THE NATURE & PHASESOF DRUG USE

Western RegionDrug & Alcohol Task Force

Meitheal Drugaí an Iarthair

2

The Nature & Phases of Drug Use

The Nature & Phasesof Drug Use

The Nature of Drug Use

In understanding drug use, it is useful to considerthe following three key factors.

These are:

• Personality

• The type of drug taken

• The context of drug use

These factors are connected and cannot beseparated. They influence the reasons for usinga drug and the effects it can have. Also, thereare different levels of drug use with differenteffects, risks and consequences. Not all drug usewill lead to drug dependency, however, it isimportant to consider the three factors whenlooking at person’s level and type of drug use.Drug use is not the same as drug abuse.

Phases of Drug Use

Non-User

A non-user is someone who has never useddrugs or someone who has used in the past butis drug free/abstinent for a long period of time.

Experimental User

The experimental user is someone who triesdrugs out of curiosity or because others in theirsocial circle are experimenting. For many, oncethe curiosity is satisfied, they are no longerinterested in taking drugs. A small percentage ofusers may continue to use drugs on a moreregular basis. The main risk in the experimentalphase is lack of knowledge around the drugbeing taken and its possible effects.

Recreational User

The recreational user is someone who takesdrugs for enjoyment and leisure purposes, aspart of their social lives or to alleviate symptomssuch as shyness during social occasions.Recreational drug use can be sporadic (forexample, attending an occasional concert) ormore regular. Most people who take drugsrecreationally view it as a standard activity intheir social circle.

Dependent Drug Use

A dependent user is someone who relies ondrugs to function. Dependence can beexperienced both physically andpsychologically. It can involve cravings,withdrawal symptoms, needing to use regularlyas a means to cope with everyday living.Dependent drug use often causes emotional,psychological and social problems.

These four phases represent a broad outline ofdrug use. It is possible to move in a linearfashion through the four phases. It is alsopossible to remain at one phase withoutprogressing to another phase. Another possibilityis that a person can jump from one phase toanother, examples include, experimental use todependent use or recreational use to non-use.

For further information, visithttp://www.drugs.ie/drugs_info/about_drugs/ the_nature_and_stages_of_drug_use/

Non-Use ExperimentalUse

RecreationalUse

DependentUse

3

It is important to note that not everyone who usesdrugs or drinks alcohol is addicted. Even whenpeople use alcohol or drugs in a way that causesother people difficulty, this does not always meanthat they are addicted.

In recent years, there has been much debate anddiscussion in relation to alcohol and drug useand the language used to describe thisbehaviour. Some people are in favour ofdescribing different types of use in the followingway:

Drug use - where someone is using a drug(including alcohol) but not experiencing negativeimpact.

Problematic use - where someone is using ina way that is having a negative impact on themand/or those around him/her.

Dependence - where someone is using to anextent that they experience either physicaland/or emotional discomfort if they do not orcannot get their next dose.

One definition describes addiction as “apersistent, compulsive dependence on abehaviour or substance” (Gale Encyclopaedia ofMedicine, 2008, The Gale Group). There aremany theories of addiction with much researchtaking place and a host of books and articlespublished on the subject.

Models of Addiction

Addiction can be regarded as a complexcondition. There is no consensus regarding thecauses or treatment of addiction. There are manytheories as to the cause of addiction and why

some people are more susceptible to developingan addiction than others. This section describessome of the more well-known theories. Theoriestrying to explain addiction are commonlyreferred to as “Models of Addiction”.

The Moral Model

Historically the moral model of addiction viewedaddiction as a chosen behaviour. It viewedpeople who engaged in heavy drinking or druguse as morally deficient. Engaging in thisbehaviour was viewed as evidence that theindividual is “sinful”. Punishment was viewed asan appropriate measure to make people stoptheir sinful behaviour.

The Disease Model

In 1956, the American Medical Associationclassified addiction as a treatable disease. Thisway of viewing addiction was quite differentfrom the Moral Model. Advocates for the diseasemodel describe addiction as a primary diseasecaused by biological, personality and spiritualdysfunction. The condition can become chronicand can only be treated, not cured. Abstinenceand sobriety maintenance is the overall treatmentgoal. Alcoholics Anonymous (AA) and other 12-step programmes employ this model.

The Genetic Model

Some theorists suggest that genetic inheritanceplays an important role in the susceptibility todeveloping an addiction. Genes together withenvironmental factors can either increase ordecrease the likelihood of inheriting addictivedisorders. The heritability of addictive disordershas been estimated at around 30–50 % (Brewerand Potenza, 2008)

What is Dependency / Addiction

What is Dependency/Addiction?

The Social Learning Model

This theory has a grounding in behaviourism andputs forward the idea that people’s behaviour islearned through interaction with the environmentand through observing other peoplesbehaviours. Substance use is therefore seen assomething which is learnt and as such can be“unlearned”. Various outcomes of treatment areviewed as acceptable within this way ofunderstanding addiction; from harm reduction(reducing use, safer use, etc.) to total abstinence.

The Bio-psychosocial Model

Within this model, addiction is viewed as acomplex behaviour with several components toit;

Biological- physical and genetic factors

Psychological- mood, personality, andbehavioural factors

Social- family, culture, and socioeconomicfactors

4

The Nature & Phases of Drug Use

5

Change can be viewed as an ongoing processrather than a single event, therefore the processof change for a dependent user happens overtime. The “Wheel of Change” is one model that

is very popular and highlights the stages in theprocess of change (Prochaska and DiClemente,2002).

1. Pre-Contemplation

At this stage the user is unaware that there is aproblem or that change is necessary, (even ifothers are).

2. Contemplation

The user now begins to consider their situationand develops more awareness of the need tochange. They continue their drug use at this stage.

3. Preparation

A decision is now made by the user to changetheir substance using behaviour and he/sheprepares to do so.

4. Action

Practical steps are now taken to bring about achange to their substance using behaviour.He/she may decide to reduce their use or to giveup completely.

Understanding Change

UnderstandingChange

UNDERSTANDING

CHANGE

6Relapse

1Pre-Contemplation

2Contemplation

3Preparation

4Action

5Maintenance

5. Maintenance

Maintenance means a change has beenachieved in their substance using behaviour.He/she may have either stopped using drugs oralcohol, or have moved to a more controlled,less harmful way of using. The maintenance ofchanged behaviour can be difficult.

6. Lapse and Relapse

There is a subtle difference between “lapse” and“relapse”. A lapse is a temporary return to oldsubstance using behaviour where the user returnsquickly to the Cycle of Change. A relapse, onthe other hand, is a full return to old substanceusing behaviour and a total break from the Cycleof Change. The whole process would need tobegin again.

It is worth noting at this point that while lapseand relapse can and do occur, it is not alwaysinevitable that this will happen. Furtherinformation is available on:

www.psychcentral.com/lib/stages-of-change

6

Understanding Change

Refer to Information on Support Services section or www.supportme.ie for details on supports available