Chapter 8 - Addictions Flashcards
Addictions
psychological and/or physiological need for a drug to maintain a sense of well-being and avoid withdrawal symptoms
Abuse
excessive or inappropriate use of a drug that results in some form of physical, mental, or social impairment
Perceptions about Use
about the consequences of drug use can diverge, eg. cannabis vs alcohol.
Alcohol Use
70% of youth age 15–24 and 80% of adults age 25+ reported consuming alcohol in 2012, making it the leading psychoactive substance used by Canadians by a wide margin
An estimated 3.2% of the Cdn pop age 15 + abused or were dependent on alcohol in 2012
substantially higher for men (4.7%) than for women (1.7%)
Tabaco Use
toxic, dependency-producing psychoactive drug “more addictive than heroin”; a stimulant
use has declined since 2000
~ 23% men, 17% women 15+ smoked in 2011 (StatsCan 2012 cited in Kendall, 165)
Consequences: kills 37,000 people/year = 5 x the number of deaths from car accidents, murder, suicides, and alcohol abuse combined (Health Canada 2009, cited in Kendall, 165)
Marijuana Use
Marijuana is the most extensively used illicit drug in Canada.
Bill C-45 (April 2017) will create a new Cannabis Control Act that will legalize and regulate cannabis for adult useMajor health risks: (CAMH 2015; Cdn Centre on Substance Use and Addiction 2017)
Motor vehicle accidents: 4-12% of motor vehicle deaths or injuries occurred under the influence of cannabis.
Cannabis abuse or dependence was estimated to affect 380,000 Canadians; 1.3% of Canadian adults aged 15 + could be considered to be dependent on or to misuse cannabis in 2012.
research findings now available on cannabis and cognitive functioning including psychosis, maternal use during pregnancy, driving, respiratory effects including lung cancer, as well as effects on some medical conditions
Medical Use Marijuana
Individuals must receive a prescription from a medical practitioner to be able to use marijuana for medical purposes.
quantities, period of time, form of product, and source is controlled (and continues to change in response to court cases)
129,876 patients are registered with licensed producers of medical marijuana (cited in Canadian Centre on Substance Use and Addiction, 2017)
It has not undergone clinical testing, so doctors don’t have sufficient info about indications, dosage, strains, contraindications, adverse reactions, or interactions with other meds or medical conditions
“The body of evidence is not currently at the level deemed acceptable to Canada’s medical colleges.” (Canadian Centre on Substance Abuse and Addiction, 2017, p. 6)
Illegal Use and Abuse
Misuse or recreational use = use by people other than those to whom the medication is prescribed or use in a manner or for a purpose contrary to what is intended
Borrowing or stealing medications, deliberately using higher-than-recommended doses, hoarding medications, tampering, altering the route of delivery, using opioids together with alcohol or other medications, “double doctoring”, prescription fraud and forgery, theft, street drug markets
The Fentanyl Crisis
an opioid, prescription-grade fentanyl is up to 100 times more toxic than morphine
may be absorbed through the skin, or inhaled when airborne
illegal to import without a licence or permit, but online suppliers conceal the drugs and ship in packages under the 30-gram threshold
anyone can buy and sell fentanyl; 1 kg sells on the street for $20-million
Public Health Agency of Canada report = at least 2,458 Canadians died from apparent opioid-related overdoses in 2016
Solutions to Addictions
National Anti-Drug Strategy (launched in 2007)
primary, secondary, tertiary prevention for different groups of users
treatment and rehabilitation reflects the medicalization of addiction for which individuals have to take responsibility
neglect of social factors and root causes, eg. poverty, exclusion, abuse, government revenues from alcohol sales, international drug trade
private trouble or public issue?
