CHAPTER 1

How Substance Abuse Starts

There is a debate in this country about how substance abuse begins. In the past, it was believed to be a moral issue. At that time, alcoholics and addicts were seen as morally deficient. This is not the view of clinicians today. Today physicians, psychologists, and counselors identify chemical dependency as a disease. The question still remains, however: why can some people use alcohol or drugs safely while others become chemically dependent? The debate points to heredity or environment, or a combination of these. Many experts theorize that chemical dependency is hereditary. If we examine the background of someone who is alcohol- or drug-dependent, we often see a family history of the illness. One thing is certain: in order to become chemically dependent, an individual must first begin using alcohol or drugs. As mentioned previously, the United States, though comprising only 5-6% of the world's population, consumes three-quarters of all illegal drugs produced in the world! Additionally, Americans are the leading abusers of alcohol and prescription drugs in the world. Why is this?

One environmental theory is based on the fact that American society today over-emphasizes the importance of "feeling good." In our society, if a person doesn't feel well, we reach for substances as a solution. As a result, our society has developed a "pill for every ill" attitude. These "ills," regardless of type or severity, are often being treated with drugs or alcohol. Our "pill-for-every-ill" attitude influences many individuals in our society to believe that a chemical cure is the only solution for any societal problem. (We're not referring here to the appropriate use of medication, as prescribed by a physician or other health care professional, for physical, mental, or emotional disorders, but rather to the abuse of alcohol and drugs.)

As adults, we demonstrate this "pill for every ill' attitude to our children. We may take pills to get started in the morning, to get to sleep at night, to deal with mild pain, or to deal with situational sadness. This vicious cycle of chemical cures is paraded in front of our children on a daily basis. This behavior does not provide a proper example for our children. Today, the morals we teach our children have changed. Unfortunately, the breakdown in discipline of children and the many changes in family structure (such as families where both parents work, single-parenting situations, etc.) have eroded the traditional family structure. It is often replaced with a loose structure, in which children may doubt their parents' authority and values.

Community is another area where society has weakened. Changes in the community have contributed to a breakdown, a lack of respect, in the general moral standards of the past. We live in a society where "anything goes." Often, there are no repercussions when moral standards or laws are broken. Looking at our society, we see gang wars, prostitution, drug trafficking and theft. Many people do not know who their neighbors are and have little concern for them. Children are being taught (by the example of the adults in their lives) to "look the other way," and to avoid confronting important issues.

Drugs are in our children's lives at an early age. Often children face major decisions before they are twelve years old as to whether or not to smoke, drink or use drugs. Because of this, information about alcohol, drugs and appropriate decision making must be presented early by knowledgeable individuals in the school system. This education of our youth should not stop with the school system but should be reinforced in the home, in athletics, in the workplace and in the community.

Childhood and adolescence is a time of tremendous change in a child's life. Teens, in particular, undergo rapid changes in emotions, coinciding with the numerous physiological changes taking place. This is also the age at which a child begins to create his/her own value system. It is very important for parents to understand that substance use by children and teens is a very critical issue. Substance abuse affects a young person's emotional, physical, and moral development. It contributes to emotional immaturity, improper physical development, poor moral standards, an inability to learn and faulty decision making. But we must start setting the right example even before the teen years. For pre-school age children and toddlers, parents should reinforce the concept that medicine is taken only for illnesses or by direction of a physician. Drug education in primary schools is extremely important. Teachers, administrators and parents should all provide educational information to the children and reinforce the consequences associated with substance use.

Substance abuse is on the rise by our adolescents. During the teenage years, experimentation with alcohol and/or drugs is common; this is when most drug problems begin. Most people are unaware that alcohol is classified as a mood-altering drug. Use of alcohol by teenagers often leads to use of other drugs. Experimentation with substances may occur in the home, at school, in social situations or at a stressful time in youngsters' lives. Alcohol and drugs are used on a regular basis by a large percentage of our teenagers, many of whom later become alcoholics or drug addicts. Sadly, we know that some will even die as a result of their substance use.

Today, an alarming number of adolescents are smoking cigarettes. Once they begin using tobacco, marijuana is the logical next step. Over half of adolescents admitted to drug treatment programs are seeking treatment for marijuana addiction. Adolescents who smoke marijuana are 85 times more likely to eventually turn to cocaine and other "hard" drugs, compared to those who have not smoked marijuana. Thus, tobacco, alcohol, and marijuana are known as "gateway" drugs. Use of these "gateway" substances may lead to "harder" drugs, especially for adolescents who are already chemically dependent upon alcohol or marijuana.

Once our children become adults, the cycle doesn't end. As adults, they become part of our nation's workforce. In our corporations today, we see many problems caused by substance abuse. The list is staggering: increased absenteeism and illness, lower productivity, theft, an increased number of accidents and fatalities, greater use of medical benefits, violence, altercations, and lower employee morale are all related to drug and alcohol abuse in the workplace.

To combat experimentation and substance abuse, all aspects of society must join together and provide educational information to our children on the dangers of substance use. We must be good role models. We must provide community support, and encourage effective law-enforcement programs. We must arm our youth with the knowledge they need to make important decisions about alcohol and drug use.

