The development of substance use - Why do people use legal and illegal substances?

in order to understand substance abuse disorders we first have to understand why people start using substances in the first place and there seem to be four main reasons the first is that substances feel good they can elevate someone's mood or induce euphoria and these are things that people like the second reason is that sometimes people take certain drugs to calm them down so they can help people find a relief from things like anxiety and pain substances can also provide some kind of enhancement so someone might take substances to help them concentrate better at work or to increase alertness so they can stay up all night studying and lastly substances can be involved in important social functions things like peer bonding and other types of social facilitation or even peer pressure and so these four things can help us understand why people start using substances but we also want to know why they keep using substances and we can think about that question as it relates to a number of different psychological theories or psychological models and the first way and maybe the simplest way to talk about this has to do with operant conditioning and all this is really saying is that we are likely to continue to do things that have been rewarded in the past and the simplest way of thinking about this is with positive conditioning so if someone takes a substance it feels really good and so they will want to do it again in the future or maybe they take substances with friends and it produces a very positive social interaction it brings them closer together or gives them a reason to come together and this would reinforce substance use in the future another part of operant conditioning is negative reinforcement and this is slightly more complicated than positive reinforcement so let's say that you have a terrible headache and in a response to that you take a painkiller and that makes the headache go away this is what negative reinforcement is all about it says that something that takes away something bad is likely to be repeated in the future so our person here will probably take a painkiller the next time that they have a headache so negative reinforcement tells us that when an action takes away something bad in our environment that action is likely to be repeated so let's say that we do have someone and maybe they're in a lot of pain they don't just have a headache maybe they just had surgery and so in response to this they take a substance either one that's prescribed by their doctor or maybe one that isn't and when they take that substance it takes away their pain or maybe let's say that someone is getting in trouble at work for falling asleep on the job and so the next time that individual is dozing off maybe they'll take a substance to help keep them awake and because this substance allows them to do a job and because it means that they don't in trouble they're likely to use it when they find themselves dozing off again and as you can tell these models are really simple and I actually think that there's something really nice about that simplicity but maybe because it's so simple this model also leaves a few things out in particular this model seems to ignore all of the negative consequences that can come along with drug use even before it develops into addiction and the fact that this is a problem is actually supported by operant conditioning because it side from saying that behaviors that are rewarding will be repeated operant conditioning also says that actions that have negative consequences are not likely to be repeated and there are a lot of negative consequences that can come along with drug use imprisonment losing friends family losing a job or financial security or your health all of these are very serious things so why should feeling good for a little bit Trump all of the punishments that can come along with drug use one reason for this might be that study is on operant conditioning so that timing is very important the reward of the drug the high is felt immediately or fairly close to immediately but the punishments for drug use the negative consequences probably won't show up until much so let me squeeze the word future in here because it's really future punishments that we're talking about so what we might actually be seeing here is that immediate reinforcers are stronger than future punishments another problem with these models though and really with all of these models is that they're really focused on people's behaviors they're not really taking things like cognition or conscious decision making or individual differences they're not really taking those things into account and honestly those things seem like they would be really important and so I want to shift focus for a minute and talk about some cognitive models for substance use one of these models is called the self-awareness model and this model states that once drug use has started it is maintained because the substance makes us less self-aware over time and it does this by decreasing our negative feedback so for example here we have Tim and Tim has some negative feelings about himself he thinks that he isn't smart or funny or likable and these thoughts might keep him from interacting with people in the way that he wants to or maybe they keep him from going to parties or from meeting new people and so by reducing these thoughts certain substances might make people feel better about themselves which would then reinforce the use of the drug but the problem is that the effects of the substance don't typically end there as well as making someone less self aware substances can also inhibit normal decision-making or they can make people less cautious they can also inhibit memory formation so if someone does something embarrassing while they're on a substance they might not remember it and so substances could lead individuals to be less critical of themselves in general and so they might lose the ability to reflect on how drug use is negatively impacting their lives or the lives of friends and family a similar model is called the tension reduction hypothesis and this theory holds that individuals use substances because they reduce the stress in their lives so let me redraw him and let's say that Tim has a lot of stress in his life maybe he's really stressed out from all of the work he does in college he's worried about his relationship with his significant other and maybe someone he knows is sick maybe his parent is ill and so the tension reduction hypothesis would say that all of these things together would lead tend to use substances as a way to reduce that stress in his life or at least to make him feel less affected by the stress in his life and I think that these two models are useful in figuring out why people might keep using substances but these models break down a bit when we think about their predictions so both of these models both the self-awareness model and the tension reduction hypothesis seem to predict that individuals who would benefit the most from reduce self-awareness or reduce tension they predict that these individuals would be most likely to use and abuse drugs but that doesn't actually seem to be the case it just isn't supported by the research another reason why people might keep using substances after their initial use is because of modeling and we're gonna call this a social learning model and this model says that drinking and drug use are learned behaviors so we know for example that people tend to adjust their level of drinking to match the level of those around them so if someone is in a social group or substance use is normalized as part of social bonding that individual is likely to model the behaviors from that group and I want to take a minute to point out something that these three cognitive models have in common and that is that they all seem to assume at least on some level that people's actions will follow their attitudes so someone wishes to be less self-aware because of negative cognitions and as a result they drink or someone is really stressed out by the things that are going on in their life and so they'll drink to reduce that tension or maybe they see their friends using substances maybe they see their friends drinking at a party and so they want to join in and drink as well and so it seems pretty clear that people's actions do follow their thoughts and beliefs but that might not always be the case we know from years of cycle research that people will often base their attitudes and beliefs on the actions that they perform and not the other way around and this is a theory known as cognitive dissonance so let's say that our guy and we'll say his name is still Tim he's in college and he goes to a party where he sees lots of people who he admires and these people are all drinking and let's say that at this point Tim has never had alcohol before in fact he really doesn't believe in underage drinking but he's at this party and he sees the people who he admires drinking and so he decides that he's just going to have a little bit of beer as well but when Tim finds himself thinking about the situation later he might find himself in a state of cognitive dissonance his stated beliefs that he doesn't think that people who are underage should drink doesn't go along with his actions it doesn't match the fact that he drank at this party and it turns out that as humans we don't really like it when our actions and beliefs don't match up it's kind of uncomfortable and that is what Tim is feeling right now but the thing is is that Tim can't go back in time to change his actions he can't go back and not drink at that party he's already done it and so in order to reduce the dissonance between his beliefs and behaviors he might respond by changing his beliefs which are the only thing that he can change so if someone drinks or uses a substance because of peer pressure or even just peer bonding they might try to deal with the inconsistency in their behavior by deciding that using that substance isn't all that bad they'll address the inconsistency of their actions by deciding that those actions are consistent with their personal beliefs and this opens the door to continued substance use in the future