Functionalism
legal use of drugs is functional in societies
abuse was kept in check by traditional mechanisms of social control
now law enforcement is the mechanism of regulation, enforcement, criminalization
Conflict Theory
illicit drug users are economically disempowered, and the drug trade is controlled by the economically powerful
it serves corporate interests, eg. alcohol, tobacco, pharmaceuticals, gaming industries big profits
Interactionsim
addiction is learned behaviour
reinforced through social interaction with people who use or abuse drugs
drug sub-cultures
Feminism
different reasons for drug use among men and women
women’s vulnerability, disadvantage, abuse
they are more likely to use legal drugs
increases risk of drug abuse for this class of drug
Drug
any substance other than food or water that, when taken into the body, alters its functioning in some way
Recreational Drug use
occurs when a person takes a drug for no other purpose than achieving some pleasurable felling or psychological state
Alcohol and Tabacco
Licit drugs that are used for recreational purposes
Illicit Drugs
heroin or cocaine
are socially defined as deviant and therefore a social problem
Drug Abuse
the excessive or inappropriate use of a drug that results in some form of physical, mental, or social impairment
Objective Component
the physical, psychological, or social evidence that harm has been done to individuals, families, communities, or the entire society by the use of the drug.
Subjective Component
the belief that marijuana is harmful
the subjective belief about alcohol is that is it harmless
Drug Addiction
refers to a psychological and physiological need for a drug to maintain a sense of well being and avoid withdrawal symptoms
Tolerance
occurs when larger doses of a drug are required over time to produce the same physical or psychological effect that was originally achieved by a smaller dose
it is a matter of degree
Withdrawal
refers to a variety of physical and/or psychological symptoms that habitutat drug users experience when they discontinue drug use
Drug Abuse
Is the excessive or inappropriate use of a drug that results in some form of physical, mental, or social impairment
Objective componenet
Physical, psychological, or social evidence that harm has been done to individuals, families, communities or the entire society by the use of a drug.
Subjective Componenet
The perception of consequences overrides the objective component
Ex. Consider our society’s objective or subjective components underlying our society’s view of the use of marijuana
Subjective is the belief that marijuana is detrimental to health
Subjective component of alcohol is that it is generally acceptable
Drug addiction
Refers to a psychological and or physiological need for a drug to maintain a sense of well being and avoid withdrawal symptoms
Tolerance
Occurs when larger does of a drug are required over time to produce the same physiological effect that was originally achieved by a mallet dose
Withdrawal
Refers to a variety of physical and or psychological symptoms that habitual drug users experience when they discontinue drug use
Alcohol use and Abuse
Canadian Alcohol and Drug Use Monitoring Survey (CADUMS)
National Poulation Health Survey (NPHS) - in depth interviewing of 17000 Canadians
Alcohol is considered a dominance part of our culture
Beer 3-6 percent
Distilled spirits -40% (80 proof) 50% (100 proof)
Alcohol is a depressant
Heavy drinkers
Are more frequent drinkers who typically consume greater quantities of alcohol when they drink and are more likely to become intoxicated
Acute Alcoholics
Have trouble controlling their use of alcohol and plan their schedule around drinking
Chronic Alcoholics
Have lost control over their drinking and tend to engage in compulsive behaviour such as hiding liquor bottles
High alcohol consumption
90% of Canadians have drank alcohol
Binge Drinking 5+ drinks in one sitting
Low risk drinking - no more than 10 drinks for women, 2 drinks a day
Men 15 drinks a week,3 drinks a day
These are not arbitrary but standard in relation to liver disease
A higher rate of men in the acute and chronic alcohol catagory
Cardiovascular Prolems
Such as inflammation and enlargement of the heart muscle, poor blood circulation, reduced heart contractions, fatty accumulation in the heart and arteries, high blood pressure and cerebrovascular disorders such as stroke
Alcohol Cirrhosis
Chronic alcohol contributes to irreversible changes in the liver a progressive development of scar tissue in the liver tat chokes off blood vessels and destroys liver cells by interfering with their use of oxygen
Canadian Addiction Study (2004)
CADMUS did not survey harms done by ones own or others drinking. The researchers surveyed harms done only for drug taking behaviour
Likely safe to assume that much harm was committed as a resul of problem drinking
Fetal alcohol spectrum disorder (FSD)
is an umbrella term used to describe the range of disabilities and diagnoses that result from dinking alcohol during pregnancy
Specific birth defects and the degree of the disability can depend on how much alcohol wa drunk and how often and when during the pregnancy
More prevalent that Down Syndrome or Spina Bifida
123 and 740 babies are born with FAS per year
Drinking and Driving
Drinking often do not realize how much alcohol they consumes or what the effect it has on their drinking ability
Anything over 0.08 is referred to as impaired driving
Family Problems Charles Levinithal (2011)
For every person who has a problem with alcohol, about four other people are directly addicted on a daily basis.
