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Chapter 3

Alcohol and Other Drugs

Mooney/Knox/Schacht, Understanding Social Problems, 10th Edition. © 2017 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Chapter 3: Alcohol and Other Drugs

“Substance abuse, the nation’s number one preventable health problem, places an enormous burden on American society, harming health, family life, the economy, and public safety, and threatening many other aspects of life.”

– The Robert Wood Johnson Foundation, Institute for Health Policy, Brandeis University

Learning Objectives

Compare international drug use trends.

Propose recommendations to reduce drug abuse based on each of the three sociological theories.

Summarize the use and abuse of legal drugs.

Summarize the use and abuse of illegal drugs.

Argue which consequence of drug abuse is the most harmful for society.

Evaluate each of the treatment alternative types.

Assess the viability of each of the proposed drug-fighting strategies.

Chapter Outline

The Global Context: Drug Use and Abuse

Sociological Theories of Drug Use and Abuse

Frequently Used Legal Drugs

Frequently Used Illegal Drugs

Societal Consequences of Drug Use and Abuse

Treatment Alternatives

Strategies for Action: America Responds

Understanding Alcohol and Other Drug Use

The Global Context: Drug Use and Abuse

Sociologically, the term drug refers to any chemical substance that:

has a direct effect on the user’s physical, psychological, and/or intellectual functioning

has the potential to be abused

has adverse consequences for the individual and/or society

Drug Use and Abuse around the World (1 of 2)

Figure 3.1 Alcohol, Cigarette, and Illicit Drug Use over the Last Two Decades for 8th, 10th, and 12th Graders, 2013*

Source: N I D A 2014.

*Past 30 day use.

Drug Use and Abuse around the World (2 of 2)

Globally, 3.5 to 7.0 percent of the world’s population between the ages of 15 and 64—162 to 324 million people—reported using at least one illicit drug in the previous year

Globally, nearly 20 percent of the adult population smokes cigarettes, and 80 percent of the people who smoke cigarettes are from low- and middle-income countries.

Drug Use and Abuse in the United States

In the United States, cultural definitions of drug use are contradictory

condemning it, on the one hand (e.g., heroin),

yet encouraging and tolerating it, on the other (e.g., alcohol).

In the 1800s and the early 19 00s, opium was routinely used in medicines as a pain reliever, and morphine was taken as a treatment for dysentery and fatigue.

What Do You Think? 1

As of 2015, the recreational use of marijuana was legal in four states—Alaska, Colorado, Oregon, and Washington. Nonetheless, to date, the drug remains illegal under federal law. Do you think the federal government should legalize marijuana? What other drugs, if any, should be legal?

Sociological Theories of Drug Use and Abuse

Drug abuse occurs when acceptable social standards of drug use are violated, resulting in adverse physiological, psychological, and/or social consequences.

Chemical dependency refers to a condition where drug abuse is compulsive; users are unable to stop.

Various theories provide explanations for why some people use and abuse drugs. Theories of drug use explain how structural and cultural forces as well as biological and psychological factors influence drug use and society's responses to it.

Structural-Functionalist Perspective

Drug abuse is a response to weakening of societal norms (anomie).

Drug use is a response to the absence of a perceived bond between the individual and society.

Consistent with this perspective, a recent study on attitudes and drug use concluded that the dramatic increase in teenage use of prescription drugs is, in part, the result of:

Lax attitudes and beliefs of parents and caregivers

Parents not effectively communicating the dangers

Parents not safeguarding the prescriptions at home

Conflict Perspective

Drug use is a response to political, social and power inequality.

Drug use is an escape from alienation from work, friends and family and frustration caused by inequality.

Most powerful members of society influence the legal definition of drug use.

Symbolic Interactionist Perspective

If the label “drug user” is internalized, drug use will continue or even escalate.

Drug users learn motivations and techniques of drug use through interaction with others.

Symbols may be used for political and economic agendas (e.g., the D.A.R.E. campaign against drugs).

Biological and Psychological Theories (1 of 2)

Biological Theories

Genetics may predispose an individual to alcoholism.

