Sociology of Addiction Research Paper Starter

Sociology of Addiction

According to the World Health Organization (WHO), addiction is a worldwide problem. Indeed, more than 15.3 million people confront drug abuse issues internationally, and the abuse of alcohol results in 2.5 million deaths every years (World Health Organization, 2012). A British Social Trends report (2002) notes that drinking, smoking, and drug addictions are rising in the United Kingdom, especially among young people, with more than 50 percent of teenage boys consuming these substances regularly by the age of fifteen. In the United States, the incidence of addiction is so high that there are insufficient trained professionals to assist those affected by drug abuse (Brandeis University Institute for Health Policy, 1993), precipitating a crisis in treatment. "Fewer than one-fourth of the persons in need of alcohol and drug abuse services in the United States actually receive treatment" (p. 60, as cited in American Psychiatric Association, 2008). Yet, according to WHO, such rehabilitation is cost- effective, saving seven dollars in "health and social costs" for every one dollar invested in drug treatment programs (WHO, 2008). The establishment and endorsement of addiction prevention and treatment programs are somewhat compromised by debates and controversies over cause.

Keywords Abstinence; Abuse; Addiction; Chronic; Compulsive; Disease; National Institute on Drug Abuse (NIDA); Predisposition; Relapse; Responsibility; Volition

Deviance

Overview

According to the World Health Organization (WHO), addiction is a worldwide problem. Indeed, more than 15.3 million people confront drug abuse issues internationally, and the abuse of alcohol results in 2.5 million deaths every years (World Health Organization, 2012). A British Social Trends report (2002) notes that drinking, smoking, and drug addictions are rising in the United Kingdom, especially among young people, with more than 50 percent of teenage boys consuming these substances regularly by the age of fifteen. In the United States, the incidence of addiction is so high that there are insufficient trained professionals to assist those affected by drug abuse (Brandeis University Institute for Health Policy, 1993), precipitating a crisis in treatment. "Fewer than one-fourth of the persons in need of alcohol and drug abuse services in the United States actually receive treatment" (p. 60, as cited in American Psychiatric Association, 2008). Yet, according to WHO, such rehabilitation is cost- effective, saving seven dollars in "health and social costs" for every one dollar invested in drug treatment programs (WHO, 2008). The establishment and endorsement of addiction prevention and treatment programs are somewhat compromised by debates and controversies over cause.

Defining Addiction

Addiction is "a chronic relapsing illness with onset typically occurring in the early teenage years, followed by cycles of drug use and abstinence" (Elkashef, Biswas, Acri and Vocci, 2007). The source of addiction is complex and entails interactions between biological factors (specifically genes) and environmental factors. Some research suggests that some people are born with a higher tendency to become addicted (NIDA, 2008). According to this argument, addiction is a biological disease, much like diabetes or hypertension, and acquiring the tendency (or predisposition) to addiction is as much out of a person's control as the predisposition to some other diseases.

Alternately, the environment in which people develop (including how they are parented, their socioeconomic status of origin, peer group influences, traumatic or stressful experiences and their levels of education) produces protective or risk-enhancement effects (Elkashef, Biswas, Acri and Vocci, 2007). While many laypeople may view addictive behavior as a choice, there is a growing consensus that both biology and environment are factors in addiction.

Nonetheless, even with explanations about brain chemistry and genetic predisposition, certain images of addiction prevail: the beggar on skid row or the drunk driver. Those images are powerful, and scientific jargon does not erase them from the cover of newspapers or the lead story on the six o'clock news. Concomitantly, Alan I. Leshner (1997) notes the difficulty in addressing such stereotypes:

One major barrier [to treatment] is the tremendous stigma attached to being a drug user or, worse, an addict. The most beneficent public view of drug addicts is as victims of their societal situation. However, the more common view is that drug addicts are weak or bad people, unwilling to lead moral lives and to control their behavior and gratifications … We need to face the fact that even if the condition initially comes about because of a voluntary behavior (drug use), an addict's brain is different from a nonaddict's brain … Recall that as recently as the beginning of this century we were still putting individuals with schizophrenia in prison like asylums, whereas now we know they require medical treatments (par. 4).

Amphetamine-type stimulants are the second most widely abused drugs worldwide, after cannabis (United Nations Office on Drugs and Crime, 2011). According to the WHO Report on the Global Tobacco Epidemic (2013), 19 percent of Americans smoked nicotine in 2012 and tobacco kill nearly six million people each year, up to half of all tobacco users. In many instances, people who become addicted first use substances voluntarily. As Linda S. Cook (2001) noted, most teenagers have used some substance by the time they turn eighteen. One recent study (Sweeting & West, 2008) on the lifetime prevalence of drug use among a cohort of people in the United Kingdom (which tracked use over twenty years), found that drug use, in general, rose from 9 percent at the age of fifteen to 58 percent by age twenty-three.

Many addicts go through a cycle of abuse and recovery that is difficult to explain. As Leshner (2008) observes:

Many people equate addiction with simply using drugs and therefore expect that addiction should be cured quickly, and if it is not, treatment is a failure. In reality, because addiction is a chronic disorder, the ultimate goal of long-term abstinence often requires sustained and repeated treatment episodes (p. 10).

This cycle of repeated treatment and relapse is difficult for individuals with addiction, their families, and the general public to understand and can also be viewed as an excuse for an addict's behavior. Davies (1997) notes that the biological source of addiction may be accepted for the wrong reasons, as a means to absolve people who behave badly because the disease is out of their control.

Further Insights

Neurobiology

The biological explanation for addiction is based on research linking addiction to significant changes to brain chemistry caused by repeated substance use. Different kinds of drugs produce particular responses in precise areas of the brain, although the mechanisms underpinning these responses vary, as do the outcomes (Elkashef, Biswas, Acri & Vocci, 2007). For instance, Leshner (1997) notes:

Virtually all drugs of abuse have common effects, either directly or indirectly, on a single pathway deep within the brain … Activation of this system appears to be a common element in what keeps drug users taking drugs. Not only does acute drug use modify brain function in critical ways, but prolonged drug use causes pervasive changes in brain function that persist long after the individual stops taking the drug … The addicted brain is distinctly different from the nonaddicted brain, as manifested by changes in brain metabolic activity, receptor availability, gene expression, and responsiveness to environmental cues … That addiction is tied to changes in brain structure and function is what makes it, fundamentally, a brain disease (p. 45).

According to Nora Volkow (2008), director of the National Institute on Drug Abuse (NIDA), the recognition of addiction as a biological disease has not only changed the way of thinking about addiction for the scientific community but also the options for treatment.

When science began to study addictive behavior in the 1930s, people addicted to drugs were thought to be morally flawed and lacking in willpower. Those views shaped society's responses to drug abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punitive rather than preventative and therapeutic actions … addiction is a disease that affects both brain and behavior. We have identified many of the biological and environmental factors and are beginning to search for the genetic variations that contribute to the development and progression of the disease (Volkow, 2008, n.p.).

Genetics

In addition to biochemical factors and the cycle of addiction outlined above, according to D. Ball, M. Pembrey, and D. Stephens (2005), genetics is also a causal factor linked to addiction. For instance, they note:

Twin and adoption studies show that genetics contributes (along with environment) to our vulnerability to different types of addiction, probably via genes that regulate the metabolism of psychoactive drugs and the brain neurotransmitter systems on which they act (as cited in Hall, 2006, p. 1530).

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