Chapter 1 Drug Use: An Overview 5
Drugs in Depth
Some terms that are commonly used in discussing drugs and drug use are difficult to define with precision, partly because they are used so widely for many different purposes. For each of the following terms, we have pointed out some of the “gray areas” that help us to clarify our understanding of the term, as well as to make us leery of hard-and-fast labeling of someone’s behavior. The word drug will be defined as “any sub-stance, natural or artificial, other than food, that by its chemical nature alters structure or function in the living organism.” One obvious difficulty is that we haven’t defined food, and how we draw that line can sometimes be arbitrary. Alcoholic beverages, such as wine and beer, may be seen as drug, food, or both. Are we discussing how much sherry wine to include in beef Stroganoff, or are we discussing how many ounces of wine can be consumed before becoming intoxicated? Since this is not a cookbook but, rather, a book on the use of psychoactive chemicals, we will view all alcoholic beverages as drugs. Illicit drug is a term used to refer to a drug that is unlawful to possess or use. Many of these drugs are available by prescription, but when they are manufactured or sold illegally they are illicit. Traditionally, alcohol and tobacco have not been considered illicit substances even when used by minors, probably because of their widespread legal availability to adults. Common household chemicals, such as glues and paints, take on some characteristics of illicit sub-stances when people inhale them to get “high.” Deviant drug use is drug use that is not common within a social group and that is disapproved of by the majority, causing members of the group to take corrective action when it occurs. The corrective action may be informal (making fun of the behavior, criticizing the behavior) or formal (incarceration, treatment). Some examples of drug use might be deviant in the society at large but accepted or even expected in particular subcultures. We still consider this behavior to be deviant, since it makes more sense to apply the perspective of the larger society. Drug misuse generally refers to the use of prescribed drugs in greater amounts than, or for purposes other than, those prescribed by a physician or dentist. For nonprescription drugs or chemicals such as paints, glues, or solvents, misuse might mean any use other than the use intended by the manufacturer.
Abuse consists of the use of a substance in a manner, amounts, or situations such that the drug use causes problems or greatly increases the chances of problems occurring. The problems may be social (including legal), occupational, psychological, or physical. Once again, this definition gives us a good idea of what were talking about, but it isn’t precise. For example, some observers would consider any use of an illicit drug to be abuse because of the possibility of legal problems, but the majority of marijuana users do not meet the clinical criteria for substance abuse. Also, the use of almost any drug, even under the orders of a physician, has at least some potential for causing problems. The question might come down to how great the risk is and whether the user is recklessly disregarding the risk. For someone to receive a diagnosis of having a substance use disorder (see the DSM-5 feature in Chapter 2), the use must be recurrent, and the problems must lead to significant impairment or distress. Addiction is a controversial and complex term that has different meanings for different people. Some people want to reserve the term only for those whose lives have been completely taken over by sub-stance use, whereas others will apply the term broadly to anyone who is especially interested in watching television, reading, running, skiing, or any other activity. When it comes to substance use, we will use addiction only to refer to cases in which people have struggled to control their use and have suffered serious negative consequences from that use. Drug dependence refers to a state in which the individual uses the drug so frequently and consistently that it appears that it would be difficult for the person to get along without using the drug. For some drugs and some users, there are clear withdrawal signs when the drug is not taken, implying a physiological dependence. Dependence can take other forms, as shown in the DSM-5 feature in Chapter 2. If a great deal of the individual’s time and effort is devoted to getting and using the drug, if the person often winds up taking more of the substance than he or she intended, and if the per-son has tried several times without success to cut down or control the use, then the person meets the behavioral criteria for dependence. This behavioral dependence is what we mean when we use the term addiction.
Review Questions
1. Besides asking a person the question directly, what is one way a psychologist can try to deter-mine why a person is taking a drug?
2. What two characteristics of a drug’s effect might change when the dose is increased?
3. In about what year did drug use in the United States peak?
4. About what percentage of college students use marijuana?
5. What do the results of the National Survey on Drug Use and Health tell us about the overall rates of marijuana and cocaine use among whites compared to African Americans and Hispanics in the United States?
6. How does having a college degree influence rates of drinking alcohol? Using tobacco?
7. Name one risk factor and one protective factor related to the family/parents.
8. How does impulsivity relate to rates of drug use in the general population? How does im-pulsivity relate to substance dependence?
