Theories of Drug Use & Addiction
THEORY
INITIAL DRUG USE or
INVOLVEMENT
Nature
Weil
Biological
DRUG ADDICTION
Biogenetic
Neurological/ “brain plasticity”
Psychological
Psychoanalytic
Personality
Psychoanalytic
Personality
Behavioral
Sociological
Differential Association
Differential Reinforcement
Becker’s Learning Theory
Social Control Theory
Strain Theory
Conflict Theory
Dislocation Theory
Differential Reinforcement
Becker’s Learning Theory
Integrated Theory
Strain Theory
Cultural Deviance Theory
Labeling Theory
Conflict Theory
Dislocation Theory
Adapted from Faupel, Sociology of American Drug Use
1. Globalization of
Capitalist Free Market
System
4. Proliferation of
Addiction3
2. Decline of PsychoSocial Integration
3. Poverty of the Spirit
Social Location
• Social categories shape our identities, our experiences
and perceptions, and our life chances.
• Gender
• Sexuality
• Race
• Class
• Age
• Intersectionality
• Race, class, and gender intersect to shape experience in
unique ways
• Capital – material or non-material resources that confer
social power to the carrier (there are four types). Follows a
definite distribution.
The Forms of Capital
• Economic Capital – access to income, wealth
or property
• Cultural Capital – prestige associated with
specialized knowledge. Symbolic, not tangible.
• Social Capital – our social connections to
others and the benefits those connections
confer
• Symbolic Capital – capability of actors to use
certain practices symbolically to defend or
maintain their positions in social space
• Capital is partially transferable– “Cashing in”
social capital for a job that increases your
economic capital
Social Class and Drug Addiction
I.
Considerable drug use and crime in “conventional
communities”
II. “Invisible” addictions of the more advantaged
• Less likely to seek treatment and “recover naturally”
• Social support– drug use can be sustained longer
before needing help.
• When help is needed, easier to pull selves out.
• “Private addictions” are less targeted and less
“suspect.”
• Harder to measure– most data comes from official crime
and treatment reports– self data notoriously unreliable
III. Conventional life: Buffer or trap?
I. Do “pro-social” bonds prevent us from using drugs? Or is
too much attachment a bad thing?
Granfield and Cloud: Discuss
• How did participants’ social capital translate into
an ability to recover from addiction without
treatment? What were the different types of
social capital working for them, and how did they
work?
• How might G&C’s argument revise the disease
model of addiction?
“Natural Recovery” among
Individuals with High Social
Capital
• Granfield & Cloud: Evidence that a number of people
overcome addictions without treatment
• Interviews with 46 drug users who were able to recover
“naturally”
• Link between social capital and likelihood of natural recovery
• Relationships
• Economic and non-economic resources
• Capacity for “self-actualization,” “self-efficacy,” and “self-esteem”
• How “social” is addiction?
Granfield and Cloud
“Those who possess larger amounts of
social capital, perhaps even independent
of the intensity of use, will be likely
candidates for less intrusive forms of
treatment such as those associated with
brief intervention and natural recovery.”
“Two Women Who
Used Cocaine Too
Much”
• How did each woman's race, class, and gender shape her access to and
experience with cocaine? What kinds of social/economic capital did
they possess?
• How do race and/or class and/or gender intersect to shape experience
with drugs?
• Class X Gender
• What theories from class can explain their entry into use?
• The differences in their addictions?
• Their pathways out of addiction?
• How did each woman’s class position enable her to control her drug
use (or not?)
Murphy and Rosenbaum: “Two Women
Who Used Cocaine Too Much”
• Part of a classic study of
female cocaine users, 1990
• Single comparative case
studies
• The intersection of race,
class, and gender shape our
experiences with drugs.
The rise of “binge drinking” or
“drinking like a guy”
• Drinking as a “rite of passage” in college
• “Binge drinking” among undergraduate women on the rise
• Data suggests more women are drinking more, as the gender
gap is shrinking
• Widest gender differences in drinking occur in societies with
most traditional gender roles
Recap: Social Location and Addiction
• Race, class, and gender shape drug experiences as
much as the drugs themselves.
• Poverty, racism, and sexism cannot be separated from
drug use.
• Individual consequences or outcomes from drug use
are determined in part by the drug user’s social
location.
Righteous Dopefiend – Intro
Work in groups to find definitions for the following
from the introductory chapter:
1)
2)
3)
4)
5)
6)
Photo-ethnography and ethical dilemmas
“Moral economy” among Edgewater homeless
Cultural relativism
“Theory of lumpen abuse”
Symbolic violence & Structural violence
Habitus
“How can they live like that?”
CULTURAL RELATIVISM
POLITICS OF REPRESENTATION
~Habitus~
• Links a person’s position in social space with their practices
• Dispositions, shaped by early experience, that “generate &
organize” practices throughout life, which become like enduring
“habits” within the person
• Habitus is deeply embedded within the person
• Embodied – physically enacted!
