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SUBSTANCE USE
AND ABUSE
TOPIC
SUB TOPICS
1 Defining substance use and
abuse
SUBSTANCE USE
AND ABUSE
2 Theories of substance use
and abuse (only one
substance)
3 Preventing and quitting
substance use and abuse
(only one substance)
CONTENTS
Sub Topic
Studies
1. Defining substance use Medical Approach
and abuse
Behaviourist Approach
2.
Theories of substance Behaviourist Approach
use and abuse
Eysenk
3. Preventing and quitting Behaviourist Approach
substance use and abuse
Medical Approach
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Sub Topic 1. Defining substance use and
abuse
There are different approaches to defining substance use and abuse. The
physiological (or medical) approach is to define substance abuse as a
medical problem. A type of disease which needs curing.
However
psychological approaches (e.g. the behaviourist approach) tend to take a
wider view of substance abuse and see smoking as just one example of a
wider set of addictive behaviours, such as gambling, shopping and even
love.
The medical model (the nicotine regulation model)
The physiological or medical approach to defining substance use and
abuse is to view substance abuse as a medical problem. This approach
concentrates on the excessive use of various substances and commonly
defines addiction as ‘dependence on a drug, resulting in tolerance and
withdrawal symptoms when the addict is deprived of the drug’.
According to the nicotine regulation model (an example of the medical
approach) established smokers continue to smoke to maintain a certain
level of nicotine in their bodies and to avoid withdrawal symptoms.
Stanley Schachter (1977) conducted an ingenious serious of studies with
adult smokers that provides strong evidence for this model. In one
experiment, the researchers had subjects smoke low-nicotine cigarettes
during one week and high-nicotine cigarettes during another week. As the
model predicts, the subjects smoked more low- than high-nicotine
cigarettes. This effect was especially strong for heavy smokers, who
smoked 25% more of the low- than high-nicotine cigarettes.
Evaluation
+ Support for the nicotine regulation model comes from a study carried
out by Maron (1987) who found that people who regularly smoke ‘ultralow’ nicotine cigarettes do not consume less nicotine than those who
smoke other cigarettes.
+ This model has gained a lot of empirical support from studies such as
Schachter (1977).
A Strength of Schachter’s experiment was that it
controlled many variables such as exactly how much nicotine was in each
cigarette.
+ The model has lead to the development of nicotine replacement
substitutes which are used by smokers to help them quit.
- However this model is very limited. Because it uses a medical or
physiological approach it ignores the many other factors that influence
why people are addicted to cigarettes.
For example, there are
psychological factors (e.g. habit or peer pressure) involved in addiction,
which the model ignores. The model is therefore a reductionist model.
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- For example, when some people quit smoking they return to smoking or
continue to crave for it long after the nicotine is absent from their bodies,
which suggests that there are other factors influencing the addiction.
- Many psychologists now see addiction as psychological phenomena and
evidence suggests that people can become addicted to many different
things including drug use, gambling, game playing, eating and sex.
Behaviourist approach
There are many psychological approaches to substance use and abuse.
One such approach is behaviourism. The behaviourist approach, and in
particular operant conditioning (e.g. Skinner) and Social Learning Theory
(e.g. Bandura) can be used to define substance use and abuse.
According to the behaviourist approach substance use is defined as a
learned phenomenon. According to behaviourists substance use is simply
a behaviour which has become addictive.
Therefore according to
behaviourists people can addicted to many things such as drug use,
gambling, game playing, eating, shopping, sex and so on.
Operant conditioning suggests that people learn patterns of behaviour
(including smoking) because they are reinforced in some manner for those
behaviours. Reinforcements include being accepted or of 'being grown up'
and to some people the feeling of 'relieving tension'. Such reinforcements,
according to operant conditioning, must outweigh all of the negative
aspects of smoking - perhaps because such reinforcements are
immediate.
Social Learning Theory suggests that smoking behaviour is largely learned
from observing and imitating other role models. Research suggests that
the single most important factor predicting whether or not people smoke
is whether or not their parents smoke.
Evaluation
+ The behaviourist approach (and psychological approaches in general) is
useful because it recognises that substance abuse is more than just a
medical problem. For example when people are addicted to cigarettes this
is more than an addiction to nicotine. People may be addicted to having
something to do with their hands and mouth or the social environment
that comes with smoking.
+ The behaviourist approach is also useful as it is able to explain why
people start smoking and also offer an explanation for why people
continue to smoke. Once smokers become addicted they must continue to
smoke to receive the rewarding affects of a stimulant drug and especially
to avoid the aversive affects of withdrawal.
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+ The behaviourist approach not only provides an explanation for why
people engage in health risk behaviour such as smoking it also suggests a
variety of treatment techniques to overcome smoking. Because behaviour
is learned, it can be unlearned or relearned. For example studies have
shown that whereas mass media campaigns have been unsuccessful in
deterring young people to start smoking, providing non-smoking role
models for teenagers has an effect by buffering those at risk from the
pressures of beginning smoking.
