Center of Health Statistics

The United States is country of people abused with substances. In 2002 the prevalence of drug users among persons older than 12 years was 8%. The number of cocaine related emergencies was around 200,000 cases per year (National Center of Health Statistics, 2004; USDHHS&SAMHSA, 2004). The data of the survey of high school seniors in the coterminous United States (see table 63 in the Annex) shows that the quantity of substance users among young male is higher than among females. (There is only exclusion: cigarette smoking).

For example, average percent using marijuana was in all seniors 21. 5% (2002) but males smoked marijuana in 25. 3% and females only in 17. 4%. This gap is even bigger for the use of cocaine (2. 7% vs. 1. 8%) and inhalants (2. 2% vs. 0. 8%). The number of the males using MDMA (known as Ecstasy) and alcohol was also relatively higher. More sensitive indicator is binge drinking. Binge drinking means five or more alcoholic drinks in arrow at least once in the period prior to the survey.

There were 34,2% of males and 23. 0% of females who drinks more they should do (and too much frequently). You see that every third of young males is addicted to alcohol and many of them use other psychoactive substances. Why they do it and what origin has gender difference in the substances abuse? What social, political and environmental factors imprint on this issue? Phenomena of masculinity are an important element in the explanation of the addictions in male adolescence.

If we look through literary sources we will find that REAL MAN should be “tough, competitive, emotionally inexpressive, public, active and autonomous” (White, 1997); to have a good physique; to be able to withhold emotion and restrain intimacy; to be entitled to freedom for fun, to be initiated into adulthood through specific behavior and, mandatory, to be a member of an established group where he can get recognition, conformity and security. In the literary tradition male’s power and masculinity were always related to drinking.

Man can drink and do not get intoxicated, drinking together is important for mate ship etc. Our society expect drinking by males and young men just adapt their behavior to this social demand. But drinking is not related to intoxication only it changes behavior also. Saunders and Baily (1993) wrote that youth are very vulnerable to these issues of alcohol use “Lack of experience with alcohol, low tolerance for alcohol, impulsivity, relative disregard for risks, and peer modeling can cause problematic alcohol use. ” The common problems related to drinking in young males are numerous.

There are job loss, accidents, interpersonal violence and arrest, road accidents, poor progress in learning etc. In 1997, 21% of the drivers 15-20 years old were killed in road accidents because they were intoxicated. If we will compare the percentage of drunk young male drivers involved in fatal crashes with the percentage of drunk female drivers we will find that for one “bad girl” we will find two “bad boys”. Binge drinking causes aggressive behavior and often brings infringers to police (Abusus non tollit usum). The highest risk of delinquent behavior has drinking occurring in groups.

Today we know the factors of predisposition to alcohol abuse. There are personality disorders, family history of alcoholism and other. Hotton’s study (2004) on the alcohol use in early adolescence shows that the odds of drinking to intoxication and drug use were highest among adolescents whose friends used alcohol or drugs, who reported low commitment to school, or whose parents had a hostile and ineffective parenting style. Alcohol (Spear L. P. , 2002) is reinforcing stimulus for brain structure. Adolescents exhibit increased stressor responsivity and an altered sensitivity to a variety of ethanol effects.

Exposure to alcohol during the time of rapid brain development alters neurocognitive function and later propensity for problematic ethanol use. Thus “young males are more prone to use illicit drugs, to use drugs earlier, more frequently and in greater quantity, and as a solution to social problems, than young females” (AU). Let’s analyze the peculiarities of drug use in young males. Cannabis is the most spread drug in adolescents. Cannabis dependency risk in young males double that in young females (MYDR. COM, 2004). Heavy use patterns are also more common among males (Druglibrary.

org, 1998). By the data of the study cited above, the most common type of cannabis use is smoking waterpipe with the marijuana. Other methods of the use are smoking cigarettes with cannabis and use of hash or hash oil. Some studies (Lettieri D. J. et all. , 1980) showed that initiation to marijuana is critical to the initiation to other drugs (except alcohol). Three major factors have been identified in the initiation of marijuana: (1) prior use of alcohol, (2) predisposing factors (sex, family cohesion, political conservatism/leftism, ethnicity, religiosity, etc.

), and (3) friends’ use of marijuana. Young males often underestimate the danger of cannabis use. They do not believe themselves or others faced much risk if they smoke marijuana rarely or variable. Another most commonly used illicit drug is “speed” or amphetamine. There is evidence from surveys that young people do not see amphetamines as dangerous and that many who inject do not identify themselves as intravenous drug users (). Many young male heroin users explain that their drug use is a response to external societal forces such as school, poverty, or street life.

