CH. 12. Drugs Flashcards
1
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Drugs In Societies
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DRUGS IN SOCIETIES – All societies have social norms and values governing the use of drugs, who may use them, and how those users should behave. The social context is important.
- EX: in the United States, drinking a beer at a professional sporting event is perfectly acceptable behavior for an adult. However, if the same adult were to drink a beer while attending a play performed by 8-year-olds at the local elementary school, he or she would likely face disapproval and social sanctions from others. One location is deemed socially acceptable for alcohol use by the community; the other is not.
2
Q
Drugs as a Social Problem “War on Drugs”
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DRUGS AS A SOCIAL PROBLEM:
- In the 1970s. President Richard M. Nixon first declared the War on Drugs, calling drugs “public enemy number one,” channeling unprecedented resources toward drug abuse treatment programs, and addressing drug use as a public health problem.
- NATIONAL INSTITUTE ON DRUG ABUSE (NIDA) – Leading government agency on the health impacts of drug use, abuse, and dependence.
- DRUG ABUSE LAW ENFORCEMENT (ODALE) – created specifically to police narcotics. ODALE became the DRUG ENFORCEMENT AGENCY (DEA) in 1973.
- However, the War on Drugs is popularly associated with President Ronald Reagan because of his administration’s:
- massive increase in spending on both federal law enforcement and the drug enforcement agency,
- while drastically reducing the drug education, prevention, and treatment budgets.
- When the Reagan administration began its own War on Drugs in 1982, less than 2% of Americans considered drugs the most important issue facing the nation.
- The media was used to reinforce the rhetoric and link drugs to crime, especially in impoverished inner-city minority neighborhoods.
- Then, crack came onto the scene in 1985. Due to these efforts and the emergence of the crack epidemic, by 1989, 63% of Americans viewed drugs as the most important issue facing the country.
- Today, the U.S. government allocates about 52% of its drug-related funding to supply reduction programs, such as federal, state, local, and international law enforcement, while the remainder (48%) goes toward demand reduction (prevention and treatment).
- SUPPLY REDUCTION: An approach to drug policy aimed at disrupting the manufacturing and distribution supply chains of drugs.
- DEMAND REDUCTION An approach to drug policy aimed at providing education, prevention, and treatment.
- In contrast, other countries around the world have reduced or even eliminated their criminal justice focus on drugs.
- For example, in 2001, Portugal decriminalized the possession of personal-use amounts of all drugs.
3
Q
Differences Among Drug Use, Abuse, and Dependence
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DIFFERENCES AMONG DRUG USE, ABUSE, AND DEPENDENCE:
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DRUG USE – Simply the ingestion of substances in order to produce changes in the body or mind.
- Any consumption of psychoactive substances (including legal drugs such as alcohol) for any purpose is considered drug use.
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DRUG ABUSE – Use of psychoactive substances in a way that creates social, psychological, or physical problems for the user.
- All drugs can be abused, including legal ones such as alcohol, tobacco, diet pills, decongestants, and even caffeine.
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DRUG DEPENDENT – Characterized by compulsive drug use behaviors despite negative consequences and produces psychophysiological changes in the user.
- Compared with more socioeconomically disadvantaged persons, those with sufficient resources or wealth may experience fewer problems associated with drug dependence and be less likely to be arrested, fired from their jobs, or lose custody of their children.
4
Q
Misuse of Prescription Drugs
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MISUSE OF PRESCRIPTION DRUGS – “any intentional use of a medication with intoxicating properties outside of a physician’s prescription for a bona fide medical condition”.
- Risen significantly during the past decade, particularly among adolescents and young adults.
- After marijuana and alcohol use, the nonmedical use of prescription drugs is the most widespread drug issue in the United States.
- Young adults ages 18–25 are the segment of the U.S. population with the highest rates of prescription drug misuse.
- Many are introduced to prescription drugs by means of legitimate prescriptions or through their social networks.
- Young adults in various nightlife scenes are especially likely to misuse prescription drugs.
