Sociological Aspects of Drug Addiction Research Paper

1. Medical Definitions

First, it is necessary to define the terminology. Generally speaking, a drug (heroin, crack, ecstasy, cannabis, cocaine, alcohol, or psychoactive medicines) is either a natural or a synthetic substance that can alter the mind and influence mood behavior and perception. But common points of view and modern Western law generally consider drugs to be only those psychotropic substances that are illegal and that can lead to addiction. The concept of addiction remains very controversial and troublesome (Akers 1991), but physicians usually define drug addiction as a personal inclination to use drugs that can provoke dependence. From this medical point of view, drug addicts experience at least one of two kinds of dependence: (a) a physical dependence characterized by withdrawal symptoms that follow abstinence from drug use; (b) a psychological dependence that manifests itself by a strong desire to continue using drugs. But this medical definition does not offer any information and knowledge about what sociology is actually concerned with: the social dimension of the drug user’s experience.

2. The Recent Development Of Drug Uses

People have always used drugs for medical, religious, and artistic purposes (opium was used in Babylon), and those uses have long been culturally regulated and socially integrated in all kinds of traditional rituals (Escohotado 1998, Knipe 1995). But in the middle of the nineteenth century, some drugs formerly used as medicines came to be regarded as dangerous (Bachmann and Coppel 1989, Yvorel 1992): Abuse of certain substances gradually became regarded as pathological. The medical concept and the term ‘drug addiction’ appeared at the end of the nineteenth century (the term ‘alcoholism’ was invented by Magnus Huss around 1850), but in those times drug addiction was restricted to only a few soldiers and officers in the colonies, artists, and some physicians who had experimented with these substances on themselves. Both the use of drugs and of the term ‘drug addiction’ became more widespread in the 1920s (Bachmann and Coppel 1989), and the stereotypes according to which ‘drugs are a demon, leading to social and moral misery,’ ‘drug addicts’ behavior is completely irrational,’ ‘drug addiction is an epidemic disease,’ etc., started to spread in Western countries.

Sociological research began to consider drug addiction as a legitimate object when drug use became very widespread in Western countries at the beginning of the 1950s. Indeed, in the 1950s in the USA and from the early 1960s in Europe, drug use and abuse developed considerably and behaviors appeared not to be as socially and culturally patterned as they were previously considered: chronic and massive individual use started to spread in slum neighborhoods. For that reason, drug addiction was soon viewed as a kind of deviance, and not surprisingly, sociological theories concerning drug addiction, drug experiences, and drug addicts emerged from the sociology of deviance, at least at the beginning: The theoretical issues were then quite similar to those existing in this older sociological field. Apart from the diversity of the results of these studies, they almost all contributed, willingly or not, to the denial of commonly held beliefs and the contradiction of medical conceptions (see e.g., the causal theory developed by Dole and Nyswander 1967 about opiate addiction as metabolic disease) and psychological reasoning (see e.g., the psychoanalytic points of view of the French specialists Bergeret and Fain 1981 which considers drug addiction as basically determined by traumas which have occurred during childhood). All the more so since these points of view quickly dominated the discourse on drug care policies. Indeed, research in social sciences about drug addiction was a lot less developed than biomedical and epidemiological studies (Berridge 1988, Ogien 1992).

3. Ethnography And Sociology Of Drug Use And Addiction

The theoretical perspective of most of the sociological research of the 1950s and 1960s was heavily grounded in symbolic interaction, labeling, and role theory. An exception is the theory of Cloward and Ohlin (1960), inspired by the work of Finestone (1957), in which drug addiction is considered to be an extreme case of ‘retreatism adaptation’ (known as the ‘double failure’ hypothesis), emphasized by the functionalist theory of anomie by Merton (1949) and which attempts to discover a social causality for drug use. After having criticized the perspective of theories (Cloward and Ohlin, Merton) that are primarily concerned with social structure, and having distanced themselves from social psychological research (Jessor and Jessor 1977, Kandel 1980 ) which tries to discover the etiology of drug addiction in individual dispositions and in the immediate social context of the individual, most of these works focused on the mechanisms of social control (Becker 1963), but above all, on social aspects of drug use and drug addiction experiences as well as on the lifestyles of drug users and addicts (Ogien 1992).

