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Alcohol & Other Drugs

Drugs play only a small part in the story of risk and harm

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Some people struggling with drug use believe the drug itself is the main problem. (They think to themselves, “If this drug didn’t exist, I wouldn’t have a drug problem!”) But drugs aren’t the only factor to consider when trying to understand how and why your drug use is becoming—or has already become—a problem.

The reasons for using a drug powerfully influence a person’s pattern of use and their risk of harmful consequences. If the person’s motive is fleeting (e.g., curiosity), then only occasional or experimental use tends to follow. If the motive is strong and enduring (e.g., a chronic sleep or mental health problem), then more long-lasting and intense substance use may follow. Motives for intense short-term use (e.g., to fit in, have fun or alleviate temporary stress) may result in risky behaviour with high potential for immediate harm (e.g., falls, fights, accidents, sexual assault).

Similarly, the places, times and activities associated with substance use powerfully influence a person’s pattern of use and the likelihood of harm occurring. For example, unsupervised teen drinking is particularly likely to be high risk. Other examples include:

  • Using substances in situations when strong emotion, anxiety or frustration are likely

  • Using substances before or while driving, boating, alpine hiking or any other activity requiring concentration

The overall social and cultural context surrounding drug use is also significant. The economic availability of different drugs is critically important—the cheaper and more available they are, the more likely they are to be used. What is accepted in a community also influences individual behaviour, as does the degree of connection to family, friends and the wider community. In short, places that promote healthy living and offer alcohol-free social events encourage citizens to think and behave in healthy ways.

In addition, a variety of personal factors may affect a person’s chances of engaging in risky substance use. These factors include physical and mental health status (e.g., a person with anxiety or depression may try to feel better by drinking alcohol). Physical, sexual or emotional abuse can contribute directly to risky substance use patterns. There is also evidence that genetic inheritance and personality or temperament may have an impact. For example, tendencies towards sensation seeking increase a person’s risk of harm from substance use.

Finally, certain factors about the drugs influence the risk of harm. All psychoactive substances, whether legal or not, have the potential to cause harm. The key factors in determining risk and harm include the amount used, the frequency of use, the purity of the drug, the mode of use, and the chemical properties of the drug. Alcohol, heroin and other depressants, for example, have elevated risks related to overdose, whereas heavy use of some stimulants can lead to psychotic behaviour. Likewise, injecting concentrated forms of cocaine is much more risky than chewing coca leaves, even though the same drug is involved.


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