3 Chapter 3. Drug Abuse
7.4 Explaining Drug Use
Learning Objectives
- Understand the possible biological origins of drug addiction.
- Explain why longitudinal research on personality traits and drug use is important.
- Outline the aspects of the social environment that may influence drug use.
To know how to reduce drug use, we must first know what explains it. The major explanations for drug use come from the fields of biology, psychology, and sociology.
Biological Explanations
In looking at drug use, the field of biology focuses on two related major questions. First, how and why do drugs affect a person’s behavior, mood, perception, and other qualities? Second, what biological factors explain why some people are more likely than others to abuse drugs?
Regarding the first question, the field of biology has an excellent understanding of how drugs work. The details of this understanding are beyond the scope of this chapter, but they involve how drugs affect areas in the brain and the neurotransmitters that cause a particular drug’s effects. For example, cocaine produces euphoria and other positive emotions in part because it first produces an accumulation of dopamine, a neurotransmitter linked to feelings of pleasure and enjoyment.
Research on identical twins suggests that alcoholism has a genetic basis.
Michael Dorausch – Identical Twins Jedward – CC BY-SA 2.0.
Regarding the second question, biological research is more speculative, but it assumes that some people are particularly vulnerable to the effects of drugs. These people are more likely to experience very intense effects and to become physiologically and/or psychologically addicted to a particular drug. To the extent this process occurs, the people in question are assumed to have a biological predisposition for drug addiction that is thought to be a genetic predisposition.
Most research on genetic predisposition has focused on alcohol and alcoholism (Hanson et al., 2012). Studies of twins find that identical twins are more likely than fraternal twins (who are not genetically identical) to both have alcohol problems or not to have them. In addition, studies of children of alcoholic parents who are adopted by non-alcoholic parents find that these children are more likely than those born to non-alcoholic parents to develop alcohol problems themselves. Although a genetic predisposition for alcoholism might exist for reasons not yet well understood, there is not enough similar research on other types of drug addiction to assume that a genetic predisposition exists for these types.
One clear limit of biological explanation is that it cannot explain different rates of addiction across cultures and through time. While some societies have had very low rates of substance abuse and addiction, at other times and places, rates are extremely high. Population genetics change very slowly so we know that such changes in the rate of addiction must be due to non-biological factors. We now turn to these factors.
Psychological Explanations
Psychological explanations join biological explanations in focusing on why certain individuals are more likely than others to use drugs and to be addicted to drugs (Hanson et al., 2012). Some popular psychological explanations center on personality differences between drug abusers and non-abusers. These explanations assume that users have personality traits that predispose them to drug abuse. These traits include low self-esteem and low self-confidence, low trust in others, and a need for thrills and stimulation. In effect, drug users have inadequate personalities, or personality defects, that make them prone to drug use, and once they start using drugs, their personality problems multiply.
One problem with research on personality explanations is methodological: If we find personality differences between drug users and nonusers, should we conclude that personality problems cause drug use, or is it possible that drug use causes personality problems? Most of the research on personality and drug use cannot answer this question adequately, since it studies drug users and nonusers at one point in time (cross-sectional research). To answer this question adequately, longitudinal research, which examines the same people over time, is necessary. Among initial drug abstainers at Time 1, if those with the personality traits mentioned earlier turn out to be more likely than those without the traits to be using drugs at Time 2, then we can infer that personality problems affect drug use rather than the reverse. Longitudinal research on personality and drug use that studies adolescents and college students does indeed find this causal sequence (Sher, Bartholow, & Wood, 2000). However, some scholars still question the importance of personality factors for drug use and addiction (Goode, 2012). They say these factors have only a small effect, if that, and they cite research questioning whether personality differences between users and nonusers in fact exist (Feldman, Boyer, Kumar, & Prout, 2011).
Other psychological explanations are based on the classic concept from behavioral psychology of operant conditioning—the idea that people and animals are more likely to engage in a behavior when they are rewarded, or reinforced, for it. These explanations assume that people use drugs because drugs are positive reinforcers in two respects. First, drugs provide pleasurable effects themselves and thus provide direct reinforcement. Second, drug use often is communal: People frequently use drugs (alcohol is certainly a prime example, but so are many other drugs) with other people, and they enjoy this type of social activity. In this manner, drug use provides indirect reinforcement.
