Why do adolescents use drugs?

Several authors have attempted to explain drug use debut in teenagers. Petraitis, Flay, and Miller (1995) proposed a conceptual model that includes three kinds of influences: (1) cultural and attitudinal, such as public policy and social values; (2) social and interpersonal, including social influences, family beliefs and relationships; and (3) individual baggage, including temperament and confrontation skills. They also suggested that three levels can be identified within each: proximal, distal, and distant. They recognized, however, that even though the model is conceptually clear, there has not been enough research to identify other influences underlying drug use debut. In another related study, Castro-Sarinana (2001) identified 50 factors related to teenage drug use. He classified them into three groups using an epidemiological model: (1) predisposing environment, including type of family, demography, and social environment; (2) the drug itself (as an agent), including use and access, among other factors; and (3) individual (host), including sociodemography and personal biography. Other reports have identified such factors as easy access to a drug, drug users among family or friends, peer approval, a perception of low risk, and unpleasant mood state as being linked to drug use (Medina-Mora, Villatoro, Lopez, Berenzon, Carreno, & Juarez, 1995). Additional associated factors include domestic violence, drug use by relatives, and sexual abuse (SanchezHuezca, Guisa-Cruz, Ortiz-Encinas, & de Leon Pantoja, 2002).

In a qualitative study, Nuno-Gutierrez and Flores-Palacios (2004), noted that one of the central perceptions underlying teenage drug is that they do not see it as a problem, and believe that "nothing wrong is going to happen." This perception seems to be learned from a family member. The adolescent addict also believes that s/he is stronger than others.

Some reports indicate school-related factors, such as academic failure (Bryant, Schulenberg, Bachman, O'Malley, & Johnston, 2000; Bryant & Zimmerman, 2002; Bryant, Schulenberg, Bachman, O'Malley, & Johnston, 2003; Luthar & Crushing, 1997), absenteeism, peer drug use, and psychological distress as being linked to teenage drug use (Dryfoos, 1990; Hawkins, Catalano, & Miller, 1992; Newcomb, Abbot, Catalano, Hawkins, Battin-Pearson, & Hill, 2002; Newcomb, & Bentler, 1989). Further, teenagers who engaged in misconduct and had low school performance scores had higher tobacco, alcohol and marijuana use levels (Brook, Whiteman, Gordon, & Cohen, 1986; Bryan & Zimmerman, 2002; Hawkins & Weiss, 1985; Roeser, Eccles, & Fredman-Doan, 1999; Sanchez-Huezca et al., 2002; Smith & Fogg, 1978; Voelk & Frone, 2000). This finding is supported by a number of reports showing that teenagers with more motivation and interest in school, more positive attitudes, defined academic goals, and higher self-esteem also have a lower risk for drug use (Bachman, Johnston, & O'Malley, 1981; Schulenberg, Bachman, O'Maley, & Johnston, 1994).

Adolescent drug abuse is also linked to such family factors as faulty and triangulated communication (Klein, Forehand, Armistead, & Long, 1997), multiproblem families (Sokol, Dunham, & Zimmerman, 1997), inter-parental conflict (Klein et al., 1997), parent-child conflict (Klein et al., 1997; Sokol et al., 1997), intergenerational alliances and coalitions (Graham, 1996; Sanchez-Huezca et al., Strauss et al., 1994), addiction-perpetuating family patterns (Tomori, 1994), affection-deprived family environment (Voelkl et al., 2000), ineffective problem-solving patterns (Klein et al., 1997, Sokol et al., 1997), low familial satisfaction levels (Choquet, Kovess, & Poutignat, 1993; Yeh et al., 1995), family perceptions oriented toward negative aspects (Anderson & Henry, 1994; Denton & Kampfe, 1994; Foxcroft & Lowe, 1995), family disintegration

(Hagell & Newburn, 1996), type of religious practice (Foshee & Hollinger, 1996), and low levels of parental monitoring (Hawkins et al., 1992).

Apparently, the main risk and preventative factors for drug use debut have been identified in the literature. These do not, however, include the common sense explanations by the teenagers themselves. Common sense explanations form part of the Social Representations Theory (SRT) of Moscovici (1979), who proposes the existence of two knowledge universes: a reified one consisting of scientific knowledge, and a consensual one consisting of common sense explanations. Reified knowledge is excluding because not all people have the abilities needed to form part of it, and only those who have acquired certain skills can effectively access and add to it. The consensual knowledge universe, in contrast, is the space encompassing the common sense explanations produced by the collectivity in an attempt to explain their daily experience (Moscovici, 1979; Moscovici & Vignaux, 2001). People have no need to be scientists to transmit ideas and build theories. People transmit their ideas about knowledge by communicating, for which they require no specific expertise; they express their beliefs, thus adopting the role of amateur psychologists, medical doctors or researchers (Moscovici, 1979).

Given that the phenomenon of teenage drug use debut is rooted in common sense, a study was done to build and analyze the common sense model used by a group of teenager illicit drug users under rehabilitation at Youth Integration Centers (Centros de Integracion Juvenil-CIJs) in the city of Guadalajara, Mexico.

METHOD

Using SRT, this study was designed to be interpretative-analytical, with a quantitative-qualitative analysis level (Borgatti, 1996) done in three crosssectional phases. The study population consisted of teenagers (mean age 16.3 years; limits 13-19; 56% males) who were multi-drug users (30% cocaine, 25% marijuana, 14% chemical solvents, 9% hypnotics, 2% hallucinogens) during at least one month before the study began. They had been drug addicts for 2 to 6 years, and 20% had had previous treatment for their dependence in selfhelp groups or other treatment methods. In response to a high loss rate (20%) in a pilot study, all participating subjects entered the study by invitation when beginning treatment. Most of them lived in marginal urban neighborhoods. A background of alcohol abuse by male family members was present for 90% of the subjects, and 72% noted drug abuse by some family member. Substance abuse (98%), friend relationships (98%), family relationships (82%), education level (70%) and mental health were the factors associated with drug use based on the POSIT scale (Marinio, GonzalezForteza, Andrade, & Medina-Mora, 1998). Problem levels were higher for female than for male subjects, specifically for the family relationships, mental health, and criminal behavior items.

Sample size was calculated using a classic equation. The sample size required for the proportion estimation was 69 subjects, using a 10% precision level and a 30% expected proportion for the studied features (Garcia-Nunez, 1972). However, nine subjects left the study before it was completed, reducing final sample size to 60 subjects.

Phase 1: Free list

Using an inductor term, a free association technique (Abric, 2001; Borgatti, 1996) was applied to explore the subjects' beliefs about drug use. Initially they were asked: "Tell me, in one or two words, why you believe young people start to use drugs?" Their answers were recorded by the interviewer on a form with just five spaces. Answers were then analyzed with the Anthropac software (Borgatti, 1996b) to generate a list of the associated descriptors by order of mention, frequency, and cultural weight (CW). Identified descriptors were then classified by dimensions (Table 1-4) according to the background, in which influences such as individual, familial, and social factors have been recognized as linked to drug use. We used these classifications to create a hypothesis that drug use debut was viewed as originating in an individual who was emotionally vulnerable to influences from family and friends. However, we anticipated that these kinds of relationships would be further clarified in later study phases. Based on the analysis, twelve descriptive terms were chosen for use in the data collection portion of Phase II: family problems; curiosity; neighborhood environment; faulty parental care; "I am ignored by other people"; "weak temperament"; "I see others doing it"; "family example"; "peer influence"; "feeling alone"; "peer pressure"; and "it is forbidden."