Who uses drugs and why

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Recreational drug use is a worldwide phenomenon with considerable national and regional variations. In 1995, 28 per cent of British men and 26 per cent of women admitted to being regular cigarette smokers. The decline in smoking by adults in the developed world has not been mirrored in children, and in particular the rate of initiation among girls under 16 has doubled over the last two decades in the United Kingdom. By the age of 16 years, 94 per cent of young people have tried alcohol, and 78 per cent will have been drunk on at least one occasion.

Sixteen-year-olds from the United States and the United Kingdom topped the league in lifetime experience of any illicit drug in a comparison of 23 countries. (5) Forty-one per cent of British school students admitted using cannabis in comparison with 34 per cent of North American, 19 per cent of Italian, 15 per cent of Spanish, 12 per cent of French, and 2 per cent of Greek students. Overall, around one in four of the British population have tried an illegal drug at some time. Peak use occurs in the late teens and early twenties. Cannabis accounts for 85 per cent of this and most cannabis smokers never use any other illegal drug.

Polydrug use is the norm on the club scene. Among a sample of Scottish clubbers,(6) individuals had consumed a lifetime average of 11 different drugs. Drug use within the past year included alcohol (96 per cent), cannabis (96 per cent), ecstasy (87 per cent), tobacco (86 per cent), LSD (79 per cent), amphetamine (77 per cent), cocaine (59 per cent), 'poppers' (51 per cent), psylocybin mushrooms (47 per cent), temazepam (39 per cent), diazepam (26 per cent), codeine (19 per cent), heroin (11 per cent), ketamine (7 per cent), solvents (6 per cent), and buprenorphine (6 per cent). Other studies confirm that use of LSD, amphetamine, ecstasy, magic mushrooms, and poppers cluster together among young people. A quarter of all 18-year-olds have tried two or more illegal drugs. ^ In a consecutive sample of 100 patients attending an Oxford drug dependency unit, 22 per cent were regularly using three or more street drugs apart from heroin at presentation (unpublished data).

Only 3 per cent of the drug-using population ever injects, but those who do expose themselves to greatly increased risks of accidental overdose, poisoning by adulterants and impurities, and life-threatening infections. Superficial veins progressively thrombose, necessitating recourse to the larger vessels in the neck or groin where damage to an adjacent artery or nerve may threaten life or limb. A sizeable minority persist in exposing themselves to the risk of hepatitis and HIV through the sharing of equipment, and this is particularly prevalent among younger injectors.

Why take drugs? Some have argued that the search for 'altered consciousness' is a basic human appetite, fy,8) but most young experimenters would simply say that drugs are pleasurable, exciting, or useful for getting into the party spirit. Other reasons include the relief of unpleasant feelings such as shyness or anxiety, fitting in with friends, or revelling in a sense of sophistication, rebellion, or independence. (4) Males are less likely to be total abstainers and tend to consume larger quantities than females. Genetic make-up, psychological factors, family background, and socio-economic circumstances are all influential in shaping the response to an offer of a drug and in determining the cost-benefit equation that will result in cessation, persistance, or abuse. (9)

Risk-taking is an essential part of the process of developing independence and individual identity during the progression through adolescence into adulthood. Because drugs are now part of the environment for most school students, it can no longer be assumed that experimentation is necessarily pathological or abnormal. In a prospective study*1,0) of 100 American children followed from the age of 3 to 18 years, the subjects broadly fell into three categories with regard to illicit drug use at the end of the investigation: total abstainers, experimenters, or regular users. Those with the healthiest psychological profiles proved to be the experimenters, who had also been in receipt of a significantly higher quality of parenting than either of the other two groups. Psychological traits detectable in the earliest years can predict future drug use, and the triad of alienation, impulsivity, and distress usually precedes abuse. The authors concluded that problem drug use was more likely to be a symptom, rather than a cause, of personal or social maladjustment.

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