The purpose of this paper is to investigate specifically
one kind of deviant behavior – drug addiction.
We will start off by introducing the reader to
deviant behavior and then move on to our topic
of concern which is substance abuse. We will describe
this behavior and then look into its many causes
and the different theories which researchers have
proposed to explain drug addiction. In the end,
we provide a view of the consequences of drug
addiction for the individual, his friends and
family and society in general.
Introduction to Deviant
Behavior:
Deviant behavior is generally described as any
behavior that is not in alignment with the accepted
cultural norms. Deviation can be of many types
and of varying levels of intensity. Today, there
are a lot of formal and informal controls prevalent
which try to prevent and minimize deviance (Deviant
Behavior).
For example, crime or its subcategory, juvenile
delinquency, the violation of formally enacted
law, is known as formal deviance which is usually
controlled by the criminal justice system. Variations
in hairstyles would be informal social violation
which is usually controlled by people through
their reactions to influence others.Hence, deviance
does not necessarily mean criminal behavior. It
also means not doing what the majority does or
alternatively doing what the majority does not
do. For example, behaviors caused due to cultural
differences can also be interpreted as deviance
(Deviant Behavior).
Deviant behavior can be of many kinds: homosexuality,
alcoholism, white-collar crimes, cyber crimes
to name a few. In this paper, however we carry
out a thorough investigation of drug addiction
– a type of deviant behavior which was previously
thought to be uncommon and easily curable. However,
this paper will paint a different picture (Deviant
Behavior).
Drug Addiction - Description:
Drug Addiction which is often also known as
dependence is defined as having at least 3 of
the following signs: a tolerance for the drug
(the addict needs more of the drug to achieve
the same effect), withdrawal symptoms, having
more of the drug than what was intended or over
a longer period of time than was intended, always
having a desire to decrease or the inability to
decrease the amount of the drug consumed, spending
a lot of time and effort trying to get hands on
the drug and lastly, persistently using the drug
even when one has knowledge of the reoccurring
physical or psychological problems that the drug
is responsible for (Cohen, 1995).
Causes of Drug Addiction:
Risk Factors and Individual Differences
– Increasing the Probability of Drug Addiction:
It should be remembered that up till now, there
are an impressive number of 72 risk factors which
have been identified for drug abuse and addiction
but their levels of importance vary. They operate
either at the level of the individual, the level
of the family or the level of the community.
But these are the same risk factors for a lot
of other bad things as well: poverty, racism,
weak parenting, peer-group pressure, and getting
involved with the wrong friends. Hence, these
are not determinants because a lot of people who
have a lot of risk factors do not end up using
drugs. What these do is simply increase the probability
that people with certain characteristics will,
in fact, take drugs (Cohen, 1995).
Also, another important thing to note at this
stage is that the determinants for drug usage
and drug addiction might not be the same. Drug
usage might depend on a person’s personal
situation – whether he is under stress,
or his peers use drugs, or he is going through
a situation in life where he has to use drugs
to medicate. In the beginning, a person usually
takes drugs because he feels that if he changed
his mood through the, he would have a happier
life, i.e., to alter their mood, perception, or
emotional state. They use drugs to make themselves
feel good.
A little later in this paper, we will look into
the brain mechanisms which are involved in causing
this ‘good’ feeling and the scientific
theories which confirm these (Cohen, 1995; Leshner,
1997).
Hence, there are a lot of individual differences
which prevail which make it difficult to correctly
answer the important question of why did addicts
become addicted to drugs? Studies have even shown
that individual differences prevail not just in
determining the causes of drug addiction, but
also in the responses to drugs.
A Harvard University study proved that there
is a genetic component which determines how much
a person would like marijuana. Obviously, the
more a person likes it, the higher the probability
of them taking it again and getting addicted.
Hence, drug addiction even has a causal factor
in genes (Julien, 1995; Leshner, 1997).