Domestic abuse and alcoholism are frequently associated with heavy drinking and alcohol abuse
Compared to those that have partners that drink, 6 times the risk of violence
Abused women frequently use drugs to deal with the pain (health Canada 1993)
Impacts on Family Members - Alcohol
Depends on the degree of the alcoholic
Some are violent and abusive others are quiet withdrawn and sullen
Enablers are those that adjust their behaviours to accommodate an alcoholic
Codependency
Enabling can lead family members into a reciprocal relationship between the alcoholic and one or more non alcoholics who unwittingly aid and abet the alcoholics excessive drinking
Children
Growing up in these families shows that they have higher antisocial behaviour, lower academic achievement and cognitive impairments and higher rates of hyperactivity
Drinking around the world
Alcohol is the third largest risk for disease
Causal factor for 60 types of disease
Associated with many serious issues such as violence
The (WHO) published a report in 2011 on global drinking patterns
Eastern and most of Western Europe had the highest consumption rates, Americas are in the mid range and Middle Eastern countries the least since drinking is illegal
4% of the deaths world wide are associated with HIV, violence and tuberculosis -
Tobacco as a social problem
Stimulant because it stimulates the central nervous system - speeds up heart beat
1 in 5 Canadians over the age of 15 smoke (17% women 23% men)
Responsible for 37000 deaths per year
10 cigarettes a day reduces a life expectancy by 4 years
40 cigarettes by 8 years
About 75% of the nicotine ends up in the air
Children and Nicotine
Slower rates of physical and mental growth
Carbon monoxide transmitted from the mother’s blood to the fetus interferes with the distribution of oxygen that does reach the fetus
Marketing campaigns - culturally desirable attributes, such as achieving maturity, gaining wealth and happiness, being thin and sexy.
New Tabasco problem
Ecigarette - not regulated by health canada
Seen as a harm reduction method
Long term inhalation of propylene glycol is not yet known
Prescription Drugs, over the counter drugs and caffeine
1/5 of Canadians use pharmaceuticals, less than 5% abuse them
Narcotics - used to control pain, suppress coughing, control chronic diarrhea, and reduce heroin withdrawal symptoms
There are risks of short term abuse and long term dependency
Dependency Prescription Drugs: Iatrongenic addiction
Results from physician supervised treatment for a recognized medical disorder is call iatrogenic addiction
Most likely to occur with long term use
Most often affects people from the middle and upper class
Methylphenidate (Ritalin) and Fluoxetine (Prozac)
Us a stimulant that is prescribed for children who are diagnosed with attention deficit disorder (ADHAD)
Advocates believe that children with normal to above average intelligence who are performing poorly in school can benefit from Ritalin
Some commentators argue that while the diagnosis is correct that it is over perscribes - most girls are diagnosed with it
OVer the Counter Drugs (OTC)
65% tool pain relievers, 20% took cold and flu medications, 11% tool stomach remedies - Canadians over 12
Abuse of aspirin and other analgesics can cause gastric bleeding, problems with bold clotting complications during surgery and during labour and delivery
Reye’s Syndrome
A potentially life threatening condition that can arise when children with the fl, chicken pox, or other viral infections are given aspirin
Analgesics
Acetaminophen, aspirin, and ibuprofen have been linked to attempts of suicide in white females 6-17 years old
Few resulted in death with the accept ion of when it was combined with drugs and alcohol
Caffeine
Dependency producing psychoactive stimulant
According to a study it is an ingredient in coffee, tea, chocolate
2/3 of Canadians drink 2.8 cups of coffee per day
How much it improves performance is highly debated
Little impact on complex tasks such as analytical thinking and decision making
Illegal Drug use and Abuse: Opium Act 1908
Matter of social and legal definitions that subject to change over time
Patent medicines that sometimes contained such ingredients as opium, morphine, heroin, cocaine, and alcohol could be purchased in stores through mail order
In canada opium could be consumed legally until it was banned
Opium Act 1908
Was banned after the investigation by Mackenzie King
The reason for the ban was that opium smoking was a favourite pastime of the Chinese workers building railroads in Western Canada
Narcotic Control was part of the department of Health Col. C.H.I. Who undertook the moral entrepreneurship criminalizing the drug did similar to the US
Canada’s Drug Strategy
Had enforcement measures “ for the interdiction and suppression of unlawful import, export production, distribution and possession of controlled substances and for the forfeiture of any property used or intended to used in the commission of such offences and profits derived from such offences
Drug Use in Canada
Can I is, cocaine, ecstasy, salvia and heroin
Over 15 years old - 9.4% reported using these drugs
12.4 vs 6.5 more males than females
Drug use among Ontario Students
Angela Paulina -Boak (1977)Grade 7-12 inclusive
2011 - alcohol and energy drinks were by far the drug used most and little difference exists between the sexes in their use.