- Those central to the drug-using network are more likely have Hepatitis C.
- The problem with prescription drug misuse is that some users may perceive the drugs to be safe (They’re not) because physicians prescribe them for medical problems.
- Because prescription drugs are still needed for legitimate treatment of severe or chronic conditions including cancer, the policies surrounding them are complex.
- Government and industry cannot simply make them illegal to inhibit access to those who misuse them.
- Much of the reduction in OxyContin is associated with a transition to other opiate drugs such as heroin.
- “DOCTOR SHOPPERS” are people who go from doctor-to doctor seeking prescriptions for drugs for a number of reasons, including getting high, self-medication of pain, anxiety, and depression.
5
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Problem of Drug Dependence
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PROBLEM OF DRUG DEPENDENCE:
- PHYSIOLOGICAL DEPENDENCE – Leads the user to experience physical withdrawal symptoms in the absence of the drug.
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PSYCHOLOGICAL DEPENDENCE – Leads to distress or anxiety when the user is without the drug.
- These are very real experiences including intense cravings that can prevent the individual from carrying out a normal routine.
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WITHDRAWAL from an opiate drug can be an extremely unpleasant experience.
- In heavy users, symptoms may begin only hours after the previous use and typically peak within 2 days and can include cold sweats, insomnia, bone and muscle pain, cramping, diarrhea, vomiting, nausea, and intense drug cravings.
- For very heavy users, sudden withdrawal may even lead to death because the symptoms are so severe.
- Dependence on such drugs can develop in a matter of a single week.
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TOLERANCE – Acclimation to such drugs builds over time, resulting in Tolerance, which then requires greater and greater amounts of the drug for the same effect.
- This results in increased dosages or more potent forms of drug administration such as snorting or injecting drugs
- During 2014, an estimated 21.5 million people (about 6.5% of the population, but 8% of the population over 12 years) in the United States had a substance dependence problem in the preceding year.
- This is almost double the 2010 estimate of 11.3 million people with a substance use disorder.
- 17.0 million were dependent on alcohol, 7.1 million were dependent on illegal drugs, and 2.6 million were dependent on both alcohol and illegal drugs.
6
Q
Drug Treatment
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DRUG TREATMENT – The key to effective treatment is to have a multi-prong approach:
- Stop the use of the drug immediately
- Strive to stimulate behavioral changes in the individual’s wider life.
- Target related influences in the user’s emotional, material, and social life to address unmet needs.
- Relapse rates are high.
- Individuals must contend with powerful social and psychological forces that shape drug cravings – the people, locations, and events associated with the drug-dependent person’s use provide powerful stimuli that provoke desires to use again. – Environmental Impact
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Some social contexts encourage people to seek treatment:
- Threat of loss – If social relationships, career, status, or self-esteem seem threatened.
- Personal Costs – anxiety about the need to support a drug habit, negative health consequences, fear of bodily injury or death, and the user’s need to improve the quality of his or her life or better care for any children.
- Forced into treatment – Individuals mandated to treatment as part of sentencing have shown improved treatment outcomes. So being forced into drug treatment IS helpful.
ACCESS to TREATMENT – High-quality treatment can be difficult to obtain.
- Only 11% of those who need treatment actually received it at a drug treatment center.
- Uninsured individuals have limited access to basic treatments.
- Public treatment programs—particularly for individuals with special circumstances, such as women with children—often have long waiting lists.
- Compared to those who are not drug dependent, people with substance use disorders are both more likely to need help and less likely to have health insurance.
- The 2010 passage of the Patient Protection and Affordable Care Act (also known as ACA, or Obamacare) was the first piece of legislation mandating that individuals have insurance coverage and that insurance companies cover substance abuse treatment as essential health benefits by 2014.
TREATMENT APPROACHES:
- ALCOHOLICS ANONYMOUS (AA)** or **NARCOTICS ANONYMOUS (NA)– Primary benefits of AA/NA are that meetings are readily available in most urban/suburban areas, it is free, and it can be used in combination with outpatient and medication-assisted treatments.
