1 page essay (single space)

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Chapter 2

Drug Use as a Social Problem

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Costs of Drug Use to Society

• Deaths
• Emergency room visits
• Drugs in the workplace and lost productivity
• Broken homes, illnesses, shorter lives, etc.
• Cost of maintaining habit
• Cost of criminal behavior
• Cost of treating patients
• Fetal alcohol syndrome
• Others?

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Changing Attitudes

• What made the government change from the laissez-faire attitude of the 1800s to one of control?
• Toxicity
• Dependence
• Crime

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Toxicity

Toxic = poisonous, deadly, or dangerous

• What makes a drug toxic?
• Amount used
• How it is used
• What the user did while on the drug

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Drug-Related Toxicity

Examples of acute toxicity

• Behavioral: “Intoxication” that impairs the actions of drug users and increases the danger to themselves and others
• Physiological: Overdose that causes the user to stop breathing

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Drug-Related Toxicity

Examples of chronic toxicity

• Behavioral
• Personality and lifestyle changes
• Effects on relationships with friends and family
• Physiological
• Heart disease
• Lung cancer
• Cirrhosis
• Other health effects

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Blood-Borne Diseases

• Specific toxicity for users who inject drugs
• AIDS, HIV infection, and hepatitis B and C
• Sharing needles passes infectious agents directly into the bloodstream
• Some states, cities prohibit

needle purchase without Rx

• Syringe exchange programs

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Substance Dependence

• Three basic processes
• Tolerance
• Physical dependence
• Psychological dependence

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Tolerance

• Diminished effect on the body after repeated use of the same drug
• The body develops ways to compensate for the chemical imbalance caused by the drug
• Regular drug users may build up tolerance to the extent that their dosage would kill a novice user

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Physical Dependence

• Physical dependence is defined by the occurrence of a withdrawal syndrome
• Tolerance typically precedes physical dependence
• If drug use is stopped suddenly, withdrawal symptoms occur, ranging from mild to severe
• Physical dependence means the body has adapted to the drug’s presence

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Psychological Dependence

• Psychological or behavioral dependence
• High frequency of drug use
• Craving for the drug
• Tendency to relapse after stopping use
• Behavior is reinforced by the consequences
• Over time, this becomes the biggest reason users report they continue to use

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Changing Views of Dependence

• Early medical model = true addiction involves physical dependence; key is treatment of withdrawal symptoms
• Positive reinforcement model = drugs can reinforce behavior without physical dependence
• Psychological dependence is increasingly viewed as the driving force behind repeated drug use
• This refutes the sometimes common belief that drugs that aren’t as strongly physically addicting are less dangerous

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.

Is Dependence
Caused by the Substance?

• Some drugs are more likely than others to lead to dependence
• Method of use, as well as other factors, influences risk of dependence
• The “war on drugs” reflects the perspective that drugs are themselves evil

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Is Dependence Biological?

• Is dependence due to biochemical or physiological actions in the brain?
• Still no way to scan the brain and know if a person has/had developed dependence
• Genetic physiological or biochemical markers have been sought as well, but none has proven reliable

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Is There an “Addictive Personality”?

• No way to know if the drug or the drug use changes a person’s personality
• Many other factors affect personality
• Sensation-seeking = a personality characteristic statistically associated with early substance use and abuse

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Is Dependence a Family Disorder?

• Alcohol dependence often exists within a dysfunctional family
• Evidence suggests that dysfunctional relationships play a role in dependence, but they aren’t the only factor

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Is Substance Dependence a Disease?

• Founders of AA characterized alcohol dependence as a disease
• Others argue that dependence doesn’t have all the characteristics of a disease
• There are ways to test and treat the effects of alcoholism but not the disease itself
• There is some disagreement over how to define disease as well

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Biopsychosocial Perspective

• Dependence is related to dysfunctions of:
• Biology
• Personality
• Social interactions

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Drugs and Crime

• Drug use may change a person’s personality
• People under the influence may commit crimes (e.g., many cases of homicide, domestic violence, etc.)

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Drugs and Crime

• Crimes may be carried out to obtain money for drugs
• Drug use is a crime

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Why We Regulate Drugs

• We want to protect society from the dangers of some types of drug use = legitimate social purpose
• Some laws are not developed as part of a rationally devised plan and may not be realistic or effective
• Current laws