Marijuana
THC - primary psychoactive chemical, delta 9 tetrahydrocannabinolIn low to moderate doses the drug produces mild sedation in high douses a sense of wellbeing, euphoria
Heavy use can impair concentration and recall
Can disrupt the development of the fetus
Stimulants
Cocaine and amphetamines are amonthe major stimulants
19th century was produces as a local anesthetic in medical practice and a mod enhancer in patent medicines
Cocoa cola from the 1880s to the early 1900s
Today it is the third most widely used psychoactive drug
Crack and Cocaine
The only statistically significant change noted between ecstasy, cocaine or crack and speed was a decrease in crack and cocaine of 0.9% in 2011 from 1.4% in 2004
Powerful high- “rush” increase blood pressure and respiration
Reactions vary in length and intensity
Occasionally results in death triggered by an irregular rhythm
Long Term Impacts of Cocaine use
Internal bleeding, hypertension, cardiac arrest, heart disturbance and neurological and cardiovascular disorders that others do not
Intravenous Cocaine Users
Contaminated needles and syringes are also at risk for HIV,AIDS
The risk of contracting HIV is especially high in crack houses where women addicts often engage in prostitution to acquire drugs
Crack babies
Must often be cared for at the public expense
Philippe Bourgeois suggested that blame for the problem cannot be placed on the women alone
Blames patriarchal family, dysfunctional public sector that regulates the responsibility for supporting and nurturing children almost exclusively to mothers- fathers and the larger society must share the burden
Speed Freaks
Easy users inject massive does of methamphetamine several times a day
Often do runs staying awake extended periods of time eating very little and engaging in bizarre behaviour such as counting corn flakes
“Crashing” for several days
Depressants
Barbiturates - most commonly used - Eg, Valium
Some may develop both a physical and psychological dependence to these depressants
Sometimes heroin and barbiturates are combined in the hopes of lengthening ones high
Rohypnol
Benzodiazepine known colloquially as “roofies” or as the date rapedrug
Linked to aurmobile accidents
Problem on university campuses , but it is used as a sleep aid in other countries
Narcotics
Natural (opium, moth one, or codeine) synthetic (heroin or pecodan) produce opioid like effects
1% of Canadians were using the drug, but this increased to 9.4% of Canadian
Mainlining or shooting - produces tingling sensation followed by a state of drowsiness
Heroin users develop a tolerancee for the drug and have to increase their dosage to achieve the same high
Heroin and Crime
Has been linked to crime more than any other drug used - they often turn to robbery prostitution, shoplifting and pimping, prostitution or working for underground drug industry
Hallucinogens
Mescaline (peyote), lysergic acid diet hula die (LSD), Phencyclidine (PCP) and MDMA (ecstasy produce mild to profound psychological effects depending on the dosage
1980s PCP hit the streets manufactured in clandestine labs
E is a designer drug derived from aphetimines
Inhalants
Gasoline, glue, paints, cleaners
Overall harm from drug use
17.6% of drug users reported harm to themselves
A higher percentage was youth and women
Gambling and Problem Gambling
1990s growth of the gambling industry
Study showed that 36% of the population were non gamblers, 54% were non problem gamblers and 6% were at risk
PGSI (problem gambling Severity Index) - *+ represents severe problem gambler
20 times as much as the average problem gambler and 21% of income
Gambling and Gender, Age, Income, And Marital Status
54% if household with incomes less than $20,000 and spent $469per year, while income $80,000 spent $566 per year.
