Life-style and drug use habits among secondary school students
Author: A. CALAFAT FAR,, M. AMENGUAL MUNAR,, C. FARRES SNELDERS, A. PALMER POL
Pages: 113 to 123
Creation Date: 1985/01/01
M. AMENGUAL MUNAR,
C. FARRES SNELDERS
Drug Abuse Information and Prevention Centre, Health Commission, Insular Council of Mallorca, Palma de Mallorca A. PALMER POL Computer Centre of the Polytechnical University of Cataluna, Barcelona, Spain
Four groups of respondents - non-users, users of psychoactive sub stances, users of legal substances and users of illegal substances categorized on the basis of a survey of a representative sample of 3,690 secondary school students on the island of Mallorca, were correlated with 13 psycho-social variables, the results of which showed distinct characteristics for each of the four categories of respondents. Between two poles consisting of non-users and users of illegal substances, there is a category of users of legal substances, while all three categories form a continuum from one end to the other. This continuum supports the view that drug abuse is a sequential learning process that leads from simple drug use to drug addiction.
The authors believe that it is essential to identify characteristics of specific groups among secondary school students in order to implement a realistic and effective drug abuse prevention programme in a given school. A prevention programme should meet the needs of the target group; this study identifies such needs and shows how they can be assessed. Many drug abuse prevention programmes in schools have been ineffective because they have failed to respond to the realistic requirement of specific school groups.
There is extensive literature on the personality characteristics of drug addicts. While not discounting the role of personality characteristics in the dynamics leading to addiction, it is recognized that there is no such thing as a typical addict personality. The difficulty arises when an effort is made to apply theoretical conclusions relating to personality characteristics to the work of drug abuse prevention, since it is often difficult to distinguish between a cause and a consequence of drug addiction.
When the abuse of a specific drug first takes root in a society, it is possible that such abuse may primarily appeal to a particular social stratum or that it may be most readily adopted by persons sharing specific characteristics, a circumstance that makes it easier to describe these initial drug users by defining them in terms of a stereotype. At present, because of the increasing spread of the phenomenon, the increase in the rates of multiple drug abuse, early first drug use and other circumstances, the classic indicators, such as sex and social status, are becoming less significant as the need arises to seek other factors of more immediate causality (such as the ease of acquisition of the drug, drug using friends or family members, pro drug attitudes, previous experiences with drug use and relationships with authority figures), on the understanding that none of these variables alone can provide the ultimate explanation. These factors, together with others, come into play with varying degrees of force at different stages in the user's learning process, a process which eventually leads to drug addiction. A better understanding of these factors, making them a part of a causal hypothesis, can facilitate planning for drug abuse prevention.
The authors accept as an operating premise Rounsaville's [ l] classification regarding three modalities or pathways to opiate addiction. The first pathway is pursued by those persons who during their childhood were the victims of major personal conflicts, i. e. young men and women who dealt with serious individual problems before they had any contact with drugs. Secondly, there are youths who have had a background of crime prior to Contact with drugs and for whom the use of narcotics represents a continuation of this background. In the third modality are young persons, well integrated within their settings and with no previous history of personality disturbances or crime, whose first problems stem from drug contact. The population that is the subject of the present study coincides precisely with this third modality, consisting of secondary school students who generally behave in accordance with social expectations. The authors have adopted such a three-group classification to make it clear from the outset that this study is regarded as valid if taken to refer to the process of learning about the use of drugs by these young persons who, specifically, are not impaired by significant prior personality conflicts and who, by comparison, accounted for 45 per cent of the total in Rounsaville's drug addict sample.
This study is not based on a survey of drug addicts ; instead, the focus of attention in this study is on students, a fair number of whom are non-users of drugs, together with others who are occasional and in some instances daily users of drugs. .
It is necessary to postulate a continuum in drug consumption, which ranges from simple drug use to drug addiction. Epidemiological findings do not support a concept of alcoholic disease based on bi-modality that implies the existence within the population of one group of normal drinkers and another of alcoholics [ 2] , [ 3] . Studies in various populations have found that the distribution of alcohol use is graphically expressed by a variety that characterizes the normal distribution curve and that the overall increase in alcohol Consumption within a population bears a correlation to the increase in the number of alcoholics. In their own study [ 4] the authors have shown how the extent of use of alcohol, tobacco, cannabis and other psychoactive substances [ 4] is directly related to the number of years of consumption. This indicates that the degree of use depends to a large extent on a learning process and that, although it is true that many persons will continue to be non-addictive users, the number of persons who will ultimately become addicted to a given drug depends on the earliness of its first use [ 5] and on its overall consumption [ 6] .