Vancouver Psychologist Dr. Maté, suggests a final psychological approach in his emphasis of the role of trauma in addiction. Dr. Maté argues that “childhood trauma is the template for addiction” and that drug abuse should be seen as, “neither a choice nor a disease, but originates in a human being’s desperate attempt to solve a problem: the problem of emotional pain, of overwhelming stress, of lost connection, of loss of control, of a deep discomfort with the self.” (Maté 2017). While trauma does indeed seem a ‘gateway’ to addiction, this argument has been challenged as reductionist — rooted in a biological model that posits early-life trauma induced brain changes as the principal cause of addiction, overstating the percentage of those who have experience early trauma that go on to face addiction, and obscuring the range of routes to addiction for those that do not have such a history (Peele 2011). While centring the psychological effects of trauma may be useful to the psychological clinician dealing with patients with a history of trauma, a more sociological approach is needed if we are to understand the social patterns of addiction, especially why rates of addiction vary so drastically between communities.
Sociological Explanations
Sociological explanations emphasize the importance of certain aspects of the social environment—social structure, social bonds to family and school, social interaction, and culture—or drug use, depending on the type of drug. For drugs like heroin and crack that tend to be used mostly in large urban areas, the social structure, or, to be more precise, social inequality, certainly seems to matter. As sociologist Elliott Currie (1994, p. 3) has observed, the use of these drugs by urban residents, most of them poor and of color, reflects the impact of poverty and racial inequality: “Serious drug use is not evenly distributed: it runs ‘along the fault lines of our society.’ It is concentrated among some groups and not others, and has been for at least half a century.” This fact helps explain why heroin use grew in the inner cities during the 1960s, as these areas remained poor even as the US economy was growing. Inner-city youths were attracted to heroin because its physiological effects helped them forget about their situation and also because the heroin subculture—using an illegal drug with friends, buying the drug from dealers, and so forth—was an exciting alternative to the bleakness of their daily lives. Crack became popular in inner cities during the 1980s for the same reasons.
Social bonds to families and schools also make a difference. Adolescents with weak bonds to their families and schools, as measured by such factors as the closeness they feel to their parents and teachers, are more likely to use drugs of various types than adolescents with stronger bonds to their families and schools. Their weaker bonds prompt them to be less likely to accept conventional norms and more likely to use drugs and engage in other delinquent behavior.
Regarding social interaction, sociologists emphasize that peer influences greatly influence one’s likelihood of using alcohol, tobacco, and a host of other drugs (Hanson et al., 2012). Much and probably most drug use begins during adolescence, when peer influences are especially important. When our friends during this stage of life are drinking, smoking, or using other drugs, many of us want to fit in with the crowd and thus use one of these drugs ourselves. In a related explanation, sociologists also emphasize that society’s “drug culture” matters for drug use. For example, because we have a culture that so favors alcohol, many people drink alcohol. And because we have a drug culture in general, it is no surprise, sociologically speaking, that drug use of many types is so common.
To the extent that social inequality, social interaction, and a drug culture matter for drug use, sociologists say, it is a mistake to view most drug use as stemming from an individual’s biological or psychological problems. Although these problems do play a role for some individuals’ use of some drugs, drug use as a whole stems to a large degree from the social environment and must be understood as a social problem, and not just as an individual problem.
Beyond these general explanations of why people use drugs, sociological discussions of drug use reflect the three sociological perspectives introduced in Chapter 1 “Understanding Social Problems”—functionalism, conflict theory, and symbolic interactionism—as we shall now discuss. Table 7.6 “Theory Snapshot” summarizes this discussion.
