We surveyed random samples of 500 practicing physicians and 504 medical students in a New England state during 1984-1985; 70 percent of the physicians and 79 percent of the students responded. Fifty-nine percent of the physicians and 78 percent of the students reported that they had used psychoactive drugs at some time in their lives. In both groups, recreational use most often involved marijuana and cocaine, and self-treatment most often involved tranquilizers and opiates. In the previous year, 25 percent of the physicians had treated themselves with a psychoactive drug, and 10 percent had used one recreationally. Although most of the use was experimental or infrequent, 10 percent of the physicians reported current regular drug use (once a month or more often) and 3 percent had histories of drug dependence. More physicians and medical students had used psychoactive drugs at some time than had comparable samples of pharmacists and pharmacy students. The results suggest a need for renewed professional education about the risks of drug misuse.

Although the importance of euphoria-seeking in opiate addiction has been debated by leading drug abuse theorists including Lindesmith, Wikler, Brill, Bejerot and others, few researchers have heretofore collected systematic data on the issue. Statistical and case study data obtained over the past few years show that euphoria-seeking is a major cause of opiate addiction for most nontherapeutic addicts but for only a few therapeutic addicts. Theoretical analysis and empirical data indicate that euphoria-seeking is also a key component in the causation of many of the secondary problems of nontherapeutic addiction, including crime, unemployment, death, and disease. In the absence of euphoria-seeking, opiate addiction would be a much less severe public health and social problem.

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