2: Why people
use drugs?
Prepared by J. Mabbutt & C. Maynard
NaMO
September 2008
2: Why people use drugs:
Objectives
1.
During the session nurses and midwives will explore why people
use drugs and alcohol and what the models of drug use are
2.
Nurses and midwives will undertake an exercise to challenge and
explore attitudes and opinions regarding drug & alcohol use
3.
By the end of the session nurses and midwives will have a broader
understanding of why people use drugs and alcohol, which will
increase their ability to work with this patient group
2: Why people use drugs
Activity 1 Repugnancy Scale (1)
Handout Repugnancy Scale and ask participants to complete without
discussion (or ask them to score them within this presentation)
Once everyone is finished discuss selections
You may find it useful to do a tally of responses on the whiteboard
Allow 10 minutes minimum
RPA Education Unit CSAHS Powell, Keen & Brown 1994
2: Why people use drugs
Activity 1 Repugnancy Scale (2)
Please rate the following From 1 to 10
1 Being the Most repugnant and 10 Being the Least
Use each number from 1 to 10 only once
2: Why people use drugs
Activity 1 Repugnancy Scale (3)
An overweight man with his family at the beach, sucking on a beer can
A 14 year old smoking a joint with friends at a party
A woman shooting up heroin in the flat with her children
A businessman staggering drunk out of a hotel
A pregnant woman chain smoking
2: Why people use drugs
Activity 1 Repugnancy Scale (4)
A young man shooting up heroin in a public toilet
A woman staggering drunk out of a bar
A middle aged school teacher taking a dose of serepax
(oxazepam) during the lunch break
A 60 year old man with a history of heavy alcohol intake
A 60 year old woman with a history of benzodiazepine use
From Attitudes Module 3 A Teaching Kit for Nurses RPA Education Unit CSAHS
Powell, Keen & Brown 1994 RPA Education Unit CSAHS Powell, Keen & Brown 1994
2: Why people use drugs
Activity 2/Attitude Measurement Scales
Handout the attitude measure scale as an optional activity
See Training Activities section in the CD-Rom for further information
2: Patterns of drug use
dependent
intensive
purposive
experimental
From Commonwealth Government /NCETA 2004 GP Trainers Illicit Drug Issues CD Rom
2: Why people use drugs (1)
People use drug for many reasons
Experimentation as a young person is a normal learning process, this can
include the use of alcohol and drugs
Some people take more risks than others, they may like the appeal of taking
drugs, being in a sub culture, breaking the rules
Peer pressure can play a part, people can use to fit in, to be part of the group
and end up using regularly or suffered major consequences from even one
episode of alcohol or drug use
2: Why people use drugs (2)
Initially the drugs or alcohol can deliver a high to the users or make
them just feel normal
In time they may become tolerant as the drugs stop working as well and
they may need to use more to stay feeling normal and to not experience
withdrawal
The Australian movie Candy had three parts to it: heaven, earth and
hell this is an example of this progression
As the drugs or alcohol stop working, people may change to another
drug to get an effect, this is colloquially known as a drug geographical
2: Why people use drugs (3)
The use of drugs can numb the emotional pain people are feeling
Trauma and related PTSD from many causes may be a reason to
commence and continue to use drugs e.g.
childhood sexual/physical abuse
rape
domestic violence
other life traumas, assault, accidents, losses, relationship
breakup, poverty, unemployment etc.
2: Why people use drugs (4)
Drugs and alcohol are also used for self medicating physical pain
People may move to another town, state, country hoping to leave the problem
behind, often the problem follows them this is called a geographical
Drugs and alcohol are also used by many people with mental health or other
issues as a form of self medication
2: Why people use drugs
Some Models/Theories of Drug use (1)
Moral: people use because they are bad/immoral
Pharmacological: due to the drug/half life/effects etc
The Dopamine Theory of drug reward: due to dopamine rewards effects
via the receptors in the brain
Disease/Biological: having a predisposition/genetic to being an alcoholic
or drug user
Cognitive: due a persons thoughts & beliefs about their drug and alcohol use
2: Why people use drugs
Some Models/Theories of Drug use (2)
Gateway theory: If you use a drug with less powerful effects you are
more at risk to use a drug with more effects
Transtheoretical model (TTM): Stages of change model. People can
move backwards & forwards through the stages
Social learning: the learnt behaviour from others/groups
Public health: due to the individual, the drug, the availability/temptation
to use the drug and the environment
Adapted from Commonwealth Government /NCETA 2004
GP Trainers Illicit Drug Issues CD Rom & West, R. Theory of Addiction. 2006.
2: Treatment success in dependence
Dependence
Success rate %
Alcohol
50 (4070)
Opioid
60 (5080)
Cocaine
55 (5060)
Nicotine
30 (2040)
OBrien, C. & McLellan, A. (1996)
From Commonwealth Government /NCETA 2004
GP Trainers Illicit Drug Issues CD Rom
2: Some medical conditions
Compliance and relapse (<12 months)
Disorder
Compliance & Relapse
IDDM
Medication regimen
< 50%
Diet & foot care
< 30%
Relapse
3050%
Medication regimen
< 30%
Diet
< 30%
Relapse
5060%
Medication regimen
< 30%
Relapse
6080%
Hypertension
Asthma
OBrien, C. & McLellan, A. (1996) From Commonwealth
Government/NCETA 2004 GP Trainers Illicit Drug Issues CD Rom
2: Why people dont seek help (1)
Fear of professional judgment
Poor access to care
Money problems
Services not always designed to meet the needs of culturally
and linguistically diverse people and their families
Fear of being labeled a junkie, addict or alcoholic
2: Why people dont seek help (2)
Fear of lack of confidentiality
Age most drug and alcohol services are unable to address the needs
of people under 16 or people over 60
Gender few services can meet the needs of women and children of
parents who are seeking treatment
Fear of professional consequences professionals with drug and alcohol
problems often fear being recognised and judged
2: Why people use drugs
Myths of drug and alcohol use (1)
It is someone elses problem
Nurses and midwives are in ideal settings to address D&A problems
People who have drug and alcohol problems are hopeless people
most people have jobs, manage households and raise their children
2: Why people use drugs
Myths of drug and alcohol use (2)
Addicts are beyond help
Many people modify their use or move away from D&A dependence
All substance misusers are dependent on drugs
Many people use recreationally, only a small proportion become dependant