By adolescence, these young males are doing poorly at school and gave up on their studies. Males usually had higher levels of academic problems than females; low income and unemployment could be another factor of risk. Injecting heroin as well as other illicit drugs can cause many health effects. They includes overdose, spreading blood infections (e. g. HIV-infection or viral hepatitis). We can find some gender differences in the routes of heroin and other parenteral drugs administration. It’s known that males are more likely to inject heroin than females who preferred to heat the heroin on foil and inhale the vapors.

Males are also more likely to share needles with friends and strangers. The most popular theories of substance use could be sorted into five categories. Cognitive-affective theories consider how adolescents’ beliefs about the consequences of experimenting with specific substances contribute to their decisions to use those substances. (Petraitis J. , Flay B. R. , 1995). Young males with poor school results and low attendance can underestimate the risk of substance use. If he was grown up in the family where parents are addicted to alcohol or other substance he can think that this life style is not unusual.

In the preventive medicine when use this theoretical approach they focus on increasing adolescents’ beliefs about negative consequences of using drugs, highlighting the benefits of not using drugs, and correcting inflated estimates or perceptions of drug use. Social learning theories assume that adolescents acquire their beliefs about substance use and other delinquent behaviors from their role models, friends, and parents (Petraitis J. , Flay B. R. , 1995). This theory is very attractive to apply for the problem of adolescent addictive behavior.

The role of friends is crucial, it’s also important to take in the account the images of teen leaders. Some modern idols of youth (like rock-stars) are known as drug users. In the preventive activities using those theories it is important to provide adolescents with positive role models, and to teach them refusal skills and the belief that they can resist drugs. Conventional commitment and social attachment theories assume that the emotional attachments adolescents have with peers who use substances is the cause of substance use. (Petraitis J. , Flay B. R. , 1995).

In this case the best preventive strategies is improving bonds between adolescents and positive peer groups. Such groups have norms that discourage them from engaging in deviant behavior. Interventions focus on improving adolescents’ academic and career skills, providing them with career opportunities, and teaching parents how to socialize and reinforce their children. Intrapersonal theories examine how adolescents’ personality characteristics, emotions, and behavioral skills contribute to their substance use. Examples include stress at school, self-esteem, social interaction skills, coping skills, and emotional distress (Petraitis J.

, Flay B. R. , 1995). The preventive interventions target many of these individual characteristics of adolescents rather than focusing on their beliefs about specific drugs and behaviors. Comprehensive theories combine components from all of the other theories. They attempt to account for how adolescents’ biology, personality, relationships with peers and parents, and culture or environment interacts to cause drug use. In the monograph “Theories on Drug Abuse: Selected Contemporary Perspectives” published in 1980 authors proposed some theoretical approaches for understanding the gender peculiarities of substance use.

They described several tens of theories; the most of them could be classified as comprehensive and Conventional commitment and social attachment theories. For example “personality deficiency theory” by Ausubel regards drug abuse as a result of an individual’s social involvement with drug-using age mates: Ausbell supposed that “adolescent who is motivationally immature, in addition to commonly having ready access to drugs and living in a socio-cultural milieu attitudinally tolerant of drug use” is the most vulnerable. Bejerot proposed Theory “addiction-to pleasure”.

Chein describes environmental issues of drug abuse among adolescents in the «Disruptive environment theory». In his studies of juvenile males he found that the majority did not begin their experimentation with drugs until they were in their late teens, frequently not until they had stopped attending school. Young users who become addicts showed evidence of deep personality disturbances prior to the onset of drug use. The most of young drug addicts live in the urban slums. They share addiction to substances with other kinds of delinquent behavior.

These adolescents were characterized by a special orientation to life, in particular by general pessimism, negativism, and mistrust so on. These attitudes stem from a family life. Their parents have low income and poor educated; they have little hope of a better future for either themselves or their children. In these families there is a lack of love and support for the children and no clear standards of behavior. Teenager lost emotional contact with his parents, there is nobody to whom he can relate in a warm and sustained fashion. Incomplete lost theory by Coleman views drug addiction as a means of coping with a traumatic family experience.

In the explanation to learned behavior theory by Frederick he wrote: “Drug use is initiated primarily as a function of the destructive components in the personality … and the risk-taking aspects that predominate in the life of the individual at the time of the onset of substance abuse or addiction … While there is no drug abusive or addictive personality, per se, it is not unlikely that those with weaker, dependent personality traits may be more inclined toward problems of drug usage than other persons without such traits” (cited by Lettieri D.