Some individuals are physiologically “wired” to get more pleasure from drugs than others.

Biological and Psychological Theories (2 of 2)

Psychological Theories

Some personality types are more susceptible to drug use.

Positive reinforcement: drug use results in pleasurable experience.

Negative reinforcement: drug use reduces pain, anxiety, loneliness and boredom.

Frequently Used Legal Drugs

Alcohol: The Drug of Choice (1 of 3)

Between 2002 and 2013, the rate of current alcohol use among 12 to 17 year olds decreased steadily.

Still, alcohol remains the most widely used and abused drug in America.

In a recent poll (2014), 64% of U S adults drink alcohol, preferring beer to wine, and wine to liquor.

Alcohol: The Drug of Choice (2 of 3)

The U.S. Department of Health and Human Services defines:

Heavy Drinking as five or more drinks on the same occasion on each of five or more days in the past 30 days prior to the National Survey on Drug Use and Health.

Binge Drinking as drinking five or more drinks on the same occasion on at least 1 day in the past 30 days prior to the National Survey on Drug Use and Health.

Alcohol: The Drug of Choice (3 of 3)

Additional results from the National Survey on Drug Use and Health (2013):

Half of Americans age 12 and older consumed alcohol at least once in the month prior to the study.

Nearly 9 million current users of alcohol who were 12 to 20 years old (underage) and many of those got their alcohol for free from adults, many from parents.

Just over 14% were binge drinkers and 3.7% were heavy drinkers.

What Do You Think? 2

It’s clear that drinking norms vary between males and females, but some evidence indicates that may be changing. Why do you think binge drinking has increased among women and girls?

The Tobacco Crisis (1 of 3)

Globally, over 80% of the 1 billion smokers in the world live in low or middle-income countries.

Tobacco is one of the most widely used drugs in the United States. According to the U.S. Department of Health and Human Services survey, 66.9 million Americans – 25.5% of those 12 and older – are current tobacco users in 2013.

The Tobacco Crisis (2 of 3)

In 2014, more 8th, 10th, and 12th graders used e-cigarettes than conventional cigarettes or any other tobacco product.

16 percent of 10th graders reported using e-cigarettes compared to 7 percent using conventional cigarettes.

Although the safety of e-cigarettes remains unknown, only 15 percent of 8th grade students believe they are harmful.

The Tobacco Crisis (3 of 3)

Despite the growing popularity of e-cigarettes, many experts are concerned about the lack of research on their health impacts. Additionally, e-cigarette smokers, particularly young e-cigarette smokers, are now replacing the liquid nicotine with marijuana oil, all but eliminating telltale odor of the drug. Consequently, marijuana smoking is now taking place in locations previously unheard of including schools, malls, public walkways, and restaurants where electronic cigarette smoking is permitted.

Prescription Drugs

Psychotherapeutic drugs – nonmedical use of any prescription pain reliever, stimulant, sedative, or tranquilizer.

Approximately 6.8 million people, 2.6% of the US population 12 and older, reported current use of a psychotherapeutic drug in 2012.

Recent research suggests nonmedical use of prescription drugs is on the rise in recent years.

Frequently Used Illegal Drugs

Frequently Used Illegal Drugs (1 of 2)

More than 24.6 million people in the United States are current illicit drug users, representing 9.4% of the population ages 12 and older.

Users of illegal drugs, although varying by type of drug used, are more likely to be male, to be young, and to be a member of a minority group.

Frequently Used Illegal Drugs (2 of 2)

Figure 3.4 Past-Month Illicit Drug Use among U.S. Residents Aged 12 or Older, 2013

Source: N S D U H 2014.

Marijuana Madness (1 of 2)

Most commonly used and trafficked illicit drug.

Globally, there are between 177 and 227 million marijuana users, representing 4% of the world’s 15 to 64 year old population.

Regionally, marijuana is the most dominant illicit drug, particularly in North America.

Marijuana Madness (2 of 2)

There are more than 19.8 million current marijuana users, representing 7.5% of the U.S. population age 12 and older.

