Risk-Takers

Alcohol, Drugs, Sex and Youth

Moira Plant

• Publisher: Routledge
• Year: 2002
• eBook ISBN: 9781134960439
• Edition: 1
• Topic: Medizin
• Subtopic: Gesundheitsversorgung

Risk-Takers gives a comprehensive view of youthful involvement with drinking, smoking, drug use and sex. It provides a challenging assessment of health education for young people showing that, despite the threat of AIDS and HIV infection, risk-taking remains a feature of normal adolescent behaviour, difficult to restrain or curb.

1 The causes of drug use

This book is primarily concerned with the youthful use and misuse of alcohol, tobacco and illicit drugs and with the sexual behaviour of young people. As a preliminary to the presentation of a selective review of some of the evidence related to these topics it is considered important to provide readers with a brief introduction to the many possible reasons why people sometimes use and misuse psychoactive (mind-altering) drugs. Such drugs, it should be noted, include alcohol, tobacco and prescribed as well as illicit drugs.

The inclusion of this chapter may seem anomalous. It is the authors’ intention to include it for two reasons. Firstly, the complexity of the factors that influence human risk-taking is crucial to any understanding of such behaviour. Secondly, the aetiology, not only of drug use, but of other potentially harmful behaviours has to be taken into account when considering realistic ways of minimizing risk-taking by young people.

‘Drugs’ are frequently portrayed by the mass media as inherently harmful, injurious and malign. This impression, reasonably enough, is clearly reinforced by stereotypes of the casualties of various form of damaging drug use. Such stereotypes, the ‘wino’, the ‘alcoholic’ and ‘the junkie’, are frequently held up as cautionary representations, and combined with warnings about the perils of excess or deviant forms of drug use. Simple images often beget simple solutions. Messages such as ‘Just Say No!’ have both clarity and a popular appeal. In fact, neither drug use nor other health-related behaviours conform to convenient stereotypes. Moreover, there are, as yet, no simple magic solutions whereby harmful behaviours may be prevented. Human behaviour is as varied and confusing as its attendant problems and negative consequences abound.

The following chapters present, from the authors’ perspective, an overview of some of the recent evidence related to psychoactive drug use and sexual behaviour in relation to young people. Alcohol and drug use and sexual behaviour are influenced by many factors. The existence of these factors has profound implications for policies intended to reduce, even to prevent, harmful drug use or the adverse consequences of unprotected sex.

This chapter does not provide a detailed and comprehensive review of evidence and theories related to the aetiology of drug use and drug dependence. More complete reviews are available elsewhere (e.g. Fazey 1977; Plant 1981; Peck 1982). Theories abound. They may be broadly divided into constitutional or biological, individual and environmental.

CONSTITUTIONAL FACTORS

Constitutional or biological theories are related to biological predispositions to use or to misuse drugs or with the physical effects of their use. For example, animal research has indicated the existence of genetic predispositions to use drugs or to become dependent upon them. There is also some evidence in humans indicating that some people are predisposed to develop such problems as liver disease, alcohol dependence or certain types of cancers. It has been suggested that specific individuals, due to biological or psychological traits, are particularly attracted to stimulant, depressant or hallucinogenic drugs. Some people like particular drug effects. Such theories need to be considered in relation to a host of other individual factors, as well as social and cultural factors. If alcohol problems run in families, this could be for social as well as biological reasons (Goodwin 1976; Partanen, Bruun and Markkanen 1966; Kiianmaa, Tabakoff and Saito 1989; Kozlowski 1991).

INDIVIDUAL FACTORS

Personality

A considerable amount of work has been conducted to identify an ‘addictive personality’. The resulting evidence is contradictory. Many of these results stem from studies which have compared those who use alcohol or illicit drugs in a problematic way with ‘control groups’ of different types. Often the latter have been chosen from rather unusual groups of people. These include those in penal institutions and clinic patients. Some studies have suggested that problem drinkers or problem drug users do differ from controls in relation to psychological characteristics such as neuroticism, hostility or extraversion. Even so, no unique ‘alcohol-dependent’ or ‘drug-dependent’ personality has been delineated (Fazey 1977; Plant 1981).

Gender

In most societies males use drugs more than do females. Even so, as elaborated in Chapters 2–7, there are exceptions to this rule. Females are as likely or, in some cases, more likely than males to use or to misuse specific drugs. For example, males in Britain drink more than females, but the latter are more likely than males to take prescribed tranquillizers. Social mores which once constrained women from drinking and using other drugs have been changing. This has been reflected by a change in the genders’ relative positions with regard to patterns of drug use. This is elaborated in Chapters 2–7.