Reasons for Using Substances

People like to feel good. Many experiences in our world are geared toward altered states of consciousness--natural highs. These "natural highs" are derived from many experiences: roller coaster rides, skydiving, white water rafting, dancing, or anything else that can produce an adrenaline rush. Our enjoyment of these sensations begins at an early age. Small children will spin around in circles or scare each other in order to feel this altered state of consciousness. Unfortunately, "artificial highs" from drugs or alcohol are easier to obtain than natural highs, and drugs are readily available to children at an early age. The following seem to be the most common reasons for drug use today.

Parental or Guardian Influence

As seen in the previous section, the "pill for every ill" attitude that is seen in the home has a major impact on children. Approximately 80% of children's values, morals, work ethic and attitude are derived before age 8. A child is exposed to his/her parents for the majority of his/her life before age 8. Therefore, parents will have the greatest influence on their children. A child learns many lifelong habits and attitudes from his/her parents. Unfortunately, in about 80% of cases, a child's first exposure to alcohol and drug use is in the home. Children may see a parent drinking alcohol, popping pills or doing other drugs. Parents may have a liquor cabinet, a steady supply of beer in the refrigerator, or other drugs in the home. The influence of a child's parents cannot be emphasized enough. Parents need to understand this and be proper role models for their children. What is the subliminal programming that is occurring every time a child opens the refrigerator and sees beer? It becomes the norm. We are not saying that parents should never drink beer in the home, but rather that they must assess the role that alcohol plays in their home.

Unfortunately, too, some children are exposed to illegal drugs from the time of their birth. Worse, some are exposed even before birth, if the mother uses during pregnancy. Such babies may be born addicted to drugs (i.e., "crack babies"). Infants may be exposed to drugs in the mother's breast milk or in the home environment. One client in drug treatment described a baby picture of himself, in which a bottle of beer and a marijuana "joint" were photographed with him in his crib. He grew up believing that drug and alcohol use was normal for everyone. He began using at age eight and was chemically dependent and involved in the courts by age 17. Another client in treatment, an adolescent, shared a story of being beaten by her father-for smoking his marijuana. She had the black eye to prove it.

Peer-Group Influence

Most people are aware that during the adolescent years, a person's most influential group is their peer group. When their peers are using substances, teens often feel a need to use them as well, in order to gain acceptance, to be "tight" with their friends. Using substances because "everyone else does" may not seem to be a valid reason to adults, but to high school and junior high students, it is compelling. Failure to join in can cause a teen to become an outcast from the group-the worst fate imaginable to many teenagers. So they will often do whatever it is that their friends are doing so that they can fit in.

Even "good" kids may submit to peer pressure. For many adolescents, using drugs or alcohol can make them feel rebellious, as if they are being independent and carving out their niche in the world. It may also make them feel "grown up". As a person grows older, he/she may decide to continue using or to stop using for many different reasons. He/she may outgrow the peer group influence but may not outgrow the substance involvement.

To Get An Effect or To Get High (Pleasure)

The majority of people using substances do so to get the mood-altering effect or some type of pleasurable sensation. Many available substances will induce a feeling of euphoria. People who use substances for pleasure, who have few problems with their substance use, are often labeled "social" users. These individuals can drink or get high on weekends just to feel good and have no resulting problems. Other persons who get involved in this type of substance use will eventually develop major substance abuse problems. No one can predict before beginning use if he/she will become drug- or alcohol- dependent.

Curiosity and Boredom

Curiosity is the most familiar reason given for first trying a substance. Curiosity is quickly satisfied. Therefore, if the person chooses to continue using the drug, he/she does so for other reasons. With the current availability of many substances, people are aware that if they want to try substances, they can. Young people are naturally curious; they are attracted to new and exciting things. Adolescents want immediate gratification and often don't look at the possible consequences. This also leads them into trying many different drugs, to experiment with the different highs. This need for immediate gratification also allows them to get bored very easily. Obtaining and using illegal drugs is often viewed as exciting or "cool" by adolescents and can take up a large amount of time, thus alleviating their boredom.

Internal Issues

Internal issues correlate with serious substance abuse problems. Internal pressures to use include: stress, low self-worth, depression, anxiety and nervousness. Low self-esteem has been found to be a major factor in an individual's choice to begin using substances. Alcohol and drugs are called mood-altering substances for a reason. Drugs alter (change) the mood (emotions) of the individual. They may either exacerbate an existing problem or create a new one. Many drugs also contribute to additional internal issues, such as depression, anxiety, or low self-esteem. Once again, substances may provide an easy but temporary method of dealing with these internal issues but usually cause additional problems. Often, the user doesn't realize that substance use does not solve problems. When the substance wears off, the problem is still present, and often there are additional problems resulting from the substance use.

External Pressures

An individual may use substances to escape external pressures. These external pressures--situations with which an individual may feel uncomfortable-may include school problems, work difficulties, family problems, peer pressure, relationship issues, etc. If an individual feels upset about a certain situation and gets drunk or high, he/she may feel relief from the problem. This escape, however, will only last for a limited period of time. When the individual is no longer high, the problem will return. Using drugs or alcohol as an escape is only temporarily effective--and very dangerous.

An individual may begin to regularly rely on the drug or alcohol as a coping mechanism. This leads to addiction and produces an individual who has no other coping skills for difficult situations. Often, the use of drugs creates additional external pressures and exacerbates the existing ones. A vicious cycle occurs: the individual uses drugs or alcohol to deal with existing problems and the use causes more problems. The individual then uses more drugs to deal with these new problems. This additional use then causes more problems, which leads to more use. It is a never-ending cycle of use and problems.