Course of drug use disorders

Both the causes and diffusion of problematic drug use are uncertain. Susceptibility to drug use is highest amongst young people, with most individuals embarking on their drug using careers before the age of 20. Drug use is also associated with social and economic deprivation and some individuals, particularly those dependent on opiate and stimulant drugs, may become involved in crime to support their dependence. In the United Kingdom, police surveillance estimates suggest that half of all recorded crime is drug related, with associated costs to the criminal justice system estimated to be £1 billion per annum. (2) The putative link between crime and drug use may also be related to lifestyle aspects of criminality which lead individuals to become deviant in other areas (8) and as a cultural fact of life in areas of economic and social deprivation. (9,;L9

It is important to recognize that illicit drug use does not inevitably result in problems and people who do experience problems are not a homogenous group. (H) Studies of the natural history of drug use have made an important contribution to our understanding of how illicit drug use and dependence is initiated, maintained and terminated. Recovery may be apparently spontaneous and many individuals stop using because of a need to change their lifestyles or because of perceived external pressures, responsibilities, and revised outlooks. (1. 13> Nevertheless, for a substantial minority of users, drug use may become problematic and continue for many years, and they will require treatment and rehabilitation. Reflecting the chronic relapsing nature of an illicit drug-oriented lifestyle, many individuals develop a treatment 'career' profile alongside their drug use 'career'.

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