Why do people use?

People use alcohol and other drugs (AOD) for a variety of reasons:

to relax
for enjoyment
to be part of a group
to avoid physical and/or psychological pain
experiment out of a sense of curiosity
excitement
rebellion.¹

They may also be used to:

cope with problems
relieve stress
overcome boredom.

AOD use is influenced by many factors, but most people use substances for the benefits (perceived and/or experienced) - not for the potential harm. This applies to both legal and illegal substances.

No one takes a drug to feel worse.

Most people who drink alcohol and/or use legal or illegal drugs do not become dependent on any of these substances.²

Drugs used in Australia

Most Australians drink alcohol (85.5%) with 15.6% of the population using illicit drugs.
Cannabis is the most commonly-used illicit drug (10.4%).
A much smaller proportion use illegal drugs, such as crystal methamphetamine (ice) (1.4%), cocaine (2.5%) ecstasy (2.2%), and inhalants (1%).³

Prescribed and over-the-counter drugs can also be used for their psychoactive properties. A drug being used off-script, or not for its prescribed medical purpose, is a growing issue in Australia and leads to an increased risk of harms.

Types of use

Drugs are used in different situations and frequencies, and for different reasons, depending on the individual and their specific point in life. People can move between categories, with one stage not inevitably leading to another, and with no clearly defined start or end stage.

Most people who use AOD do not become dependent or develop serious problems as a result.

Experimental use: a person tries a substance once or twice out of curiosity.
Recreational use: a person chooses to use AOD for enjoyment, particularly to enhance a mood or social occasion. Most people use substances for this reason and rarely develop problems as a result.
Situational use: AOD is used to cope with particular situations such as peer group pressure, shyness in a social situation or stress.
Intensive use or 'bingeing': a person intentionally consumes a heavy amount of AOD over a short period, which may be hours, days or weeks.
Dependent use: a person becomes dependent on AOD after prolonged or heavy use over time. They feel the need to keep taking the substance to feel normal and/or to avoid uncomfortable withdrawal symptoms.
Therapeutic use: a person takes a drug, such as a pharmaceutical, for medicinal purposes.⁴

Why do people choose certain drugs?

People choose a particular drug mainly for the specific feelings they get from using it. For example, people may use codeine to relieve pain or drink alcohol to relax and relieve stress. Some people take amphetamines to increase energy or use hallucinogens to alter their perception.⁵

Using one drug doesn’t necessarily lead people to trying other drugs. Research dismisses concerns about so-called 'gateway drugs'.

There is no evidence suggesting people who use cannabis will ‘graduate’ over time to other drugs such as heroin or amphetamines.⁶

A person's AOD use may be influenced by the availability, price and purity of specific drugs. It’s often a combination of factors that determine which drug a person uses. Usually if supplies of a preferred drug fall (which in turn can significantly increase the price) then people may switch to an alternative drug to satisfy their needs.⁷

The feelings people experience when taking a certain drug plays a major role in their decision to use it. Some substances might be used only for specific occasions. For example, people often use ecstasy and amphetamines to increase their energy during a dance party.⁸ Another person may use performance and image enhancing drugs, such as steroids, or cognitive enhancers to improve their performance at work, study or sporting competitions. Others may turn to alcohol and tobacco to relax after work or to combat stress.^9,10

Availability can be a major factor determining whether people use a specific drug. The greater the level of supply of a drug in a society, the more likely it is to be used, and the more likely people are to experience problems with it.¹¹

The widespread availability of alcohol is one of the reasons it is the most commonly-used drugs and creates such significant harms.

Drugs such as heroin and amphetamines are less likely to be used because they are illegal, making them more difficult to obtain.⁵ Even within the illicit drug market, availability plays a major role. Supplies of heroin and ecstasy have fluctuated in the past two decades for a number of reasons, including stronger law enforcement restricting supplies of the drugs.^7,12

Price is also a major influence and is closely linked with availability. Drugs that are available in high quantities tend to be cheaper to buy, and lower drug prices may result in higher levels of drug consumption and drug-related harm.^13,14

The cheaper the price, the more likely it is that the drug will appeal to more people.