According to the Monitoring the Future (M T F) survey, after five years of increases, marijuana use declined among teens in 2014.

Cocaine: From Coca-Cola to Crack (1 of 2)

Cocaine is classified as a stimulant and, produces feelings of excitation, alertness, and euphoria.

Cocaine, made from the coca plant, has been used for thousands of years.

According to the National Survey on Drug Use and Health:

1.5 million Americans 12 years and older are current cocaine (including crack) users, representing 0.6% of the population.

Cocaine: From Coca-Cola to Crack (2 of 2)

Crack is a crystallized product made by boiling a mixture of baking soda, water, and cocaine.

The result, also called rock, base, and gravel, is relatively inexpensive and was not popular until the mid-19 80s.

Crack dealers often give drug users their first few “hits” free, knowing the drug’s intense high and addictive qualities are likely to produce returning customers.

Methamphetamine: The Meth Epidemic

Methamphetamine (meth, speed, crank) is a central nervous system stimulant that can be injected, snorted, smoked, or ingested orally and is highly addictive.

The use of meth has steadily decreased over the last decade.

Today, use is fairly low, with about 1% of 8th, 10th, and 12th graders reporting lifetime use.

Methamphetamine

For those who use methamphetamine, the physical transformation is remarkable. The time lapse between the before (left) and after (right) pictures of this meth user is only three years, five months.

Heroin: The White Horse

Heroin is a painkiller and is the most commonly abused opiate drug.

Highly addictive, heroin can be injected, snorted, or smoked.

If intravenous injection is used, the euphoric effects are felt within 7–8 seconds; if heroin is snorted or smoked, the effects are felt within 10–15 minutes.

What Do You Think? 3

Inhalants include adhesives, food products, aerosols, anaesthetics, gases, and cleaning agents—more than 1,000 household products in total. “Huffing” is a serious problem and can lead to sudden sniffing death syndrome, but the availability of inhalants cannot be legally controlled. What would you do to attack this potentially deadly practice?

Synthetic Drugs

Synthetic drugs – a category of drugs that are “designed” in laboratories rather than naturally occurring in plant material.

Synthetic marijuana use is higher in the U S than in other parts of the world.

“Bath Salts” – A.K.A. Zoom, Cloud Nine, Blue Silk, and Hurricane Charlie, bath salts are highly addictive synthetic stimulants.

Hallucinogens includes L S D and Ecstasy (M D M A)

Societal Consequences

The Cost to Children and Family

It is estimated that 1 in 10 U.S. children live with at least one parent in need of treatment for drug or alcohol dependency.

Children raised in such homes are more likely to:

Live in an environment riddled with conflict

Have a higher probability of physical illness including injuries or death from automobile accidents

Are more likely to be victims of child abuse and neglect

Crime and Drugs (1 of 2)

The drug behavior of individuals arrested, incarcerated, and in drug treatment programs also provides evidence of a link between drugs and crime.

The relationship between crime and drug use, however, is complex. Sociologists disagree to whether drugs actually “cause” crime or whether, instead, criminal activity leads to drug involvement.

Crime and Drugs (2 of 2)

In addition to the hypothesized crime–drug use link, some criminal offenses are defined by use of drugs: possession, cultivation, production, and sale of controlled substances; public intoxication; drunk and disorderly conduct; and driving while intoxicated.

The High Price of Alcohol and Other Drug Use

A report by the National Center on Addiction and Substance Abuse at Columbia University (C A S A 2009) set the total annual cost of substance abuse and addiction in the United States at $467.7 billion.

The report contends that, for every dollar spent on drug abuse by federal and state governments:

95.6 cents went to shoveling up the wreckage and only 1.9 cents on prevention and treatment, 0.4 cents on research, 1.4 cents on taxation or regulation and 0.7 cents on interdiction.

What Do You Think? 4

In Alabama a woman can be charged with “chemical endangerment” if she uses a controlled substance while pregnant (Alabama Code 2015). Do you think all states should have such a law? Should a pregnant woman be arrested for smoking? For drinking a glass of wine? For refusing to take prenatal vitamins?

