A critical analysis of the concept of addiction with reference to drug misuse

In this assignment I will be critically analysing the meaning of the term addiction when used in relation to drug misuse, and assess its merits as a concept for defining drug related behaviour. The key factors will be considered as to why people use drugs on a regular basis and how these factors impact the ‘validity’ of the overall concept of addiction. Also, I will be looking at what related concepts, such as ‘dependence’, imply for our use of addiction as a term to describe regular drug use.

The term ‘Addiction’ is perhaps most commonly used to describe problematic drug use. Drug addiction is a very controversial topic with many diverse definitions and opinions. Barber (1995) addressing this issue says “Many attempts have been made to arrive at a universally acceptable definition of addiction but the matter remains unresolved and contentious. As a result, terms which might sound as if they refer to much the same thing take on subtle shades of meaning and can lead to spirited, even acrimonious debate among drug experts.” Popular conceptions of addiction do not stop at drugs but people can become overly attached to alcohol, gambling, chocolate, sex, computer games and even using the internet. These non-drug addictive behaviours are similar in that the person has a lack of control over their behaviour.

Rasmussen (2000) giving a fairly general definition of addiction writes:

“Addiction is a broad term that embraces both substance related (chemical) and behavioural (non-chemical) problems. Addictive disorders include (a) substance use disorders, such as intoxication, withdrawal, and flashbacks. Because nonchemical disorders such as pathological gambling, compulsive shopping, sex and love addictions, and eating disorders resemble substance- related disorders etiology, expression and treatment, it is useful to include these problems in addiction practice.”

From a sociological point of view Abercrombie (1988) defines ‘addiction’ as “..the devotion to or enslavement by a substance, typically a drug, which is regarded as physically or socially harmful.”

This definition indicates towards the traditional perception of this subject where the substance is only seen as being addictive and the one doing the enslaving. But this definition does not seek to clarify the procedure of how the drug actually exerts this influence but it basically reproduces a physiological understanding of addiction. It implies that it is the biological/chemical properties of a drug which is the key factor in determining why people develop problems with regular use. (lecture notes)

Keith Hellawell, the former head of the UK’s Anti Drugs Coordination Unit speaking in 1999 also brought up the ‘enslavement’ concept in the following quote:

“It is difficult to exaggerate the damage that drugs bring to our communities. Our young people are entrapped or enticed into drug misuse, and some become reliant and addicted to these substances.”

So, here again usage of terms such as ‘entrapped’ and ‘being addicted’ give the proposed implications that it is the drugs that are addictive and which effect people’s behaviour and responses.

It will have to accepted that the physiological action of a drug is fundamental to our experience of it but still it would not be correct to define the drug experience solely in relation to the chemical effect it has upon our bodies. There are many other factors which greatly determine people’s behaviour and responses. For example, the drug users’ beliefs about the effect of drugs are just as important a part of the experience as the actual taking of the drug itself.

Gossop (2000 p15) explaining about the effects of drugs says:

“The way in which a drug affects the person who has taken it depends as much upon the psychological characteristics of the individual (his personality, how he believes the drugs will affect him, his emotional state, etc.) as upon the chemical properties of the drug itself.”

Furthermore, he caries on to say that ‘the biochemistry of a drug is only one of a wide range of factors that interact to produce the final effects’ and ‘these depend to a certain extent upon the basic personality structure of the person who took it’.

Illustrating the immense effect of the psychological factor, Gossop (2000 p20) says:

“Because psychological factors play such a large part in determining how people respond to drugs, it is possible for them to react as if they had taken a drug even when no such drug had been used.”

Similarly, as well as psychological factors, the social environment also has a major influence on the drug user. Zinberg (1984) supports this view and he believes that the drug, in combination with the (mind) set and setting are the crucial determinants of the way drug use is experienced. The importance of the social context of substance use has been proven by research studies which followed up American soldiers on their return home from the Vietnam War. Gossop (2000 Chapter2) mentions about the soldiers using heroin on a regular basis during their stay there and then commenting on their status after returning home he says:

“It must have surprised everyone that when these men returned to America, only a small minority of them became re-addicted.”

