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R. Lanier Britsch and Terrance
D. Olson, eds., Counseling: A Guide to Helping Others, 2 vols. [Salt Lake
City: Deseret Book Co., 1983-1985], Volume 2 © 2001, Deseret Book, GospeLink
2001, Used by permission
5 Drug Behavior
Brent Q. Hafen and Kathryn J. Frandsen
Seventeen-year-old Greg is exhausted. The school year is drawing to a close,
and he feels a frantic pressure to perform well on exams—after all, he wants
desperately to get the highest grade-point average possible so he can get into
the college of his choice. His dream is to become a lawyer, and he needs all the
help he can get. He thrusts his hand into his pocket; the small capsules he
fingers are his key to mustering the energy to get through the next three weeks.
Robin was functioning on less than three hours of sleep. The twins had spent
a fretful night, and throughout the long hours of the day they had been fussy
and demanding. Between changing diapers and spooning baby food into their
mouths, she has tried to keep the main floor clean and get a good start on
dinner. The guests would be arriving in two hours, and she was hopelessly
behind. Robin headed for the medicine cabinet; she needed something to calm
herself down.
Everything at the office seemed to be caving in, and Bill didn't know which
way to turn. Two of the employees he supervised were causing problems and
demanding too much of his time. With a busy period drawing near, the work was
piling up, and there didn't seem to be enough hours in the day. Right at the
worst time, the boss demanded that he take a few trips—and he knew he'd fall
even further behind. He knew he shouldn't stop in at the club for those drinks
after work each night, but it became so difficult for him to relax at home that
he felt he really needed them.
Greg, Robin, and Bill have something in common—they all have a drug
problem. A person who enjoys an occasional drink with friends doesn't
necessarily have a drug problem; a woman who uses a sleeping aid very
infrequently doesn't have a drug problem. But people who come to depend on drugs
(including alcohol) to help them "get through the day" have a drug
problem.
And it's a problem that's growing rapidly in the United States today.
The Extent of the Drug Problem
Falling under the category of "drug" is a variety of substances
that can sometimes be used legally and that can be obtained with a doctor's
prescription in a pharmacy. Some "drugs of abuse" can even be
purchased over the counter by anyone with the money to do it. Drug abuse doesn't
always involve substances that are bought from a street seller or obtained in
some other illicit way.
In order to understand the extent of the drug problem, it's important to
understand the wide variety of drugs that can be involved.
Depressants
As the name implies, depressants are drugs that depress the central nervous
system—in other words, they slow down circulation, slow down breathing, and
make you sleepy. Common depressants include tranquilizers, like Valium;
barbiturates, like Seconal; alcohol; and methaqualone (Quaalude).
Tranquilizers—such as Valium and Librium—are the most commonly prescribed
drugs in the United States; at one point, Valium was used more frequently than
aspirin by women in this country. Doctors prescribe them to help relax muscles
or to help relieve tension and anxiety. But because they are safe under
controlled conditions, people tend to misuse them—to take them more often or
to take more than prescribed. That's when people get into trouble: they decide
they need the tranquilizer just to cope with the stresses of everyday life.
Barbiturates are much less safe than tranquilizers; doctors use them to
sedate patients in hospitals and to treat insomnia, tension, or anxiety. The
potential for overdose is high: barbiturates can cause loss of memory,
confusion, drowsiness, and even coma. The potential for abuse is also high:
barbiturates cause physical dependence, which means that you have to increase
the dose to get the same effect.
One of the greatest problems with depressant drugs is that people aren't
aware of the danger of mixing them with alcohol. Alcohol is a depressant too,
and when you mix it with another depressant, you can get much more sedation than
you had intended. A frequent cause of overdose is taking Valium and then having
a drink or two.
Stimulants
A second classification of legal drugs is stimulants. The stimulants (such as
nicotine, caffeine, and amphetamines) stimulate the nervous system, making you
nervous, alert, and more active. Some people use them to disguise the effects of
fatigue; others use them to relieve drowsiness.
Some stimulants such as the caffeine in tea, coffee, and cola drinks or the
nicotine in cigarettes—are available without a prescription. Others, such as
amphetamines, usually do require a prescription.