Age

This book is concerned with ‘young people’. It is clear that the young are more likely than older people to use illicit drugs. The young, however, are less likely than their forebears to smoke. As emphasized constantly throughout this book, the young are, by virtue of their relative inexperience, possibly more likely to get into difficulties than older people in relation to psychoactive drug use. In addition, adolescents may well be more inclined than older people to take risks, to test out their limits to the full. Sometimes such risk-taking involves serious drug misuse (Jessor and Jessor 1977; Stimson 1981; MacGregor 1989).

Intelligence

Most drug misusers are not stupid. Some are from severely disadvantaged backgrounds, others are not. Various studies support the conclusion that neither the use nor the misuse of legal or illicit drugs can be attributed to low intelligence or to lack of information.

Psychological health

Some of those with serious alcohol or other drug problems have serious psychological disorders. It is often extremely difficult to tell whether these disorders are a cause or a result of the alcohol or drug use. Sometimes an alcohol or a drug problem appears to be at least partly caused by a secondary psychological condition. Studies of institutionalized problem drinkers and problem drug users vary considerably in their findings, with differing levels of association between psychoactive drug problems and psychological ill health (e.g. Kraft 1970; Barnes and Noble 1972; Lane 1976; Silver 1977).

Stressful life events

Clinical studies have commonly noted a high level of stressful life events amongst those with serious alcohol and drug problems. Such connections may reflect the fact that stressful life events may be caused by or result from alcohol and drug misuse. In addition, it is possible that difficult life circumstances may combine to produce both such life events and heavy or problematic psychoactive drug use (e.g. Ogborne 1975; Melotte 1975; Blumberg 1981).

Risk-taking

‘Risk’ is one of the major themes of this book. It is emphasized that for many people drinking, smoking, illicit drug use or sexual behaviour are neither perceived as being risky nor do they lead to adverse consequences. Risk-taking is the subject of Chapter 11 and is discussed at length therein. There is evidence to suggest, firstly, that risk-taking is normal amongst young people and, secondly, that some individuals do take more risks than others. In relation to certain behaviours, adolescence appears to be a time of heightened risk-taking (Baumrind 1987).

Hedonism

Most people who use drugs do so because the effects are enjoyable or rewarding in some way. These ‘rewards’ could be attributable to the chemical/ psychological effects of particular drugs or, equally, to their perceived social significance and prestige. Most drug use is recreational or, to at least some extent, motivated by enjoyment.

Self-medication

Clinical studies of those who use drugs heavily or for long periods of time suggest that some drug use is motivated by a wish for self-medication. Many drug users and problem drinkers attribute their behaviours to a wish to attain specific psychological states. These range from euphoria to oblivion. It is not uncommon for heavy drug users to seek drug supplies both legally from medical practitioners and illegally through black market transactions.

Curiosity

Initial drug use has been widely attributed to curiosity (Goode 1970; Davies and Stacey 1972). This is elaborated in Chapters 2, 3 and 4 and applies as much to initial alcohol and tobacco use as it does to the use of illicit drugs. Curiosity is not solely a youthful characteristic, nor does it explain why some people, after drug initiation, continue use or become heavy or problem users. It is emphasized that, while some individuals may be inherently more inquisitive, curious or venturesome than others, curiosity may be strongly influenced by social and cultural factors including, for example, peer pressure and mass media coverage of drug issues.

ENVIRONMENTAL FACTORS

Many theories have been propounded which attempt to relate drug use or misuse to the wider context in which such behaviours take place. A huge body of literature has examined social and cultural factors such as socioeconomic status, poverty, truancy, delinquency and family backgrounds. Some studies have sought to identify factors which are linked with drug use in the general population. Others have attempted to distinguish factors associated with atypical or harmful forms of drug use. As noted above, there is a considerable body of evidence that institutionalized problem drinkers and other problem drug users do exhibit high rates of other ‘problem’ characteristics. The inter-correlation of such problems or types of risky behaviour is central to the material presented in this book and is considered further in Chapter 11.

Socio-economic status/poverty

Patterns of drug use and misuse often v...

Table of contents

• Front Cover
• Half Title
• Title Page
• Dedication
• Copyright
• Contents
• List of figures and tables
• The authors
• Acknowledgements
• Introduction
• 1 The causes of drug use
• 2 Drinking habits
• 3 Smoking habits
• 4 Illicit drug use
• 5 Alcohol misuse
• 6 Tobacco-related harm
• 7 Drug-related harm
• 8 Alcohol, drugs and pregnancy
• 9 Sexual behaviour
• 10 Alcohol, drugs and risky sex
• 11 Risk-takers
• 12 Prevention and harm minimization
• 13 Conclusions
• Bibliography
• Name index
• Subject index