Physical and Mental Health Costs (1 of 2)

Cigarette smoking is the leading preventable cause of disease and death in the world.

According to the World Health Organization (2014b):

Half of all tobacco users, 6 million people, will die from its use.

If nothing changes, that number could rise to 8 million by 2030.

Americans who smoke are 2X as likely to develop coronary heart disease and/or have a stroke.

Physical and Mental Health Costs (2 of 2)

Annually, alcohol abuse is responsible for over 3.3 million deaths, 6 percent of all deaths worldwide. Alcohol kills more people than A I D S, tuberculosis, or violence, and is annually responsible for 88,000 deaths in the United States.

Maternal prenatal alcohol use is associated with one of the leading preventable causes of birth defects and developmental disabilities in children, fetal alcohol syndrome, a syndrome characterized by serious physical and mental handicaps, including low birth weight, facial deformities, mental retardation, and hearing and vision problems.

The Cost of Drug Use on the Environment

Although not something usually considered, the production of illegal drugs has a tremendous impact on the environment.

Much of the impact is a consequence of the cultivation of marijuana, cocaine, and opium.

For example, the Colombian government estimates that during the decades of 19 88 to 2008, nearly 5.4 million acres of rainforest (an area the size of New Jersey) were destroyed because of illegal drug production.

Treatment Alternatives (1 of 2)

In 2013, 21.6 million people aged 12 or older were classified as either dependent on or abusers of alcohol or illicit drugs.

Individuals seeking treatment have several options: family therapy, counseling, private and state treatment facilities, community care programs, pharmacotherapy (i.e., use of treatment medications), behavior modification, drug maintenance programs, and employee assistance programs.

Treatment Alternatives (2 of 2)

Figure 3.5 Locations Where Past Year Substance Abuse Treatment Was Received among Persons Aged 12 or Older, 2013

Source: N S D U H 2014.

Treatment Alternatives

Inpatient and Outpatient Treatment (1 of 2)

Inpatient treatment refers to treatment of drug dependence in a hospital and, most importantly, includes medical supervision of detoxification.

The longer patients stay in treatment, the greater the likelihood of a successful recovery.

Inpatient and Outpatient Treatment (2 of 2)

Offenders who were the least likely to complete treatment:

(1) had a history of significant problems with their mothers

(2) had problems with their sexual partners in the 30 days prior to admission to the program,

(3) had longer periods of incarceration

(4) had used heroin in the 30 days prior to admission to the program

(5) were younger in age than those who successfully completed the program.

Twelve-Step Programs

Both Alcoholics Anonymous (A A) and Narcotics Anonymous (N A) are voluntary associations whose only membership requirement is the desire to stop drinking or taking drugs.

A A and N A are self-help groups in that nonprofessionals operate them, offer “sponsors” to each new member, and proceed along a continuum of 12 steps to recovery.

Drug Courts

Drug courts are special courts that divert drug offenders to treatment programs in lieu of probation or incarceration.

A cost–benefit analysis sponsored by the National Institute of Justice examined 23 drug courts and 1,787 drug offenders.

The authors conclude that “drug courts are doing exactly what they are supposed to do”

Strategies for Action: America Responds

Strategies for Action: America Responds (1 of 2)

Because society sends mixed messages about the acceptability of drug use, many programs, laws or initiatives may be unrealistic. Nevertheless, numerous social policies have been implemented or proposed to help control drug use and its negative consequences with various levels of success.

Alcohol, Tobacco, and Prescription Drugs

There are a number of promising strategies aimed at reducing alcohol and tobacco use including the following:

Economic Incentives

Government Regulations

Legal Action

Prevention

Strategies for Action: America Responds (2 of 2)

Raising the costs of tobacco by 10 percent is associated with a 4 percent decrease in tobacco consumption in high income countries and a 5 percent decrease in tobacco consumption in low and middle income countries (W H O 2014c).