Amphetamines, usually prescribed as diet pills, are also used medically to
treat people with chronic fatigue or to help people overcome mild depression.
Unfortunately, the same thing occurs as with depressants: people who get
stimulants by prescription end up abusing them by taking them more often or in
greater quantities than prescribed. The result is tolerance, psychological
dependence, and exaggerated drug effects—the person can become extremely alert
and active, or he can become angry, suspicious, and irritable.
One stimulant—cocaine—is obtained most often illicitly and is the subject
of growing abuse throughout the country.
Narcotics
Used medically to suppress coughs or to relieve intense pain (generally
following surgery), narcotics such as Demerol, morphine, and codeine—can
produce a feeling of euphoria and are highly addictive. Narcotics are safe when
used under strict medical supervision, but much narcotic use is illicit and
dangerous.
Marijuana
A drug surrounded by controversy, marijuana causes different effects on each
person who uses it; some become relaxed or euphoric, while others become anxious
or panic-stricken. Most often, a user loses a keen perception of time and loses
some short-term memory. Use and sale of marijuana is illegal in all fifty
states, while a few states have decriminalized the possession of a small amount
of marijuana.
Much of the controversy surrounding marijuana is due to the fact that little
is known for sure about its longterm effects; while some argue that marijuana is
harmless, others have made claims about devastating long-term consequences.
Inhalants
Inhalants substances that are sniffed or inhaled—are generally not illegal
themselves, but the practice is. A number of common household items (such as
gasoline, aerosol sprays, cleaning products, or glue) are used as inhalants,
mostly by children. This cuts oxygen off from the brain, resulting in an extreme
"high."
Inhalant use is extremely dangerous; lung and kidney damage is common, and
death can result.
Hallucinogens
None of the hallucinogens (such as LSD or PCP) currently have recognized
medical uses; they are obtained illicitly and have been the subject of intensive
law-enforcement efforts. Hallucinogens affect perceptions—users have a warped
feeling of what is seen, heard, felt, and understood. Some hallucinogens occur
naturally and are derived from plants; some mushrooms are hallucinogenic, as is
peyote (which comes from the peyote cactus). Other hallucinogens, such as
"angel dust" and LSD, are produced in the laboratory.
At the beginning of this decade, the government identified seven drugs that
give particular cause for public concern because of their potential for serious
health problems, the extent to which they are used, or the way in which they are
used.
1. Heroin is of highest concern for two reasons: first, it has an obvious
relationship to crime, and second, it is extremely addictive.
2. Cocaine is of concern because it has come to be associated with
status" it is the drug of the rich and famous. In addition, it is the most
powerfully reinforcing of the illicit drugs, usually creating a strong
addiction.
3. Marijuana has become a major concern because of its rising incidence
of use; while some other drugs are tapering off or even declining in use,
marijuana use continues to increase sharply, especially among the young, and
longterm effects have not yet been established.
4. Inhalants are a cause for serious concern because of their
considerable danger: because they cut off oxygen to the brain, they can cause
sudden death. Another source of concern is the fact that inhalants are so
readily accessible (many are just under the kitchen counter) and are used by
young children.
5. PCP (Phencyclidine), commonly called angel dust, is a cause of concern
for many reasons. First, it is easily manufactured in home laboratories, so it
has the potential of being available in huge quantities; and because it can be
manufactured by relative amateurs, it is also susceptible to dangerous
contamination. More serious, however, is its association with a sizable number
of violent and bizarre deaths, especially among the young.
6. Amphetamines have been of concern since they were first introduced
more than fifty years ago because of their potential for tolerance and
phychological dependence.
7. Barbiturates share the number-one spotlight with heroin because they
are so highly addictive and because they are linked to about 20 percent of
accidental drug deaths.
Today some of the most alarming drug use occurs among high school students—once
not heavily involved in drug use, they now use marijuana, cocaine, amphetamines,
barbiturates, hallucinogens, opiates, and alcohol in growing numbers. Still
another source of concern is among women: the number of women alcoholics has
doubled since the close of World War II, and the rate of women using all kinds
of drugs (legal and illicit) has grown tremendously in the last twenty years.