The above discussion was meant to prove that there
are individual differences in the experience of
drug-taking and so, it is not possible to pinpoint
the exact causes of drug addiction. But psychologists
and sociologists have come up with theories that
try to make the mark. We will now look upon some
theories of drug addiction (Julien, 1995).
Theories of Drug Addiction:
There are number of theories of drug addiction.
McKim (1997) has described three models of why
people become addicted to drugs, or as is said
today, engage in substance abuse. These are: the
disease model, the physical dependency model and
the positive reinforcement model.
All these models could only be formulated after
people with problems associated with alcohol or
other drugs stopped being referred to as sinners
or criminals as was the case at one time.
At that time, they could only receive help via
the courts or the church. It was towards the end
of the 19th century that the medical profession
began using the term ‘addiction’ to
explain and diagnose excessive drug use. In the
1950s, the World Health Organization (WHO) and
American Medical Association (AMA) categorized
alcoholism as a disease and this opened the doors
for explaining other types of addiction such as
drug addiction.
An important result of this attitude shift was
that. One consequence of this change in attitude
is the belief now that the addict can not control
their behavior, and that they need treatment and
not punishment (Deans, 1997; McKim, 1997).
We will not discuss the disease model in great
detail because it has one basic problem: it does
not clarify how one catches this disease. The
physical dependency model on the other hand is
based on the very premise that, since withdrawal
symptoms exist, people continue to use drugs in
order to avoid withdrawal symptoms.
Physical Dependency Model
| Effects of heroin |
Heroin withdrawal
symptoms |
Euphoria |
Dysphoria |
| Constipation |
Diarrhoea & Cramps
|
Relaxation |
Agitation |
The effects and withdrawal symptoms of heroin
are showed on the table at the right. The physical
dependency model says that it a person is exposed
to certain drugs repeatedly, he starts to experience
withdrawal symptoms if he discontinues the drug.
Basically, withdrawal symptoms are compensatory
reactions that counter the primary effects of
the drug. They can be said to be the opposite
of the effects of the drug (Deans, 1997; Richards,
1993).
Withdrawal effects are obviously unpleasant and
unwanted and a reduction in these effects would
therefore be negative reinforcement, which is
the reinforcement of behavior that ends an unwanted
and disliked stimulus. This could explain why
addicts continue to take the drug in spite of
the havoc it might be wreaking on their mind and
body (Deans, 1997).
Again, this model could not recognize or explain
the addictive properties of cocaine. Cocaine is
different because it does not produce physical
dependency (tolerance and withdrawal symptoms)
but it is definitely more addictive than heroin.
Also, the above model does not really explain
why people take drugs in the first place.
it is only in few situations that negative reinforcement
could be the reason for initial drug taking: for
example, if a person is suffering from unpleasant
emotions, he may find that these feelings go away
when he takes the drug, which is again, negative
reinforcement (Deans, 1997).
It is the third model which puts forward the most
likely reason for drug taking. This is the Positive
Reinforcement Model.
Positive Reinforcement Model
Most people become addicted to drugs because
of its reinforcing properties. The drugs which
are addictive drugs are also positive reinforcers.
Positive reinforcement usually causes the person
to learn a new response or keep indulging in existing
behaviors.
Hence, when a person smokes or injects a drug
in his body, its positive reinforcing properties
increase the probability of the person doing the
same again, and then yet again (Richards, 1993).
The ‘Oops’ Phenomenon:
Although this is not a formal
theory of drug addiction, it does help to explain
quite a few questions regarding it.
It is a fact that no one ever starts using drugs
with the intention of becoming a drug addict.
They are simply trying out something new, meaning
to sue it once or a few times.
They start using drugs occasionally and this
decision is a voluntary one and one within their
control. It is with the passage of time that this
occasional and voluntary user becomes a compulsive
one. This change happens because with time, use
of addictive drugs alters the brain, this could
be in major or subtle ways but both are destructive
(Leshner, 2003).
