Psychoactive drugs include legal compounds such as caffeine, tobacco, and alcohol, as well as illegal substances such as heroin, cocaine, and LSD (Figure 13.1). This section examines general issues that apply to the use of any psychoactive drug. Later sections discuss two commonly used and abused psychoactive drugs: alcohol and tobacco.

Who Uses Drugs?

Drug use and abuse occur at all income and education levels, among all ethnic groups, and across all age groups. Society is concerned with the casual or recreational use of illegal drugs because it is not really possible to know when drug use will lead to abuse or addiction. Some casual users develop substance-related problems; others do not. Some psychoactive drugs, however, are more likely than others to lead to a substance use disorder (Table 13.2).

Characteristics that place people at higher-than-average risk for trying illegal drugs include being male, young, a troubled adolescent, a thrill-seeker, in a dysfunctional family, in a peer group that accepts drug use, and poor; beginning dating at a young age is another risk factor. Drug use is less common among young people who attend school regularly, get good grades, have strong personal identities, are religious, have a good relationship with their parents, and are independent thinkers whose actions are not controlled by peer pressure. Coming from a family that has a clear policy on drug use and deals with conflicts constructively is also associated with not using drugs.

Why do some people use psychoactive drugs without becoming dependent, while others aren’t as lucky? The answer seems to be a combination of physical, psychological, and social factors. Some people may be born with a brain chemistry or metabolism that makes them more vulnerable to drug dependence. Psychological risk factors include having difficulty controlling impulses and having a strong need for excitement and immediate gratification. People may turn to drugs to numb emotional pain or to deal with difficult experiences or feelings such as rejection, hostility, or depression. Social factors that may increase the risk for dependence include exposure to drug-using family members or peers, poverty, and easy access to drugs (see the box “Club Drugs”).


Treatment for Substance Use Disorder and Addiction

Different types of programs are available to help people break their drug habits, but there is no single best method of treatment. The relapse rate is high for all types of treatment, but being treated is better than not being treated. Professional treatment programs usually take the form of drug substitution programs or treatment centers; nonprofessional self-help groups and peer counseling are also available. To be successful, a treatment program must deal with the reasons behind users’ drug abuse and help them develop behaviors, attitudes, and a social support system that will help them remain drug free. For resources related to treatment, see “For Further Exploration” at the end of the chapter.

Young people with drug problems are often unable to seek help on their own. In such cases, friends and family members may need to act on their behalf. One or more of the following signals may suggest serious drug misuse:

• Sudden withdrawal or emotional distance

• Rebellious or unusually irritable behavior

Ethyl alcohol The intoxicating ingredient in fermented liquors; a colorless, pungent liquid.

Proof value Two times the percentage of alcohol in a beverage, measured by volume; a 100-proof beverage contains 50% alcohol.

One drink The amount of a beverage that typically contains about 0.6 ounce of alcohol; also called a standard drink.

Date-rape drugs can be slipped into beverages, especially when you are at parties or socializing with strangers. Never accept a drink unless you see it being poured.

• Loss of interest in usual activities or hobbies

• Decline in school performance

• Sudden change in group of friends

• Changes in sleeping or eating habits

• Frequent borrowing of money

Preventing Substance Use Disorder

The best solution to drug misuse is prevention. Government attempts at controlling the drug problem tend to focus on stopping the production, importation, and distribution of illegal drugs. Creative efforts are also being made to stop the demand for drugs. Approaches include building young people’s self-esteem, improving their academic skills, increasing their recreational opportunities, providing them with honest information about the effects of drugs, and teaching them strategies for resisting peer pressure.

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