American society is drug-oriented. We spend more than $30 billion each year
for legal drugs, including over-the-counter medications, chocolate, coffee, tea,
cola drinks, tobacco, and alcohol. One study estimates that you could easily
find at least thirty such substances in any American home—but most Americans
take their legal drug behavior for granted. What's more, most of us would defend
it—we simply don't consider it to be addiction or abuse.
Perhaps it's time to rethink our definitions of-those words. By addiction we
don't mean the skid-row bum who slurps cheap wine in a bleary trance or the
high-school dropout who hovers in a dark room with a heroin needle in hand.
Addiction can refer to anyone who relies on any substance to gain a sense of
well-being: the joint after class, the cup of coffee in the morning, the mild
sleeping pills at the end of a hard day.
Nor does the word abuse apply only to extreme cases. Abuse means using
any substance that is illegal, but it also means using a legal substance in a
situation where it is illegal, using a drug or other substance without medical
approval, or using a substance in excess of the accepted standards for
self-medication.
You are abusing a substance when you can no longer control your behavior or
when you can no longer control your desire for more. You are also abusing a
substance if you use it only to alter your state of mind or to impair
your consciousness.
To put things in a nutshell, there are certain realities about drug use and
abuse that we need to face. People use drugs because they want to feel better;
they keep taking drugs because they derive certain pleasures or rewards from the
drug use. A person won't stop taking a drug until he finds something better—some
more effective way to feel good.
Personality: Who Uses Drugs?
Obviously, not all drug users are alike; they can be as different as the
sixty-eight-year-old woman who abuses the aspirin her physician advised her to
take sporadically and the sixteen-year-old boy who gathers with his friends to
smoke marijuana during lunch hour. But researchers have been able to identify
certain personality traits or characteristics that may make a person more likely
to get involved in drug abuse. Just because a person possesses some of the identified personality traits
does not mean that he will begin abusing drugs; it does mean that
he has traits that may lead to drug abuse.
What does that mean to you? It doesn't mean that you should become alarmed if
your teenage daughter or some teenager you are working with has some of the
traits. It doesn't mean you should jump to conclusions if the woman next door
fits the picture. Nor does it mean that you should panic and resign yourself to
eventual addiction if you recognize them in yourself. What it does mean is that
we can all be more informed about the things that make us act as we do. If you
recognize that your teenage daughter has a number of the traits, for example,
you can begin early to help her learn to change those traits, and, when
possible, you can help her examine alternatives that can fill her needs.
The personality traits that have been identified among drug-addicted people
are almost identical to those shared by others who have addictive problems. This
subject maybe reviewed by turning to page 40 in the previous chapter.
Apart from specific personality traits, the U.S. Department of Health and
Human Services identified four major groups who appear to be at extremely high
risk for drug abuse. Those groups include the following: youth, women, ethnic
and racial minorities, and the elderly.
The Role of the Home and Family
People who come from happy homes and who grow up in well-adjusted families
have much less tendency to use drugs than do people who come from troubled
surroundings.
Adolescence is usually the time when drug behavior begins; the impact of the
home and family is great, and certain home and family situations have been
identified as leading to drug abuse.
The following situations have a tendency to precipitate drug use among family
members:
1. Family relationships as a whole are troubled.
2. One or more family members feel alienated from the others.
3. One family member is strikingly different from the others in appearance,
physical ability, mental aptitude, interests, or behavior.
4. Parents are not involved with and concerned about the children.
5. Parents are overly strict, imposing unrealistic or impossible limits on
children.
6. Parents are domineering, attempting to maintain control over all aspects
of their children's lives.
7. Parents are too permissive, and children are not subject to conventional
rules and guidelines, such as curfew, check-in, and regular hours at home.
8. The family is under an unusual amount of stress, such as the stress that
comes from divorce, terminal illness, death in the family, severe financial
problems, or problems with the law.
9. The parents have an extremely different value system than do the children,
prompting the children to reject the parents' values and to look for an
appropriately dramatic way to express their rebellion.
10. Children have not been provided with an adequate environment to learn how
to develop relationships and share intimacies with other people.
11. A parent constantly tries to render the child helpless and emotionally
dependent in a conscious or subconscious effort to maintain control over him.
