional counseling, something that many who are in the grip of the painful emotions may not be ready or willing to accept. On the other hand, drugs are ubiquitous. It’s often quicker and far easier to gain access to a drug that will calm the mind and ease
While everyone has problems, most people do not resort to drug use to forget about them. Indeed, there are better ways to temporarily get past a difficult issue or situation that’s currently causing distress. Exercise is one example. When you engage in vigorous physical exercise, the activity releases endorphins, the body’s natural feel-good chemical. This helps life mood and often results in being able to more clearly see potential solutions to what seemed like impossible or unsolvable problems.
ESCAPE FROM REALITY
Everyday living is filled with stressful situations. When things get out of hand, the temptation to check out by using drugs can be strong, particularly if this often-ineffective technique has been employed in the past. The more someone uses drugs to escape reality, however, the more disappointed and potentially upset they’ll be when reality comes crashing back once the drug effects wear off.
TO FEEL EUPHORIA, GET HIGH
Going to adolescent and teen parties where a cornucopia of prescription and illicit drugs are freely available to attendees is a common behavioral trend that is both disturbing and dangerous. As a 2017 study in Pediatric Emergency Care reported, 1 in 4 American adolescents presenting to the emergency department say the took prescription medications without a doctor’s prescription. Exploring current trends of adolescent drug misuse, the researchers found 69 percent were males. Illicit drugs (mostly synthetic cannabinoids and “bath salts”) accounted for 50 percent of the cases of drug misuse, followed by 28 percent for prescription medications (most frequently benzodiazepines), 25 percent for over-the-counter (OTC) drugs. Thirty-seven percent of the cases documented polypharmacy exposure. Among the adolescents, 81 percent were symptomatic, with central nervous system impairment (81 percent), psychosis (38 percent), agitation (30 percent), coma (26 percent), involuntary muscle twitching or jerking (11 percent), and seizures (10 percent).
Such misuse of drugs is not limited to adolescents and teens, however, as young adults and adults, including seniors, who engage in nonmedical use of drugs often say they do so for the express purpose of getting high.
Sometimes, when people are abusing drugs and may be dependent or addicted to them, they can’t or won’t take responsibility for their actions. With their thought processes hijacked by the effects of the drugs, the follow-through on responsibilities is likely to be broken. As a consequence of this continuing misfiring of brain signals, it may become easier to use drugs rather than tend to responsibilities. While this may seem like a generality, it is somewhat common when looking at the behavior of those hooked on drug use.
AVOID WITHDRAWAL SYMPTOMS
Once the effects of the substance (alcohol or drugs) begin to wear off, withdrawal symptoms may set in. The longer a person uses or misuses substances of abuse, the more likely it is that withdrawal symptoms will start to appear upon cessation, or when the substance is not immediately available. Whether the substance is a prescription or illicit drug, switching to another more readily-available substance is generally prompted by the drug user’s strong desire to avoid withdrawal symptoms. Even among those drug users who want to quit, when withdrawal symptoms get too uncomfortable or painful, resolve may disappear and a quick return to using shortly follows.
COPE WITH CO-OCCURRING SUD, MENTAL HEALTH DISORDER
Substance use disorder (SUD) and co-occurring (dual diagnosis) mental health disorder, according to estimates from the 2017 National Survey on Drug Use and Health (NSDUH), affected 8.7 million adults. That’s from a total of 18.7 million adults with a SUD and 46.6 million adults with a mental illness. Of the 11.2 million adults in 2017 who had a serious mental illness, the overlap with the 18.7 million adults with a SUD was estimated at 3.1 million adults with both that year.
Both SUDs and mental illness can be seriously debilitating, causing great emotional and physical distress. Those who experience both, whether they go into detox and formal treatment or try to tough it out on their own, may turn to drug use in order to cope with these symptoms.
Family History of Drug Addiction, Mental Health Disorder
If someone in the family, especially a close blood relative, has substance abuse problems, there’s a higher likelihood that succeeding generations may inherit genetic predisposition to substance abuse, as well as be at risk to develop a mental health disorder. According to NIDA, environmental influences in and outside of the family – being exposed early to drug use, parental drug use, lack of parental guidance, and physical and sexual abuse – are other factors contributing to reasons why people use drugs.
For many older adults, insomnia is a continuing problem that precipitates a doctor visit to prescribe a medication to help restore normal sleep. Indeed, a 2018 study published in a German publication on the long-term use of benzodiazepines and Z-drugs among older adults found a high association with insomnia as the reason for drug use. Most of the study participants took the medications in low-dose form, yet a majority of long-term users were likely to develop low-dose dependency. The study found only a limited need for intervention, however, as only a few of the older adults dependent on the benzos and Z-drugs went into addiction treatment.
A study in Current Psychiatry Reports found that excessive duration and/or dosage of prescription or self-medication of benzodiazepines were the most frequent inadequate situations. The study said the consequences of such drug use include falls, delirium and other cognitive dysfunction, dementia, acute respiratory failure, car accidents, dependence, and withdrawal symptoms. Researchers noted that, despite the belief of most clinicians, halting chronic benzo use in elderly patients is feasible with counseling, psychoeducation and other behavioral therapies, and can lead to long-term abstinence.
For more about addiction and recovery, check out these articles:
- American Journal of Psychiatry. “Current Status of Co-Occurring Mood and Substance Use Disorders: A New Therapeutic Target.” Retrieved from https://ajp.psychiatryonline.org/doi/pdfplus/10.1176/appi.ajp.2012.12010112
- Current Psychiatry Reports. “Benzodiazepine Misuse in the Elderly: Risk Factors, Consequences, and Management.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27549604
- Foundation for a Drug-Free World. “Why Do People Take Drugs?” Retrieved from https://www.drugfreeworld.org/drugfacts/drugs/why-do-people-take-drugs.html
- Gesundheitswesen. “Reasons for Long-Term Use of Benzodiazepines and Z-Drugs in Older Patients.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30357800
- Journal of Adolescent Health. “How Collegiate Fraternity and Sorority Involvement Relates to Substance Use During Young Adulthood and Substance Use Disorders in Early Midlife: A National Longitudinal Study.” Retrieved from https://www.jahonline.org/article/S1054-139X(17)30496-2/fulltext
- Journal on Studies of Alcohol and Drugs. “Magnitude and Trends in Heavy Episodic Drinking, Alcohol-Impaired Driving, and Alcohol-Related Mortality and Overdose Hospitalizations Among Emerging Adults of College Ages 18-24 in the United States, 1998-2014.” Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551659/
- National Center for Complementary and Integrative Health. “NIH study broadens understanding of High Impact Chronic Pain in the US.” Retrieved from https://nccih.nih.gov/news/press/high-impact-chronic-pain
- National Institute on Drug Abuse. “Greek life membership associated with binge drinking and marijuana use in later life.” Retrieved from https://www.drugabuse.gov/news-events/news-releases/2018/02/greek-life-membership-associated-binge-drinking-marijuana-use-in-later-life
- National Institute on Drug Abuse. “Understanding Drug Use and Addiction.” Retrieved from https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction
- Pediatric Emergency Care. “Drug Misuse in Adolescents Presenting to the Emergency Department.” Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26466148
- Substance Abuse and Mental Health Services Administration. “2017 National Survey on Drug Use and Health.” Retrieved from https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report
- The Journal of Pain. “Prevalence and Profile of High-Impact Chronic Pain in the United States.” Retrieved from https://www.sciencedirect.com/science/article/pii/S1526590018303584?via%3Dihub