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Kendall: Social Problems in a Diverse Society, 4/e |
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Chapter 8 |
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CHAPTER 8: ALCOHOL AND OTHER DRUGS
The over consumption of alcohol, even on an occasional basis, creates a major social problem in the United States. Alcohol-related fatalities alone on U.S. streets and highways accounted for over 17,000 deaths in 2003. When adding other alcohol-related problems such as disease, work related issues, and family dysfunction the extent of the social problems created by alcohol abuse become clearly evident.
Alcohol is only one of several substances classified as a drug. A drug is any substance, other than food or water, that, when taken into the body, alters its functioning in some way. Drugs can be therapeutic when taken for a specific purpose or recreational when taken purely for pleasure. Alcohol, tobacco, aspirin, and prescribed substances are classified as licit drugs because they are legally obtainable. Substances that are illegal to possess, transport, or use are classified as illicit drugs. These substances include heroin, cocaine, LSD, marijuana, and other substances identified by the government as illegal.
Drug abuse is an excessive or inappropriate use of a drug that results in some form of physical, mental, or social impairment. Drug abuse includes both a subjective and objective component. Continued use of a drug, including licit drugs, can lead to dependency or addiction as well as tolerance. With addiction and tolerance physical and psychological symptoms can occur when the drug is discontinued. The symptoms that occur during withdrawal can include insomnia, mental confusion, and a reduced feeling of self-worth.
Although alcohol is classified as a licit drug, it may pose a greater social problem in the United States than illicit drugs because it is considered an accepted part of the dominant culture. In the United States, adults consume an average of 2.7 gallons of wine, 32 gallons of beer, and 1.8 gallons of beer a year. But since some people drink very little or not at all, about 10 percent of the drinkers account for half of all the alcohol consumed.
Alcohol qualifies as being a depressant because it lowers the activity level of the central nervous system. The classifications of alcohol users include social drinkers, heavy drinkers, acute alcoholics, and chronic alcoholics. As little as three or four drinks can affect self control. Depending on one’s tolerance to alcohol, a drinker can lapse into a stupor, become comatose, and even die. Although people in all social classes consume alcohol, income and class differences are associated with alcohol use. Those who earn less than $20,000 a year, for example, tend to drink less expensive domestic beer and more beer than wine or liquor. Drinkers in the $50,000 and up category drink expensive imported beer and more wine than liquor. More men than women drink and men are more likely to be problem drinkers and alcoholics.
Alcohol-related social problems include health problems such as nutritional deficiency, cardio-vascular problems, and cirrhosis of the liver. Children born to mothers who consume large amounts of alcohol are prone to fetal alcohol syndrome, a condition that can result in mental retardation and cranio-facial malformation. In the workplace, alcohol-related problems that include lost production, treatment, and accidents cost about $100 billion annually. Alcohol is implicated in approximately 40 percent of all fatal accidents. In the home, alcoholism ruins families, destroys social relationships, and creates fragile living conditions among family members.
Another licit drug creating a social problem is the use of tobacco. The nicotine in tobacco is a toxic, dependency producing psychoactive drug more addictive than heroin. It is classified as a stimulant. Tobacco is responsible for one in every five deaths in the United States. Ninety percent of the deaths resulting from lung cancer are attributed to cigarette smoking. The use of tobacco products shortens one’s life expectancy and second hand smoke adversely affects infants and children. Infants born to women who smoke have lower than average birth rates and slower rates of physical and mental growth. Children who grow up in households where one or both parents smoke suffer more frequent ear infections, upper respiratory infections, allergies, asthma, and other health problems than children in homes where neither parent smokes. The use of smokeless tobacco, such as snuff and chewing tobacco, also experience higher rates of certain cancers and other diseases. Research suggests that most tobacco users recognize the dangers associated with their use but lack the ability to quit.
