Why do people use alcohol and other drugs?
People use alcohol and other drugs (AOD) for a variety of reasons: to relax, to function, for enjoyment, to be part of a group, out of curiosity or to avoid physical and/or psychological pain.
Many may also use AOD to cope with problems, relieve stress or overcome boredom while others may experiment out of a sense of curiosity, excitement or rebellion1.
AOD use is influenced by a number of factors but most people use them to feel better or different. They use AOD for the benefits (perceived and/or experienced), not for the potential harm. This applies to both legal and illegal substances.
Some drugs are prescribed by medical practitioners or sold over-the-counter to treat medical conditions.
The vast majority of people who drink alcohol and/or use legal or illegal drugs do not become dependent on any of the substances2.
What drugs are being used in Australia?
The majority of people in Australia drink alcohol (78.3%) with 12% of the population using illicit drugs. Cannabis is the most commonly-used illicit drug (10.2%). A much smaller proportion (2%) use illegal drugs, such as crystal methamphetamine (ice), cocaine and ecstasy, and even smaller misuse inhalants (0.8%).3
Types of AOD use
The list below details some of the different categories of AOD use. People can move between the categories, and one stage will not inevitably lead to another. The majority of people who use AOD do not become dependent or develop serious problems as a result of using them.
Experimental use: a person tries a substance once or twice out of curiosity.
Recreational use: a person chooses to use AOD for enjoyment, particularly to enhance a mood or social occasion. The majority of people use substances for this reason and never develop problems as a result.
Situational use: AOD is used to cope with the demands of particular situations such as responding to peer group pressure, overcoming shyness in a social situation or coping with some form of stress.
Intensive use or 'bingeing': a person intentionally consumes a heavy amount of AOD over a short period of time, which may be hours, days or weeks.
Dependent use: a person becomes dependent on AOD after prolonged or heavy use over time. They feel the need to take the substance consistently in order to feel normal and/or to avoid uncomfortable withdrawal symptoms.
Therapeutic use: a person takes a drug, such as a pharmaceutical, for medicinal purposes.4
Why do people choose certain drugs?
People choose AOD for the specific feelings they get as a result of using them. For example, people may use codeine to relieve pain, drink alcohol to relax and relieve stress, take amphetamines to increase energy or use hallucinogens to alter their perception.5
Using one drug does not necessarily lead people to trying other drugs with research dismissing concerns about so-called 'gateway drugs'. There is no evidence suggesting people who use cannabis will graduate over time to other drugs such as heroin or amphetamines.6
However, a person's AOD use may be influenced by the availability, price and purity of specific drugs. It is worth noting that often it is the combination of such factors that determine which drug a person uses. For example, tougher law enforcement policies combined with lower profit margins made Australia a less attractive option for heroin traffickers, which led to the heroin drought in the early 2000s. Similarly, if supplies of a preferred drug fall (which in turn can significantly increase the price) then people may switch to an alternative drug to satisfy their needs. 7
The feelings people experience when taking a certain drug play a major role in their decision to use it. Some substances might be used for a specific occasion. For example, people often use ecstasy and amphetamines to increase their energy during a dance party.8
Another person may use performance and image enhancing drugs, such as steroids, or cognitive enhancers to improve their performance at work, study or sporting competitions. While others may turn to alcohol and tobacco to relax after work or to combat stress.9,10
Availability can be a major factor determining whether people use a specific drug. The greater the level of supply of a drug in a society, the more likely they are to be used and the more likely people are to experience problems with it11. For example, alcohol is the most commonly-used drug given its widespread availability. Whereas drugs such as heroin and amphetamines are less likely to be used because they are illegal drugs which make them more difficult to obtain.5
Even within the illicit drug market, availability plays a major role. Supplies of heroin and ecstasy have fluctuated in the past two decades for a number of reasons, including stronger law enforcement restricting supplies of the drugs.7,12
Price is also a major influence, which is closely linked with availability. Drugs that are available in high quantities tend to be cheaper to buy, and lower drug prices may result in higher levels of drug consumption and drug-related harm.13,14
The cheaper the price the more likely the drug will appeal to more people. For example, an oversupply of heroin in the 1990s saw prices drop to a historic low, resulting in it becoming the most-commonly injected drug15. Conversely, a dramatic heroin shortage in 2000 saw the price skyrocket from $360 to $1200 per gram in Australia14.
It is also worth noting that the price of one drug can affect the demand for another. If the price rises too high, in some cases people who use a particular drug may seek a cheaper alternative if they can no longer afford their preferred choice.16
The purity of a drug refers to the strength or amount of the active ingredient. While a person's individual perception of purity can be influenced by their tolerance levels and frequency of use, the actual purity of a drug can be impacted by external market forces that affect its availability.
For example, the popularity of ecstasy fell in 2010 when international restrictions on the chemicals needed to make the drug saw its purity levels drop significantly. Although ecstasy demand is on the rise again, many people had already switched to using the synthetic compounds, which had been introduced as a substitute when ecstasy's availability and purity levels had fallen.6
Initial reports suggest the shift around 2013 to the more potent form of crystal methamphetamine (ice) from the more traditional powder methamphetamine form (speed) may be linked to the higher purity of crystal methamphetamine, which means the effects of the drug are much stronger3.
Multiple (poly) drug use
Some people combine different kinds of AOD to increase the intensity of the experience5. They may also combine substances such as alcohol with prescription drugs without thinking about the side effects. They may not be aware of the harms that may be caused when the different drugs interact with each other.16,17
People may also use some drugs to counteract the effects of another drug. For example, people may smoke cannabis to 'come down' from the stimulating effects of amphetamines. However, using one drug after another means the person may suffer the side effects from both drugs.5