Substance use and professional identity (2018)

Processes of professional socialization influence types of substances used, patterns of use, and estimation of normalization. This project explores psychoactive substance use among professionals and students in professional programs in Canada, rationales for use, strategies to manage use and potential consequences, and factors within professional education and culture that influence decisions about use. The intent of this study is to uncover social processes through which professional contexts influence substance use. The researchers sought to explore how professionals and professional students described their own decision-making about substance use and their perceptions of professional influences. The mixed methods pilot study involved ecological momentary assessment (EMA), using an app designed for the study, and qualitative interviews. Participants completed a brief survey on the app each time they used a substance during a 4-week period, reporting what substance was used, how much, where, who with, and anticipated or delayed effects. Thirty-four participants were involved in the EMA component, 20 of whom engaged in interviews. The findings suggest a certain amount of substance use is expected, accepted, and even promoted in professional fields. Thematic analysis revealed novel understandings about (i) deliberate decisions, (ii) disclosure and use, (iii) stigmatized substance use, (iv) normative substance use, and (v) the professional context. This study demonstrates potential advantages of undertaking research to explore substance use, as distinct from substance abuse, problematic use, dependence, or addiction. Conceptualizing substance use more broadly can help to identify factors that both encourage use (e.g., performance demands, social norms) and constrain use (e.g., responsibility, role modeling). This can expand approaches to address substance use that look beyond the individual to social and institutional contexts, acknowledging that responsibility is a collective process.