Sociology of Substance Abuse - Exam #1

constructed reality

meaning is not something that is inherent in things; it is a property that arises out of the interaction that takes place among people in the course of their daily lives (alcohol, steroids, supplements, & marijuana)

drug addiction

a condition characterized by the physical need for a drug, commonly accompanied by physical symptoms when a drug is withdrawn (medical model)

medical model

involves defining deviance as a medical problem or “disease”

• this has become an increasingly popular way to view deviant behavior in our society

• alcoholism, drug addiction, gambling, sexual behavior, shopping, ADD/ADHD

• main advantage is a humantarian benefit: less condemnation of individual because they are seen as “sick” and not “immoral”

assumptions of the medical model

• deviance is caused by a physical or biological defect

• deviance is pathological - it is a sickness residing within the individual

• there is a qualitiative different between deviants and non-deviants

• deviants will deteriorate without treatment

criticisms of the medical model

• lack of objective diagnostic criteria - psychology and psychiatry lack specificity of other types of medicine

• expert control and domination - a big business

• medical social control - things can be done in the name of medicine that wouldn’t be done other wise

• lack of personal responsibility- people aren’t held responsible for their own behavior

moral entrepreneurs

interest groups that attempt to control social life by promoting their own personalvset of moral values and establishing them as law (MADD, religious groups, gun control lobby, PETA, & anti-smoking lobby)

• rule creation is a social process - a product of someone else’s initiative

Howard Becker

argued that legal and social rules are frequently created by moral entrepreneurs

drug abuse

the use of a drug in such a way that it leads to unintended personal, interpersonal, or social consequences

prototype rule creator

a crusading reformer who believes something is evil in society

• fervent and often self-righteous

• often have strong humanitarian motives - think their ideas are good for society and will provide a better way of life

• typically members of upper-levels of society who wish to help those beneath them

• often assisted by those with less pure motives (polticians, lawyers, etc.)

David Courtright

historian that argued that “what we think about addiction depends on who is addicted”

Erik Roskes

called the war on drugs “eugenics without surgery”

• mass incarceration for drug-related offenses of person who disproportionately come from relatively powerless groups

_____, ________, and __________ have been closely tied to reactions to drugs in the U.S.

race, ethnicity, and religion

• Irish Catholics and alcohol; Chinese and opium; Blacks and cocaine; Mexicans and marijuana; “hippies” and heroin

When was the open availability of most drugs like morphine and opium?

late 19th century

Pure Food and Drug Act (1906)

• required patent medicines to indicate on label whether certain drugs were contained in them

• targeted narcotics, cocaine, and cannabis

• first federal law regulating drugs and it opens the door for future regulation efforts

• it also began the tendency to classify certain drugs as “dangerous”

Harrison Narcotic Tax Act (1914)

• federal law that regulated and taxed the production, importation, and distribution of opiates and coca products

• made in unlawful to sell, barter or give away narcotics except in pursuance with a written order from the IRS

• written as a “tax/revenue” measure

• supreme court later ruled that drug possession was illegal under this act

• the use of the term “narcotics” in the title of the act to describe not just opiates but also cocaine-which is a central nervous system stimulant, not a narcotic

• supported by both the American Medical Association and the American Pharmaceutical Association

Marijuana Tax Act (1937)

• required sellers of marijuana to register with the government and pay taxes

• soon after passage of the act, arrests were made for possession of marijuana without paying taxes since “theoretically” someone could distribute marijuana

• the results of lobbying efforts by the FBN resulted in 46 states adopting anti-marijuana laws at that time

prohibition

• made alcohol illegal

• all states did not repeal prohibition in 1933

• hundred of counties are still “dry” (46 in Texas, 55 in Kentucky, and half of those in Mississippi)

• regarded as a dismal failure for a number of reasons: 1. help organized crime groups to grow and prosper, 2. led to widespread corruption of police and public officials, 3. lead to increasing violence, since illegal transactions are governed by the parties and not the “rule of law”

Volstead Act (1919)

defined intoxicating beverages as those containing 0.5% or more alcohol by volume and prohibited the manufacture, sale, transportation, and possession of such beverages

18th Amendment (1920)

prohibited the manufacture, sale, and transportation of intoxicating liquors in the United States, marking the beginning of the Prohibition Era.

21th Amendment (1933)

repealed prohibition

Symbolic Crusade

• author: Joseph Gusfield

• extremely influential book that argued that the temperance movement was about power and politics and not alcohol

• drinking and abstinence became symbols of social status, identifying social levels of the society whose styles of life separated them culturally

• temperance was one way in which a declining social elite tried to retain some of its social power and leadership

• the repeal of the 18th amendment gave the final push to the decline of old middle-class values in American culture

What are the three ways of the triple wave epidemic?

1. Prescription Opioid Pills

2. Heroin

3. Synthetic Opoids (Fentanyl)

What is the leading cause of accidental death in the U.S.? How many Americans die on average to this daily?

overdoses; 130

What are the estimated yearly costs of the opioid crisis?

$500 billion

How many estimated drug overdose deaths were there in the U.S. in 2021? Was it in increase or decrease compared to 2020?

107, 622 ; increase (15%)

What are some of the reasons (4 of them) for increasing overdose deaths in the U.S.?

• increasing dominance of fentanyl in the opioid drug supply

• increases in stimulant use

• use of fentanyl and stimulants in combination

• COVID-19 pandemic

Wave 1: What, when, where, and cause?