- RESIDENTIAL AND OUTPATIENT TREATMENT – Are more costly but are more likely to employ evidence-based treatment approaches and have access to formally trained or licensed clinical professionals.
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MEDICATION ASSISTED TREATMENT – (such as methadone, buprenorphine, or naltrexone) is helpful for certain substance use disorders such as alcohol or opiate dependence.
- However, these medications are often costly and controversial, as some MATs have the potential for drug diversion and many individuals and clinicians are proponents of an “abstinence-only” lifestyle, meaning ZERO drugs now and forever.
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NATURAL RECOVERY –Some experience a kind of spontaneous remission, giving up drug habits without treatment.
- Natural recovery often occurs as a response to changing social conditions—the user changes residential location or finds a new job or romantic partner—and usually when the user has access to resources and support for assistance.
7
Q
Drugs and Health
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DRUGS AND HEALTH – The biggest reason societies concern themselves with drug control is the negative health impact of drug consumption.
- Excessive consumption is what leads to harm – overdose, mental health problems, cognitive impairment, organ damage, infectious disease transmission, violence, and accidents.
- The financial cost imposed by alcohol and drug problems (not including tobacco) in the United States is approximately $417 billion per year.
- Compared to the $15 billion spent on drug prevention and treatment in the United States.
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Most of these costs are productivity losses – particularly those related to abuse-related illness, crime/incarceration, black market activities, and premature death.
- Substance-using employees claim more sick days, are late to work more often, have more job-related accidents, and file more workers’ compensation insurance claims than do nonusing employees.
- Higher risk of transmission of infectious diseases such as HIV and HCV – Needle-borne epidemics travel faster than sexually transmitted ones.
- NEEDLE EXCHANGE PROGRAMS: Drug abuse harm reduction programs that provide new syringes to intravenous drug users who exchange used syringes – meant to inhibit the transmission of diseases through shared needle use.
European governments have implemented innovative approaches to address the employment, health, and legal costs associated with heroin injection. Germany, Spain, and Switzerland have implemented HEROIN-ASSISTED PROGRAM:
- Individuals are required to register, complete an assessment intake, and adhere to strict rules (e.g., no drug sharing). These programs aim to reduce disease transmission, have professional staff on-site to address health issues (e.g., wound care, overdoses, other health issues), and promote referrals to treatment programs.
- As a result, HIV transmissions have declined, criminal offending has declined, and many participants have stopped heroin use because the programs provide points of entry for drug treatment and other health care services. Participants have also been able to obtain stable employment and housing.
In the United States, in contrast, injection drug users have accounted for almost one of every three HIV infections.
- African Americans and Hispanics are disproportionately affected by drug-related HIV exposures.
- Policies shown to be effective elsewhere (such as needle exchange programs) continue to lack support among federal officials in the United States but have been gaining recent traction in light of the HIV outbreak in rural southeastern Indiana.
8
Q
Patterns of Drug Use Across Social Groups
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PATTERNS OF DRUG USE ACROSS SOCIAL GROUPS:
- Patterns of drug use differ across various groups within any society.
- This occurs because of the ways in which statuses, social norms, and societal treatment organize and define people’s behaviors and interactions.
- Inordinately affects minorities in lower socioeconomic areas.
9
Q
Drugs and the Life Course
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DRUGS AND THE LIFE COURSE:
- Drug use in the United States peaks during the early adulthood ages of 18 to 25.
- Drug consumption may occur during the intense period of identity development expected during adolescence and early adulthood.
- In attempting to more clearly define their identities, young people may see risks as a challenge and sensation seeking as a part of personal growth.
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Early adulthood is distinguished by relative independence from social roles and normative expectations, a freedom that allows young people to be tremendously self-oriented and to engage in behaviors such as drug use.
- Some indicate they are doing drugs because youth is “the time to get it out of my system.”
MATURING OUT – drug use, including drinking alcohol, typically declines beginning in the mid-20s as young adults assume the social roles and responsibilities of full adulthood.