Illegal Drugs (1 of 5)

The War on Drugs: In the 19 80s, the federal government declared a “war on drugs,” which was based on the belief that controlling drug availability would limit drug use and, in turn, drug-related problems. This “zero-tolerance” approach advocates get-tough law enforcement policies, and is responsible for the dramatic increase in the jail and prison population.

The contrasting idea to the “war on drugs” is a harm reduction position, which focuses on minimizing the costs of drug use for both user and society (e.g., distributing clean syringes to decrease the risk of H I V infection).

Illegal Drugs (2 of 5)

Effects of the “War on Drugs”

In 19 80, there were an estimated 41,000 drug offenders in jail or prison; in 2011, there were more than half a million.

Required prison sentences for almost all drug offenders – first time or repeat – and limited judicial discretion in deciding what best served the public’s interest.

Is it working? Is it stopping the flow of illegal drugs into the U.S. and lowering drug-related problems?

There are also concerns that present policies are not only ineffective but create collateral damage.

Illegal Drugs (3 of 5)

Deregulation or Legalization:

Deregulation is the reduction of government control over certain drugs.

Legalization is making prohibited behaviors legal; for example, legalizing drug use or prostitution.

Decriminalization, which entails removing state penalties for certain drugs, promotes a medical rather than criminal approach to drug use that encourages users to seek treatment and adopt preventive practices.

What Do You Think? 5

In a recent interview Marianne Alexander, a civil rights activist and law professor at Ohio State University, in reference to the trend toward the legalization of marijuana made the observation that “Forty years of impoverished black kids getting prison time for selling weed, and their families and futures destroyed…Now, white men are planning to get rich precisely doing the same thing” (quoted in Jarecki 2014). What do you think of Alexander’s comments?

Illegal Drugs (4 of 5)

Figure 3.7 Federal Drug Control Spending by Function, Fiscal Year 2016

Source: White House 2015.

Illegal Drugs (5 of 5)

State Initiatives:

Several initiatives have resulted in statewide referendums concerning the cost effectiveness of government policies.

Over the past decade, voters and state governments have enacted significant drug policy reforms.

Understanding Alcohol and Other Drug Use

In summary, substance abuse—that is, drugs and their use—is socially defined. As the structure of society changes, the acceptability of one drug or another changes as well.

There are two issues that need to be addressed in understanding drug use.

The first is at the micro level—why does a given individual use alcohol or other drugs? Many individuals at high risk for drug use have been “failed by society.”

The second question, related to the first, asks why drug use varies so dramatically across societies, often independent of a country’s drug policies.

Quick Quiz 1

Which drug use is the leading preventable cause of death in the United States?

A. cigarette smoking

B. alcohol use

C. heroin

D. cocaine

Answer for Quick Quiz 1: A

Cigarette smoking is the leading preventable cause of death in the United States.

Quick Quiz 2

If the government reduced its control over various illegal drugs that would be termed:

A. legalization.

B. deregulation.

C. decriminalization.

D. interdiction.

Answer for Quick Quiz 2: B

If the government reduced its control over various illegal drugs that would be termed deregulation.

Quick Quiz 3

Which substance is the most widely used and abused drug in the United States?

A. nicotine

B. cocaine

C. marijuana

D. alcohol

Answer for Quick Quiz 3: D

Alcohol substance is the most widely used and abused drug in the United States.

Quick Quiz 4

A conflict theorist would argue that the war on drugs:

A. all of these choices.

B. unfairly targets minorities.

C. has resulted in the changing of definitions and labels.

D. contributes to society by providing thousands of jobs for people.

Answer for Quick Quiz 4: B

A conflict theorist would argue that the war on drugs unfairly targets minorities.

Quick Quiz 6

The most commonly used and most heavily trafficked illegal substance in the world is:

A. cocaine.

B. methamphetamines.

C. heroin.

D. marijuana.

Answer for Quick Quiz 6: D

The most commonly used and most heavily trafficked illegal substance in the world is marijuana.

Psychology soc assignments 3

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