2.2 Why do people use substances

“I grew up around a family of smokers who gave cigarette smoking a classy edge. I would always be mimicking the adults by pretending to smoke. This is the introduction to me normalizing cigarettes and participating in the social norms of tobacco use”.[1]

There are many reasons why people use psychoactive substances, from medicinal to religion to enjoyment.  You may be wondering why; however, some people can use substances and have healthy relationships with substances yet do not develop a disorder while others do.[2] Watch the following video of Tyler Sullivan-King[3] who shares their story of using substances and developing a substance use disorder.

Tyler’s prescription for an opiate from an injury was a powerful experience with a powerful substance.  Tyler also mentioned their environment as “not ideal”.  This combination of factors developed into a substance use disorder.

What is a substance use disorder (SUD)?  A substance use disorder according to the American Psychiatric Association[4] is a “pattern of symptoms resulting from the use of a substance that you continue to take, despite experiencing problems as a result”.[5]  As with other diseases and disorders, the likelihood of developing a substance use disorder differs from person to person, and no single factor determines whether a person will develop a substance use disorder.[6]  In general, the more risk factors a person has, the greater the chance that taking substances may lead to substance use and a SUD. “Risk factors are those that make drug use more likely”. [7]  Protective factors, on the other hand, “are those associated with reduced potential for drug use”.[8]

Key Risk and Protective Factors for Drug Use [9]

 
Catagories/Domains Risk Factors Protective Factors
Community
  • Community disorganization
  • Laws and norms favorable to drug use
  • Perceived availability of drugs
  • Community cohesion
  • Community norms not supportive of drug use
School
  • Academic failure
  • Little commitment to school
  • Participation in school activities
  • School bonding
Family
  • Parental attitudes favorable to drug use
  • Poor family management
  • Family history of antisocial behavior
  • Family sanctions against use
  • Positive parent relationships
Peer/Individual
  • Early initiation of antisocial behavior
  • Attitudes favorable to drug use
  • Peer drug use
  • Positive peer relationships
  • Network of non-drug using peers

According to this research, “for individuals who begin using illicit substances at an early age, several risk factors may increase the likelihood of continued and problematic use in later ages”.[10]

Please watch this video from the Canadian Centre on Substance Use and Addiction[11] exploring the power of protective factors in lifetime wellness.

Activities

  1. Review the risk and protective factors.
  2. Reflect on the social determinants of health.  How many of these risks or protective factors can you identify relate to the social determinants of health?
  3. Reflect on Tyler: can you identify any risk factors that may have impacted his development of a substance use disorder?
  4. Why do you think those with all the risk factors may not develop a substance use disorder?
  5. On the other hand, why might someone who has all the protective factors develop a substance use disorder?

In Canada, there is a social acceptance within many cultures around the use of substances, including weddings, graduations, funerals, celebrations.

Activities

  1. Reflect on the social acceptance of substances.  Name the activities that accept substances.
  2. Reflect on how companies promote the use of alcohol through the media.
  3. What is the narrative you have heard about using alcohol throughout the lifespan?
  4. Watch the CBC Documentary- Girls Night Out: A Personal Look at Binge Drinking in Young Women (cbc.ca)
  5. What does this suggest about substance use and age?  What does this suggest about substance use and gender?
  6. Substance abuse and dependency is stigmatized, yet alcohol use is often culturally accepted. Why is that?
  7. Choose a “normal” day and make note of how many advertisements you see for substances.  Categorize them into medication, alcohol, and cannabis.  What are the numbers?  What does this suggest?

There are many reasons why societies, cultures and people use substances.  As Social Service workers you may have the opportunity to explore an individual’s journey, using your individual helping skills.  You may have the opportunity to engage with a community, focusing on a specific group of people. For example, you may be working with a school, developing a survey on substance use among the youth.  What types of interventions might you explore based on what you know about why people use substances?  Be prepared, as you have learned, to explore every story, from a lens of “nothing about us, without us”.  The individual and the community must be the leader in their stories.

References

Credit: Adapted from Drugs, Health & Behavior by Jacqueline Schwab. https://psu.pb.unizin.org/bbh143/front-matter/introduction/

Updated with Canadian Content.


  1. Lee, B., Yanicki, S., & Solowoniuk, J. (2011). Value of a health behavior change reflection assignment for health promotion learning. Education for Health, 24(2), 509. http://www.educationforhealth.net/
  2. Schwab, J. (2021). Drugs, health and behaviour. Pressbooks. https://psu.pb.unizin.org/bbh143/chapter/drugs-and-the-brain-national-institute-on-drug-abuse-nida/
  3. City of Hamilton. (2019, Novmber 18 ). #SeeThePerson - Tyler. YouTube. https://www.youtube.com/watch?v=J2OcFc-_bac
  4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596.
  5. Ibid, p. 175
  6. Schwab, J. (2021). Drugs, health and behaviour. Pressbooks. https://psu.pb.unizin.org/bbh143/chapter/drugs-and-the-brain-national-institute-on-drug-abuse-nida/
  7. Public Safety Canada. (2018). School-based drug abuse prevention: Promising and successful programshttps://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/sclbsd-drgbs/index-en.aspx
  8. Public Safety Canada. (2018). School-based drug abuse prevention: Promising and successful programshttps://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/sclbsd-drgbs/index-en.aspx
  9. Public Safety Canada. (2018). School-based drug abuse prevention: Promising and successful programs. https://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/sclbsd-drgbs/index-en.aspx
  10. Ibid, para. 1
  11. Canadian Centre on Substance Use and Addiction. (2021). Community connections supporting lifetime wellbeing. [Video]. Youtube. https://www.youtube.com/watch?v=1Hj06BlVrnI

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