J. et all. 1980) Cognitive control theory by Gold does not specifically address the issue of initiation of drug use. In this theory drug experimentation is not seen as a sign of psychopathology or personality weakness. Gold sees preference of drug use as a function of availability, frequency of use in the individual’s subculture, and affordability. To explain causes of early initiation of the use of substances Goodwin proposed so called “bad habit theory”.

He wrote, “My theory would indicate that the genetically predisposed person would more rapidly be initiated into alcohol abuse (and, by inference, other drug abuse) and that the switch from use to abuse would occur very rapidly” (cited by Lettieri D. J. et all. 1980). The example of this can be fact that so called “familial alcoholics” is younger than nonfamilial alcoholics when they initiated to use alcohol. Gorsuch has derived three interactive models (so called “Multiple models theory”) for the initiation of illicit drug use: the nonsocialized drug users model, the prodrug socialization model, and the iatrogenic model.

The first model describes the propensity for drug use in the nonsocialized person. The prodrug socialization model is concerned with those people in whose society drug use is sanctioned. This applies to societies in which drugs are part of religious or other cultural rituals and to groups whose members use drugs for licit purposes. The iatrogenic model pertains to individuals who have been introduced to a drug in a medical setting. These people may seek the drug’s beneficial effects again when they no longer have the original medical need.

You see that only the first model could be applied to adolescent’s addiction. Unlike to described theories the adaptation theory by Hendin see the routes of substance abuse in the adaptive difficulties. Hendin found that if young man start to use drugs it us an evidence that he is a disturbed, vulnerable person. Drug-subculture theory hypothesizes that the predisposing factors indicate the influence of the parent culture upon youths; parent culture values may also influence the choice of friends and patterns of friendship choice.

Self-esteem theory by Steffenhagen considers that drug use is a compensatory mechanism, an excuse for life’s failures, which can insulate one from social responsibility. Low self-esteem can provide the impetus for initiation for one looking for immediate gratification, but low self-esteem, by itself, is not sufficient to account for initiation into drug use. The male peer group provides the greatest pressure and opportunity for the initiation into drugs, although young male have to look to a wider community to see what drugs are provided, and how: Nobody can use a drug which does not exist or for which the zeitgeist is not right.

For example, marijuana has been known since the ancient times but did not become popular worldwide until the late 1960s. We can continue the list of theories explaining the phenomena of young male addiction to psychoactive substances. It will be l-o-o-n-g. Understanding gender peculiarities of drug abuse are important for effective planning and conducting preventive programs. Today in the United States every fourth young male use marijuana or other illicit drugs. This statistics is better than it was twenty years ago. But we should do the best to decrease this number.

References: 1. Cannabis dependency risk in young males double that in young females (2004) http://www. mydr. com. au/default. asp? article=3933 2. Copeland J, Swift W, Clement N. , Reid A. Young cannabis users’ attitudes about cannabis and school drug education (2004) http://www. schools. nsw. edu. au/learning/yrk12focusareas/druged/cannabis_young. php 3. Drug Use by Young Males (1998) http://www. druglibrary. org/schaffer/kids/duy/DUYMLIT. htm 4. Hotton T, Haans D. (2004) Alcohol and drug use in early adolescence. Health Rep. May;15(3):9-19.

5. National Center of Health Statistics (2004) http://www. cdc. gov/nchs/fastats/druguse. htm 6. Petraitis J. , Flay B. R. (1995) Reviewing theories of adolescent substance use: Organizing pieces in the puzzle. Psychological Bulletin, 117(1): 67-86. 7. Saunders, W. , ; Baily, S. (1993). Alcohol and young people: Minimizing the harm. Drug and Alcohol Review, 12, 81-90. 8. Spear L. P. (2002) The Adolescent Brain and the College Drinker: Biological Basis of Propensity to Use and Misuse Alcohol Journal of Studies on Alcohol, Suppl.

No. 14: 71-81 http://www. collegedrinkingprevention. gov/Reports/Journal/spear. aspx 9. Theories on drug abuse: Selected Contemporary Perspectives ed. by Lettieri D. J. , Sayers M. , Wallenstein H. P. (1980) National Institute on Drug Abuse Rockville, Maryland 531 pp. 10. US Department of Health and Human Services and SAMHSA’s National Clearinghouse “Alcohol and drug information” (2004) http://www. health. org/govpubs/rpo992 11. White, R. (1997). Young men, violence and social health. Youth Studies Australia, 16(1), 31-37. Annex: