Society/Discussion

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in heart rate and blood pressure, and gooseflesh

(which is responsible for the term cold turkey). Cramp- ing and abdominal pains are also common.

As mentioned above, physical dependence (or

neuroadaptation) is a physiological response to

repeated dosing with morphine and is seen in virtu-

ally all patients repeatedly given morphine or another

opiate drug. Physical dependence, however, is distin-

guished from drug dependence or addiction, which

is defined by drug-seeking behavior. While addiction

is common among drug abusers, it is rare when

morphine is used for appropriate medical conditions.

The reasons for this difference were not clear as of

2008, and they remain a major issue in understand-

ing and treating opiate addiction.

See also Addiction: Concepts and Definitions; Diagnostic and Statistical Manual (DSM); Opiates/Opioids; Opioid Complications and Withdrawal.

B I B L I O G R A P H Y

Reisine, T., & Pasternak, G. (1996) Opioid analgesics and

antagonists. In J. G. Hardman et al. (Eds.), The phar-

macological basis of therapeutics (9th ed., pp. 521–555.

New York: McGraw-Hill.

GAVRIL W. PASTERNAK

n

MOTHERS AGAINST DRUNK DRIV- ING (MADD). Mothers Against Drunk Driving (MADD) is a national organization that works to

reduce drunk driving and to help the victims of drunk

driving accidents. Many of MADD’s members are

volunteers who have personally suffered from the

results of drunk driving.

MADD was founded by Candy Lightner,

whose 13-year-old daughter, Cari, was killed by a

drunk driver on May 3, 1980. Lightner was out-

raged to learn that only two days before the acci-

dent that killed her daughter, the driver had been

released from jail, where he had been held for

another hit-and-run drunk driving crash. Although

he had been arrested for drunk driving several

times before, he was still driving with a valid Cal-

ifornia license. Candy Lightner decided to begin a

campaign to keep drunk drivers off the road so that

other mothers would not have to suffer the anguish

she was experiencing. On September 5 (Cari’s

birthday), 1980, MADD was originated.

Since then, MADD has evolved into an organ- ization with millions of members and hundreds of local chapters across the United States. Chapters have also been started in Canada, Great Britain, New Zealand, and Australia. Membership is not restricted to mothers of victims or to the victims themselves. Everyone who is concerned about the drunk driving issue is welcome to join. Funding for the organization comes from membership dues and contributions. MADD also applies for and receives grants from federal and state governments and pri- vate organizations. Paid staff members are employed to provide leadership on the state and national lev- els. MADD is involved in three major kinds of activity: (1) advocacy for stricter drunk driving laws and better enforcement, (2) promotion of public awareness and educational programs, and (3) assis- tance to victims.

THE LEGISLATIVE AGENDA

According to MADD, drunk driving is a violent crime. One of its rallying slogans is ‘‘Murder by Car Is Still Murder!’’ Over the years, MADD mem- bers have worked to generate public support for passage of stricter drunk driving legislation, puni- tive sanctions, and more consistent enforcement measures aimed at deterring drunk driving. In the 1980s, intense lobbying efforts were undertaken for the passage of laws making 21 the minimum legal age for drinking (now in force in all 50 states). The group believes that this measure has saved thousands of young lives that would have been lost in drunk driving crashes.

MADD has also lobbied for changes in judicial procedures that would make the system more responsive to victims of drunk driving. For exam- ple, in many states victims had been barred from the courtroom during the trial of their own drunk driving cases because their testimony (or even their presence) might prejudice the jury. Because of the efforts of MADD and other groups, victims’ rights bills have now been passed in all states. These ensure that victims will be notified about court hearings and, in most states, allowed to testify about the impact of the crime on their lives. Other lobbying efforts have sought to close legal loop- holes that drunk drivers were using to avoid

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punishment. For example, drivers might have refused to take a Breathalyzer or blood test for intoxication and were allowed to plead guilty to a lesser charge. In other cases, drivers were allowed to claim that despite their high blood alcohol con- tent, their driving was not really impaired.

MADD has been instrumental in the passage of more than 1,000 tougher drunk driving laws that close these loopholes and institute other deterrent measures, such as mandatory jail sentences for drunk drivers. MADD also supports efforts to require offenders to undergo treatment for alco- holism and/or drug dependency, if this is deemed necessary.

PUBLIC AWARENESS AND EDUCATION

MADD is involved in various efforts to raise public

awareness and concern about drunk driving. The

National Candlelight Vigil of Remembrance and

Hope is held in many locations each December,

drawing victims together to give public testimony

to the suffering that results from drunk driving. Dur-

ing the Red Ribbon: Tie One On for Safety cam-

paign, which takes place between Thanksgiving and

New Year’s Day, MADD encourages citizens to

attach a red ribbon to their car as a reminder to

themselves and others to drive sober. MADD’s

well-known public awareness campaign of the past

used the slogan, ‘‘Think . . . Don’t Drink and Drive’’

in public-service announcements on radio and tele-

vision and in print materials. A more recent cam-

paign, ‘‘Keep It a Safe Summer (KISS),’’ emphasized

the need for sobriety during recreational activities

that involve driving, boating, and other activities

that might pose a danger when under the influence

of alcohol. MADD also provides curriculum mate-

rials for schools and each year sponsors a poster

and essay contest for children on the subject of

drunk driving.

ASSISTANCE TO VICTIMS

Programs that provide aid to victims of drunk driv- ing crashes constitute the heart of MADD’s mis- sion. Support groups help victims share their pain with others who understand their feelings. MADD members send ‘‘We Care’’ cards to victims of recent crashes. Specially trained victim advocates offer a one-on-one personal relationship with vic- tims, trying to respond to both their emotional and

practical needs. Victims are briefed on their legal rights and on the judicial procedures relevant to their cases. They can call a toll-free number (1- 800-GET MADD) for information and help in case of a crisis. MADD also offers death-notification training for police and specialized training for other community professionals, such as clergy and med- ical workers, who are called on to assist victims.

‘‘20 � 2000’’ Since the founding of MADD in 1980, the per- centage of alcohol-related traffic fatalities has stead- ily decreased, from almost 60 percent to around 50 percent. In 1995, MADD established ‘‘20 � 2000,’’ a program that sought to reduce that pro- portion by an additional 20 percent by the year 2000. Intensified efforts focused on more effective law enforcement, increased sanctions, and preven- tion programs that included education for youth and more responsible marketing and service practi- ces in liquor establishments. The program coin- cided with federal laws tying state highway funding to passage of state legislation establishing zero tol- erance laws aimed at drunk drivers. Because of its concerted efforts in changing the culture of how many Americans perceived drunk driving and its risks, MADD reached its ‘‘20 � 2000’’ goal three years early, when alcohol-related traffic fatalities fell to below 40 percent nationally by 1997.

See also Blood Alcohol Concentration; Blood Alcohol Concentration, Measures of; Breathalyzer; Dram- shop Liability Laws; Driving, Alcohol, and Drugs; Driving Under the Influence (DUI); Legal Regu- lation of Drugs and Alcohol; Minimum Drinking Age Laws; Psychomotor Effects of Alcohol and Drugs.

B I B L I O G R A P H Y

Bloch, S. A., & Ungerleider, S. (1988). Whither the drunk driving movement? The social and programmatic ori- entations of Mothers Against Drunk Driving. In F. B. Dickman (Ed.), Alcohol and traffic safety. New York: Pergamon.

Cerulo, K. A. (2006). Never saw it coming: Cultural chal- lenges to envisioning the worst. Chicago: University of Chicago Press.

Lightner, C. (1987). Youth and the road toll. In P. C. Noordzij & R. Roszbach (Eds.), Alcohol, drugs and traffic safety. Amsterdam: Elsevier.

