Drug use desistance

Abstract

Drug dependence is generally thought to involve a loss or reduction of individual autonomy. Yet of the 11 million people in the UK (27 per cent of the population aged 16–74) who have ever used illicit drugs at some point in their life, probably no more than 300,000 (1%) are drug dependent. Many commentators find the apparently self-destructive behaviour of problematic drug users difficult to explain. According to rational theory, choices are made with respect to a long timeframe so as to maximize overall utility. Under maximization, individuals cannot gradually slide towards a very high level of drug use at the expense of other activities as this would reduce their overall utility. The key to understanding drug dependence is that it involves ‘matching’ different behavioural combinations at any given point in time that do not take account of long-term consequences. There is growing evidence that drug users are much more likely to match compared to non-drug users and that they have difficulty in learning to maximize. We argue that current practice within the UK criminal justice system is implicitly based on the idea that relearning the value of alternative behaviours can lead to drug use desistance.