In our formulations of the structure of the symptom of drug use, we emphasize that the choice of a specific drug derives from the mutual interaction of the psychodynamic meaning and pharmacogenic effect of the drug with the particular conflicts and defects in a person's psychic structure throughout his development. For this reason, drugs are not as indiscriminately chosen or as freely interchangeable as superficial observation might indicate. When changes in drug preferences occur, as they do, they indicate that internal psychodynamic changes have occurred.

The adolescent struggle with the biological upsurge of the drives and the regressive resurgence of archaic childhood fears and wishes temporarily threaten the loss of social adaptation, sublimations, rationality, and maturity. Therefore, the adolescent is particularly vulnerable to drugs holding out the promise of magic alleviation of his distress.