Table 7.6 Theory Snapshot
| Theoretical perspective | Contributions to understanding of drug use |
|---|---|
| Functionalism | Drug use is functional for several parties in society. It provides drug users the various positive physiological effects that drugs have; it provides the sellers of legal or illegal drugs a source of income; and it provides jobs for the criminal justice system and the various other parties that deal with drug use. At the same time, both legal drugs and illegal drugs contribute to dysfunctions in society. Another functionalist approach suggests that societies with low social solidarity, that do not create strong social bonds between members and a sense of connectedness to society as a whole, are more likely to have a high rate of addiction. |
| Conflict theory | Much drug use in poor urban areas results from the poverty, racial inequality, and other conditions affecting people in these locations. Racial and ethnic prejudice and inequality help determine why some drugs are illegal as well as the legal penalties for these drugs. The large multinational corporations that market and sell alcohol, tobacco, and other legal drugs play a powerful role in the popularity of these drugs and lobby to minimize regulation of these drugs. |
| Symbolic interactionism | Drug use arises from an individual’s interaction with people who engage in drug use or from ‘messages’ from society that encourage consumption/problematic drug use. From this type of social interaction, an individual learns how to use a drug and also learns various attitudes that justify drug use and define the effects of a drug as effects that are enjoyable. |
Functionalism
Recall that functionalist theory emphasizes the need for social stability, the functions that different aspects of society serve for society’s well-being, and the threats (or dysfunctions) to society’s well-being posed by certain aspects of society. In line with this theory, sociologists emphasize that drug use may actually be functional for several members of society. For the people who use legal or illegal drugs, drug use is functional because it provides them the various positive physiological effects that drugs have. For the people who sell legal or illegal drugs, drug use is functional because it provides them a major source of income. Illegal drug use is even functional for the criminal justice system, as it helps provide jobs for the police, court officials, and prison workers who deal with illegal drugs. Legal and illegal drugs also provide jobs for the social service agencies and other organizations and individuals whose work focuses on helping people addicted to a drug. At the same time, drugs, whether legal or illegal, have the many dysfunctions for society that this chapter discussed earlier, and this fact must not be forgotten as we acknowledge the functions of drugs.
Simply thinking about the ways that current drug use and abuse might be ‘functional’ for particular interests in our society does not take us far in understanding why we face the social problem of widespread drug abuse (as opposed to use) and addiction. One of the founders of functionalist theory, Emile Durkheim, in emphasizing the importance of social ties, or what he called social solidarity, for both society and its members, does however, offer insights that remain relevant today. Durkheim wrote that all societies must find ways to bind members to each other and to society more generally, a phenomenon he called social solidarity. While social solidarity is functional for society as it encourages members to work toward common social goals and adhere to social norms and expectations, it is also functional for individuals. Without a connection to others, achieved through meaningful social interaction, individuals are left adrift. The consequences of this lack of social connection, Durkheim explored in his most well-known book, Suicide: A Study in Sociology (1897/1997). In this work Durkheim used empirical evidence to demonstrate that rates of suicide increased in those religious groups that emphasized individualism and had fewer institutional means to bring members together and decreased in those that created shared experiences and beliefs that bound people together (see text box). Today, similar arguments are made to explain why some societies have high rates of addiction and others have much lower rates.
Durkheim and the Sociological Study of Suicide
Durkheim was very influential in defining the subject matter of the new discipline of sociology. For Durkheim, sociology was not about just any phenomena, it was not about the biological or psychological dynamics of human life, but about the external social facts through which the lives of individuals were constrained. Such a sociology explained how phenomenon that may seem deeply personal are influenced by the societal structures and cultural constraints of individual lives.
This is the framework of Durkheim’s famous study, Suicide: A Study in Sociology (1897/1997). Using statistics compiled by police and other state agencies across Europe, Durkheim observed that while there was no correlation between rates of suicide and rates of psychopathology, suicide rates did vary by social context. For example, suicide rates varied according to the religious affiliation of suicides. Protestants had higher rates of suicide than Catholics, even though both religions equally condemn suicide. In some jurisdictions Protestants killed themselves 300% more often than Catholics. Jews meanwhile were even less likely than Catholics to commit suicide.