Over here, it is important to reinforce that
drug addiction is a disease of the brain. Every
different type of drug abuse has a different effect
on the brain, but these effects fall under a general
umbrella and are quite similar. Also, they all
result in compulsive use of the drug. The changes
in the brain could be long-term and fundamental
like changes in the biochemical makeup of the
brain, or short term like mood swings or changes
in memory processes and motor skills.
These changes however greatly affect the life
and behavior of the person and when a person is
addicted, the drug ‘becomes the single most
powerful motivator in the life of the drug user.
He will do virtually anything for the drug’
(Leshner, 2003).
In most cases, this is a totally unexpected consequence
and Leshner (2003) has coined this as the ‘oops
phenomenon’. This is because this destructive
result was by no means intentional.
This can be compared to the similar situation
that no one intends to get lung cancer when they
start smoking, and no one sets out to become a
drug addict when they use drugs. But in both cases,
because of the ‘inexorable, and undetected,
destructive biochemical processes at work’,
the result was a damaging health condition.
There is also an argument that addicts are simply
possessors of weak will, they simply can’t
say NO to drugs. But in the face of all scientific
evidence which does point to the conclusion that
drug addiction is indeed a brain disease, this
argument does not hold. However, this should not
be taken to mean that those addicted to drugs
are not responsible for their actions, or that
they are just unknowing, hapless victims of the
harmful effects that their use of addictive drugs
has had on their brains and lives.
It was their behavior which caused them to become
addicted in the first place, and their behavior
after knowledge of addiction is equally important
for their treatment and recovery (Leshner, 2003).
A drug treatment regimen is also not without its
challenges. The nature of this brain disease is
that the very changes that the drug has caused
on the brain make it very difficult for addicts
to control their actions and complete treatment.
Also, if they come across any situation which
reminds them of the euphoric experience of drug
use, their craving only reaches higher limits
(Leshner, 2003).
Drug addiction, like a lot of other brain diseases
like Alzheimer’s, Parkinson’s, schizophrenia
and clinical depression has biological and behavioral
dimensions. Both biological and behavioral explanations
of drug abuse must be given equal importance:
brain disease which is caused by drug use cannot
and should not be artificially isolated from its
behavioral components, as well as its larger social
components.
Drug addiction stands out from the league of
other brain diseases because it starts out as
voluntary behavior. But after use of an addictive
drug has wreaked havoc on the brain, the results
are often the same as in people with other kinds
of brain diseases (Leshner, 2003).
Drug Addiction as explained by cognition:
e now engage in a discussion which picks up from
where the reinforcement theories left, but goes
further to put forward some contrary views.
A lot of researchers of substance abuse have
explained drug abuse and addiction by their reinforcing
effects. Pharmacological studies have also supported
that view, and as was mentioned above, have concluded
that drugs of abuse have a strong impact on the
brain's dopamine system, which ‘regulates
emotional responses and plays a part in abuse
by providing an emotional "reward" for
continued use’ (Carpenter, 2001).
Today, however scientists have learnt that the
actual story might not be so simple. When brain-imaging
studies were carried out in humans and neuropsychological
studies in nonhuman animals, they showed that
when a drug is used repeatedly, the brain’s
frontal cortex is disrupted. This part is responsible
for carrying out cognitive activities such as
decision-making, response inhibition, planning
and memory.
According to Herb Weingartner, PhD, of the Division
of Neuroscience and Behavioral Research at the
National Institute on Drug Abuse (NIDA), “We
now know that many of the drugs of abuse target
not just those aspects of the brain that alter
things like emotion, but also areas that affect
our ability to control cognitive operations”
(Carpenter, 2001).
These findings help us to better understand
why only some drug users become addicted, why
drug abusers get tempted and use drugs even after
a long, painstaking period of drug abstinence
and, most importantly, how prevention and treatment
efforts can be adjusted according to people's
individual vulnerabilities. This is also one of
the reasons treatment is so difficult. According
to Elliot A. Stein, PhD, a neuroscientist at the
Medical College of Wisconsin, it is a tall order
to find a ‘magic bullet to attack both the
pharmacological and the behavioral parts of addiction’
(Carpenter, 2001).
