Why people use substances

• Starting: People start using alcohol or drugs for a wide range of reasons – none of which are specific to substance users. It is extremely important that we recognise that nobody starts using substances intending to develop problems. Drug and alcohol problems carry with them shame, stigma and a judgemental and intolerant attitude from most sections of society. However, people start using alcohol, licit and illicit drugs some of the following reasons:

  • to experience something new
  • to take a risk
  • to feel better
  • to escape emotional or psychological pain or stress
  • to rebel, fit in, or to forget work/home/problems
  • for medical purposes
  • to celebrate or commiserate
  • to conform with cultural norms
  • and to have fun!
    
    
• Continuing: If the effects of using substances were all negative, as some anti-drug campaigns have suggested, few people would continue. It has to be accepted and acknowledged by everyone working with substance users that there are also good effects from using substances, however short or long term these are. Pretending there isn’t a positive side to substance use is ignoring the obvious and will only demonstrate to the substance user your ignorance about the effects of substance use. Often people continue to use alcohol or drugs for the same reasons listed above. In addition, however, people will continue their use because withdrawal from the substances can be painful, both physically and emotionally, and the substance has become a crutch for them to lean on. (Don’t remove the crutch unless you/they can replace it with something else!) They may also have a partner who is using substances and/or their circle of friends and relationships may be built on alcohol or drug use as a common factor. For people whose lives may be stressful, unpredictable or unstable in some way, alcohol or drugs may be the one constant in their lives they can rely on.
  
  
• Stopping or reducing: The important thing to remember about people who want to stop or reduce their substance use is that most people will be ambivalent about stopping because of the real or perceived positive effects. They may feel rather exposed without the protective veneer of the effects of the substance, eg think about the sober reality of the woman who is drinking to cope with domestic abuse or the man who is using drugs to escape trauma of childhood sexual abuse. Good brief intervention will explore the costs and benefits of the person continuing their substance use set against the costs and benefits of stopping or reducing the substance use. It is also difficult to stop and people may try many times before succeeding however determined they are to stop. Stopping or reducing use is not just about having the will power. It is about having alternatives to drinking or using that the individual feels are achievable and have some benefit to them. Stopping or reducing substance use will also often require medical supervision, particularly for people whose substance use has continued for some time and/or for those experiencing physical and mental ill effects as a result of their continued use
  
  
Links between social work and substance use - introduction | Extent of substance use
The social worker's role | Barriers to good practice and how to overcome them
Frequently asked questions | Examples of good practice