Drug of choice

Sometimes people who have or have had a substance use problem themselves or other people refer to a person’s ‘substance of choice’. This usually is taken to mean the main or usual substance they use for example alcohol or heroin.

It is worth bearing in mind that most substance use including substance use involving a specific ‘drug of choice’ is a actually polysubstance use (see poly-substance use). For this reason there has been dispute over the accuracy of this term. People may not disclose the range of the substances they use because of stigma. People may not realise or recognise the range of substances a person is using for a number of reasons including the stereotyping and stigmatisation of people who use certain substances or have a substance use problem.

This term is also contested in that it implies that a person chose to use substances which throws up issues in a similar way to ideas of drug use and even problem substance use as a lifestyle choice (see lifestyle choice).

Lastly there is an issue with this phrase for some people as it may undermine the insight that people use substances as a way of self-medicating for health conditions like pain or anxiety or PTSD, for example. (See self-medicating). People who have developed problem substance use sometimes reflect that ‘As soon as I tried X I knew it was the drug for me’. Given that people may be in a situation where they are seeking relief from symptoms, is it more accurate to say that the substance chose them rather than vice versa?