Since the 1980s, scientists have been aware
of the fact that many addicts of drugs like cocaine
and marijuana appeared be suffering from frontal
cortex abnormalities. As Steven Grant, PhD, a
program officer in NIDA's Division of Treatment
Research and Development explained, these abnormalities
were thought of as harmless side effects of drug
use.
He said that in the 1980s and 90s, researchers
have not really paid attention to the influence
of those processes on substance abuse and addiction
“because we have been so focused on the
role of reinforcement and the hedonic effects
of drugs as being the driving force in drug abuse”
(Carpenter, 2001).
But a recent development has resulted in a changing
of gears for researchers of substance abuse. At
a 1992 scientific conference, University of Iowa
neuroscientist Antoine Bechara, PhD, put forward
research which showed that patients with frontal
cortex damage had disturbed decision-making abilities
as was reflected in their performance on a laboratory
gambling task (Carpenter, 2001).
When Grant saw Bechara's presentation, he thought
that the same principle applied for drug abuse
as well and he hypothesized that impairments in
the frontal cortex could be said to cause disturbed
decision-making and behavioral inhibition in drug
abusers. This could very well be the reason why
addicts compulsively seek the same drug which
has caused them so much damage and harm already
(Carpenter, 2001).
Grant and his colleagues got to work and started
an experiment based on Bechara's gambling task,
to test drug abusers' decision-making abilities.
In 2000, they found out that drug abusers did
in fact make worse decisions on the gambling task
than did participants in a control group (Carpenter,
2001).
It was in 2003 that Bechara and his colleagues
made more progress in these initial findings.
They found that there were thee distinct subgroups
of drug abusers. One group showed none or negligible
decision-making impairment when confronted with
the gambling task. About 25 percent of the people
acted in the same way as patients with frontal
lobe damage usually do, that is that mostly choose
a higher reward in the short term even with knowledge
that this would cause them harm in the long run.
Lastly, about 40 percent of Bechara's study participants
showed that they were hypersensitive to potential
reward, whether immediate or in the long-term
(Carpenter, 2001).
According to Bechara, these variations in decision-making
impairment are a sign of varying vulnerabilities
to drug addiction. Hence, he finds them an important
stepping stone to future treatment strategies.
He says that the group who showed no impairment
in decision-making abilities might be the one
at least risk of addiction while with those suffering
from serious decision-making impairments, “There's
probably nothing you can do. You can put them
in jail, but in my opinion, they're unlikely to
respond” (Carpenter, 2001).
For drug users who show sensitivity to both
the short- and long-term consequences of drug
use, possible treatment strategy could be to increase
awareness of the negative long-term consequences
of abuse so that they get alarmed and quit using
drugs.
In 1996, Grant and NIDA colleagues David B. Newlin,
PhD, Edythe D. London, PhD, proposed that the
impairment of a person’s decision-making
abilities might be a very important reason why
people take drugs continuously.
According to Nora D. Volkow, MD, a research scientist
at the U.S. Department of Energy's Brookhaven
National Laboratory, “Classically, people
thought that drug addiction was a disease that
involved the centers of pleasure – that
people are taking the drug because it's pleasurable.
But that's not the case – in fact, addicted
people don't have as strong a pleasure response
as people who aren't addicted. Recent data are
showing us that addiction entails a basic disruption
of motivational circuits” (Carpenter, 2001).
This destruction of the frontal cortex makes
a person caught in a vicious cycle where he is
not able to look beyond the drug’s immediate
reinforcing or euphoric effects and pay attention
to the long-term consequences of drug use. It
is usually in the frontal cortex that the residual
effects of drugs stay, even after the dopamine
effects have disappeared (Carpenter, 2001).
Consequences of drug abuse:
Deviant behavior often has
harmful effects on the individual, his friends
and family and society in general. Substance abuse
and drug addiction also impacts these entities
in major ways.