+ Many people do adopt operant conditioning techniques when quitting
smoking, for example by giving themselves reinforcements for going for a
particular amount of time without smoking or by spending the money they
are saving on treats.
- However there are a number of problems with the behaviourist
approach. The major limitation with behaviourist explanations is that they
are reductionist. For example by only focusing on observable behaviour
they often neglect other important factors such as people’s cognitive
processes (e.g. attitudes). In doing so they often provide a very passive
view of human beings.
- The behaviourist approach also ignores physiological explanations. For
example twin studies have demonstrated that genetics may be an
important factor in substance use and abuse.
- Whilst behavioural approaches have been fairly successful there are
often ethical problems with using the approaches in real life settings and
the successes also tend to be short lived.
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Sub Topic 2. Theories of substance use
and abuse (only one substance)
There are many theories of why some people abuse substances such as
smoking. Some theories take a physiological approach and argue that
substance use is genetic or inherited. Some theories argue that it is part
of a person’s personality (e.g. Eysenk).
Other theories (e.g. the
behaviourist approach) argue that substance use and abuse is learned.
The Behaviourist Approach
According to the behaviourist approach substance use is a learned
phenomenon. According to behaviourists substance use such as smoking
is simply a behaviour, which has become a habit
The behaviourist approach, and in particular operant conditioning (e.g.
Skinner) and Social Learning Theory (e.g. Bandura) and classical
conditioning (e.g. Pavlov) has been used to explain why people abuse
substances.
Operant conditioning suggests that people learn patterns of behaviour
(including smoking) because they are reinforced in some manner for those
behaviours. Reinforcements include being accepted or of 'being grown up'
and to some people the feeling of 'relieving tension'. Such reinforcements,
according to operant conditioning, must outweigh all of the negative
aspects of smoking - perhaps because such reinforcements are
immediate.
Social Learning Theory suggests that smoking behaviour is largely learned
from observing and imitating other role models. Research suggests that
the single most important factor predicting whether or not people smoke
is whether or not their parents smoke. Research has also demonstrated
that peers and role models in the media can have an affect on smoking
behaviour.
Classical conditioning suggests that substance use such as smoking is
learned through association. That is through associating smoking with a
pleasurable activity such as relief form stress, taking breaks or going to
the pub.
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Evaluation
+ The behaviourist approach is useful as it is able to explain why people
start smoking and also offer a suitable explanation for why people
continue to smoke. Once smokers become addicted they must continue to
smoke to receive the rewarding affects of a stimulant drug and especially
to avoid the aversive affects of withdrawal.
+ The behaviourist approach not only provides an explanation for why
people engage in health risk behaviour such as smoking and drinking, it
also suggests a variety of treatment techniques to overcome smoking
habits. Because behaviour is learned, it can be unlearned or relearned.
For example studies have shown that whereas mass media campaigns
have been unsuccessful in deterring young people to start smoking,
providing non-smoking role models for teenagers has an effect by
buffering those at risk from the pressures of beginning smoking.
+ Many people do adopt operant conditioning techniques when quitting
smoking, for example by giving themselves reinforcements for going for a
particular amount of time without smoking or by spending the money they
are saving on treats.
- However there are a number of problems with the behaviourist
approach. The major limitation with behaviourist explanations is that they
are reductionist. For example by only focusing on observable behaviour
they often neglect other important factors such as people’s cognitive
processes (e.g. attitudes). In doing so they often provide a very passive
view of human beings.
- The behaviourist approach also ignores physiological explanations. For
example twin studies have demonstrated that genetics may be an
important factor in substance use and abuse.
- Whilst behavioural approaches have been fairly successful there are
often ethical problems with using the approaches in real life settings and
the successes also tend to be short lived.
Trait theory of personality (Hans Eysenk)
Hans Eysenk's approach to personality can be used to explain why people
use and abuse substances – particularly smoking.
According to Eysenk personality traits originate in biology. Eysenk stated
that people characterised by extroversion, have a greater need for
external stimulation to maintain an optimal level of arousal in the cortex
of their brains. To maintain homeostasis, these extroverted individuals are
compelled to seek arousal from exciting or stimulating activities, including
smoking.
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Other people, Eysenk claimed, are able to maintain an optimum level of
arousal without much external stimulation, and these individuals are
characterised by introversion. The basic differences between extroverts
and introverts are genetic, not learned.
In contrast to extroverts,
introverts naturally have a higher level of cortical arousal. Because of a
lower sensory threshold, they experience stronger reactions to sensory
stimulation.