People living alone are likely to gamble more
Higher percentage of men than women
Those who completed post secondary are less likely to gamble
2.4 to 1.7 percent higher income had higher gambling
Gambling Related Social Problems: Difficulties with Problems Gambling
64.5% of difficulty making a pay cheque
Negatively affected work relationship
Negatively affected work
Thoughts of suicide
Interactionist Perspective
Believe that addiction is a learned behaviour
Howard Becker: concluded that drug users learn to use drugs from other drug users, but also what pleasurable reactions they should expect to have.
Drug subculture: a group of people whose attitudes, beliefs, and behaviours retaining to drug use differ significantly from those of most people in the larger society.
Interactionist Perspective: Labelling Theory
Suggests that it is particularly difficult for individuals to discontinue once they have been labelled alcoholics or drug addicts because of the prevailing ideology that alcoholism and drug addiction are personal problems rather than social problems, individuals tend to be held solely responsible for their behaviour
Functionalist Perspective
Virtually no society in which nobody does drugs or gamble
Drugs contribute to many rituals, including wedding and other celebrations
Social institutions such a s the family, education and religion kept deviant behaviour in check and have become fragmented and somewhat disorganized
Functionalist Perspective
Social control to prohibit people from engaging in these activities
External controls in the form of law enforcement are also required to discourage people from growing, manufacturing, or importing illegal substances
Functionalist Perspective : Illicit drugs and Function and Disfunction
The illegal drug trade creates and perpetuates jobs at all level of the criminal justice system
In the federal government, in social services agencies that deal with it
On the other hand the dysfunction is the enormous costs to society. Another is the loss of human potential
The economic crisis that it creates for friends, family, and aquantinces
Conflict Perspective
Economic and political power make the sale, use, and possession of drugs abused by the poor and the powerless illegal
Powerful corporate and government interests perpetuate addictions. Corporations market and sell tobacco and exact a heavy toll on the well being of addicts, their families and communities
Feminist Perspective
Significant part of the explanation of drug abuse of women has to do with women’s vulnerability and disadvantaged position in society
Vulnerability to sexual and spousal abuse, the wage gap and fewer promotional opportunities like the second shift
Women use drugs to reduce stress and to nurture themselves
Feminist Perspective: The Sick Role
Explain the differences in dug taking are the risk taking behaviour and the willingness of women to adopt the sick role
Men are socialized to take risks and women are socialized to be more cautious about their health - women are more likely to use drugs to deal with their problems
The future of Addiction
The federal government developed an Anti Drug strategy
Prevention Action Plan: To prevent use
Treatment action plan - aims to treat those with dependency
Enforcement Action Plan - which aims to combat the distriution of illegal drugs
Prevention Programs
Primary, secondary and tertiary
Primary Prevention Program
refers to programs that seek to prevent drug problems before they begins
EX. youth diversion programs
Awareness campaigns, educational resources, training of service providers.
Secondary Prevention Programs
Seek to limit the extent of drug abuse prevent the spread of drug abuse to substances beyond those already experiences and teach strategies for the responsible use of licit drugs
Eg. Inside is a safe injection site that opened in 2003
$14 million and prevent more than 1000 HIV infections and 54 cases of Hepitius C over a 10 year period.
Tertiary Programs
Are programs that aim to ensure that people who have sought help for some form of drug abuse remain drug free
Drug treatment involves the use of activities designed to eliminate physical and psychological addiction and to prevent relapse
Medical Treatment Model
Considers drug abuse and alcoholism to be medical problems that must be resolved through medical treatment by medical officials
Aversion therapy or aversion therapy behavioural conditioning
Cyclazocine and Nalozone are given to heroin and opioid addicts to prevent the euphoric feeling
Anatabuse is the treatment of alcoholics following detox - nausea
Therapeutic Community
Short and long term services are available both live in and at home at no charge, except for specialized services for people seeking help with addiction
For substance abusers with psychological problem - treatment generally involves
Outpatient programs
Allow drug abusers to remain at home and continue working
Day Treatment
Takes place in a hospital setting where the abuser participates in day long treatment and individual counselling sessions and returns home in the evenings.
Therapeutic Community Approach
Is based on the idea that drug abuse is best treated by intensive individual and group counselling in a residential setting.
