Substance Abuse

Substance use is where taking a substance involves no harm.

Substance abuse is where the substance harms either the person taking it or others.

However what is viewed as use and abuse varies depending on societies.

Addiction occurs when, with repeated use, someone preoccupied with a substance and dependent on it.

It causes a pleasant feeling (high).

Increased levels of the substances have to be maintained to preserve this feeling.

Withdrawal symptoms are experienced when the substance is not taken.

Relationships with others suffer and the risk of relapse is high.

Physical dependence, the body has got used to the substance and needs it to be in a normal state

I.e. Without withdrawal symptoms

This is because drugs act by changing brain chemistry.

In psychological dependence, there is an emotional and mental compulsion to keep taking the substance.

The drug becomes the focus of life and determines daily routines.

 There is a craving, these are a motivational state of want and desire for the substance.

Tolerance: A state of progressively decreased responsiveness to a frequently used substance. Hence more of the substance need to consumed to achieve similar effects as the first time round.

Key Study to illustrate tolerance:

Siegel

Aim: Investigating how drug tolerance may be situationally dependent.

Method: Rats were injected with heroin in their normal place of living for a period of 80 days. Later half of those rats were placed in a different environment.

Results: 65% of the rats placed in a new environment died after being injected with an overdose of heroin, while only 30% of the rats in their normal environment died after being injected with an overdose of heroin.

Conclusion: Drug tolerance can be related to the normal environment in which the drug is taken.

Withdrawal: The unpleasant physical and psychological side symptoms that occur when the person suddenly stops consuming the substance. This occurs after the body has become tolerant to the substance. Withdrawal effects are usually the opposite of the initial and pleasant effects of the substance. There are high chances of relapse after withdrawal depending on the person’s age and situation.

Solvent Abuse: widely used in everyday products such as glues, paints, and cigarette lighter fuels. They evaporate at room temperature allowing the fumes to be inhaled through the mouth or the nose. Inhaling solvents provides a similar experience to that of being drunk on alcohol.

Aim: Investigating the trend in deaths from solvent abuse in the United Kingdom.

Method: Data collected from various different sources such as the press and coroners’ reports.

Results: In the 1990 there were 152 recorded deaths due to solvent abuse. This fell to 64 in 2000.

Conclusion: Death rates from solvent abuse have fallen; this could be due to advertising campaigns by the department of Health that took place in 1992.

Tobacco and nicotine: Tobacco contains an addictive drug known as nicotine. Nicotine is a mild stimulant and a person needs to be smoke regularly as the chemicals are quickly absorbed into the bloodstream. Smoking cigarettes or other tobacco-based products can be bad for your health. A link has been found between smoking and lung cancer and many other forms of cancer. Passive smoking can also be very harmful to non-smokers.

Schacter

Aim: Investigating the nicotine regulation model of smoking.

Method: Smokers were asked to smoke low-nicotine cigarettes for one week, then high-nicotine cigarettes for another week.

Results: Participants smoked more low-nicotine cigarettes than high-nicotine cigarettes.

Conclusion: Smokers maintain a certain nicotine level in their body, as predicted by the nicotine regulation model.

Tomkins

Type of smoker:

Habitual: Continues smoking as a matter of habit. Gain little pleasure from smoking and are unaware that they are smoking.

Positive Emotion: Smoking provides a way relaxing and feeling good.

Addictive: Are aware of their smoking and are also aware of the times when they are not smoking.

Negative Smoking: Smoking provides a way of reducing anxiety and stress.

Alcohol: Alcohol is an addictive drug and many build a tolerance when it is drunk consistently. Alcohol creates both physical and psychological dependence; this explains why alcoholics find difficult to give up drinking. Severe withdrawal symptoms are experienced when drinking is suddenly stooped.

Alcohol has both positive and negative effects on health:

Negative effects: Alcohol can cause various forms of cancer. Alcohol can affect a person’s memory and the ability to learn new things. Alcohol can also affect skilful behaviour such a driving as concentration level is reduced significantly as well as slowing down reaction time.

Positive effects: Light/moderate drinking can be beneficial for the body as cholesterol levels can be reduced.

Stimulants: Stimulate the central nervous system resulting in feelings of happiness and full of energy.

E.g. ecstasy, cocaine.

Depressant:  Slows down the activity of the central nervous system resulting in feelings of relaxation.

 E.g. alcohol, solvents and heroin.

