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Drug Use

Policy on Drug Use

Cleared personnel are held to a higher standard than other Americans who have not assumed the privileges and obligations of a security clearance. Persons who have used drugs in the past may be approved for access to classified information. In accepting a security clearance, however, government employees and contractors also accept an obligation to remain drug free in the future.

Unlike other personal problems, any confirmed use of an illegal drug is automatically a basis for appropriate administrative action, including mandatory counseling or treatment. Presidential Executive Order 12564 dated September 15, 1986, established the U.S. Government as a drug-free workplace. It declares that "persons who use illegal drugs are not suitable for Federal employment. . . . The use of illegal drugs, on or off duty, by Federal employees is inconsistent not only with the law-abiding behavior expected of all citizens, but also with the special trust placed in such employees as servants of the public."

Similarly, current use of an illegal drug, while on or off duty, by a contractor with access to classified U.S. Government information is incompatible with the terms of the contractor's security clearance.

Use, Abuse, and Dependence

When categorizing extent of drug involvement, medical personnel use three terms: drug use, abuse, and dependence.1 This medical usage differs substantially from the way the terms use and abuse are used by the U.S. Government. For the government, any use at all of an illegal drug or misuse of a legal drug is drug abuse.

Medical personnel generally define the terms as follows:

Use: Any taking in of a psychoactive substance. The term simple use is sometimes used to distinguish experimentation or occasional recreational use that does not reach the point of abuse or dependence. Note: The distinction between use and abuse is not meant to imply that simple use is benign or that there is any level of drug involvement that is not potentially dangerous.

Abuse: Use becomes abuse when it continues despite persistent or recurrent social, occupational, psychological or physical problems caused by or made worse by this use. Use before driving a car or engaging in other activities that are dangerous when under the influence of a psychoactive substance also qualifies as abuse. The transition from use to abuse is often gradual, and there is no clear threshold for defining the point at which use becomes abuse. Frequency and quantity of use are important considerations, as is the extent to which drug use has become a regular feature of one's lifestyle.

Dependence: Habitual, compulsive use of a substance over a prolonged period of time. The substance may be taken in larger amounts or over a longer period than intended. Increased amounts of the substance may be needed to achieve the desired effect. There may have been unsuccessful efforts to cut down on the amount of use. A great deal of time may be spent in obtaining the substance or recovering from its effects. There may be a significant impact on one's work, home or social life, or mental or physical health.

Drug Dangers

There are two aspects of a drug's dangerousness -- the risk of addiction and the adverse health and behavioral consequences. Both differ greatly from one drug to another. There is no illegal drug that does not have serious adverse consequences.

Drug dependence can develop through either psychological or physical processes.

• Psychological dependence is characterized by emotional and mental preoccupation with the drug's pleasurable effects. One craves more to regain the stimulation, elation, sense of well-being, or other psychological pleasures from the drug. Psychological dependence also occurs when one develops a lifestyle that depends upon drug use.

• Physical dependence occurs when the body adjusts to the presence of a drug, so that physical symptoms usually involving discomfort and pain occur when the drug is withdrawn. The addict craves more drugs in order to avoid or alleviate the pain.

The development of psychological or physical dependency depends, in part, on frequency of use. Increasing the frequency or dosage over time suggests tolerance and physical dependence.

Indicators of Severity

The circumstances of an individual's drug use provide indicators of the severity of a current problem or the likelihood that a past problem will recur in the future.2

Age: Early initiation of drug use is one of the best predictors of future drug abuse and dependence. Individuals whose drug use started before high school (age 14 or younger) are more vulnerable to drug problems later in life than those who started using drugs in high school or college. Initiation of drug use between age 15 and 18 is common. Drug use usually peaks during the senior year in high school or in college (age 17 to 23). Continuation of peak usage after college (or age 23) indicates potential for future problems. Initial experimentation with drugs after college (or age 23) is unusual and suggests future problems.

Increased maturity and lifestyle changes that usually accompany employment, marriage, or the birth of children often lead to reduction or cessation of drug use. Continuation of the same social environment in which past drug use occurred suggests that use may continue.

Solitary Drug Use: Solitary drug use is more indicative of future drug problems than is social use. Use of drugs to relax prior to a social event is more indicative of future drug problems than use at social events.

Means of Acquiring Drugs: Purchase of drugs from a stranger may indicate as much about an individual's need for and dependence upon drugs as growing one's own. Buying drugs from a friend is more predictive of future problems than being given drugs by a friend. Few drug users admit to buying or selling drugs; almost everyone says they share or split. Asking what was given or shared in return for the drug may help distinguish a purchase in kind from a true gift.

