Causes of drug dependence
The cause or causes of drug dependence are not known. More specifically, it is not known why some people but not others in the same situation start experimenting with drugs, or why some, but not others, then continue to take them and, finally, why some but not all become dependent on drugs. When seeking causes it is easy to limit the scenario to that of the local problems which receive so much publicity: poverty, unemployment, breakup of local communities, drug pushers, organized crime and breakdown of parental authority. These often-repeated phrases spring to mind and they may well be contributory factors, as far as the European and North American drug scene is involved, in the ever-increasing number of people abusing or dependent on drugs – but they are not the causes of drug dependence. It must never be forgotten that drug dependence is not a new phenomenon; the use of drugs is probably as old as humankind and dependence has been recognized for thousands of years. It occurs in every culture, and any theory of drug dependence should be sufficiently general to encompass the vast range of dependent behaviour that exists today; for example, the young drug abuser, taking a wide range of drugs; the housewife dependent on benzodiazepines; the adolescent sniffing glue; the Middle Eastern opium smoker; a Jamaican cannabis smoker; the American freebasing cocaine; the Yemeni khat chewer; the mystic seeking truth with LSD; the doctor self-injecting with pethidine, to describe just a few. These many different scenarios of psychoactive drug consumption can be summarized in four categories which are not mutually exclusive: traditional/ cultural, medical/therapeutic, social/recreational and occupational/functional. For example, drug consumption may start with a prescription for a diagnosed condition but may continue illegally; or stimulant drugs, taken initially to promote alertness when studying, may be continued purely for recreational purposes. It is perhaps not surprising, therefore, that there are almost as many theories about dependence and its causes as there are types of dependence behaviour. While recognizing that very different situations may share hidden commonalities, it is fair to comment that many theories seem to say more about the viewpoint of the investigator than about the dependent state they attempt to describe, and as such they are not helpful in getting to grips with the phenomenon of drug dependence. Specifically, although many research studies explore features of personality, family history and environment that occur more or less frequently in those who abuse drugs than in those who do not, any such correlations do not necessarily indicate causality, although a variety of models of drug dependence have been developed that do indeed explain correlative factors in a causal mechanism. Within a diversity of approaches and different models, three factors – the drug, the individual and society – interact to lead to a variety of drug-related behaviours; none of them alone is sufficient to cause drug dependence/abuse and their relative importance varies in different circumstances.
The cause or causes of drug dependence are not known. More specifically, it is not known why some people but not others in the same situation start experimenting with drugs, or why some, but not others, then continue to take them and, finally, why some but not all become dependent on drugs. When seeking causes it is easy to limit the scenario to that of the local problems which receive so much publicity: poverty, unemployment, breakup of local communities, drug pushers, organized crime and breakdown of parental authority. These often-repeated phrases spring to mind and they may well be contributory factors, as far as the European and North American drug scene is involved, in the ever-increasing number of people abusing or dependent on drugs – but they are not the causes of drug dependence. It must never be forgotten that drug dependence is not a new phenomenon; the use of drugs is probably as old as humankind and dependence has been recognized for thousands of years. It occurs in every culture, and any theory of drug dependence should be sufficiently general to encompass the vast range of dependent behaviour that exists today; for example, the young drug abuser, taking a wide range of drugs; the housewife dependent on benzodiazepines; the adolescent sniffing glue; the Middle Eastern opium smoker; a Jamaican cannabis smoker; the American freebasing cocaine; the Yemeni khat chewer; the mystic seeking truth with LSD; the doctor self-injecting with pethidine, to describe just a few. These many different scenarios of psychoactive drug consumption can be summarized in four categories which are not mutually exclusive: traditional/ cultural, medical/therapeutic, social/recreational and occupational/functional. For example, drug consumption may start with a prescription for a diagnosed condition but may continue illegally; or stimulant drugs, taken initially to promote alertness when studying, may be continued purely for recreational purposes. It is perhaps not surprising, therefore, that there are almost as many theories about dependence and its causes as there are types of dependence behaviour. While recognizing that very different situations may share hidden commonalities, it is fair to comment that many theories seem to say more about the viewpoint of the investigator than about the dependent state they attempt to describe, and as such they are not helpful in getting to grips with the phenomenon of drug dependence. Specifically, although many research studies explore features of personality, family history and environment that occur more or less frequently in those who abuse drugs than in those who do not, any such correlations do not necessarily indicate causality, although a variety of models of drug dependence have been developed that do indeed explain correlative factors in a causal mechanism. Within a diversity of approaches and different models, three factors – the drug, the individual and society – interact to lead to a variety of drug-related behaviours; none of them alone is sufficient to cause drug dependence/abuse and their relative importance varies in different circumstances.
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