Week 2

Question 1

What are the 4 major themes in the history of substances?

Answer 1

1) ambivalence
2) race, class, and gender
3) rising potency
4) difficulties in enforcement

Question 2

How is ambivalence seen as a theme in the history of substance use?

Answer 2

Ambivalence is reflected in a combination of heavy alcohol or drug use coupled with strict social control policies

Question 3

What is the moral theory of addiction? (Timeline, beliefs, supporting evidence, implications for treatment)

Answer 3

• substance misuse is a vice or a sin
• belief that people, through free will, make a conscious choice to become substance misusers. Bad people doing something morally wrong
• treatment-holding people accountable through blame or shame, punitive treatment, religious or social persecution to eliminate bad behaviour
• no scientific evidence to support this model, this treatment does not show success

Question 4

What are the beliefs of disease theory? Timeline?

Answer 4

• since 1800’s but popular since 1950’s
• substance misuse is a unitary disease characterized by specific features including loss of control and abnormal cravings
• drug abuse is considered irreversible, progressive, incurable illness with an identifiable natural history
• drug and alcohol users thought to be different than non users
• a percentage of the population is thought to inherit a genetic predisposition for the disease and are at high risk

Question 5

What are the treatment for disease theory? What is the supporting evidence?

Answer 5

-all substance misusers require the same treatment goal-abstinence
-treatment required to avoid consequences (including death)
-spontaneous recovery unlikely
-release is always possible, regardless of the duration of sobriety
AA, NA, Minnesota Model based on this theory
-evidence is correlation although, confounded, provides uncertain outcomes, treatment shows success for some, but not most

Question 6

What is an example of race, class or gender as a theme in the history of substance misuse?

Answer 6

• building of the railroad by Chinese people, used opium, opium became stigmatized
• it was previously popular in Western culture as a remedy

Question 7

What is an example of rising potency in the history of substance misuse?

Answer 7

-during prohibition, moonshine became popular, much stronger
-can get high for less
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