Durkheim argued that the key factor that explained the difference in suicide rates were the different degrees of social integration or social solidarity of the different religious communities, measured by the degree of authority religious beliefs hold over individuals, and the amount of collective ritual observance and mutual involvement individuals engage in in religious practice. In short, the more a religion created shared experiences and beliefs that bound people together, the less likely members of that religion were to commit suicide.
Durkheim noted that Catholicism included shared, public ritual practice of the sacraments, such as confession and taking communion and fostered a strong adherence to religious authority. Protestants meanwhile were taught to take a critical attitude to religious authority and formal doctrine and shared ritual was reduced to a minimum. They were less integrated into their communities and more thrown back on their own resources. Protestants were more prone to what Durkheim termed egoistic suicide: suicide which results from individuals having to depend on themselves in the absence of strong social bonds tying them to a community. Suicide, Durkeim wrote, “varies inversely with the degree of integration of the social groups of which the individual forms a part” (Durkheim, 1897/1997).
Here the situation of Jews is instructive. It seems paradoxical that a group, which faced the significant discrimination and hardship of antisemitism would also have low suicide rates. Durkheim’s explanation was that, such threat, encourages unity and the creation strong intra-community ties, ties that protect individuals from violence, provide economic and cultural opportunity and coincidentally provide the social integration that reduces the risk of egoistic suicide. Durkheim’s study was sociological because he did not try to explain suicide rates in terms of individual psychopathology. Instead, he argued that “Suicide varies inversely with the degree of integration of the social groups of which the individual forms a part” (Durkheim, 1897/1997).
Durkheim looked at several other variables such as sex, nationality and marital status and while the passage of time, and the quality of the data available in his day, mean that we cannot simply rely on his findings directly, contemporary research into suicide in Canada shows that suicide rates continue to vary considerably by age, gender and marital status. Males are considerably more likely to commit suicide across all age groups. It is elderly men, however, that have the highest rate of suicide and this is followed by those in middle age. Those under 14 years of age and even those 15 to 19 years of age have lower rates of suicide than all other age groups. On the other hand, married people are the least likely group to commit suicide. Single, never-married people are 3.3 times more likely to commit suicide than married people, followed by widowed and divorced individuals respectively.
How do sociologists explain this? It is clear that early adulthood is a period in which social ties to family and society are strained. It is often a period in which young adults break away from their childhood roles in the family group and establish their independence by going off to college or university. Youth unemployment meanwhile is higher than for other age groups and, since the 1960s. These factors tend to decrease the quantity and the intensity of ties to society. Married people on the other hand have both strong affective affinities with their marriage partners and strong social expectations placed on them, especially if they have families: their roles are clear and the norms which guide them are well-defined. According to Durkheim’s proposition, suicide rates vary inversely with the degree of integration of social groups. Young adults are less integrated into society, which puts them at a higher risk for suicide than married people who are more integrated. It is interesting that the highest rates of suicide in Canada are for adults in midlife, aged 40-59. Midlife is also a time noted for crises of identity, but perhaps more significantly, as Navaneelan (2012) argues, suicide in this age group results from marital breakdown. This is also a time when children are leaving the household an act that leaves both child and parent with lessened social ties and commitments.
Durkheim’s sociological approach to suicide, one that recognizes the importance of social bonds, has been used over the years by social psychologists and sociologists to challenge biological and strictly psychological explanations of similar phenomena such as depression, anxiety and addiction. Could the root cause of addiction be found in a lack of social connection?
Conflict Theory
Conflict theory stresses the negative effects of social inequality and the efforts of the elites at the top of society’s hierarchy to maintain their position. This theory helps us understand drugs and drug use in at least three respects. First, and as noted just earlier, much drug use in poor urban areas results from the poverty, racial inequality, and other conditions affecting people in these locations. They turn to illegal drugs partly to feel better about their situation (self-medication), and partly because the illegal drug market is a potentially great source of income that does not require even a high school degree.
