Policy > General > Why do people take drugs?

Introduction

Why do people take drugs? To the outside observer, this might seem to be the central question on which any effective drug policy would need to be based. Like the question of motive in a criminal investigation, it should be the key which unlocks the patterns of behaviour which we observe, and allows us to assess the strategies which we have at our disposal to achieve our goal of reducing the harm drugs can cause to individuals and communities. Instead, it is historically one of the most superficially considered aspects of illicit drug use, and one which is still governed by largely unquestioned assumptions.

There are at least two prima facie reasons why this might be the case. The first is that drug policy primarily addresses itself to problematic drug use, treating this as the model for drug use per se. But problematic drug users, variously defined, are typically estimated at around three percent of the total user group - a small fraction with, perhaps, a set of motives which differs from the norm. Thus the motives of the average drug user may be only tangentially relevant to the core of drug policy: however, if we accept that we are expending 97% of our efforts on 3% of drug users, it is surely worth spending 3% of our time considering the other 97%.

The second reason, less charitable to the medical and psychiatric professions, is that 'drug abuse', although exhaustively described with an ever-increasing scientific vocabulary, contains elements of value judgement and moral prescription which are exposed as soon as the motives for drug use are clearly and impartially understood. Thus the professional discourse is best served by an unquestioned acceptance that people take drugs for certain given reasons.

Two reasons typically given for the use of drugs

The primary explanation for drug use, historically, has always been addiction - an account which was formulated by early psychiatrists such as Levinstein and Kraepelin and which was maintained as the sole motive for all illicit drug use by enforcement units like Harry Anslinger's US Narcotics Bureau. A significant part of the appeal of addiction theories is that they short-circuit any further discussion of motive: users take drugs simply because they cannot do otherwise. But its significant drawback is that addiction as a specific clinical syndrome (metabolic craving, tolerance and dependence) only accurately describes a small percentage even of long-term drug use, and clearly cannot account for experimental or recreational use.

In recognition of this, a second explanation for drug use has now become a standard account of motive: peer pressure. Drug education programmes typically identify this as the initial reason for drug use, and tailor their message to counter it: Just Say No. But peer pressure is also a motive which sits uncomfortably with the facts. Research in the UK by Exeter University Health Education Unit, supported by similar results in the US, demonstrates that experimental teenage drug users have higher than average levels of self-esteem - i.e. that they are less likely than average to respond to peer pressure. This suggests that a misidentified motive for drug use is producing policies which, though they may succeed in frightening parents or convincing them of government concern, are unlikely to be effective in their primary goal of prevention.

Two different reasons (which are given much more rarely)

By contrast, there is one motive for drug use which, though rarely mentioned in policy debate, would be by far the most apparent to any outside observer: pleasure. It is pleasure which is essentially the defining quality of all illicit drugs: those drugs which are abused have pleasurable effects, and those which have no pleasurable effects are not abused. Furthermore, the use of drugs for pleasure is readily identifiable throughout history and across most cultures; the work of behavioural psychologists like Ronald K.Siegel demonstrate that it is widespread even throughout the animal kingdom.

But, although pleasure is the obvious motive for the majority of drug use, it is one which has always sat uncomfortably in this century's predominantly punitive drug policy debate. When referred to, it is usually in conjunction with qualifying adjectives: "trivial pleasure", "superficial pleasure" or, most oddly, "illusory pleasure". But if we accept pleasure as the motive for the majority of drug users, we have by the same token to accept that the substances in question would not be used unless the pleasure obtained from them was experienced as genuinely rewarding and relatively low-risk. And we may also conclude that its presence in the debate, though unspoken, remains powerful: pleasure is, for example, perhaps the most significant distinction between heroin and methadone maintenance.

A second unacknowledged motive for drug use does not even have a recognised name, but may perhaps be referred to as 'consumer exoticism'. It is this which presents the most credible answer to the question of why the prevalence of drug use has increased so greatly over the last thirty years or so, despite the billions spent on its prevention. Most people in the Britain of the 1950s would have been deeply suspicious if offered an avocado; the same people now happily buy them from supermarkets. As consumer culture encourages adventurousness in our choice of food, clothes, holidays - and bombards us with messages intended to identify our self-worth with the boldness of these choices - it becomes ever more anomalous that we are asked to accept on faith, and against much of the cultural evidence, that alcohol is the only drug in which we should be interested.

It is this 'sampling culture', rather than motives such as peer pressure, which best describes and predicts the growth of today's experimental drug culture. Few surveys have been done on the reasons why people don't take drugs, but they suggest that the major (and majority) motive is simply lack of interest, followed by concern about health risks. Few people cite the illegal status of drugs as a motive for abstention, suggesting that, legal or not, the overall prevalence of drug use in Western societies is approaching its natural limit.

Problematic drug use

Even this cursory review of the reasons why people do and don't take drugs enables us to construct a model of problematic drug use which differs substantially from those offered by the questionable motives of addiction and peer pressure. If people take drugs essentially because they want to - and pleasurable and functional use of drugs is far more common than dysfunctional use - then why and under what circumstances does problematic use occur?

This analysis suggests that there are two distinct reasons. The first of these is ignorance, particularly with respect to purity or dosage, and most commonly with substances like opiates or PCP where effective and dangerous doses are relatively close to one another. This is typically a problem with synthetic or extracted drugs rather than natural substances and plant forms; it is also a pattern of problematic use which is historically associated with prohibition and the lack of choice and information which it entails, from the meths injectors and wood alcohol drinkers of 1920s America to the tranquilliser and solvent use of today.

The second reason for problematic use, by this analysis, is the situation of the subject before they begin to use drugs. If they are used as an attempt to escape from insoluble problems, or to tolerate otherwise intolerable conditions (such as social deprivation or prison), they will be used in conformity with the usual motive - pleasure - but will present the pattern of a chronic and dysfunctional habit (with or without a bona fide metabolic addiction). In this sense their problematic use can be seen as pleasure only in the sense that it is preferable to the alternative - in other words, self-defence.

Conclusion

As our outside observer would have assumed at the beginning, a realistic re-examination the motives for drug use does indeed lead us to reconceive the role of an effective drug policy. It suggests that problematic drug use is not the rule but the exception, and that neither recreational nor problematic drug use are likely to be significantly diminished by penal policies. It suggests, furthermore, that the most effective methods for reducing the problematic use of drugs will combine accurate and impartial information with the analysis and targeting of its underlying conditions.

This briefing was written for Transform by Mike Jay, a Trustee of TDPF, freelance writer (published work includes 'Emperors of Dreams: Drugs in the Nineteenth Century' and editor of the standard Penguin anthology of drug literature, 'Artificial Paradises') journalist, and former chair of the Drug Policy Review Group.