Given these genetic differences, one would expect extroverts to seek
excitement from a variety of stimulating activities, including smoking. In
addition, Eysenk hypothesised that smoking is associated with a number
of other stimulating behaviours, including drinking alcohol, drug abuse,
changing sexual partners and engaging in criminal activity.
Evaluation
+ Eysenk's trait theory has been very popular. One of the main reasons
for its popularity has been its ease of application. Eysenk's personality
traits are assessed by a relatively simple questionnaire, the EPI, which is
easy to use and the quantitative data easy to analyse.
+ Eysenk's trait theory has also been influential because the personality
traits can be applied to many forms of behaviour e.g.: criminality,
smoking, drug use, risk taking and so on
+ Many studies do support Eysenk's predictions that extroversion is
closely linked to smoking.
- However it is important to remember that the findings from studies
using Eysenk's personality inventory are correlational and not causal. It is
not possible to make causal statements from correlational studies. For
example, it is possible that smoking is causing the person to be an
extrovert or more likely that a third variable is causing the person to
smoke and affecting there personality, such as the way a person is
socialised, their role models and so on.
- The EPI has been criticised because of its forced choice ('yes/no') form.
Many psychologists have argued that a few simple 'yes/no' questions
cannot be expected to do justice to the complexities of human
personalities. The lie scale has also been criticised for its lack of subtlety.
- Eysenk believed that the basis of personality was biological - that is, we
inherit our personality. Most psychologists would disagree with this and
argue that the development of personality is an interaction of inherited
factors and learning.
- It can also be argued that Eysenk's approach over emphasises the
importance of personality and other dispositions (i.e. it makes an
attribution error). Many studies demonstrate that personality is not a
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good prediction of how a person will behave in any given situation. Often
behaviour is affected by other individuals, such as peer pressure.
- A further problem with Eysenk's trait theory is that because it argues
that health risk behaviour is governed by personality and that personality
is inherited this means that it must be very difficult to modify such
behaviour.
Eysenk might suggest, however, that we could modify
behaviour by replacing the stimulating experience (e.g. smoking) with an
equally stimulating, but less dangerous experience (e.g. bungee jumping).
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Sub Topic 3. Preventing and quitting
substance use and abuse (only one
substance)
Psychologists have developed many different ways of attempting to
prevent and help people quit substance use and abuse. Some of these
suggestions have come from physiological approaches such as the use of
nicotine substitutions and some from psychological approaches such as
the use of role models
The Medical or Physiological Approach
The physiological or medical approach to helping people prevent or quit
substance abuse has been heavily influenced by the nicotine regulation
model. This approach to substance abuse is to see such behaviour as a
medical problem. This approach concentrates on the excessive use of
various substances and commonly defines addiction as ‘dependence on a
drug, resulting in tolerance and withdrawal symptoms when the addict is
deprived of the drug’.
According to the nicotine regulation model (an example of the medical
approach) established smokers continue to smoke to maintain a certain
level of nicotine in their bodies and to avoid withdrawal symptoms.
Stanley Schachter (1977) conducted an ingenious serious of studies with
adult smokers that provides strong evidence for this model. In one
experiment, the researchers had subjects smoke low-nicotine cigarettes
during one week and high-nicotine cigarettes during another week. As the
model predicts, the subjects smoked more low- than high-nicotine
cigarettes. This effect was especially strong for heavy smokers, who
smoked 25% more of the low- than high-nicotine cigarettes.
Therefore using this model, a way of helping people quit smoking is to use
nicotine substitution. There are various ways of allowing people to get
their dose of nicotine without the dangerous activity of smoking – for
example, patches, chewing gum and even nasal drops. The idea behind
this is that smokers will be able to change their habits of smoking without
suffering the cravings associated with nicotine withdrawal.
This approach would argue that we prevent substance abuse by stopping
the availability of the substance altogether such as banning the sale of
cigarettes.
Evaluation
+ Support for the nicotine regulation model comes from a study carried
out by Maron (1987) who found that people who regularly smoke ‘ultra-
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low’ nicotine cigarettes do not consume less nicotine than those who
smoke other cigarettes.
+ This model has gained a lot of empirical support from studies such as
Schachter (1977).
A strength of Schachter’s experiment was that it
controlled many variables such as exactly how much nicotine was in each
cigarette.
+ The model has lead to the development of nicotine replacement
substitutes, which are widely used by smokers to help them quit.
- However this model is limited.
Because it uses a medical or
physiological approach it ignores the many other factors which influence
why people are addicted to cigarettes.
For example, there are
psychological factors involved in addiction (e.g. peer pressure), which the
model ignores. The model is therefore a reductionist model.
- Not surprisingly relapse is quite high with this method as it would seem
that people are not just addicted to the substance (e.g. nicotine), but are
also addicted to the other habits of the drug abuse (e.g. what to do with
one’s hands, mouth after lunch, first thing in a morning and so on)
- For example, when some people quit smoking they return to smoking or
continue to crave for it long after the nicotine is absent from their bodies
which suggests that there are other factors influencing the addiction.