A conflict theory would emphasize that trauma in childhood and beyond which has been linked to addiction, can affect anyone, however due to the social inequities noted above, such trauma is not equally distributed across the broader population. The colonial experience of Indigenous peoples in Canada, especially the Residential school experience, the ‘Sixties Scoop’ and high rates of Indigenous youth in care have left this population more vulnerable to trauma. Similarly families faced with poverty, and racialized groups are more likely to face domestic violence, racialized violence and other forms of trauma.
In Canada, and in most areas of the world, women tend to have lower rates of addiction than men. A Durkheimian, functionalist approach might suggest that women’s ascribed role in care giving and care work would partially explain this phenomenon. A feminist conflict approach, however, would note that explaining women’s substance abuse and addiction problems must centre the role of patriarchal forms of inequality. Women are more likely to face sexualized violence in domestic spaces and beyond, more likely to live in poverty, especially with children, and they increasingly face the ‘second shift‘ of unpaid care work in the home and community alongside paid work. All of which can leave women vulnerable to stress and social isolation. As in other groups, addiction here can be seen as a form of self-medication with root causes in gender inequality.
Second, conflict theory emphasizes that racial and ethnic prejudice and inequality help determine why some drugs are illegal as well as the criminal penalties for these drugs. For example, the penalties for crack are much harsher, gram for gram, than those for powder cocaine, even though the two drugs are pharmacologically identical. Crack users are primarily poor African Americans in urban areas, while powder cocaine users are primarily whites, many of them at least fairly wealthy. These facts prompt many observers to say that the harsher penalties for crack are racially biased (Tonry, 2011). Other evidence for this argument of conflict theory is seen in the history of the illegality of opium, cocaine, and marijuana. As we discussed earlier, racial and ethnic prejudice played an important role in why these common drugs in the nineteenth century became illegal: prejudice against Chinese immigrants for opium, prejudice against African Americans for cocaine, and prejudice against Mexican Americans for marijuana.
Third, conflict theory emphasizes the huge influence that multinational corporations have in the marketing and sale of the legal drugs—alcohol, tobacco, and many prescription drugs—that often have harmful individual and societal consequences. To maximize their profits, these companies do their best, as noted earlier, to convince Americans and people in other nations to use their products. They also spend billions of dollars to lobby Congress. As also mentioned earlier, the tobacco industry hid for years evidence of the deadly effects of its products. All these efforts illustrate conflict theory’s critical view of the role that corporations play in today’s society.
Symbolic Interactionism
Symbolic interactionism focuses on the interaction of individuals and on how they interpret their interaction. Given this focus, symbolic interactionism views social problems as arising from the interaction of individuals in particular social and cultural situations. This approach examines how we ‘learn’ to use or abuse drugs and recognizes what social psychologists call ‘the power of the situation’.
A classic example of this approach understands drug use as a behavior arising from an individual’s interaction with people who engage in drug use. From this type of social interaction, an individual learns how to use a drug and also learns various attitudes that justify drug use and define the effects of a drug as effects that are enjoyable.
A study of drug use that reflects this approach is Howard S. Becker’s (1953) classic article, “Becoming a Marihuana User.” Becker wrote that someone usually begins smoking marijuana in the presence of friends who are experienced marijuana users. This social interaction, he argued, is critical for new users to wish to continue using marijuana. To want to do so, they must learn three behaviors or perceptions from the experienced users who are “turning them on” to marijuana use. First, new users must learn how to smoke a joint (marijuana cigarette) by deeply inhaling marijuana smoke and holding in the smoke before exhaling. Second, they must perceive that the effects they feel after smoking enough marijuana (spatial distortion, hunger pangs, short-term memory loss) signify that they are stoned (under the influence of marijuana); their friends typically tell them that if they are feeling these effects, they are indeed stoned. Third, they must learn to define these effects as pleasurable; if people suddenly experience spatial distortion, intense hunger, and memory loss, they might very well worry they are having huge problems! To prevent this from happening, their friends say things to them such as, “Doesn’t that feel great!” This and similar comments help reassure the new users that the potentially worrisome effects they are experiencing are not only bad ones but in fact very enjoyable ones.
