1. Drug Use as a Social Problem
Chapter 2
Drug Use as a Social Problem

2. US Attitude Toward Substances
Laissez-Faire- The US governments attitude toward substances prior to the early 1900’s was described by this expression.
If the seller wants to sell it, and the buyer wants to buy it, let them.
Three reasons for concern
Toxicity
Dependence-Dealers seen as victimizing individuals.
Crime-Drug user viewed as a threat to society.

3. DAWN Developed in 1974. Drug Abuse Warning Network
Monitors emergency rooms in major metropolitan areas for visits involving substances from charting, as well as on drug related deaths from coroners.
Records only that a substance was involved in a hospital visit, not the cause.
Page 31 provides some statistics.

4. Blood Borne Diseases
HIV-recent study of IV users in 6 US cities resulted in rates of infection between 3 and almost 30%.
Hepatitis B-infection in IV users ranges from 50 to 80%.
Hepatitis C-infection in IV users ranges from 66 to 93%.

5. Dependence
The Diagnostic Statistical Manual- IV-TR (the manual used by clinicians to diagnose a disorder) defines substance dependence as follows:
A maladaptive pattern of substance abuse, leading to clinically significant impairment or distress, as manifested by three (or more) of the following:
Tolerance
Withdrawal
The substance is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down or control the substance use.
A great deal of time is spent in activities necessary to obtain the substance, use of the substance, or recovering from its effects.
Important social, occupational, or recreational activities are given up or reduced because of the substance use.
The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance use.

6. Theories of Dependence
Caused by the substance- although some substances are more addictive, the substance alone is not thought to be responsible.
Table of seven categories of dependence potential.
Demonizing of the substance.
Biological
Physiological changes produced by substances, but no direct indicator that predicts drug dependence.

7. Theories of Dependence
Addictive Personality
Popular theory of substance dependence.
Sets of personality traits contributing to addiction.
A personality trait that has statistical significance (but is not sufficient to support the theory) is sensation seeking.
In a study, although those who had become alcohol dependent scored normal, they also were more independent, nonconformist, gregarious, and impulsive.

8. Theories of Dependence
A Family Disorder
Typical patterns of family adaptation to the problem.
Enabling
Codependence
Homeostasis of the family
Adult Children of Alcoholics

9. Theories of Dependence
Addiction as a Disease (Disease Concept)
Addiction as a primary disorder rather than the previously held belief it was secondary to another diagnosis. (Could be considered another theory).
Doesn’t lend itself to the rigors of other diseases, such as blood tests.
Preferred (by the text) to be considered “like a disease.”
High Blood Pressure is a disease. Can be produced by genetic factors, behaviors, or other medical issues.

10. Crime and Violence Do drugs cause crime?
Frightening possibility that drugs change a person’s personality. What do you think?

11. Crime and Violence Do drugs cause crime?
Frightening possibility that drugs change a person’s personality. What do you think?
Remember studies indicate antisocial and criminal behavior often exist before the first substance use. Does this rule out the possibility of drugs altering personality?
Second theory is people commit crimes while under the influence, as inhibitions are lowered.
Although there is question to this theory with substances, there is an abundance of evidence it is true with alcohol.

12. Crime and Violence
Third theory suggests crime is committed to obtain money for drugs.
This is due to the inflated price of illicit drugs, not the pharmacological effects.
Forth theory suggests simply that doing drugs is a crime.
There are 1.5 million arrests for drug law violations per year.
The theory also asserts that the relationship between drug use and other forms of crime is strengthened because a person willing to break one law might be more willing than someone who hasn’t to commit a crime.