Abstract
The aim of this article is to revisit the multivariate causes of drug use. From the initial drive to experiment, to a progression towards dependence, this review endeavours to extrapolate the aetiology of causation. In doing so, prevalence of, and attitudes towards drug use are firstly examined. Influences on why people use illicit drugs are subsequently explored through the lens of established risk factors. Drug use and dependence are embedded within a complex interplay of invidual, genetic, cultural, and socio-economic components. By exploring the aetiology of drug use in a holistic sense, this will not only aid the therapeutic quality of intervention from clinicians, but enable the development of more comprehensive and tailored intervention plans in supporting recovery.
References
World Health Organsiation (2023) Drugs (psychoactive). Impact. Accessed 6 Feb 2023. Available from: https://www.who.int/health-topics/drugs-psychoactive#tab=tab_2
Global Burden of Disease 2016 Alcohol and Drug Use Collaborators (2018) The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Psychiat 5(12):987–1012. https://doi.org/10.1016/S2215-0366(18)30337-7
Health Research Board (2021) The 2019–2020 Irish National Drug and Alcohol Survey: main findings. Health Research Board: Dublin
Ajzen I, Fishbein M, Lohmann S, Albarracín D (2018)The influence of attitudes on behavior. Chapter in Albarracín D & Johnson BT. (Eds). The Handbook of Attitudes, Volume 1: Basic Principles 2nd Ed (pp. 5 – 146). Routledge: New York
Bryan, A, Moran R, Farrell E, O'Brien M (2000) Drug-related knowledge, attitudes and beliefs in Ireland: report of a nation-wide survey. The Health Research Board: Dublin
Dillon L (2017) General public attitude to drug users – citywide survey. Drugnet Ireland. Spring 61:7
Lloyd C (2013) The stigmatization of problem drug users: a narrative literature review. Drug: Educ Prev Policy 20(2):85–95. https://doi.org/10.3109/09687637.2012.743506
Aronowitz S, Meisel ZF (2022) Addressing stigma to provide quality care to people who use drugs. JAMA Netw Open5(2):e2146980. https://doi.org/10.1001/jamanetworkopen.2021.46980
Chan Carusone S, Guta A, Robinson S et al (2019) Maybe if I stop the drugs, then maybe they’d care?”—hospital care experiences of people who use drugs. Harm Reduct J 16:16. https://doi.org/10.1186/s12954-019-0285-7
Biancarelli DL, Biello KB, Childs E et al (2019) Strategies used by people who inject drugs to avoid stigma in healthcare settings. Drug Alcohol Depend198:80–86. https://doi.org/10.1016/j.drugalcdep.2019.01.037
Zwick J, Appleseth H, Arndt S (2020) Stigma: how it affects the substance use disorder patient. Subst Abuse Treat Prev Policy 15:50. https://doi.org/10.1186/s13011-020-00288-0
Wilde O (1893) Lady Windermere’s Fan. London: Samuel French, p 9
Volkow ND, Michaelides M, Baler R (2019) The neuroscience of drug reward and addiction. Physiol Rev 99(4):2115–2140. https://doi.org/10.1152/physrev.00014.2018
Perry JL, Carroll ME (2008) The role of impulsive behavior in drug abuse. Psychopharmacology 200(1):1–26. https://doi.org/10.1007/s00213-008-1173-0
Verdejo-Garcia A, Lawrence AJ, Clark L (2008) Impulsivity as a vulnerability marker for substance-use disorders: review of findings from high-risk research, problem gamblers and genetic association studies. Neurosci Biobehav Rev 32(4):777–810
de Wit H (2009) Impulsivity as a determinant and consequence of drug use: a review of underlying processes. Addict Biol 14(1):22–31. https://doi.org/10.1111/j.1369-1600.2008.00129.x
Sher KJ, Bartholow BD, Wood MD (2000) Personality and substance use disorders: a prospective study. J Consult Clin Psychol 68(5):818–829
Hayes A, Herlinger K, Paterson L, Lingford-Hughes A (2020) The neurobiology of substance use and addiction: evidence from neuroimaging and relevance to treatment. BJPsych Adv 26(6):367–378. https://doi.org/10.1192/bja.2020.68
de Wit H, Richards JB (2004) Dual determinants of drug use in humans: reward and impulsivity. In R. A. Bevins & M. T. Bardo (Eds.) Motivational factors in the etiology of drug abuse (pp. 127–158). Lincoln: University of Nebraska
Kozak K, Lucatch AM, Lowe DJE et al (2019) The neurobiology of impulsivity and substance use disorders: implications for treatment. Ann NY Acad Sci 1451(1):71–91. https://doi.org/10.1111/nyas.13977
Müller CP, Homberg JR (2015) The role of serotonin in drug use and addiction. Behav Brain Res 15(277):146–192. https://doi.org/10.1016/j.bbr.2014.04.007
Blum K, Braverman ER, Holder JM et al (2000) Reward deficiency syndrome: a biogenetic model for the diagnosis and treatment of impulsive, addictive, and compulsive behaviors. J Psychoactive Drugs 32(Suppl: i-iv):1–112. https://doi.org/10.1080/02791072.2000
Li MD, Burmeister M (2009) New insights into the genetics of addiction. Nat Rev Genet 10(4):225–231. https://doi.org/10.1038/nrg2536
Kendler KS, Prescott CA, Myers J, Neale MC (2003) The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Arch Gen Psychiatry 60(9):929–937. https://doi.org/10.1001/archpsyc.60.9.929