Though now much criticized (McAuliffe and Gordon 1974, Stephens 1991), the first and most famous of these studies are certainly those of Lindesmith (1938, 1947, 1968), instigated by Herbert Blumer of the Chicago School of sociology: After having intensively interviewed about 60 heroin addicts, he concluded that if drug addicts keep on taking opiates, it is not in search of euphoria but to counter the pain suffered by withdrawal. From this perspective, he pointed out, as Becker (1953, 1963, 1967) did later on, the fact that to become addicted, one has to recognize the effects of the drug and to associate these effects with it. Becoming a drug addict is a learning process in group interaction, by which, in contradiction to the ideas of many, the pharmacological properties of the drug are not sufficient in themselves. Thus, Lindesmith suggested, to be an opiate addict, one has (a) to recognize withdrawal symptoms as resulting from abstinence and (b) to take drugs again conscientiously in order to neutralize those symptoms. This theory explains the well-known fact according to which a large number of people who have been prescribed opiates for medical reasons do not become addicted: They would associate the withdrawal symptoms with tiredness or another pathological cause.

Yet another set of studies, a little later, greatly contributed to the understanding of the social conditions of the lives of many drugs users and addicts and helped change common misperceptions about drug addiction. The well-known survey of Preble and Casey (1969) thus depicted drug addicts ‘taking care of business’ as ‘compulsive hardworking business executives,’ harassed with many intensive activities (find the dealer, get good dope, avoid the police, etc.) in which the moment of euphoria following absorption is very brief. Another study by Feldman (1968, 1973) conducted in the Lower East Side of New York argued that using heroin can be a means of obtaining the highest status in the street hierarchy (to be a ‘stand-up cat’ and to avoid being considered a ‘chicken,’ ‘punk,’ ‘square,’ or ‘faggot’), and thus ruled out the thesis, described by Cloward and Ohlin, of drug addiction as a retreat strategy (see also Lindesmith and Gagnon 1964). Both studies seem to prove that many drug addicts can manage organized activities and the pursuit of an eventful life (see Adler 1985, Cusson 1998, Johnson et al. 1985, Williams 1989 on user– sellers and drug dealers’ activities), and that for these reasons drug addiction cannot be regarded as a way of escaping reality. These studies also suggest that drug addicts are not so different from other social actors, in that they have to maintain lasting social relationships and develop all kinds of skills and competences (hustling, avoiding getting caught by police, finding a trustworthy dealer, learning how to administer drugs, etc.) to survive in the street and to cope with their passion. For Stephens (1991), street addicts from the inner cities of US large urban areas, in fact, adopt a singular lifestyle which certainly contains many disadvantages but which may give dignity and a sense of belonging to them, while also being full of excitement. Concerning this last point, many studies (see e.g., Johnson et al. 1990) point out that some drug addicts (especially those who are also engaged in drug-dealing and can thus afford a lifestyle that they would not have if working in the legal economy, see Adler 1985), are as much addicted to the lifestyle linked to drug consumption as to the drugs themselves.