Mann, P. (1985). Arrive alive. New York: McGraw-Hill.

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Mothers Against Drunk Driving home page: http:// www.madd.org/.

Sadoff, M. (1990). America gets MADD. Irving, TX: Moth- ers Against Drunk Driving.

DIANNE SHUNTICH REVISED BY MATTHEW MAY (2009)

n

MOVIES. The use and abuse of substances may be observed in movies from virtually any genre,

location, and era. One of the earliest examples of

drug use in film is the 1906 French movie Les Rêves d’un Fumeur d’Opium (The Opium Smoker’s Dream). Substances may play a minor role in a

movie, serving to enhance a particular storyline or

character. Alternatively, they may play a central

role, representing aspects of use and abuse at the

individual, community, or societal level. Although

the portrayal of substances in movies may have a

particular entertainment value, it is important to

recognize that they may also shape a viewer’s belief

system and stereotypes about persons who use and

abuse substances.

Research guided by social learning theory

shows that ‘‘learning is achieved through not only

direct experience but also through observation’’

(Stout et al., 2004, p. 544; see also Bandura,

2002). This suggests that viewer perceptions of

persons who use and abuse alcohol and drugs can

be directly influenced by the portrayal of substan-

ces in films. In a review of more than 50 movies,

Cape (2003) found that both positive and negative

stereotyping surround the use and abuse of sub-

stances. The major stereotypes include the tragic

hero, rebellious free spirit, demonized addict/

homicidal maniac, and humorous/comedic user.

In addition to shaping beliefs, films can provide a

historical context, helping the viewer to under-

stand the broader culture and beliefs about sub-

stances during a particular time. This entry high-

lights some of the different genres of movies that

portray the use and abuse of substances, the types

of characters exemplifying the stereotypes out-

lined by Cape (2003), and the interplay between

different genres of movies and the historical

context.

DRAMAS

Dramas provide fictional accounts of the lifestyle or

culture associated with substance use, varying sig-

nificantly in their realism. They offer the viewer a

unique perspective into buying and selling substan-

ces, the social contexts in which they are used, and

their biopsychosocial consequences, exhibiting sig-

nificant heterogeneity in realism and accuracy.

Some of the earliest movies were influenced by an

era of severe moralistic reasoning. For example,

Dorothy Davenport produced Human Wreckage (Davenport & Wray, 1923), which served as a

drug-prevention film following the morphine-

related death of her husband Wallace Reid. In this

film, drug use was associated with moral deficiency

in a propaganda-like manner. It provided defini-

tions of moral behavior in the midst of numerous

Hollywood scandals. Such events and the emphasis

on morality guided the architecture of the Produc-

tion Code of the Motion Picture Industry (better

known as the Hays Code) of the 1930s. This was

an attempt by the Motion Picture Association of

America to explicitly define what was acceptable in

movies, with the ultimate goal of advancing proper

or moral behavior. From the Hays Code emerged

films that contained substances as a central theme,

with a clear purpose of propaganda.

At a time when very little knowledge about substances existed, these movies helped warn parents and youth about the jeopardy of one’s morality when using illicit substances. For example, the films Reefer Madness (Hirliman & Gasnier, 1936) and Assassin of Youth (Brown & Clifton, 1937) showed well-adjusted individuals having extreme and sensational reactions when high on mar- ijuana. These films suggested that typical responses include insanity, suicidal behavior, and violence, and connected marijuana use with premarital sex and lis- tening to jazz music, two societal taboos of the time. Similar portrayals of other drugs can be found in films of the same period, such as Cocaine Fiends (Kent & O’Connor, 1935). In The Lost Weekend (Brackett & Wilder, 1945), the main character engages in a week- end of binge drinking. Subsequent to his intoxication, he becomes involved in criminal activity and serves time as a patient in a psychiatric ward.

The Man with the Golden Arm (Preminger & Preminger), released in the 1950s, also illustrated themes similar to those of the early propaganda

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M O V I E S