12. The parents are unable to accept the fact that the children are growing
up; they continue to treat the children in ways that impede their emotional
development instead of treating them like adults.
13. The family is generally devoid of joy.
14. One or both parents lack the skills to deal with their own problems or
disappointments, and one or more children become scapegoats for the parents'
problems.
15. One or both parents use drugs or alcohol heavily, conveying a message to
the children that drugs or alcohol are to be relied on to help cope with
problems.
16. Someone in the home is suffering from deep depression or from a
depressive disorder.
17. Family members, though obviously part of a group, are lonely; they do not
turn to each other for companionship or emotional satisfaction.
18. The parents do not claim responsibility for the major development of the
children but instead shift responsibility to schools, agencies, the Church, or
social services.
19. Parents isolate children from their peer group, discouraging them from
having friends.
20. The family has no religious beliefs and no church affiliation, leading
the children to seek for a set of values and a form of worship (which can become
drug centered).
21. There is no extended family; children are not privileged to know and
associate with grandparents, aunts, uncles, cousins, and in-laws.
22. The parents are experiencing serious marital problems; they are in a
cycle of divorce and remarriage.
23. Trust is missing from the family.
Why People Turn to Drugs
In general, people turn to drugs to fill a felt need—a need to relieve
anxiety, to grow, to experience adventure, to relieve boredom, to cope with
stress, to escape from problems. When drugs begin to satisfy those needs—or
when a person is simply convinced that they do—the drug behavior is
reinforced. A teenager who turns to drugs to escape his chaotic family
atmosphere finds solace and escape while he is high; the behavior is
reinforcing, and he goes back for more. Before long, he is dependent on the drug
to remove him from his family situation. He is addicted.
As a society, we are taught to turn to drugs and alcohol. According to
critics, television is a major offender situation comedies portray drug and
alcohol use, advertisements for beer proliferate during prime time, and movies
give the subtle message that drugs are a great solution for what ails you.
What Signs Indicate Drug Involvement?
While occasional drug use may escape detection, there are many signs that
enable you to determine whether someone is using drugs regularly. Some of the
signs are physical (such as needle marks on the arms), while others are changes
in behavior. Here are some of these signs:
1. A child who has been content to follow parental guidelines and rules
around the house suddenly becomes unwilling to do so.
2. A child who has been reliable and dependable at home changes; he starts
coming home past curfew, is absent without explanation, or cannot justify other
unusual behavior.
3. A child who has been a good student suddenly starts having trouble in
school, end you can discover no reasonable explanation. You should be
particularly concerned if the trouble involves frequent tardiness, unexplained
absences, inappropriate classroom behavior, or the inability to concentrate in
class,
4. A child who has not needed much money in the past suddenly seems to need
an almost endless supply; traditional allowance is no longer sufficient. You
should pay close attention if your child keeps coming to you for money but you
can't readily see how it is being spent. Some children resort to shoplifting or
theft to finance a drug habit, but many fabricate stories for their parents
about why they need money.
5. You discover evidence of drug use, such as empty liquor bottles, empty
beer cans, syringes, or papers used to roll marijuana. You may even discover the
drug itself.
6. Watch out for a person who suddenly undergoes terrific changes in
interpersonal relationships; anyone can acquire a new friend now and then, but
you should be concerned if your child suddenly seems to abandon most of his old
friends for the sake of a new group of friends.
7. A child, teenager, or adult dresses in a way that is inappropriate for the
weather conditions. A person who wears a long-sleeved shirt consistently
throughout sweltering summer weather may be trying to hide needle marks on his
arms or other evidence of drug use. A person who wears sunglasses indoors or
during periods of darkness maybe trying to hide dilated pupils.
8. A person who is generally calm and able to relate well to other people
suddenly becomes aggressive and hostile.
9. A person who was once active in community affairs, civic organizations,
church groups, or in pursuit of a hobby suddenly loses interest and stops
participating.
10. A person who has been responsible and reliable suddenly becomes less so.
A child stops mowing the lawn on Saturdays, stops doing his homework, or stops
cleaning his room or doing the other tasks that are assigned him at home; an
adult fails to complete assignments at work, forgets important family occasions
(such as birthdays), and doesn't follow through on commitments.