Another question that must be raised is the interaction that is involved in the use of more than one drug. It is a common Clinical experience that addicts are heavy consumers of more than one drug: almost all alcoholics are tobacco smokers and heroin addicts usually abuse alcohol and other psychoactive substances. Among adolescent users, too, there is significant evidence that the use of one drug helps to open the way to the use of another [ 4] , [ 7] . There are two principal ways of interpreting the fact that the use of one drug is significantly related to the use of others : either the learning process accompanying the use of one drug prepares and predisposes the individual to the use of others, or what is acquired through the consumption of a drug is a kind of general drug-use capacity so that it becomes merely a matter of social convenience whether one substance or another is used. It may be that in actual practice there is an overlapping of these two ways.
The intention of this introductory section is to define the focus of the present article. The aim is to establish the following premises :
The available information on the personality of drug addicts must be used with caution when designing primary prevention programmes ;
There is a continuum between first-time use and future heavy use, apart from the question why all drug users do not ultimately become addicts ;
Intervention during the initial phases of drug use as part of a preventive policy is justified and should be regarded as a priority task ;
Drug abuse prevention will not be effective unless consideration is given to the specific characteristics involved in the development of the consumption habit.
The discussion that follows is intended to contribute to a typology of the users and non-users of legal and illegal drugs within a student population and, in this way, to help shed light on how the drug use habit takes root in individuals undisturbed by major problems, such as affective and criminal problems, in their personal lives.
This study was based on the results obtained during the months of February and July 1981 from an extensive anonymous survey of a sample of 3,690 students, representing all students of Mallorca's secondary educational institutions [ 4] , [ 8] .
The sample covered 15,410 students distributed in 34 educational centres ; its confidence factor was 99.7 per cent with a maximum error of less than + 2.5 per cent. The age of the surveyed students was between 14 and 18. Approximately one half were males and one half females ; their average consumption totalled 8.63 litres of pure alcohol a year, 25 tobacco cigarettes a week and 0.29 cannabis cigarettes a week ; 75 per cent of the students drank on a daily basis or during weekends, 67 per cent smoked tobacco daily or occasionally, 29 per cent had tried cannabis at least once and l .5 per cent had experimented with narcotic drugs. The average age at first use was 9.6 for alcohol, l 1 .9 for tobacco, 15.4 for cannabis and 15.2 for narcotic drugs.
The respondents were first classified into two groups : non-users and users of psychoactive substances. The user group included the users of legal substances such as alcohol and tobacco, and the users of illegal substances such as cannabis. The non-user group consisted of those persons who had never drunk or had done so only on very rare occasions, who had never smoked or had done so only once, and who had never experimented with illegal drugs. This group comprised 482 students. The user group comprised 2,987 students. For 221 respondents there were no data on drug use.
The user group was further divided into two groups : users of legal substances and users of illegal substances. Each of these four groups was correlated with 13 psycho-social variables, 1 which made it possible to Characterize each of the four groups of respondents and to make the distinction between them in terms of their differences and similarities. The characteristics of each of the four groups of respondents are described below.
1 The following variables were correlated: (l) information sources used to obtain knowledge about drugs: (2) ways of spending leisure time: (3) practising or not practising religion:(4) success or failure in the last year school examinations; (5) quality of the relationship with the father; (6) quality of the relationship with the mother; (7) political preference for majority or minority parties; (8)reasons why people take drugs; (9)reasons why people do not take drugs:(10)attitudes towards drugs and drug use; (l 1)readiness to accept or reject drugs if they are offered:(12) frequency of the use of medicine by the father; (13) frequency of the use of medicine by the mother.
The non-user group, which consisted of students who did not use psychoactive substances, tended to rely on information on the communication media or on their parents and teachers ; if offered drugs at a gathering or party they would refuse to accept them or would feel uncomfortable about the offer; they usually spent leisure time doing sports, watching television or helping at home ; if offered drugs by anyone they would refuse ; they usually passed all their examinations in June, practised religion and defined their relationship vis-a-vistheir parents as one of dependence; their parents did not normally take medicine ; non-users believed that young people should not take drugs since there were other things that should appeal more to them ; they believed that drug use began as a result of thoughtlessness and that over time, such use became addictive; in terms of their political preferences, they leaned towards the majority parties.
These variables characterized the non-drug user population among secondary school students. These were adolescents of rather traditional background and ideologies, with good relationships with their parents and teachers ; they were not very active socially - their social activities took place primarily at public gatherings ; their ideas and opinions were clearly "anti-drug" in nature ; they tended to do well at school, accepted the point of view of adults and seemed to be less psychologically and socially dependent on their peers than were the respondents from the drug user group. On the basis of these data, the zero drug use option among the members of the nonuser group may be understood as being due both to the anti-drug attitudes they articulated and to the fact that they visited places where drugs are supplied, such as parties, bars and discotheques, less often. They were less inclined to use drugs because they were less dependent on their peers, which consequently made them less vulnerable to peer group pressure. Consideration must also be given to the example set by their parents in terms of non-drug use, which together with the variables described above are mutually reinforcing.