• Flexible and durable– guides patterned action, but also improvisation
• The way society becomes deposited in persons in the form of lasting
dispositions (tendencies toward action, thought, feeling)
• Examples: Career expectations, who to marry, how to raise kids,
whether or not to talk about politics at dinner…
Righteous Dopefiend
DRUGS & SOCIETY – SPRING 2014
~Habitus: Interplay between
structure and practice
Social positions in a field
Habitus– deeply rooted, but flexible
guidelines that “orient” the person
toward a particular way of seeing
and being in the world.
HABITUS
Practices: actions, behaviors,
choices, etc. that signal your
social position
The habitus mediates between positions and practices.
Understanding Habitus
o “In each one of us… is contained the person we were
yesterday.” - Bourdieu
o Habitus is all of our past experiences, conditioned by the
social environment, as they are expressed in our present
practices.
o Habitus tends to reproduce dominant structural relations–
why?
o Bourdieu’s notion of “social groups” cuts across class, race,
gender, etc. to organize groups of people by similar types of
“habitus.” Multiple forms of experience shape the
development of the habitus.
Habitus is the way we see the world-- it
shapes our expectations, hopes, and desires…
“The art of estimating and seizing chances,
the capacity to anticipate the future…or
even to take a calculated gamble… are
dispositions that can only be acquired in
certain social conditions… Like the
entrepreneurial spirit or the propensity
to invest, economic information is a
function of one’s power over the
economy” (Bourdieu).
Recap: How do we make sense out of so
much suffering, sociologically?
1. “Choice” operates in the context of culture and
biology.
2. Social categories shape our experience.
3. Habitus: Addiction is the physical embodiment of
social inequality, violence, histories of systemic abuse,
and widespread suffering.
4. Normalization & socialization – Long-term suffering
becomes “routine.”
5. Alexander: Addictive suffering is a product of largescale economic and social transformations.
LOST ANGELS: Review
• Social forces affecting Skid Row addicts:
•
•
•
•
•
•
•
Widening inequality
Gentrification
Destruction of low-income housing markets
Deinstitutionalization
Safer Cities Initiative – Broken Windows policing
Hostile police-community relations
Infringement on civil liberties
• Relationship between mental illness, homelessness,
poverty, and addiction
• Agency and resilience in Skid Row community
BLACK TAR HEROIN:
The Dark End of the Street
Directed by Steven Okazaki
Black Tar Heroin: The Dark End of the Street
--Reactions to the Film-• Race/Age – mostly young, white scene
• Class – struggled to find employment, but perhaps more
social and economic capital than Righteous addicts
• Context of inequality in San Francisco
• Role of supportive families – housing and income
• Gender
• How did gender add another layer of marginalization to the
experience of female addicts?
• Multiple forms of marginalization: prostitution, violence,
HIV/AIDS, homelessness, criminal status
• “Loneliness” and lack of integration – Alexander?
• Effect of prison/reentry on addiction?
• Harm reduction?
Harm Reduction Philosophy
• Focus is on reducing harm associated with
drug use & increasing quality of life, not
ending use.
• Harmful behavior exists on a continuum.
Progression in small, incremental steps.
Abstinence is one goal among many.
• Created by addicts, for addicts. Users set
their own goals and are active participants.
Toolkit
• Disease/overdose prevention through
syringe exchange & naloxone distribution
• Education and case management
• Non-judgmental, unconditional support.
Remove stigma so more people seek help.
• Social, political, & economic advocacy
Injection Drug Use, HIV, &
Syringe Exchange
• HIV spread through use of contaminated needles- Rates from 5% to
50% in one year in many IDU populations (UN Program on HIV/AIDS)
• African Americans IDUs are ten times as likely to become infected with
HIV from a dirty needle and Latinos 5 times as likely as their white
counterparts.
• Needle exchange programs (NEPs), substantially reduce the likelihood
of HIV transmission through needle sharing
• NY Programs: 52% of new AIDS cases to 5% (NY Dept. of Health)
• No evidence that NEPs promote drug use
• Connects a hard to reach population with services
• Cost-benefit analyses-- NEPs reduce long-term healthcare costs
• Legal status: funding ban, laws against purchase/possession of
needles
• 1988 – ban on federal funding for syringe exchange programs
• 2009 – 2011 ban lifted
harm reduction continuum: what is
“harm?”
Public health harm reduction
“Top-down”
Disease prevention
Case management
Referral to drug treatment
Clean needles
Education
Radical harm reduction
“Bottom-up”
Rights for drug users
Change social attitudes
Reform drug policy
Decriminalization/legalization
Alleviate social inequality
Five Links in the Chain of Destruction:
o Identification – identify an unliked group and label them as the
enemy
o Ostracism – separate the group from society, mark them as
outsiders
o Confiscation – take away their rights, property, eventually their
person
o Concentration – forcible confinement and exploitation of
bodies or labor
o Annihilation—direct killing of the population, or indirect
through withholding of food or medicine