Moreover, analysis of the data not only sheds light on the social conditions of drug addicts’ lives, but also proves that there are many users who do not necessarily become addicted and go downhill. After having demonstrated that some drug addicts could terminate their addiction and easily achieve abstinence by changing context (such as soldiers in Vietnam who abused heroin but quit it once they returned to the USA), Zinberg (1974), in a very important book, and also Castel and Coppel (1991), have offered evidence that many chronic drug users can continue to have a normal social life while using very addictive drugs such as heroin. Consumption can not only be self-controlled but also regulated in all kind of rituals, and addicts usually learn what is socially acceptable in terms of quantity, frequency, and behavior while consuming drugs (see also the study by Zimmerman and Wieder 1977, which describes how marijuana use in groups is a socially regulated practice); in fact, many regular drug users appear to be able to control their consumption and to remain mild habitual users, and can interrupt their habit for months or years. Finally, drug addiction, these studies suggest, would characterize the situation only of those who have lost control of their habit: becoming a ‘greasy dope fiend’ is not the destiny of every user. Other well-known studies (Biernacki 1986, Hanson et al. 1985) have come to similar conclusions: There are many regular users unknown to the police, judicial, or hospital authorities (the ‘hidden populations’) and among whom many belong to the middle class (Granfield and Cloud 1996). These individuals are capable of not becoming addicted and can manage the fact that they are participating both in the world of normality and the world of delinquency or criminality. But these studies also reveal that drug addicts do not necessarily become delinquent (Biernacki 1986), and that the causality between drug addiction and delinquency is not so obvious. Many studies (for a synthesis see Jobart and Fillieule 1999) wish thus to prove that delinquency, for a lot of people, precedes drug use and that drug use has only intensified an old practice of delinquency. But they also explain why the commonly held belief according to which drug use causes delinquency and crime is so widespread: One of the reasons could be the fact that police officers usually arrest drug addicts who are not successful at delinquent activities because they were not socialized in such a culture and social context. As a result, most of the police statistics accredit the idea that drug addiction is a cause of delinquency (Jobart and Fillieule 1999).

More recently, a great deal of work has tried to consider the reasons why individuals first try drugs, become and remain addicted but above all, achieve abstinence. This last entry point (cessation stage) is an interesting one because biological, social pathologies, or psychological theories have difficulty in explaining why many addicts stop using drugs. This type of sociological research takes from interactionism the concept of career, adopts a more rationalist view on the behavior of the addict, is more focused on decision making and choice of the actors. It has certainly produced results that contradict conventional wisdom but also medical, social psychological, and psychological perspectives like psychoanalysis, for instance, which considers drug addicts as basically determined by unconscious psychic forces (Bergeron 1999) and has never taken seriously addicts’ reasons for their behavior. Taking into account the fact pointed out by many epidemiological surveys according to which most heroin addicts are free of heroin when they are 35 years old, Castel (1994, 1998), Ogien (1994), inspired by the research of Stimson and Oppenheimer (1985), and also Bennett (1986) and Stephens (1991) have tried to discover the reasons for quitting drugs (e.g., the expense; marriage, social, and medical risks; end of euphoria; experience of violence; imprisonment, etc.). Here they demonstrate that drug addicts have to build or rebuild social networks that can help them on the road to a drug-free life and that many of them can achieve abstinence by themselves ( Waldorf and Biernacki 1981), without any professional or medical help. In this perspective, drug addiction is not, as Biernacki (1986) showed, untreatable: It is not a fatal sickness, and the phrase ‘Once an addict, always an addict’ is no longer relevant.

4. Conclusion

Finally, all these studies have tried to destroy both the psychological predisposition theory ( psychologically damaged individual) and the social structural weakness of ‘poor suburbs’ theory and have succeeded in drawing a more complex and diversified image of reality concerning drug addicts and drug experiences. They, of course, do not deny the fact that drug addiction remains for many people a terrible experience, but at the same time they offer evidence that drug addicts are not all doomed to go downhill, that the pharmaceutical properties are not sufficient to make somebody become an addict, that drug addiction is a learning process in association with others, in which one has to learn how to use drugs and to appreciate their effects, that some can control their consumption even while using very addictive drugs, that drug addiction can be a lifestyle that is chosen by people adopting the role appropriate to this way of life, etc. There is no longer any reason for the exclusive domination of the ‘sickness model’ (Stephens 1991) in the way societies respond to the drug addiction phenomenon. In this perspective, sociology and political science have studied state reaction to such a social problem and helped discover which models and values determine the public policies of each Western country. Most of the researchers have thus tried to discover specificities of national drug-care policies (see e.g., Bergeron 1999, Cattacin et al. 1996, Deviance et Societe 1999, Tham 1995), and the conclusion has been the same: Drug control and drug care policies of Western countries are now interdependent and it will be more and more difficult to maintain autonomous views and solutions on this issue (Albrecht and Van Kalmthout 1989). In addition, many sociologists, like Ehrenberg (1998), argue that the now old-fashioned barriers between alcohol, illicit drugs, and psychotropic medicines must be abolished: public health authorities should pay more attention to the way people use a wide range of psychotropic products, legal or illegal, in our modern societies. It is thus clear that policies in Western countries toward addiction problems have to take these research results into account.