The drug-user group consisted of abusers of both legal and illegal substances. Students in this group acquired drug information from their companions ; they spent their free time at such places as bars, discotheques and clubs, and if anyone offered them drugs, they would not feel disturbed or afraid to accept them ; they usually practised no religion ; and their political preferences tended to lean towards the minority parties ; in many cases, they had dropped out of some study programme and defined their relationship vis-a-vistheir parents as one of rebellion; they viewed their parents as consumers of medicine. Some of them believed that they would have difficulty refusing drugs at parties if everyone else were taking them, while others believed that drug consumption was a question of fashion ; still others took the view that they had no need for drugs although others use them ; they believed that people resorted to drugs for the associated feelings of pleasure and in order to escape periods of boredom. If they did not use drugs, they explained that the reason for it was the fact that the drug was not available in their circles.
As is evident, the typical portrait of the user group differed considerably from that of the non-user group. The students in this group exhibited greater dependence on their peers, from whom they obtained information and with whom they spent their leisure time, so that it would be difficult for them to refuse drugs if everyone else were taking them ; they had poorer relationships with adults, especially parents and teachers. Their habits were less conventional ; they were not religiously observant and would vote for minority political parties. They were poorer students and were more adventurous; they would be unafraid to buy drugs, and they believed that persons refrained from drug use because of a fear of new experiences ; they tended to overestimate their capacity for control, believing that they had no need to take drugs although others did. The findings showed a clear tendency towards hedonism or a perception of the positive aspects of drug-taking ("people use drugs for the pleasant feelings they produce or in order to avoid boredom"). In general, these were the sons and daughters of parents who normally used medicine.
The pathways to drug use for this group may have been their greater access to supplies due to their more active social life, as well as in their heightened group dependency and thus greater vulnerability to "peer group pressure", or in a need to experience new sensations, coupled with an underestimation of their own limitations. Other possibilities may have been the drug-using example set by their parents, and the need to Compensate for their low academic achievement through other activities.
The user group was further divided into two groups : the users of legal substances and the users of illegal substances. The focus of interest at this point was on the inquiry into the existence of significant differences and similarities between the users of legal and illegal substances. For this purpose these two new groups were matched against the 13 psycho-social variables that were correlated with the user and non-user groups.
The users of legal substances set themselves off in a curious way from the general drug user group in which they were originally included, adopting for their own definition, the characteristics of the non-users, except for three replies found to be typical of the users of legal substances. 2 It should be noted that, apart from these three replies, the legal drug user group scored lower in the variables that most specifically defined the non-user group.
The users of illegal substances preserved virtually all the characteristics of the user group, while adding certain new ones that indicated an accentuation of tendencies already noted for that group : the members of this group were even more hedonistically inclined, exhibited greater peer group dependence, sought new adventures, and cited, together with other replies, such explanations as "the drug user takes drugs because it's the only thing that gives him satisfaction", "the reason some persons don't take drugs is because they haven't yet considered this option" and "I would not buy drugs because I prefer to spend my money on other things". These replies suggest two explanations : either these persons were consciously saying what was happening precisely to themselves or, more probably, by using a defence mechanism they were referring to behaviour which they attributed to others, failing to realize that it was a precise reflection of what was in fact their own experience. The authors are inclined to accept this last explanation for the reason that these respondents were precisely the same young people who freely admitted at other points in the survey that they were the heaviest drug users and who in turn selected as their reply the point that they preferred to spend their money on things other than drugs.
The next level of analysis was intended to establish the similarities and differences between the non-users and users of legal substances. It was found that the users of legal substances preserved all the characteristics of the nonuser group, with the addition of one that appeared only in the legal user group and two others that appeared both in the legal user group and in the user group of all psychoactive substances, but not in the group of users of illegal substances. It is likely that these last two replies, although appearing to be typical of the group of users of all psychoactive substances, are more specifically characteristic of the legal users. Since the legal users represent the most numerous group (2,025 students), they impose the presence of these two Characteristics in the broader groups of which they are a part.