11. A person who has been warm and open suddenly shuts down the channels of
communication.
12. A person undergoes fairly rapid physical deterioration: he loses weight,
becomes slovenly in appearance, fails to groom himself well, or starts to suffer
some of the physical symptoms of drug use trembling, slurred speech, drooling, a
fixed stare, dilated pupils, redness around the eyes, and so on.
13. A person undergoes fairly rapid mental deterioration: he can't think as
quickly, doesn't seem oriented to time or place, loses motivation to achieve, or
seems confused.
14. A person undergoes fairly rapid and extensive personality changes. You
should be concerned about a person who seems to go through extensive personality
changes in a period shorter than one year—especially if the person becomes
moody, angry, hostile, sullen, secretive, apathetic, withdrawn, depressed, or
uncooperative. As a general rule, any sudden and unexplained change in
appearance, personality, behavior, or performance should be watched.
It is difficult to face up to the fact that someone you care about may be
abusing drugs, but you should watch for the signs and face the problem if you
confirm it. A child who was once well behaved and advanced at school may become
a completely different person as a result of drug use: she may lie, shoplift,
steal, stop doing homework, get involved with prostitution, drop out of school
altogether, abandon her old friends, demand more privileges at home, demand
complete privacy, or even attempt suicide. Watch for dramatic changes that you
can't explain.
If you think that you might have a problem with drug abuse yourself, it's
just as important that you confront your own problems. You might think that drug
abuse is a clear-cut situation, but it isn't always that way: drug abuse can
creep up insidiously. The National Institute on Drug Abuse has outlined ten
questions you can ask yourself to determine whether your drug behavior is a
problem:
1. Do you think you might have a drug problem? If you do, chances are that
you are right.
2. Do people who are close to you mention your drug behavior? You might be
abusing drugs if you notice that your mother, wife, or child has begun asking
you questions about how many tranquilizers you are taking or how many drinks
you're having during the day.
3. Do you have to take a pill or have a drink in order to get going in the
morning?
4. When a relative or friend mentions your drug use to you, do you find
yourself getting defensive?
5. Do you find that you really need a few drinks or a couple of pills in
order to fall asleep at night?
6. Have you experienced occasions when you are frightened about the way you
act or the things you do when you are under the influence of drugs or alcohol?
Or, worse yet, do you find that you often can't remember what you did after
having a few drinks or taking a drug?
7. Do you mix alcohol and drugs?
8. Have you ever gone to see a new physician because your regular doctor
refused to give you a prescription for the drugs you wanted?
9. When you get a prescription drug from your doctor or buy an
over-the-counter drug on your doctor's advice, do you take more than he
recommended, or do you take the drug for purposes other than that which your
doctor outlined?
10. When you begin feeling anxious or start getting under pressure, do you
automatically turn to drugs or alcohol? At the first sign of tension or anxiety,
do you take a tranquilizer or have a drink?
What Can Be Done to Help
Researchers generally agree that drug use stems from unmet needs (real or
imagined), and that a person will continue using a drug as long as it helps
fulfill an important need for him. Drug use is not always pleasant or enjoyable
in itself, but it almost always works to reinforce something, or the drug use
would not continue.
In order to help someone get away from drug use, you as a lay counselor have
to help him discover alternative ways of meeting his need. This involves the
difficult first step of identifying the need that has precipitated the
drug behavior in the first place.
Two words of caution are necessary here. First, a person must want to
change his drug behavior before you can help him. You can't simply force an
unwilling person to give up something that has been a source of relief or
pleasure.
Second, you may be able to help a person who has inappropriate drug behavior,
who is experimenting, or who is using drugs to meet unfilled needs. You probably
will not tee successful in helping someone who has developed a strong addiction
to a drug; he will almost certainly require professional help. You should also
be aware that some drug addiction carries with it physical dependence, and that
sudden cessation of drug use can result in severe withdrawal symptoms. In some
cases withdrawal can threaten life, and physicians try to hospitalize a person
so he can be closely monitored and the withdrawal can be gradually accomplished
with safety.