Motivation for Drug Use: If drugs are used to reduce stress or build self-esteem, this suggests underlying psychological problems that may persist and cause continued drug use or problems with other addictions. Rebelliousness as a motivation for past drug use does not necessarily predict future drug use, but it may indicate other antisocial behavior. Among the various possible motivations for drug use, peer pressure and a desire to be sociable are the least suggestive of future drug problems.

Use of Multiple Drugs: Use of more than one drug at a time, such as both marijuana and cocaine, suggests that drug use is well advanced and may stem from underlying psychological problems.

Behavior While Under the Influence of Drugs: If drug use is associated with traffic violations, pranks, shoplifting, fights, etc., it may be part of a larger pattern of antisocial behavior that is itself a security concern.

Prevalence

Statistics on prevalence of drug use indicate that some experimentation with drugs, especially marijuana, cannot be considered abnormal behavior among younger Americans at this time. In 1996, 50.8% of high school seniors had used some illegal drug at some time during their life, 40.2% during the previous year, and 24.6% during the previous month.3

Why People Abuse Drugs

Initial low-level involvement with drugs may result from peer pressure, drug availability or other risk factors in an individual's social or family environment. Subsequent escalation to and maintenance of higher levels of drug use is likely to result from biological, psychological or psychiatric characteristics of the individual user. In some cases, vulnerability may be inherited in the form of heightened susceptibility to a certain type of drug. In most cases, however, escalation will be caused by psychological traits or psychiatric conditions, some of which may also be inherited.

Recent scientific research shows that characteristics of the individual, rather than of the drug, play a dominant role in vulnerability to drug abuse. The social and psychological maladjustment that characterizes most frequent drug abusers precedes the first drug use.4 One study that tracked children from an early age to adulthood identified predictors of future serious drug use that could be identified in children's behavior as early as age seven. 5

Although psychoactive drugs do have potent addictive properties, addiction does not follow automatically from their use. Most people who experiment with drugs or even use them regularly for a while do not become abusers or develop dependence. For psychologically healthy youths, some experimentation with drugs does not normally have adverse future consequences. For others who already have some emotional or psychological problem, drug use easily becomes part of a broad pattern of self-destructive behavior.6

Poorly adjusted individuals who do not become involved with illegal drugs will often become involved with some other non-drug addictive behavior that fills the same psychological void.

A study based on a sample of 20,291 individuals drawn from the community at large found that more than half of those who met the medical criteria for diagnosis as drug abusers also suffered from one or more mental disorders at some point during their lifetime. This included 28% with anxiety disorders, 26% with mood disorders (depression), 18% with antisocial personality disorder, and 7% with schizophrenia. Some had multiple disorders. The prevalence of mental disorders varied with the drug being abused, ranging from 50% of marijuana abusers to 76% of those who abused cocaine. Almost half of the drug abusers also suffered from alcohol abuse at some point during their lifetime.7

Security Concerns

Much evidence indicates that drug use or abuse is associated with degraded employee performance, greater absenteeism, more workplace accidents, increased health care costs, loss of trained personnel, and theft. Drug use or abuse also raises a number of specific security concerns.

• Use of an illegal drug indicates an unwillingness or inability to abide by the law. Cleared employees must respect regulations whether they agree with them or not. If they do not respect the rules on use of psychoactive substances, they may not respect the rules for protection of classified information. This was the reasoning used by U.S. Army Sgt. Roderick Ramsey to recruit co-workers to spy for Hungary during the Cold War. Drug use was the principal weakness he looked for in selecting co-workers to recruit as spies.

• Users of illegal drugs may be susceptible to blackmail, especially if exposure of drug use could cost them their job. Police and security services actively monitor drug distribution networks. Procurement of illegal drugs while traveling abroad or carrying drugs across national boundaries risks attracting the attention of foreign intelligence services or other individuals who may seek to exploit this vulnerability.

• The more dangerous the drug, the more the drug use indicates about propensity for irresponsible or high risk behavior, rebellion against social norms, alienation, or emotional maladjustment, all of which may be security concerns. These characteristics cast doubt upon an individual's judgment and ability to protect classified information even when not under the influence of drugs.

• Drug abuse or dependence often indicates the presence of broad emotional or personality problems of security concern. It may also cause financial problems, leading to criminal activity to finance a drug habit.

