Can you get addicted to a drug after just one try?

Over the last few weeks we have seen story after story on the 'ice epidemic' (now also referred to as the 'ice age'). Interestingly, the media has decided to focus on the young people angle lately – the Sun Herald telling the story of four Sydney teenagers who had all tried the drug by the time they were 14 years old and the Canberra media running a story on users as young as 12!  One of the most common grabs that I have heard from the ex-users (and current users) of the drug that they use in these stories is "I tried the drug once and I was hooked!" – it’s a great line and I just wanted to spend a little time to discuss if it is actually possible to get hooked or 'addicted' to a drug with just one try …
 
We have used the 'one try and you're hooked' line for many years - we've even seen it in government mass media campaigns, particularly around smoking (I tried to locate the original images from the Australian campaigns that ran in the 80s (or was it the 90s?) but could only find the UK versions, one of which I have included in this blog). It's a great scare tactic and can certainly be extremely effective. If you talk to many people who have never used illicit drugs, often one of the reasons behind their decision is that fear of possible addiction (i.e., it may chemically change their brain and/or body, or they may simply like it too much) and that could all lead straight to a path of living on the street and injecting drug use. But is it true?
 
Addiction can be defined in many ways but put simply it means that a large part of a person's life is devoted to buying and taking drugs. Some people believe that addiction is a disease and that once people are addicts they will always be addicts and this is the basis of the Alcoholics Anonymous (AA) model and the support system they offer people who have a problem with their drinking. The theory behind AA has led to many other organisations being formed including Narcotics Anonymous (Nar-Anon) and even Tweakers Anonymous (for people who have problems with ice or crystal). This sort of 'treatment' is not for everyone and it is important to remember that there are many people who can and do change their alcohol and other drug using behaviour throughout their life and do not necessarily subscribe to the 'addiction as a disease' model.
 
Saying somebody is drug dependent is much more 'politically correct' than calling them an 'addict'. Dependency is a strong compulsion to keep taking drugs. There are two types of dependency – physical and psychological. Physical dependency results from the repeated, heavy use of drugs, with some drugs having a much greater addictive potential than others (e.g., heroin). Heavy and continual use of these drugs can change the body chemistry so that if someone does not get a repeat dose they suffer physical withdrawal symptoms - the shakes, flu-like effects. They have to keep taking the drug just to stop themselves from feeling ill. This change in body chemistry does not happen overnight – it takes repeated use over a period of time (e.g., it has been estimated that it may take a young woman three weeks of casual smoking to become addicted to the nicotine in cigarettes) and the belief that one try of a drug (no matter how it is used - swallowed, smoked, snorted or injected) can somehow result in some form of physical dependence simply does not make sense.
 
Psychological dependency, however, is more common and can happen with any drug. In this case people get into the drug experience as a way of coping with the world or as a way of feeling OK. They feel they could not cope without drugs even though they may not be physically dependent. You can become psychologically dependent on just about anything. If any activity becomes more important to you than everything else - including family or friends – that is when you should become concerned.
 
Dependency will often include both physical and psychological factors. While the physical aspect will only be present with certain drugs, a psychological aspect will occur with any form of dependence. Continual use of drugs like ecstasy and LSD do not seem to result in physical dependency, even though people may become psychologically dependent (e.g., ecstasy users often believe that they cannot have a good time without taking the drug and may become anxious about not having the drug if they are going clubbing or the like). With other drugs – and particularly stimulant drugs such as cocaine, amphetamine and the nicotine in cigarettes – there continues to be debate over the extent that physical dependence can occur.
 
Let's make it very clear you won't become addicted to a drug you never try! That cannot be debated. People who don't use drugs never end up hooked or in the hospital or finding themselves with a criminal record after being caught in possession of illicit substances. It is true that every person who ends up with a drug problem, whether it be becoming dependent or addicted or other issues, had a 'first time' using the drug. Did they become 'hooked' that first time? That is highly unlikely, in fact, in terms of physical dependence (i.e., their body needs the drug), it is almost impossible. Did their first shot of heroin or their first puff of crystal give them a feeling or sensation that they wanted to experience again, possibly leading them to a path of physical or psychological dependence? That is much more likely …
 
I am not for one second belittling the beliefs of those people who have been interviewed for these media stories - it is obvious that for them ice has caused huge problems in their lives and it is their view that they became hooked after one try (whatever 'hooked' means to them). However, we need to be extremely careful that we don't start using these throwaway lines to try to explain a very complex issue.
 
Absolutely, ice is a nasty little drug that can cause great problems for those who use it - but maybe we should be looking at who exactly is using it and why, and who is experiencing the greatest problems with it? Dig a little bit deeper here and it's not as simple as a 'nasty little drug' - there is an underlying social issue here that we're most probably not dealing with particularly well ... There are of course exceptions (e.g., the gay community and to a lesser extent, the nightclub/dance scene culture), but increasingly the greatest problems we are seeing with ice are in regional communities, particularly amongst lower socio-economic groups (exactly the same groups that they saw in the US). Is there an issue that we're not dealing with there that contributes to ice being much more likely to take hold amongst those groups?
 
So to answer the question this blog entry poses - no, it is highly unlikely that you will be addicted to a drug after one try. If the user is experiencing a range of social issues, however, it is possible that that first shot or puff could appear to provide an 'easy' way of avoiding the day-to-day problems he or she may be experiencing and lead to a cycle of possible dependence.

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