- Note that it is the changes in the social features of their lives not physiological or cognitive changes—that enable this shift.
- Not only weekend pot smokers but even those engaged in more frequent or “hard” drug use experience maturing out.
10
Q
Gender and Drug Use
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GENDER AND DRUG USE:
- 54% of young women and 60% of young men in the US have used an illegal drug.
- Some of this difference has to do with the fact that young men are often offered greater opportunities to begin drug use within their peer networks and experience less supervision as adolescents.
- Drug use is influenced by gender.
- Masculinity influence not only the drugs men choose to consume but also the ways they consume them. Binge drinking can be a means for men to make claims of masculinity through stamina, willingness to take risks, power, strength, and outperforming peers or winning a social competition.
- This is part of the reason why U.S. society experiences many more deaths from alcohol poisoning among men than among women.
- The gender disparity in alcohol-induced fatalities is a direct result of our cultural framing of alcohol consumption as an act with gendered meanings. (Symbolic Interactionist)
- Masculinity influence not only the drugs men choose to consume but also the ways they consume them. Binge drinking can be a means for men to make claims of masculinity through stamina, willingness to take risks, power, strength, and outperforming peers or winning a social competition.
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women’s drug-using is related to their relationships with men.
- Women exit drug-using more often than men for family reasons and because their use interferes with work responsibilities more often than do men.
- Women’s stopping drug use tends to center on the personal and emotional aspects of drug experiences,
- while men’s cessation is more directly related to external and financial factors.
11
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Race/Ethnicity and Drug Use
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RACE/ETHNICITY AND DRUG USE:
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White young adults report the highest prevalence of use, while Asian young adults report the lowest. Black and Hispanic youth tend to fall between these groups.
- We also find these patterns in the use of legal substances such as alcohol and cigarettes.
- These figures may surprise you, since you may have been led to believe that racial and ethnic minorities report more experiences with drug use than do whites.
- Many media depictions highlight drug use by members of racial and ethnic minority groups, and exposure to these depictions can create unconscious social stereotypes and influence the ways we think about the lives of drug users.
12
Q
Sexual Orientation and Drug Use
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SEXUAL ORIENTATION AND DRUG USE:
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SEXUAL ORIENTATION: including both sexual identity and sexual attraction.
- Sexual Identity – Male of female or other sex.
- Sexual Attraction – Which sex we are attracted to regardless of our sexual identity.
- Gender Identity – Societal Gender role that we identify with.
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SEXUAL MINORITIES – Individuals who identify as lesbian, gay, or bisexual.
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Sexual minorities are more likely to use and abuse drugs.
- About 4.3% of those aged 18 or older identify as a sexual minority.
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Sexual minorities are more likely to use and abuse drugs.
- SEXUAL MAJORITY – Self-identifies as heterosexual.
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Sexual minority adults aged 18 and older were more likely to both report past-year illegal drug use and meet criteria for a substance use disorder, as compared to sexual majority adults.
- In contrast to the sexual majority population, in which males are more likely to report past-year drug use (20.4% for males, as compared to 13.9% for females).
- Sexual minority females are more likely to use drugs than sexual minority males (41.1% for women, as compared to 36.3%).
13
Q
Intersections of Social Difference
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INTERSECTIONS OF SOCIAL DIFFERENCE:
- Race, socioeconomic status, age, sexual orientation, and gender identity may each influence drug use behaviors, it is the intersection of all these social differences that shape individuals’ experiences in society.
- This intersection affects everything – experiences of privilege and oppression; governs access to and experiences with the education system, housing, and peers; and influences the ways people engage with and respond to the world.
14
Q
Functionalism
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FUNCTIONALISM – Considers how societies maintain themselves by creating a certain order for those living within them. The functioning of society is managed through the collective behavior of the society’s members.
- KEYWORDS: Increase community inclusion, decrease ANOMIE, and drug use will decline.
- According to functionalists, the collective group shares norms, institutions, and rituals that allow expectations of behavior.