Ultimately, the situation was as follows : the group of users of illegal substances had its own characteristics that separated it from the group of legal users. The latter represented a less defined group. It should be stressed that the legal user group represented by far the most numerous group so that
2The three replies were: (l) people who take drugs have often been induced to do so by unscrupulous individuals: (2) people do not use drugs because the hazards involved in such use outweigh any possible benefits : (3) respondents thought that if they happened to be with friends or at a party they would not accept using drugs even though others would do so. it covered more easily a broad spectrum of individual behaviour. This factor contributed to its functioning as a kind of bridge between the non-users and the users of illegal substances, resulting in a continuum between the groups.
This study confirms the assumption that drug users differ significantly from non-users. The study identified a number of characteristics that distinguish the users of legal substances from those who have already taken the first steps towards the use of illegal substances. It is believed that the characteristics ascribed to each of the groups have sufficient intercoherence to make it possible to speak of a common internal logic and to discount the view that these are merely a series of variables juxtaposed as the result of disparate or random circumstances.
A global comparison of the results of this study with those reported by other authors seems to be impossible because of differences in the methodologies used. Nevertheless, the findings of this study corroborate in certain respects with the findings reported by certain other authors. A number of authors [ 9] - [ 11] have associated a more active social role with the use of tobacco or alcohol. Similarly, rebellious attitudes or poor relationships with authority figures have been cited by a number of authors [ 9] , [ 11] , [ 12] as factors promoting the greater use of tobacco and alcohol. Poor scholastic achievement has also been associated with the use of psychoactive substances, [ 13] as has religious indifference [ 14] , [ 15] . Certain studies [ 9] , [ 16] , [ 17] have also pointed to the influence of peers and of parents' drug use on the initiation of drug use [ 9] , [ 18] , [ 19] . The findings of the present study concerning the use of more than one drug corroborates with reports by other authors [ 7] , [ 20] - [ 22] .
This study has not inquired directly into the psychological or personality-related aspects of drug use, although it is believed that a number of the findings reported in this article may help in guiding research oriented towards more strictly psychological approaches. Since the work on prevention of drug abuse in the school, except for crisis intervention, is a task that is carried out with the entire population of a given school, the authors believe that the typology suggested by this study can adequately contribute to the planning of preventive programmes.
Although there are connections between the characteristics of the drug addict and of the occasional user, the differences are also important, so that care must be exercised when using the results of studies of drug addicts for preventive purposes. The school population is not a homogeneous whole, as there are significant differences between the users and non-users of drugs, in a pattern characterized by the establishment of two poles represented by the non-users and the users of illegal substances. A group that consists of the users of legal substances, with characteristics of its own, forms a bridge between the two Categories : the non-users of drugs and the users of illegal substances. A knowledge of these groups is necessary, and the findings of this study support the following statement of the World Health Organization : "The identification of persons and groups particularly exposed to drug dependence makes it possible to formulate increasingly effective preventive strategies" [ 16] .
It is difficult to attribute a single causality to the characteristics typical of each group ; in describing the results obtained by this study, it is hypothesized that various factors may mutually reinforce each other in their effects. Included among these factors are the following : greater or lesser peer group dependence coupled with an attitude of rebelliousness towards parents ; social life-style as a factor influencing the number of drug opportunities ; parental example in the consumption of medicine, tobacco and alcohol and the presence of a conformist outlook. Whatever the most likely hypothesis, the consumption learning process must be understood as a sequential process in which the possible causes will be differently weighted according to age, social situation and other circumstances. Regarding this sequential aspect of the learning process, the present study says very little, even if it has demonstrated that there are in fact specific stages at which the use of psychoactive substances may be initiated with particular ease ; one such stage is the transition from primary to secondary school education. It is believed that the findings of the present study will contribute to a greater understanding of these early stages in the establishment of drug use habits ; it is hoped that this will prove useful to individuals interested in formulating realistic policies in the area of drug abuse prevention in schools.
This study has demonstrated that there exists a certain polarization among students with respect to life-styles offering different opportunities for the use of psychoactive substances. Accordingly, the focus in any prevention programme should be on a particular target group of a school population rather than on the student body as a single homogeneous group. It is to be expected that different results will be obtained in different target groups, and the programme should be prepared to meet the needs of these groups. It is possible that the reasons for the poor effectiveness of many drug abuse prevention programmes in schools can be found in the failure of these programmes to accommodate themselves to the realistic requirements of specific groups existing in a given school.
It is also believed that the personal life-style of certain students, which predisposes them to drug use, reinforces the idea of the need for prevention during the initial phases of consumption, since it is logical to assume that once drug abuse has taken root, it is much more difficult to prevent an escalation of abuse in those students whose life-styles predispose them to such abuse. Often the type of drug used depends solely on the ease with which it can be obtained. In addition, those more predisposed students, whose drug use and life-styles are attractive to others, encourage other students to become involved with drugs.
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