Following are suggestions as to how you can help a person who wants to change
by helping him discover his alternatives:
1. If the drug use appears to be an attempt to relieve stress, try to find
out what the source of stress is. For example, if a young mother feels trapped
at home by her three preschoolers, offer to take her children one or two
mornings a week so she can get out of the house or so she can just have some
private time to herself.
2. If a person feels trapped in a low-paying job or does not feel rewarded at
work, help him explore ways of expanding his skills so he can get a new job.
3. If drug use seems related to boredom, help the person develop some new
interests. You'll probably have to work hard: a person who has suffered
long-term boredom is genuinely convinced that life doesn't have much to offer.
4. If you determine that the drug is being taken to relieve chronic tension,
help the person learn how to perform physical relaxation exercises that can help
relieve physical tension. There are many of them—massaging tension spots in
the neck, massaging the scalp, kneading the feet, and assuming various yoga
postures. Remember, it is much easier just to pop a few pills in your mouth and
swig some water than it is to spend half an hour doing exercises, so it will
take some work to convince a person that the exercises are better. You are also
battling reinforcement: with drugs, gratification is almost instant—with
exercise, it may take longer. Be encouraging, and keep with it.
You might also encourage the person to get more physical exercise, which can
help in many ways. Many people balk at the idea of touching toes and doing
pushups; point out that there are plenty of enjoyable activities, such as
swimming, bicycling, walking, or dancing. Follow through by making participation
feasible—find out if the person needs equipment, transportation, someone to
care for her children, and so on.
5. Encourage the person to seek help from Heavenly Father through prayer,
faith, and hope. Also help the troubled person to attend Church. Service and
association in the Church can do much to overcome drug abuse.
In general, be available to help provide alternatives. Encourage constantly;
drug use and its associated entrapments are discouraging, and a person who is
trying to steer away from drugs needs constant help, love, and reinforcement.
Preventing Drug Use and Abuse
While the suggestions for helping someone get away from drugs are by
necessity limited, there are almost a limitless number of things you can do to
prevent those around you from falling into the trap of drug use to begin with.
The family is the key to preventing drug use and abuse; the home environment
and the family unit are central to the drug use and abuse pattern. Try the
following in your own home as you relate with family members, and encourage
other parents to do the same:
1. Develop a nurturing atmosphere in the home.
2. Show respect to each family member, whether three years old or
twenty-five.
3. Take time to be aware of your family's lives.
4. Build friendships with your children.
5. Spend time with your family.
6. Encourage family members to communicate clearly and honestly.
7. Carefully define reasonable limits within the family, and let family
members know that they are trusted and expected to comply.
8. Set aside time that your family can use for fun activities together.
9. Help your children build their skills and expand their abilities by
providing opportunities for them.
10. When problems arise in the family, take a rational, problem-solving
approach.
11. Set up a regular time for a family conference or meeting where each
family member can discuss concerns and help set goals for the family.
12. Help your children learn how to make choices when they are very young.
13. Help your children learn how to be good friends— with each other and
with others outside the family.
14. Help your children develop appropriate values.
15. Help your children feel valuable to the family by giving each one
something significant to do.
16. Recognize the need for adolescents to become independent; independence is
not an attack on you, but should be an exciting experience for them.
17. Allow your children to have different opinions than you do.
18. When you impose limits on your children, be willing to discuss the
reasons why.
19. If you don't understand what's going on with your adolescent, don't be
afraid to ask questions.
20. Allow your children to have privacy.
21. If you suspect that your child might be using drugs, resist the
temptation to go on a search-and-destroy mission in his room. Instead, confront
him privately.
22. Examine your own drug behavior.
23. If you do discover that your child is using drugs, confront the child
openly and be honest about your feelings. Emphasize the child's worth, and
separate your disappointment about the behavior from your disappointment in him
as a person.
In conclusion, build an atmosphere of love, respect, and trust in the home.
Set limits for your children but be flexible and reasonable. Respect their
growing need for independence, but help them understand that you still care
about them and want them to be happy.
Parents must spend time with their children and make them feel a valuable and
worthwhile part of the family. By helping children establish a firm value system
and a good sense of self-worth, you are helping them gain the skills they need
to make responsible decisions about drug use in the future.
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