Prescription Opioid Pills

• started primarily in non-urban areas (mostly rural white users)

• rose from 1999 and peaked in 2017

• caused in large part by the massive increase in prescribing opioids for non-cancer pain during the late 1990s and 2000s

• between 2000 to 2010, rates of accidental prescription opioid overdose increased almost 4 times, while treatment admissions for prescription opioid abuse increased more than fivefold

Wave 2: What, when, where, and cause?

Heroin-Related Overdose

• started rising significantly after 2010 and peaked in 2017

• stricter controls on prescription opioids greatly restricted access to pills

• prescription opioid abuse was a “gateway” for eventual heroin use

• abuse started with prescription pain killers

Wave 3: What, when, where, and cause?

Synthetic Opioids (Fentanyl) - Present

• current rise of fentanyl is considered a supply driven more than demand-driven event

• trends: increasing death rate in urban areas, increasing death rate in Blacks & Native Americans

• overdose trends greatly accelerated during the early COVID era, March through September 2020

Wave 4: What, when, where, and cause?

Stimulants (often in conjunction with opioids)

• current rise in stimulant-related deaths appears entwined with ongoing opioid epidemic

• there has been a major rise in drug-related overdose deaths 2012-2018:

• although both cocaine and meth combined with opioids increase the risk of overdose, meth is associated with an increased risk of overdose, regardless of opioid use

self-medication hypothesis

drug use may be understood as a coping strategy to address emotional distress

• people may turn to opioid abuse to alleviate suffering as opposed to seeking pleasure or a “high” from the drugs

• opioid abusers generally have high levels of mental distress

Juvenile Drug Court Sample: Methods

• juvenile drug court participants in NW Ohio county were administered a standardized biopsychological assessment

• interviews were used to evaluate the relationship between emotional distress reported using EPS

• independent variable, emotional distress, was measured using the EPS which measures mental health functioning and functional impairment

Juvenile Drug Court Sample: Findings

• prescription drug misuse was associated with a 19.8 point higher EPS score compared with nonuse

• 10 point increase in EPS score was associated with a nearly 50% increase in the lifetime odds of prescription opioid misuse

• odds of prescription opioid misuse declined each year

• average EPS scores increased 29.5 points over the duration of the study

deaths of despair

national epidemic of opioid overdose deaths

• associated with a sense of hopelessness, fatalism, perceived helplessness, and deprivation

• concept has been used to account for the increasing mortality in the US from opioid overdoses, suicides, and liver disease among non-college educated whites

• started with the economic downturn of the 2000s

Juvenile Drug Court Sample: Discussion

• decrease in institutional engagement among groups particularly hard hit by opioid abuse

• involves a decreasing rate of participation in: family, work, religion, labor unions, fraternal organizations, etc.

Emile Durkheim

• noted that societies need to provide social integration and moral regulation to constrain the individual

• believed that unbridled individual passions could result in a state of normlessness or anomie

• anomie can translate into self-destructive behavior like suicide

• we are currently seeing the results of a lack of social inteegration and moral regulation in “deaths of despair”

The Wheel of Science

theories —→ hypothesis —→ observations —→ empirical generalizations

Richard Feynman on Basic Principles

physics concentration - the first principle is that you must not fool yourself, and you are the easiest person to fool

• science encompasses a large body of evidence collected by repeated observations & experiments

• goal is to approach true explanations as closely as possible, but its investigators claim no final or permanent explanatory truths

• scentists operate within a system designed for continuous testing where corrections and new findings are announced in refereed scientific publications and/or meetings of learned societies

• rigor in the testing of hypotheses is the heart of science

• research data are the basis for reporting discoveries and experimental results

empiricism

science relies on observations for the acquistion of knowledge

• means relying on tangible evidence instead of assumptions, speculation, or ideology

objectivity

scientific investigations should be impartial

• need to avoid personal biases in observation and interpretation of data

testability

hypotheses must be able to be tested and potentially proven wrong (called falsifiability)

• hypothesis that cannot be tested or falsified is not considered a valid scientific claim

replication

scientific findings should be verifiable by other researchers under similar conditions

causality

every event has a cause, and that cause can be identified via the scientific method and consequently used to predit future events

skepticism

encourages scientists to rigorously and critically exam evidence and claims, suspending judgment until sufficient evidence is available, and questioning even established theories

epidemiology

the study of the spread or distribution of disease

• today, the study of drug and alcohol abuse falls under the scope of this field

prevalence

the number of people who have ever engaged in a behavior (ex. lifetime, 30 days, etc.)

rate

the number of drug users per unit of the population

• simply providing the raw number of users does not give us a clue of how pervasive drug use is

• impossible to make comparisons with raw numbers

Monitoring the Future (UoM Institute for Social Research) - ISR

conducting a survey annually since 1975

• includes some 50,000 students at 400 public and private secondary schools

• most experts believe that they probably underestimate the amount of adolescent substance abuse (ex. heavy users probably are not honest, absentee/drop-out rate is so high many are omitted from the survey, etc.

Results of UoM Study of the Future

• lifetime use of “any illicit drug” = seniors in high school use the most (36.8%)

• lifetime use of marijuana = seniors in high school use the most (34.4%)

• any illicit drug other than marijuana (lifetime) = seniors in high school use the most (12%)

• alcohol (lifetime) = seniors in high school use the most (48.7%)

Trends of UoM Study of the Future

• lifetime use of any illicit drug - 12th grade

• 1975 - 55% but 1981 - 66% (peaked)

• long and gradual decline to all time low in 1992 (41%)

• relapse phase rose in 1999

• started to slowly decrease around 2000

• sharp decrease in 2021 due to pandemic