Explanations of substance abuse

Biological factors Substance abuse is a result of inheritance and genetics.  For example an alcoholic may be abusing the substance as their parents also abused the same substance. Melo found from his animal study that animals that consumed alcohol had offspring that also preferred alcohol.  Studies on identical twins suggest that certain people may be predisposed to substance abuse. Another way of investigating genetic basis of substance abuse is research on people who are adopted straight after birth. Most research in this condition suggests that those that abuse alcohol are more likely to have at least one biological parent that also abused alcohol. 

Kaji

Aim: Investigating the rates of alcohol abuse in identical and non-identical twins

Method: Identical and non-identical twins were recruited and their alcohol consumption rates were recorded and compared

Results: Identical twin pairs had a higher concordance rate than non-identical twins

Conclusion: Higher concordance rates for identical twins suggests genetic explanations for substance abuse

Evaluating kaij’s study and the biological explanation for substance abuse:

·         Identical twins are often treated the same and they share the same this may the reason behind high concordance rates rather than genetics

·         Adoption studies still suggest that genetics does play a role in explaining substance abuse even though the environment is different

·         The study found 54% concordance rate among identical twins, it is not 100%

·         Deterministic/ reductionists approach as it does not take other factors into account and assumes one certain cause will lead to one certain effect

·         Plomin argues that it is highly unlikely that an individual can possess a gene that drives them to abuse alcohol

·         Most research has been based on alcohol consumption, others substances should be investigated in relationship to heredity

Personality factors

Certain people with certain personality types are more likely to be associated with substance abuse. Flory found that extroverts have an outgoing and easily bored personality type hence they are more likely to be alcohol abusers than introverts. Similarly, McAdams found that those with low consciousness such as careless, unreliable and disorganised individuals were more likely to be alcohol abusers.  Research has also investigated the link between anti-social personality disorder and alcohol abuse. The psychodynamic approach proposes that people who abuse substances have strong dependency needs which can be traced back to their early childhood experiences. Individuals that do not receive satisfactory comfort during their childhood may grow older seeking comfort from something neutral such as substances. 

Morgenstern

Aim: Investigating the link between anti-social personality disorder and alcohol abuse

Method: Structured interview was used to identify personality characteristics and their alcohol consumption rate

Results: Anti-social personality disorder was found to be associated with alcohol abuse

Conclusion: Certain types of personality such as anti-social personality disorder are more likely to be associated with alcohol abuse than other personality types

Evaluating Morgernstern’s study and personality factors in explaining substance abuse:

·         Only 3% of the world population suffer from anti-social personality disorder, yet a much higher percentage of people abuse alcohol altogether, what causes them to abuse alcohol if they do not suffer from anti-social personality disorder

·         There are too many personality types that can link to alcohol abuse, studies may even contradict itself in this case, no one study has been found to offer a significant explanation for substance abuse

·         It is hard to establish case and effect relationship in this case, does personality type cause substance abuse or does substance abuse cause a personality type to develop

·         Most research has associated with alcohol, other substances should be investigated in relation to personality types

Social factors and peer influence

An individual starts taking a substance as a result of the influence of others.

Social learning theory is based on observational learning whereby the person being observed acts as a model by the observer. Vicarious reinforcement is when the observer notices the observed person being rewarded for their behaviour hence the observer is more likely to imitate their behaviour. Characteristics of the model have an effect too, those that we see as similar to ourselves are more influential.

Peer influence and peer pressure is also important in explain substance abuse. Social pressure and encouragement plays a significant part in starting and continuing to abuse substances. Teenagers select a group they want to socialise with, this comes with a subculture and this social selection means that some teenagers associated with groups known to abuse substances are more at risk of becoming substance abusers themselves.

Social norms and sociocultural factors are also very important in explaining substance abuse. Social norms operating within a subculture and across different cultures can influence the level of substance consumption. In certain societies the level of substance consumption can be a lot higher than other societies as different social norms operate in each society. Certain societies see heavy drinking and getting drunk as socially acceptable while others do not.

Garnier and Stein

Aim: Investigating the role of peer influence on substance abuse 

Method: In a longitudinal study from when mothers were pregnant and 18 years later data collected on peer substance abuse and the teenagers own substance abuse

Results: substance abuse by the teenager was significantly associated with peers abusing substances

Conclusion: Peer pressure and social encouragement can cause teenagers to abuse substances

Treatments - Aversion therapy and self-management are most effective when the person is motivated to give up a drug. Relapse is a problem during the first few weeks or months of a treatment programme. Many happen to relapse at least within a year.