A very common misconception is that drug misuse is simply a search for fun. In fact, people take drugs for many reasons other than to get the buzz or high. Indeed, studies have shown that straightforward pleasure seeking is the primary reason for initiation of drug use in fewer than 20 per cent of individuals. While the high or buzz is the most obvious pleasurable effect, many people also describe using drugs to feel comfortably numb, pleasantly drowsy, or full of energy and confidence. Many others will be chasing the high or buzz that they first experienced, always trying to attain the intensity of their initial experiences. Still others will be self-medicating for anxiety, strong emotions such as anger, for pain, boredom, lack of motivation, lack of self-confidence, and many other aversive states including withdrawal.
The main reason to try to ascertain the reasons for drug use is that in many cases identification of the cause can lead to effective interventions. For example, many alcoholics will point to anxiety as their reason for drinking; (1) indeed, social anxiety is one of the most common causes of alcoholism in young men.(2) If this can be treated (e.g. by selective serotonin reuptake inhibitors) then they are frequently able to become abstinent or even drink normally. Social anxiety is also a common reason for the use of stimulants by the young. Another psychiatric disorder associated with drug misuse is depression, which is particularly likely to lead to excess alcohol intake. A vicious cycle then develops because both alcohol and its withdrawal are depressogenic. Alcohol is also one of the most serious risk factors for suicide. There is increasing use of stimulants and cannabis by schizophrenic patients. In part this reflects the behaviour of their peer group but the use of stimulants may be in part due to the fact that they can offset some of the more negative aspects of neuroleptic treatment, especially the loss of drive and motivation. As both types of drug can worsen psychotic illness, dealing with drug misuse in this group is a priority.
Other factors affecting drug use may be less amenable to psychiatric intervention, such as pressure from peers or others. For instance, female opiate addicts often have a male partner who also uses drugs or even deals drugs. Following her withdrawal from drugs, relapse is almost certain to occur if she continues to live with this partner. Another reason for drug use is to reduce pain or boredom, the latter being a common reason given by disadvantaged youth in areas of high unemployment and poor environmental quality such as inner cities or out-of-town housing estates.
Other reasons for drug use, generally of psychedelics, include the search for meaning or for mystical experiences. Whilst not directly relevant to psychiatry, this use can precipitate psychotic episodes in susceptible individuals and may act as the trigger for schizophrenia.
Finally, it is important to remember that the reasons for use are not static. An opiate addict may use the same dose of heroin to get going in the morning, to 'top off a pleasant experience later in the day, to deal with angry feelings when they occur, and to promote sleep at night. Similarly during a drug-using career different motivations may become dominant. This has been well characterized in opiate users where for many the initial exploration was for pleasure or escape. Over months, as physical dependence becomes increasingly apparent, drug use becomes driven by the need to avoid withdrawal and feel normal at all costs.
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This guide Don't Panic has tips and additional information on what you should do when you are experiencing an anxiety or panic attack. With so much going on in the world today with taking care of your family, working full time, dealing with office politics and other things, you could experience a serious meltdown. All of these things could at one point cause you to stress out and snap.