Chapter 10 Flashcards
What has drug trade contributed to
tremendous wealth and political influence of societies (commodities)
What were the uses of drugs?
medicine, spiritual, concerns about addiction and misuse
What are ways of viewing someone struggling with addiction
- illness
- moral failing
- lack of control
what is addiction
repetitive consumption of a substance, or repetitive engagement in an activity considered problematic
What are the core concepts of addiction even as it evolved over time
harmful to the individual and/or the people around them
Why is drug use a better term than addict
addict = lacks precision and clarity, stigma
Drug use = transparent, neutral, free of judgement
What are illicit drugs
controlled/prohibited substances (heroin, cocaine) and diverted pharmaceuticals (prescription opioids)
What is harmful/problematic/drug misuse?
consumption that causes social, psychological or health problems for individuals or society
What is drug dependence?
- impaired control of use
- increased tolerance
- continued use despite negative consequences and withdrawal symptoms
- replaced drug addiction in ICD
Substance use vs Substance abuse
subjective distinctions and value judgements based on particular understandings of physiology, psychology, law, and history
When was a distinction made between normal drinking and abnormal drinking
18th century
What is inebriety
Late 19th century
- concept that likened abnormal drinking to physical illness…
When was the term alcoholism made what does it mean
1940’s, problem drinking and physiological dependence
What are the two parallel models of addiction developed in 19th century
- disease model
- addiction from physiological or psychological predispositions
- contributed to theory of individual degeneracy
-institutionalization and sterilization - Addiction from characteristics of the substance itself
- temperance movement
-restrictions or prohibitions
*both impact current responses
What is the temperance movement
identified substance as source of problem and advocated for severe restrictions or prohibitions
What are some consequences of medicalization?
- reduce individual responsibility and imperative to improve
- decrease emphasis on social, economic, cultural contexts
- less attention to systemic and underlying issues
What do opioids do
act on nervous system to relieve pain
what does cannabis do
produce feelings of euphoria, lightness of limbs, increased appetite, tachycardia, and impaired judgement
what does cocaine do
feelings of elation, exaggerated confidence… acute toxic reactions
what are the key components of dependence
- physiological syndrome involving tolerance
- withdrawal
What do behavioural addictions have in common with substance use disorders
compulsion, loss of control, continued use/behaviour despite negative consequences
What are some ways addiction is thought to be medical?
- neurological changes in brain/reward systems
- hijacked brain model of addiction
What are the risks of expanding definition of addiction to behaviours and making it as a disease?
- difficult to view behaviours as diseases
- downplays personal agency
- de-emphasizes social factors shaping behaviour
- need to re-examine the disease model
What is the 3 criteria for substance dependence?
- impaired control
- overriding priority
- tolerance to / withdrawal symptoms
2/11 within 12 month period
What were the Skinner box studies
captive, isolated caged rats would repetitively self administer drugs until overdose = concluded addiction due to drugs and therefore drugs addictive to humans
True or False - people who use heroin are highly disposed to have serious social problems even before they touch heroin
True
What kinds of things influence consumption of substances and what does that say about addiction
broader trends in culture, patterns of use that evolve
- a societal problem and issue
what does deaths of despair mean?
Increases in rates of deaths attributed to drugs, alcohol, and suicide (coined by 2 economists describing increase in manual workers in USA)
What are some arguments on deaths of despair
- its a consequence of lacking a meaningful life as a result of social/economic changes
- low pay/benefit, unemployment, community and family disintegration
- stress
What are the treatment options of addiction
- psychotherapy
- further work for underlying psychological problems (anxiety, depression, prior trauma)
- history of adverse childhood experiences increase vulnerability
- meds to support
- residential rehab
- LSD in treatment
- AA or religious services
What is the goal of treatment
- eliminate illicit substance use
- increase social stability
- reduce overdose and negative health outcomes (ex: HIV)
What is prescription heroin?
- harm reduction
- prescribed and dispensed in supervised condition
- reduces health, legal, and social problems from dependency
- *** not recognized as treatment by abstinence perspectives or narcotics anonymous, due to continued use
What are opioid antagonists
- along with detoxification
- ex: naltrexone
- blocks effects of opioids
What is the war on drugs
end international trade in drugs by directing military and police resources to eliminating trade and consumption
- more not have met objectives
- marginalize, criminalize, stigmatize
What are the consequences of criminalization
- constrains opportunities for regulation
- drives many harms stemming from illicit drugs (ex: HIV)
- interferes with provision of risk reduction efforts
- marginalization and stigma reduce engagement with healthcare system = poor care experiences and barriers
- encounters with police
- violence in drug scenes
- contaminated drug supply in unregulated market
engagement in criminal justice system - marginalization and stigma
- high levels of incarceration for non violent drug offences
What are lessons from alcohol prohibition
- many unintended consequences
- did reduce alcohol consumption and alcohol related harm
What is Alcoholics Anonymous
- predominant narrative regarding treatment and recovery
- controversial as frontline response
- claims people intrinsically predisposed to addiction
- 12 step process
- roots in Oxford group
What was the Oxford group and what did they do
popular religious group focusing on self improvement, self reflection, admitting wrongs, making amends, praying, meditating, preaching message to others
- led to AA
who were bill w and dr bob smith
created AA
What is the basic assumption with disease model
vulnerable to addiction because of physiology or psychology, irreversible, no cure
What is the basic assumption of temperance movement model
Some substances are inherently prone to causing habits, and cannot be allowed to be available
How is addiction a social issue
- linked with what we define as acceptable or not
- certain substances viewed as more harmful than others
- socioculturally defined what is addiction or not
How do dependency and addiction differ
addiction = compulsive, loss of control, continued use
dependence doesn’t constitute addiction (can experience withdrawal and tolerance but not display benchmarks of addiction)
what are the main components of addiction
compulsion
loss of control
continued use besides negative consequences
why don’t people view some substances as addiction
- lower levels of dependence
- generally lack risk of severe harms like overdose
When does substance use become misuse
when ‘problems’ emerge in individuals life
what was the role of war on drugs?
- problems related to drugs stem from criminalized nature
- stigma = oppose health/social programs