Other abused licit drugs contributing to the social problem of alcohol and drug abuse are prescription and over-the-counter drugs. Pain medication is the most commonly abused prescription drug. To widely prescribed drugs that have been the subject of controversy are Ritalin and Prozac. Ritalin is seen as a “quick fix” for dealing with troublesome children and Prozac has become a “cure-all for the blues.” Many drugs only available by prescription are now available as over-the-counter (OTC) drugs. OTC drugs widely abused include analgesics, sleep aids, cough and cold medicines.
Even though licit drugs are at the forefront of America’s social problem of drug and alcohol abuse, most people assume the use of illegal drugs as being the greatest public danger. What constitutes an illegal drug is a social and legal definition that is subject to change over time. Because of this, there were no illegal drugs prior to legislation being passed declaring their illicit status. In the late 19th and early 20th centuries the government passed laws making opium products, cocaine, and marijuana illegal. Each law passed had a social consideration as well as a legal one. Opium laws, for example, were directed against Chinese immigrants working on the railroads and marijuana laws were directed against Mexicans.
Illicit drugs fall into the categories of stimulants, depressants, narcotics, and hallucinogens. Marijuana is in a class of its own, having both stimulating and depressing qualities. Cocaine and amphetamines are the major stimulants abused in the United States. Stimulants provide the user increased alertness and a temporary sense of well-being. Cocaine is an extremely potent and dependency-producing drug. Powdered cocaine is snorted or taken intravenously. Crack cocaine, a hardened form of powdered cocaine, is smoked.
Depressants are most appreciated for their pain-killing properties. Barbiturates, anti-anxiety drugs, Rohypnol, and gamma-hydroxybutyrate (GHB) are commonly abused depressants. Although narcotics are similar to depressants in their affect, they are in a class of their own. Narcotics include the opiate derivatives of morphine, codeine, and heroin. Heroin is the most widely abused narcotic. Long-term use of heroin creates addiction and may also result in respiratory depression, coma, and death from overdosing.
Hallucinogens, or psychedelics, are drugs that produce illusions and hallucinations. Mescaline, LSD, and MDMA (Ecstasy) are among the most commonly used hallucinogens. Hallucinogens are usually taken orally, but some can be administered intravenously or smoked.
Explanations of drug abuse are based upon biological, psychological, and sociological theories. Biological explanations of alcohol and other drug addiction focus on genetic factors and their effect on the brain. Psychological explanations of drug abuse focus on personality disorders or the effects of social learning and reinforcement on drug taking behavior. Sociological explanations of drug abuse are addressed by the symbolic interactionist, functionalist, and conflict perspectives. Symbolic interactionists believe drug behavior is learned behavior and is strongly influenced by families, peers, and other people. Functionalists blame drug and alcohol abuse on the failure of social institutions such as the family, education, and religion. Because of this, formal mechanisms of social control, such as making certain substances illegal, are required. An added function of drug and alcohol abuse is to create and perpetuate jobs at all levels of the criminal justice system, the federal government, and social service agencies. According to the conflict perspective, people in positions of economic and political power make the sale, use, and possession of drugs abused by the poor and powerless illegal. At the same time, powerful corporate interests perpetuate the use and abuse of legal drugs including alcohol and tobacco products and pharmaceuticals.
The social response to alcohol and drug abuse is one of enforcement, prevention, and treatment.
Prevention programs can be divided into three categories. Primary prevention attack the problem before it begins. Secondary prevention seeks to limit the extent of drug and alcohol abuse once it has started. Tertiary prevention programs seek to limit the relapses by individuals recovering from alcoholism or drug addiction. The most widely used primary prevention program is Drug Abuse Resistance Education (DARE) that is present in nearly 75 percent of the public schools.
Treatment programs include the medical treatment model and therapeutic community. The medical treatment model can take the form of aversion therapy or behavioral conditioning. These treatments either prevent the euphoric feeling a drug produces or creates intense nausea when the abused substance is used, even in the smallest quantity. Therapeutic communities stress counseling and rehabilitation. These programs can take the form of outpatient, in-patient, and day treatment programs. Among the most successful drug and alcohol non-residential therapeutic communities are Narcotics Anonymous and Alcoholics Anonymous.
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