- When individuals break social norms, for instance, they disrupt the social fabric and damage society’s ability to maintain itself.
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ANOMIE – is a condition in which individuals feel disconnected from society and its social standards.)
- Individuals are more likely to break social norms when they experience anomie (normlessness).
- Functionalists see the use of certain drugs to be an act of deviance and a rejection of social norms that emerge from feelings of anomie.
- On the other hand, when a drug is socially sanctioned, functionalists would argue that, rather than disrupting the social fabric, its ritualized use may contribute to community cohesion and solidarity.
- In many Western societies, alcohol is a permitted drug that serves to enhance social bonds and community cohesion.
POLICY IMPLICATIONS OF FUNCTIONALISM:
- According to the functionalist perspective, it remains imperative for society to create supportive communities in order to prevent the use and abuse of illegal drugs.
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Individuals will be less likely to abuse drugs if they feel a deeper connection to the community.
- By reducing anomie and feelings of social dislocation, communities will be in a better position to prevent the abuse of drugs as well as the harms associated with drug use.
- Local policies that encourage communities to come together are important pieces of the puzzle.
- For example, the creation of public spaces, such as parks, malls, and public venues, in which members of the community feel invested
- Policies that stimulate community participation can reduce individuals’ needs to use drugs in response to social dislocation.
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Individuals will be less likely to abuse drugs if they feel a deeper connection to the community.
15
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Conflict Theory
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CONFLICT THEORY – At the core of conflict theory is the issue of power, grounded in political and economic structures. Those in positions of power—resources—act to facilitate inequality by ensuring the uneven distribution of power and resources across society. Conflicts then emerge over these inequitable allocations.
- KEYWORDS: Those in power attach the harshest punishment to drugs used by the poor (crack).
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With regard to drugs, conflict theorists would argue that decisions and policies about which drugs are legal and who can access them are products of the social structure.
- For conflict theorists, the creation of laws governing drugs provides a means of exerting social control and policing over those who are less powerful.
- Those in positions of power have a greater ability to shape policies on drugs, often in ways that permit them to legitimate their own social position and exert social control over those less powerful.
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EX: Prohibition – was an upper-class social movement outlawing alcohol. This movement occurred in the wake of immigration from Ireland and southern European nations in which the use of alcohol was a routine and normative behavior.
- This was a way of articulating social distinctions between the upper class and the poor and newer immigrants within society.
- EX: Some have also suggested that the outlawing of drugs such as heroin and cocaine during the early 20th century was tied to the emergence of the modern pharmaceutical industry, which profited from the control of these substances.
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EX: Prohibition – was an upper-class social movement outlawing alcohol. This movement occurred in the wake of immigration from Ireland and southern European nations in which the use of alcohol was a routine and normative behavior.
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NEW JIM CROW – War on Drugs is a strategy to continue the racial caste structure and push back the progress from the civil rights movement.
- Young whites use illegal drugs at higher rates than black youth, yet black youth are arrested for drug crimes at rates 3.5 to 5.5 times higher than the white arrest rate.
- The War on Drugs has largely contributed to the fact that one in three black men will spend time in prison in their lifetime.
- Conflict theory also says that:
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drug use becomes reasonable to individuals as a means of coping with marginalization and societal inequalities.
- This explains why whites have higher rates of drug use, while blacks and Hispanics are more likely to experience drug dependence.
- The poor are especially vulnerable to experiencing drug problems and drug harm because they also lack the resources to recover from drug dependence.
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drug use becomes reasonable to individuals as a means of coping with marginalization and societal inequalities.
POLICY IMPLICATIONS:
- Policies derived from a conflict theory perspective focus on bringing about change in the inequalities in society, and subsequently reducing the adverse impacts of drug abuse.
- For example, opening economic opportunities like jobs and developing programs that reduce poverty.
- EARLY CHILDHOOD INTERVENTION PROGRAMS – Children who completed these programs were less likely to use substances or to be arrested and more likely to graduate from high school and earn college degrees.