Goldman D, Oroszi G, Ducci F (2005) The genetics of addictions: uncovering the genes. Nat Rev Genet 6(7):521–532. https://doi.org/10.1038/nrg1635
Agrawal A, Lynskey MT (2008) Are there genetic influences on addiction: evidence from family, adoption and twin studies. Addiction 103:1069–1081
Jordan CJ, Andersen SL (2017) Sensitive periods of substance abuse: early risk for the transition to dependence. Dev Cogn Neurosci 25:29–44
Simoni-Wastila L, Yang HK (2006) Psychoactive drug abuse in older adults. Am J Geriatr Pharmacother 4(4):380–394
Beynon CM (2009) Drug use and ageing: older people do take drugs! Age Ageing 38(1):8–10. https://doi.org/10.1093/ageing/afn251
Lazarus RS (1999) Stress and emotion: a new synthesis. Springer Publishing Company, New York
Sinha R (2008) Chronic stress, drug use, and vulnerability to addiction. Ann NY Acad Sci 1141:105–130. https://doi.org/10.1196/annals.1441.030
Charmandari E, Tsigos C, Chrousos G (2005) Endocrinology of the stress response. Annu Rev Physiol 67:259–284
Wills TA (1986) Stress and coping in early adolescence: relationships to substance use in urban school samples. Health Psychol 5(6):503–529. https://doi.org/10.1037//0278-6133.5.6.503
al'Absi M (2020) The influence of stress and early life adversity on addiction: psychobiological mechanisms of risk and resilience. Int Rev Neurobiol 152:71–100
Heffernan K, Cloitre M, Tardiff K et al (2000) Childhood trauma as a correlate of lifetime opiate use in psychiatric patients. Addict Behav 25(5):797–803. https://doi.org/10.1016/s0306-4603(00)00066-6
Enoch MA (2011) The role of early life stress as a predictor for alcohol and drug dependence. Psychopharmacology 214(1):17–31. https://doi.org/10.1007/s00213-010-1916-6
Kennedy B, Chen R, Fang F et al (2019) Low stress resilience in late adolescence and risk of smoking, high alcohol consumption and drug use later in life. J Epidemiol Community Health 73:496–501
Calpe-López C, Martínez-Caballero MA, García-Pardo MP, Aguilar MA (2022) Resilience to the effects of social stress on vulnerability to developing drug addiction. World Journal of Psychiatry 12(1):24–58. https://doi.org/10.5498/wjp.v12.i1.24
Calcaterra SL, Beaty B, Mueller SR et al (2014) The association between social stressors and drug use/hazardous drinking among former prison inmates. J Subst Abuse Treat 47:41–49. https://doi.org/10.1016/j.jsat.2014.02.002
Valentine SE, Shipherd JC (2018) A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States. Clin Psychol Rev 66:24–38. https://doi.org/10.1016/j.cpr.2018.03.003
McLean G, Gunn J, Wyke S et al (2014) The influence of socioeconomic deprivation on multimorbidity at different ages: a cross-sectional study. Br J Gen Pract 64(624):e440–e447. https://doi.org/10.3399/bjgp14X680545
Fagan J (1992) Drug selling and licit income in distressed neighborhoods: the economic lives of street-level drug users and dealers in Harrell AV & Peterson GE (Eds.) Drugs, Crime, and Social Isolation: Barriers to Urban Opportunity. (pp. 99–146). University Press of America: Washington
Otiashvili D, Mgebrishvili T, Beselia A et al (2022) The impact of the COVID-19 pandemic on illicit drug supply, drug-related behaviour of people who use drugs and provision of drug related services in Georgia: results of a mixed methods prospective cohort study. Harm Reduct J 19:25
Mongan D (2021) Impact of Covid-19 on drug use in Ireland. Drugnet Ireland 76:1–7
Unger JB (2014) Special issue on culture and substance use. Subst Use Misuse 49(8):919–921. https://doi.org/10.3109/10826084.2014.887384
Lloyd C (1998) Risk factors for problem drug use: identifying vulnerable groups. Drugs: Educ Prev Policy 5(3):217–232. https://doi.org/10.3109/09687639809034084
Whiteford HA, Degenhardt L, Rehm J et al (2013) Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 382(9904):1575–1586. https://doi.org/10.1016/S0140-6736(13)61611-6
Kushner MG, Krueger R, Frye B, Peterson J (2008) Epidemiological perspectives on co-occurring anxiety disorder and substance use disorder. In: Stewart SH, Conrod PJ (Eds.). Anxiety and Substance Use Disorders: The Vicious Cycle of Comorbidity (pp. 3–17). Springer: New York
Smith JP, Book SW (2008) Anxiety and substance use disorders: a review. Psychiatr Times 25(10):19–23
Khoury L, Tang YL, Bradley B et al (2010) Substance use, childhood traumatic experience, and posttraumatic stress disorder in an urban civilian population. Depress Anxiety 27(12):1077–1086. https://doi.org/10.1002/da.20751
Groenman AP, Janssen TWP, Oosterlaan J (2017) Childhood psychiatric disorders as risk factor for subsequent substance abuse: a meta-analysis. J Am Acad Child Adolesc Psychiatry 56(7):556–569
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This article was written as an entry for the College of Psychiatrists of Ireland Faculty of Addictions Prize 2023.
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McLoughlin, A. Why do people use drugs? A neglected question. Ir J Med Sci 193, 329–333 (2024). https://doi.org/10.1007/s11845-023-03416-4
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DOI: https://doi.org/10.1007/s11845-023-03416-4