Drug Abuse Treatment

Drug abuse treatment includes detoxification, management of drug dependence, and prevention of relapse. Since drug abuse is a complex disorder with multiple causes, there are multiple treatment methods that are more or less effective with, or acceptable to, different patients. Unfortunately, the present state of knowledge does not permit matching an individual patient's drug abuse history and personal characteristics with the treatment method most likely to be successful for that person. As a result, treatment programs are varied and usually multifaceted. Treatment methods are of two general types:

• Drugs that Affect Physiological Processes: Prescribed medications may provide a substitute drug that has similar physiological effects (i.e., methadone treatment of heroin addiction and nicotine chewing gum for treatment of tobacco dependence); may block the physiological effects of the abused drug; or may treat the symptoms of the abused drug (i.e., reduce the craving or treat the insomnia and anxiety often associated with withdrawal from drug use).
• Therapies that Aim to Modify Behavior: Treatments that aim to change behavior include a variety of counseling and psychotherapy approaches based primarily on talking: peer support self-help groups modeled after Alcoholics Anonymous; behavioral conditioning to alter one's response to drug stimuli; skill development (i.e., teaching job or social skills, assertiveness, or relaxation/stress management); or relatively long term (typically 6 months or longer) treatment in a closed residential setting emphasizing drug abstinence and learning of new attitudes and behaviors.8

Many studies show that treatment is effective, but that relapse remains common and repeated treatments are often required. Successful treatment depends in part upon the amount of time spent in the treatment program. Six to 12 months of treatment is often needed. Those who remain in a program for one year are less likely to return to regular drug use than those in treatment less than one year.9

In addition to length of the treatment program, chances of relapse are influenced by the severity of the problem and by the same biological, psychological, behavioral, social and environmental risk factors that influence the onset of drug use and the escalation to drug abuse in the first place. If a person returns to a drug-taking environment, there is a strong likelihood of relapse. The longer someone has abstained from drug use, the greater the chances of continued abstinence in the future.

Sources for More Information

Your doctor, local counseling service, or Employee Assistance Program will have relevant information. Recent books that may be available in your library or book store include:

• The Betty Ford Center Book of Answers: Help for Those Struggling with Substance Abuse and for the People Who Love Them, by James W. West and Betty Ford. Pocket Books, 1997.
• Substance-Abusing High Achievers: Addiction As an Equal Opportunity Destroyer, by Abraham J. Twerski. Aronson Publishing, 1998.
• Addictive Thinking: Understanding Self-Deception, by Abraham J. Twerski. Hazelden/Rosen, 1997.

For information on the Internet, go to www.yahoo.com, then click on Health, Mental Health, Addiction and Recovery, and Substance Abuse. If you are a spouse or close friend of someone who suffers from this problem, also go to Health, Mental Health, Addiction and Recovery, and then Codependency.

Your telephone book will probably have phone listings for Narcotics Anonymous and various drug abuse hot lines and treatment centers.

Related Topics:  Standards of Personal Conduct, Ramsay Recruited Drug Users, Reporting Improper, Unreliable or Suspicious Behavior.

References
1. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised. Washington, DC: Author.
2. R. J. Heuer, Jr. (1994). Drug Use and Abuse: Background Information for Security Personnel. PERS-TR-94-003. Monterey, CA: Defense Personnel Security Research Center. Reprinted in Polygraph, Vol. 24, No. 3, 1995.
3. National Institute on Drug Abuse (1996). Monitoring the Future Study, 1996. Rockville, MD: Author.
4. M. D. Glantz (1992), A developmental psychopathology model of drug abuse vulnerability, in M. Glantz & R. Pickens (Eds.). Vulnerability to Drug Abuse. Washington, DC: American Psychological Association.
5. J. Shedler & J. Block (1990), Adolescent drug use and psychological health. American Psychologist, 45, 612-630.
6. J. Shedler & J. Block(1990). Adolescent drug use and psychological health. American Psychologist, 45, 612-630. M. Newcomb & P. Bentler (1988). Consequences of Adolescent Drug Use: Impact on the Lives of Young Adults, (Newbury Park, CA: Sage). R. Hogan, D. Mankin, J. Conway & S. Fox (1970). Personality correlates of undergraduate marijuana use. Journal of Consulting and Clinical Psychology, 35, 58-63. P. Bentler(1987). Drug use and personality in adolescence and young adulthood: Structural models with nonnormal variables. Child Development, 58, 65-79.
7. D. A. Regier, et al. (1990). Comorbidity of mental disorders with alcohol and other drug abuse: Results from the epidemiologic catchment area (ECA) study. Journal of the American Medical Association, 264, 2511-18.
8. National Institute on Drug Abuse (1991), Drug abuse and drug abuse research: The third triennial report to Congress from the Secretary, Department of Health and Human Services, (Rockville, MD: Author, pp. 66-75).
9. R. L. Hubbard, M. E. Marsden, J. V. Rachel, H. J. Harwood, E. R. Cavanaugh, & H. M. Ginzburg (1989). Drug Abuse Treatment: A National Study of Effectiveness, (Chapel Hill, NC: University of North Carolina Press).

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