For example, an oversupply of heroin in the 1990s saw prices drop to a historic low, resulting in it becoming the most-commonly injected drug¹⁵. Conversely, tougher law enforcement policies combined with lower profit margins made Australia a less attractive option for heroin traffickers, which led to the heroin drought in the early 2000s. This shortage saw the price skyrocket from $360 to $1200 per gram in Australia.¹⁴

The price of one drug can affect the demand for another. If the price rises too high, in some cases people who use a particular drug may seek a cheaper alternative if they can no longer afford their preferred choice.¹⁶

The purity of a drug refers to the strength or amount of the active ingredient. While a person's individual perception of purity can be influenced by their tolerance levels and frequency of use, the actual purity of a drug can be impacted by the external market forces that affect its availability.

For example, the popularity of ecstasy fell in 2010 when international restrictions on the chemicals needed to make the drug saw its purity levels drop significantly. Although ecstasy demand is on the rise again, many people had already switched to using the synthetic compounds, which had been introduced as a substitute when ecstasy's availability and purity levels had fallen.⁶

Initial reports suggest the shift around 2013 to the more potent form of crystal methamphetamine (ice) from the more traditional powder methamphetamine form (speed) may be linked to the higher purity of crystal methamphetamine. This also means the effects of the drug are much stronger.³

Ritter, A., King, T., & Hamilton, M. A. (Eds.). (2013). Drug use in Australian Society. Oxford University Press.
National Council on Alcoholism and Drug Dependence, Inc. (n.d.) Alcohol and Drug Information.
Australian Institute of Health and Welfare. (2016). National Drug Strategy Household Survey detailed report 2015. Canberra: AIHW.
Australian Drug Foundation (2000). Drugs in Focus: Dealing with drug issues for 9 to 14-year-olds. West Melbourne: ADF.
Brands, B., Sproule, B., & Marshman, J. (1998). Drugs and drug abuse. Addiction Research Foundation. Toronto, Canada.
Jadidi, N., & Nakhaee, N. (2014). Etiology of Drug Abuse: A Narrative Analysis. Journal of addiction, 2014.
Degenhardt, L., Reuter, P., Collins, L., & Hall, W. (2005). Evaluating explanations of the Australian ‘heroin shortage’. Addiction, 100(4), 459–469.
Ritter, A., King, T., & Hamilton, M. A. (Eds.). (2004). Drug use in Australia: preventing harm. Oxford University Press.
Urban, K. R., & Gao, W. J. (2014). Performance enhancement at the cost of potential brain plasticity: neural ramifications of nootropic drugs in the healthy developing brain. Frontiers in systems neuroscience, 8.
Wan, W., Weatherburn, D., Wardlaw, G., Sarafidis, V. & Sara, G. (2014). Supply-side reduction policy and drug-related harm.
Gossop, M. (2000). Living with drugs. Ashgate Publishing, Ltd.
Scott, L., & Burns, L. (2011). Has ecstasy peaked? A look at the Australian ecstasy market over the past eight years. EDRS drug trends bulletin, April.
Angell, M. P., Chester, N., Green, D., Somauroo, J., Whyte, G., & George, K. (2012). Anabolic steroids and cardiovascular risk. Sports medicine, 42(2), 119–134.
Degenhardt, L. J., Conroy, E., Gilmour, S., & Hall, W. D. (2005). The effect of a reduction in heroin supply on fatal and non-fatal drug overdoses in New South Wales, Australia. Medical Journal of Australia, 182(1), 20–23.
Jofre-Bonet, M., & Petry, N. M. (2008). Trading apples for oranges?: Results of an experiment on the effects of Heroin and Cocaine price changes on addicts’ polydrug use. Journal of Economic Behavior & Organization, 66(2), 281–311.
Nauert, R. (2015). Alcohol & many medications make a risky mix.
National Institute on Drug Abuse. (2011). Prescription Drugs: Abuse and Addiction.