- Many psychologists now see addiction as psychological phenomena and
evidence suggests that people can become addicted to many different
things including drug use, gambling, game playing, eating and sex.
The Behaviourist Approach
The behaviourist approach, and in particular operant conditioning (e.g.
Skinner) social learning theory (e.g. Bandura) and classical conditioning
(e.g. Pavlov) can be used to help prevent substance use and abuse and
help people quit.
According to the behaviourist approach substance
abuse is a learned behaviour.
Therefore according to behaviourists’
substance use is simply a behaviour which has become a habit and can be
changed by relearning new behaviour. It also argues that we can stop
people learning the behaviour in the first place.
According to operant conditioning, reinforcements can be useful in helping
people quit smoking. For example, the smoker can pledge money to a
disliked organisation to be paid if the person starts to smoke again. The
idea behind this method is that a person will find the thought of giving
money to such an organisation so unpleasant that they will feel it is not
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worth starting to smoke again.
Another application of operant
conditioning, which is often used successfully by smokers trying to quit, is
giving themselves rewards for stopping smoking. Perhaps with the money
they are saving.
Similarly programmes have been developed which
remind smokers of the negative consequences of smoking and the positive
consequences of quitting.
Developed from classical conditioning, aversive conditioning attempts to
associate smoking with unpleasant sensations. One way of doing this is
by rapid smoking. The smoker is asked to inhale deeply and frequently
(every six seconds instead of the average of every 90 seconds) until they
begin to feel ill and stop. The smoker eventually starts to associate
smoking with feeling sick, and so becomes aversive to cigarettes. Also
developed from classical conditioning is the use of relaxation techniques.
Smokers often relate smoking to stress relief. Therefore smokers can be
trained in relaxation techniques (or even something as simple as chewing
gum), which they can use instead of smoking when they feel stressed.
Social Learning Theory suggests that smoking behaviour is largely learned
from observing and imitating other role models. Research suggests that
the single most important factor predicting whether or not people smoke
is whether or not their parents smoke.
Therefore to prevent people
smoking in the first place non-smoking role models can be promoted in
the media, schools and so on.
Evaluation
+ The behaviourist approach is useful because it can help prevent
substance use in the first place by using positive role models and also
offers suggestions through classical and operant conditioning to help
people to quit.
+ The behaviourist approach therefore not only provides an explanation
for why people engage in health risk behaviour such as smoking, it also
suggests a variety of treatment techniques to overcome smoking and
excessive drinking habits.
Because behaviour is learned, it can be
unlearned or relearned. For example studies have shown that whereas
mass media campaigns have been unsuccessful in deterring young people
to start smoking, providing non-smoking role models for teenagers has an
effect by buffering those at risk from the pressures of beginning smoking.
+ Many people do actually adopt operant conditioning techniques
successfully when quitting smoking, for example by giving themselves
reinforcements for going for a particular amount of time without smoking
or by spending the money they are saving on treats.
- However there are a number of problems with the behaviourist
approach. The major limitation with behaviourist explanations is that they
are reductionist. For example by only focusing on observable behaviour
they often neglect other important factors such as people’s cognitive
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processes (e.g. attitudes). In doing so they often provide a very passive
view of human beings.
- The behaviourist approach also ignores physiological explanations. For
example twin studies have demonstrated that genetics may be an
important factor in substance use and abuse.
- Whilst behavioural approaches have been fairly successful there are
often ethical problems with using the approaches in real life settings and
the successes also tend to be short lived.
Substance Useful Questions
1. Which types of cigarettes are the most dangerous?
2. How does the medical model approach define substance abuse?
3. Outline one weakness of the medical approach’s definition of
substance abuse
4. How does the behaviourist approach define substance?
5. Give one weakness of the behaviourist definition of substance abuse
6. According to the behaviourist approach, why do people abuse
substances?
7. Why do people smoke, according to classical conditioning?
8. Why do people smoke, according to operant conditioning?
9. Why do people smoke, according to social learning theory?
10.Why do people smoke according to Eysenk
11.Describe one methodological strength of Eysenk’s work
12.Describe one methodological weakness of Eysenk’s work
13.Outline one weakness of Eysenk’s explanation for why some people
smoke
14.Describe why the nicotine regulation model suggests that smokers
should use nicotine patches
15.How, using the nicotine regulation model, can we prevent people
smoking?
16.What are the weaknesses of using nicotine patches?
17.How, using classical conditioning, can people quit smoking?
18.How, using operant conditioning, can people quit smoking?
19.How, using social learning theory, can we help people quit
smoking?
20.How, using social learning theory, can we prevent people smoking?
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