Life events, stress and the consumption of heroin, alcohol and tobacco
A. considerable literature exists on a possible link between life events and illness, both physical and psychiatric. This literature is reviewed in the first chapters of this thesis. The evidence that life events affect drug use is then examined. A number of methodological flaws exist in these studies and it is therefore difficult to draw any conclusions about the impact of life events. In part II of the thesis, models of drug use are reviewed and some preliminary hypotheses about the nature of the link between life events and drug use are drawn up. These hypotheses are (1) Drug use is a response to stress (2) Drug use is maintained by the stress which arises from drug use and (3) Remission from drug use results in stress reduction. These hypotheses were examined in a study using three groups of substance user; these were a group of heroin users, a group of drinkers and a group of tobacco smokers. These subjects were interviewed at three month intervals over an eighteen month period. At each interview measures of previous weeks drug consumption and of life events from the three month period preceding interview, were collected. The study found that although the heroin and alcohol users reported more events than controls, these were mainly events caused by the drug use. These two groups were also less aware than were controls of events in their lives which were not connected with drug use. The tobacco group was, for the most part, similar to the control group in the way in which they reported events. The influence of events on drug consumption was found to operate at a perceptual level i. e. remission and relapse were influenced by the subjects perception of events rather than by the objective events per se. A model of drug use is outlined in which the impact of life events on consumption varies with the persons stage in a hypothesized cycle of remission/relapse.