The drug-of-choice phenomenon: why addicts start using their preferred drug.

The reasons why addicts begin using their preferred drug are examined and compared for differences between groups. Utilizing a questionnaire regarding their drug of choice and their reasons for use, a survey was made of 130 subjects (88 men and 42 women; mean age = 34.3 years) who were actively involved in recovery programs. The most frequent period of abstinence from the use of alcohol and other drugs was between one and two years. Forty-five of the subjects preferred opioids, 27 amphetamines, 24 cocaine, 18 marijuana, and 16 alcohol. The reasons for use were separated into three categories: emotional, physical, and social. Results showed that the amphetamine and cocaine addicts selected a higher number of physical reasons for use, and that the alcohol group chose social reasons most frequently. There were no differences between drug groups in total number of emotional reasons selected. Specific reasons for use were also analyzed between drug-of-choice groups. The findings cast doubt on earlier studies that suggested differential psychopathology or emotional disorders among addicts with different drugs of choice. Clinical implications of these data are discussed.