On the individual:
People who excessively use drugs experience
a wide range of physical effects. For example,
when a person takes cocaine, he feels euphoric
and ‘high’ but this high is followed
by a ‘crash’: which is usually depicted
by feelings of anxiety, fatigue, depression, and
a strong desire for more cocaine to alleviate
the crash.
Use of marijuana and alcohol impairs motor control
and are often causal factors in many automobile
accidents. Users of marijuana and hallucinogenic
drugs often experience flashbacks, unwanted recurrences
of the drug's effects weeks or months after use.
As was mentioned earlier in the paper, abstinence
from certain drugs results in withdrawal symptoms.
For example, heroin withdrawal can cause vomiting,
muscle cramps, convulsions, and delirium. A very
harmful result of drug usage is the development
of tolerance for the drug, that is, the user has
to constantly increase the amounts of his drug
intake to duplicate the initial effect. AIDS and
some types of hepatitis can also be results because
these drugs are injected using hypodermic needles,
and sharing of these needles increases the risk
of the said diseases.
Drug overdose is definitely also an issue because
the purity and dosage of illegal drugs are uncontrolled.
Statistics reveal that there are annually over
10,000 deaths directly caused by drug use in the
United States; the substances which are named
most commonly in such deaths are cocaine, heroin,
and morphine, often combined with alcohol or other
drugs.
Drug users also often engage in criminal activity,
such as burglary and prostitution, to raise the
money to buy drugs, and usage of some drugs, especially
alcohol, have also shown to be correlated to violent
behavior (Winger, Hofmann & Woods, 1992).
On the family:
The family of a drug user often
suffers because of firstly, his preoccupation
with the substance, and also its effects on mood
and performance. This can cause marital problems
as well as lead to poor work performance or dismissal.
This way, drug use often disrupts family life
and creates destructive patterns of codependency.
This often happens when the spouse or whole family,
out of love or fear of the consequences, inadvertently
make it possible for the user to continue using
drugs by covering up, supplying money, or denying
that a serious problem exists.
Drug users who become pregnant mostly bear a
much higher rate of low birth-weight babies than
the average. This could be due to drug usage or
not taking care of oneself. Drugs like crack and
heroin cause even worse effects because they cross
the placental barrier: the result being birth
of addicted babies who go through withdrawal soon
after birth. Pregnant women who might acquire
AIDS through sharing hypodermic needles unknowingly
transfer the deadly disease to their infant (Beck,
Wright, Newman & Liese, 1993).
On the society:
Drug abuse also affects society in many ways.
In the office it is very costly because of the
lost work time and inefficiency. Drug users have
a higher probability than nonusers to have occupational
accidents, endangering themselves and those around
them.
Drug-related crime can disrupt the peace of neighborhoods
due to violence among drug dealers, threats to
residents, and the crimes of the addicts themselves.
In some neighborhoods, younger children are often
hired as lookouts and helpers because the U.S.
criminal justice system awards lighter sentences
to juvenile offenders, and guns have become common
possessions among children and adolescents. The
great majority of homeless people have either
a drug or alcohol problem or a mental illness—many
have all three (Beck, Wright, Newman & Liese,
1993).
.
Summary
Drug addiction is a kind of deviant behavior
which is also a disease of the brain. However,
it is different from other brain diseases because
it starts off as voluntary behavior, and if the
user tries to leave it, he has to continue doing
it because of the aversive withdrawal symptoms
it causes. As research has also shown, users mostly
become addicts without meaning to, and then the
harmful effect which the drugs have on the mind,
leaves its decision-making ability further impaired
– and it becomes extremely difficult to
break free from the shackles of drug addiction.
Conclusion
Even after the lengthy discussion that we have
engaged in regarding the causes and consequences
of drug addiction, it is still a phenomena which
can not be accurately explained due to variations
in individual factors which govern the person’s
motivation and responses to drugs. But, rest assured,
this is one area where researchers keep looking
for the next clue – drug addiction has become
from a crime, a disease – and from the addiction
models, we today have proof that it is actually
a vicious cycle, which when once trapped, it becomes
extremely difficult to free oneself.
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