Bibliography:

1. Adler P A 1985 Wheeling and Dealing: An Ethnography of Upper-Level Drug Dealing and Smuggling Communities. Columbia University Press, New York
2. Akers L A 1991 Addiction: The troublesome concept. Journal of Drug Issues 21(4): 777–93
3. Albrecht H-J, Van Kalmthout A (eds.) 1989 Drug Policies in Western Europe. Criminological Research Reports, vol. 41. Max Planck Institute for Foreign and International Penal Law, Freibourg, Germany
4. Bachmann C, Coppel A 1989 Le dragon domestique. Deux siecles de relations etranges entre l’Occident et la drogue. Albin Michel, Paris
5. Becker H S 1953 Becoming a marihuana user. American Journal of Sociology 59(3): 235–43
6. Becker H S 1963 Outsiders. The Free Press, New York
7. Becker H S 1967 History, culture and subjective experience: An exploration of the social bases of drug-induced experiences. Journal of Health and Social Behavior 8(3): 163–76
8. Bennett T 1986 A decision-making approach to opioid addiction. In: Cornish D B, Clarke R V (eds.) The Reasoning Criminal. Rational Choice Perspectives on Off Springer-Verlag, New York, pp. 83–102
9. Bergeret J, Fain M 1981 Le psychanalyste a l’ecoute du toxicomane. Dunod, Paris
10. Bergeron H 1999 L’Etat et la toxicomanie. Histoire d’une singularite francaise. Presses Universitaires de France, Paris
11. Berridge V 1988 Drug Research in Europe. Institute for the Study of Drug Dependence, London
12. Biernacki P 1986 Pathways From Heroin Addiction. Recovery Without Treatment. Temple University Press, Philadelphia, PA
13. Castel R 1994 Les sorties de toxicomanie. In: Ogien A, Mignon P (eds.) La demande sociale de drogue. La Documentation Francaise, Paris, pp. 23–30
14. Castel R, Benard-Pellen M, Bonnemain C, Boullenger N, Coppel A, Leclerc G, Ogien A, Weinberger M 1998 Les sorties de la toxicomanie. Editions Universitaires de Fribourg Suisse, Fribourg, Switzerland
15. Castel R, Coppel A 1991 Les controles de la toxicomanie. In: Ehrenberg A (ed.) Individus Sous Influence. Editions Esprit, Paris, pp. 237–56
16. Cattacin S, Lucas B, Vetter S 1996 Modeles de politique en matiere de drogue. Une comparaison de six realites europeennes. L’Harmattan, Paris
17. Cloward R A, Ohlin L E 1960 Delinquency and Opportunity: A Theory of Delinquent Gangs. Free Press, New York
18. Cusson M 1998 Le trafic de drogue. In Criminologie actuelle. Presses Universitaires de France, Paris
19. Deviance et Societe 1999 Politiques publiques et usage de drogues illicites. Deviance et Societe 23(2)
20. Dole V P, Nyswander M E 1967 Heroin addiction: Metabolic disease. Archives of Internal Medicine 120: 19–24
21. Ehrenberg A (ed.) 1998 Drogues et medicaments psychotropes. Le trouble des frontieres. Editions Esprit, Paris
22. Escohotado A 1998 Histoire des drogues. Des origines au XVIIe siecle. Lezard, Paris
23. Feldman H W 1968 Ideological supports to becoming and remaining a heroin addict. Journal of Health and Social Behavior 9(2): 131–9
24. Feldman H W 1973 Street status and drug users. Society 10: 32–9
25. Finestone H 1957 Cats, kicks and color. Social Problems 5: 3–13
26. Granfield R, Cloud W 1996 The elephant that no one sees: Natural recovery among middle-class addicts. Journal of Drug Issues 26(1): 45–61