These findings are very significant in developing our understanding of the meaning of the concept of addiction as Gossop (2000) reflecting on these findings explains that whatever happened in Vietnam and afterwards conflicts with several popular beliefs about drug addiction because it is usually assumed that heroin addiction is an inevitable consequence of using the drug and once it has taken hold, it is virtually impossible for the user to rid himself of the habit. He then concludes that ‘the Vietnam experience shows that neither of these beliefs is true.’

Gossop (2000) further carries on to state the main point:

“This curious episode in the history of drug taking is a good example of the ways in which changes in social circumstances can have powerful effect upon the way people use drugs. The young men who served in Vietnam were removed from their normal social environment and from many of its usual social and moral restraints.”

In conclusion it is quite clear that these other factors clarify ‘addiction’ as not just being about the physiological relationship between the person and the drug but in fact drug use can never be accurately discussed without the association of psychological and social factors. Davies (1997) on the concept of ‘addiction’ indicates towards this understanding in his conclusion:

“it is suggested that the concept of ‘addiction’ might conceivably have some value if it gave emphasis to the normal and nonpathological decisions people make about drugs; but in fact it is usually employed to encapsulate certain assumptions about what drugs do to people, thereby implying a process from which the powers, wishes and intentions of the drug user are specifically excluded. The idea that the pharmacology of drugs makes people into addicts against their ‘will’ has to be contrasted with the idea that people make addicts of themselves because they choose to do so. The latter is a challenging suggestion which deserves serious consideration, and it certainly makes sense of the fact that treatment for addictions frequently seems to have more in common with procedures for attitude change, than with medical intervention.”

Peele (1985) presents I feel a fairly appropriate definition of addiction:

“..addiction is best understood as an individual’s adjustment, albeit a self defeating one, to his or her environment. It represents a habitual style of coping, albeit one that the individual is capable of modifying with changing psychological and life circumstances. Neither traumatic drug withdrawal nor a person’s craving for a drug is exclusively determined by physiology.”

So, Peele is suggesting that addiction is primarily a way of coping and one that is capable of changing. Therefore, it would not be correct to speak about addiction to a drug when it is not the drug that causes people to continue using it. Habitual use must be explained in terms of the inter-relationship between the psychology of the person taking the drug, its chemical properties, and the physical and social environment in which use takes place. (Lecture notes)

The druglink guide to drugs (2004) published by Drugscope defines ‘dependence’ as a term which ‘describes a compulsion to continue taking a drug in order to feel good or to avoid feeling bad. When this is done to avoid physical discomfort or withdrawal, it is known as physical dependence; when it has a psychological aspect (the need for stimulation or pleasure, or to escape reality) then it is known as psychological dependence.

I believe ‘addiction’ related concepts, such as ‘dependence’ is preferable to use when looking at explanations of regular drug taking as it is less sensitive and does not imply that we are addicted to them. But in fact it seems to suggest that we only may come to depend upon drugs under certain circumstances and it does not imply negative notions of being physically ‘hooked’ on drugs. (Lecture notes)

BIBLIOGRAPHY

Abercrombie, N. (1988) Penguin Dictionary of Sociology London: Penguin Books

Barber, J. G. (1995) Social work with addictions Basingstoke : Macmillan

Davies, J.B (1997) The myth of addiction OPA : Amsterdam B.V.

Gossop, M (2000) Living with Drugs. 5th Edition Aldershot: Arena

Peele, S. (1985) The Meaning of Addiction: Compulsive Experience and Its Interpretation San Francisco: Jossey-Bass

The American Heritage Stedman’s Medical Dictionary ( 2002) Houghton Mifflin Company

The druglink guide to drugs (2004) published by Drugscope

Zinberg, N. (1984) Drug, Set and Setting: the basis for controlled intoxicant use

Yale University Press