While Becker explains how one learns to use and enjoy a particular drug, it is important to recognize that such use, and enjoyment of use, does not necessarily lead to abuse or addiction of a drug. Nonetheless, the symbolic interactionist approach could be extended to tackle drug abuse and addiction. Savic et. al. (2015) have summarized one important line of enquiry by centring micro-level ‘drug cultures’. We use drugs in particular social settings and these can encourage or discourage drug abuse. For example, family dinners may include, and even centre the drinking of wine, however, there may be strict social rules about moderation in place that discourage overconsumption or consumption outside of this confined, social setting. Similarly, pub culture, depending on the country, region or even city, might celebrate overconsumption or encourage moderation.
A symbolic interactionist approach might also turn to Erving Goffman’s concept of social stigma to explain drug abuse and addiction (Goffman, 1963). Goffman referred to stigma as attitude or behaviour that is socially discrediting, serving to distance an individual. Drug abuse and addiction is clearly stigmatized and this can make it difficult for individuals to seek help lest they be labelled a ‘drunk’ or a ‘addict’. Those suffering may not even feel comfortable speaking with friends or family.
As we might learn from the next chapter, drug abuse is a social construction, while in one circumstance, say a middle-class couple sharing a bottle of wine on a restaurant patio is, in North America, romanticized, this same behaviour, when practiced by two homeless people on a park bench is met with derision. Being homeless and drinking in public when poor are highly stigmatized and this stigma contributes to social isolation and addiction.
While many urge that society take a harsh attitude towards those that use and abuse drugs, a symbolic interactionist approach would both caution that this may backfire and remind us of our hypocrisy.
Key Takeaways
- Biological theories assume that some people are especially vulnerable to drug addiction for genetic reasons.
- A popular set of psychological theories assumes that drug addiction results from certain personality traits and problems.
- Sociological theories attribute drug use to various aspects of the social environment, including peer influences, weak social bonds, and the larger drug culture.
For Your Review
- A Durkheimian approach would argue that drug abuse can be traced to low social solidarity. Are there social changes taking place that make it more difficult to connect with others or feel connected to the larger society?
- Write a brief essay in which you discuss a time when your friends influenced you, or someone else you know, to use a legal or illegal drug.
References
Becker, H. S. (1953). Becoming a Marihuana User. American Journal of Sociology, 59, 235–242.
Currie, E. (1994). Reckoning: Drugs, the cities, and the American future. New York, NY: Hill and Wang.
Durkheim, Émile. (1951). Suicide: A study in sociology. New York: Free Press. (original work published 1897)
Feldman, M., Boyer, B., Kumar, V. K., & Prout, M. (2011). Personality, drug preference, drug use, and drug availability. Journal of Drug Education, 41(1), 45–63.
Mate, Gabor. (2017). “Beyond Drugs: The Universal Experience of Addiction.” Retrieved September 16, 2020 from https://drgabormate.com/opioids-universal-experience-addiction/
Goffman, Erving (1963). Stigma: Notes on the Management of Spoiled Identity. Prentice Hall.
Goode, E. (2012). Drugs in American society (8th ed.). New York, NY: McGraw-Hill.
Hanson, G. R., Venturelli, P. J., & Fleckenstein, A. E. (2012). Drugs and society (11th ed.). Burlington, MA: Jones & Bartlett.
Peele, S. (2011). The Seductive, But Dangerous, Allure of Gabor Maté. Retrieved September 21, 2021 from https://www.psychologytoday.com/ca/blog/addiction-in-society/201112/the-seductive-dangerous-allure-gabor-mat.
Savic, M., Room, R., Mugavin, J., Pennay, A., & Livingston, M. (2016). Defining “drinking culture”: A critical review of its meaning and connotation in social research on alcohol problems. Drugs: Education, Prevention and Policy, 23(4), 270–282. https://doi.org/10.3109/09687637.2016.1153602
Sher, K. J., Bartholow, B. D., & Wood, M. D. (2000). Personality and substance use disorders: A prospective study. Journal of Consulting and Clinical Psychology, 68, 818–829.
Tonry, M. (2011). Punishing race: A continuing American dilemma. New York, NY: Oxford University Press.