27. Hanson B, Beschner G, Walters J M, Bovelle E 1985 Life With Heroin: Voices from the Inner Cities. Lexington Books, Lexington, MA
28. Jessor R, Jessor S L 1977 Problem Behavior and Psychosocial Development: A Longitudinal Study of Youth. Academic Press, New York
29. Jobart F, Fillieule O 1999 Action publique sous dependance. Conditions et effets du changement de paradigme dans la lute contre la delinquance associee a la drogue en Europe. Re ue francaise de sciences politiques 49(6): 803–34
30. Johnson B D, Goldstein P, Preble E, Schmeidler J, Lipton D S, Spunt B, Miller T 1985 Taking Care of Business: The Economics of Crime by Heroin Abusers. Lexington Books, Lexington, MA
31. Johnson B D, Williams T, Dei K A, Sanabria H 1990 Drug abuse in the inner city: Impact on hard-drug users and the community. In: Tonry M, Wilson J Q (eds.) Drugs and Crime. University of Chicago Press, Chicago, pp. 9–67
32. Kandel D B 1980 Drug and drinking behavior among youth. Annual Review of Sociology 6: 235–85
33. Knipe E 1995 Culture, Society, and Drugs: The Social Science Approach to Drug Use. Waveland Press, Prospect Heights, IL
34. Lindesmith A R 1938 A sociological theory of drug addiction. American Journal of Sociology. 43(4): 593–613
35. Lindesmith A R 1947 Opiate Addiction. Principia, Bloomington, IN
36. Lindesmith A R 1968 Addiction and Opiates. Aldine, Chicago
37. Lindesmith A R, Gagnon J H 1964 Anomie and drug addiction. In: Clinard M B (ed.) Anomie and Deviant Behavior: A Discussion and Critique. Free Press, New York, pp. 158–88
38. McAuliffe W, Gordon R 1974 A test of Lindesmith’s theory of addiction: The frequency of euphoria among long-term addicts. American Journal of Sociology 79: 795–840
39. Merton R K 1949 Social structure and anomie. In: Merton R K (ed.) Social Theory and Social Structure. Free Press, Glencoe, IL, pp. 125–49
40. Musto D F 1987 The American Disease: Origins of Narcotic Control. Oxford University Press, New York
41. Ogien A 1992 Situation de la recherche sur les toxicomanies en Europe et aux Etats-Unis. In: Ehrenberg A (ed.) Penser la drogue. Penser les drogues. Editions Descartes, Paris, pp. 49–85
42. Ogien A 1994 La morale du drogue. Revue francaise des affaires sociales 2: 59–67
43. Preble E, Casey J J 1969 Taking care of business. International Journal of the Addictions 4: 1–24
44. Stephens R C 1991 The Street Addict Role. A Theory of Drug Addiction. State University of New York Press, Albany, NY
45. Stimson G, Oppenheimer E 1982 Heroin Addiction. Treatment and Control in Britain. Tavistock, London
46. Tham H 1995 Drug control as a national project: The case of Sweden. The Journal of Drug Issues 25(1): 113–28
47. Waldorf D, Biernacki P 1981 Natural recovery from opiate addiction: Some preliminary findings. Journal of Drug Issues 11: 61–74
48. Weisheit R (ed.) 1990 Drugs, Crime and the Criminal Justice System. Anderson, Cincinnati, OH
49. Williams T 1989 The Cocaine Kids. Addison-Wesley, New York
50. Yvorel J J 1992 Les poisons de l’esprit. Drogues et drogues au XIXe siecle. Quai Voltaire, Paris
51. Zimmerman D, Wieder L 1977 You can’t help it but get stoned. Notes on the social organization of marijuana smoking. Social Problems 25(2): 198–207
52. Zinberg N 1974 Drug, Set and Setting. Yale University Press, New Haven, CT