Drugs and Society
Review: Test III
Social Norms Approach: Norms connote a system of meanings and attitudes within
which individuals interpret a given situation and take direction for their behavior within a
particular cultural domain.
Normalization- process through which ideas and actions come to be seen as normal and
become taken for granted or natural in everyday life.
Alcoholics Anonymous- (1935, Bill Wilson or Bill W. was the co-founder) Disease notion
of addiction was established around this time.
Higher Power- term coined in the 1930’s inAA. Term refers to a supreme being or some
conception of God.
Medicalization: (problems with Disease concept) disease-oriented organizations often fail
(relapse is common), people may be less likely to outgrow problem (guarantees relapse),
disease based treatment forced on people, undercuts moral sanctions, does not address
social issues (depoliticizes problems), turns control over to professions or other addicts,
and may deter natural recovery; individuality has no control.
12 Steps of AA: these steps basically convince the members that they are powerless over
alcohol and that they should turn their will and lives over to God even though program
claims to not be religion-based.AAis not only disease based but also abstinence based.
Women for Sobriety- (“new life” acceptance program) very different fromAAbecause it
does NOT make members feel powerless. Makes them feel like they have control over
Moderation Management- members abstain from alcoholic beverages for 30 days, jot
down life priorities and set moderate drinking limits as well as start small steps toward
balance and moderation in other areas in life.
Drug Courts- specifically designated to administer cases referred for judicially supervised
drug treatment and rehabilitation within a jurisdiction or court-enforced drug treatment
programs ( individual is arrested, non-violent cases go through drug court).
Therapeutic Jurisprudence- how can courts HELP to improve mental health of
Project MATCH-patients were randomly assigned to Twelve-Step Foundation, Cognitive-
Behavioral Coping Skills, or Motivational Enhancement Therapy. RESULTS: subjects
reduced drinking intensity and freq. of drinking across all treatments but relatively few
did not drink at all ( motivation, low psychiatric probs, desire to find meaning) Treatment Outcome Prospective Study (TOPS)- (11k clients from 1979-1981)Outpatient,
methadone maintenance, therapeutic community. RESULTS: regular use of all drugs
declined. Cocaine use less effected by treatment. General decline in crim behavior and
higher success w. program completers than w. dropouts.
DrugAbuse Treatment Outcome Study (DATOS)- (10k clients) RESULTS: reductions in
drug use and predatory crime. Drug use prevalence decreased by 50% across diff
treatment modalities. Increase in employment.
DrugAbuse Resistance Education (DARE)- some approaches effective but DARE had
little impact-Highly controversial –‘new DARE” not very effective.
harm reduction-(safety first)-Rosenbaum-4 assumptions. Licit and illicit drugs can be
abused. Recognizes that abstinence is not realistic forALL young people. Use of drugs
does not constitute abuse. Context for drug use is primary factor in safe or dangerous
-Needle exchange program: exchange dirty needle for a clean one. Decreases HIV
infection and promotes drug treatment.
natural recovery: Early recognition of Natural Recovery ( Rush 1785)Adisregarded
National LongitudinalAlcohol Epidemiologic Survey (NLEAS): Natural Recovery
research by Dawson in 1996 (4585 DSM IVAlcoholAbusers) Untreated populations do
as well, if not better, than treated populations.
Process of Natural Recovery: Conversion to a New Life
Strain- financial, occupation, and health problems
Turning Points-a crisis that gets you to question the path you are on and shift to a new
Cessation strategies- take courses of action in their lives in order to help sustain cessation
of heavy use, NOT usage entirely.Activities were alternative relationships and avoidance.
Rewards-derived benefits from overcoming addictive abuse
Avoiding treatment- negative images (felt treatment identified people as powerless
addicts), does not work, did not need it/ on their own.
Recovery capital: the sum of one’s resources that can be drawn upon for successful
Social capital: sum of the social resources (ones that come from the networks and
connections we have)
Cultural capital: knowledge and acceptance of cultural norms and the ability to act in
one’s interest within those norms to meet basic needs and maximize opportunities. Conversion-redefinition of self . New meanings and new self-concepts. New language
and new associations. Radical transformation of identity.
Therapeutic community: ( Charles Dietrich 1958, founder or Synanon program) did not
think addicts could get over addiction without militarized structure. Removed them from
environment. This program was a residential program unlikeAA. PURPOSE was to
break down person so that they can build them back up, the right way. CRITICISM:
mandatory, high drop-out, artificial movement, non-professional staff, few links to
community, abusive, too much emphasis on charismatic leadership-cult of the personality.
Haircut: aversion therapy, removes one’s individuality.
Synanon game: “hot seat”
Maintenance model: addict or drug-dependent person is “maintained” on doses of the
drug in question.
Methadone maintenance: ( Dole and Nyswander 1964) Tried to give enough drug to
block any other narcotic that person might take while trying to prevent person from going
into withdrawal. Patients would drink it as opposed to injecting it. Thought to be a
narcotic blocker although it does have effects at high