Theories of Drug Use & Addiction

Theories of Drug Use & Addiction Adapted from Faupel, Sociology of American Drug Use

The Dislocation Theory: Understanding the Spread of Addiction 1. Globalization of Capitalist Free Market System 2. Decline of Psycho-Social Integration 3. Poverty of the Spirit • Proliferation of Addiction3

Social Location • Social categories shape our identities, our experiences and perceptions, and our life chances. • Gender • Sexuality • Race • Class • Age • Intersectionality • Race, class, and gender intersect to shape experience in unique ways • Capital– material or non-material resources that confer social power to the carrier (there are four types). Follows a definite distribution.

The Forms of Capital • Economic Capital – access to income, wealth or property • Cultural Capital – prestige associated with specialized knowledge. Symbolic, not tangible. • Social Capital – our social connections to others and the benefits those connections confer • Symbolic Capital – capability of actors to use certain practices symbolically to defend or maintain their positions in social space • Capital is partially transferable– “Cashing in” social capital for a job that increases your economic capital

Social Class and Drug Addiction • Considerable drug use and crime in “conventional communities” • “Invisible” addictions of the more advantaged • Less likely to seek treatment and “recover naturally” • Social support– drug use can be sustained longer before needing help. • When help is needed, easier to pull selves out. • “Private addictions” are less targeted and less “suspect.” • Harder to measure– most data comes from official crime and treatment reports– self data notoriously unreliable • Conventional life: Buffer or trap? • Do “pro-social” bonds prevent us from using drugs? Or is too much attachment a bad thing?

Granfield and Cloud: Discuss • How did participants’ social capital translate into an ability to recover from addiction without treatment? What were the different types of social capital working for them, and how did they work? • How might G&C’s argument revise the disease model of addiction?

“Natural Recovery” among Individuals with High Social Capital • Granfield & Cloud: Evidence that a number of people overcome addictions without treatment • Interviews with 46 drug users who were able to recover “naturally” • Link between social capital and likelihood of natural recovery • Relationships • Economic and non-economic resources • Capacity for “self-actualization,” “self-efficacy,” and “self-esteem” • How “social” is addiction?

Granfield and Cloud “Those who possess larger amounts of social capital, perhaps even independent of the intensity of use, will be likely candidates for less intrusive forms of treatment such as those associated with brief intervention and natural recovery.”

“Two Women Who Used Cocaine Too Much” • How did each woman's race, class, and gender shape her access to and experience with cocaine? What kinds of social/economic capital did they possess? • How do race and/or class and/or gender intersect to shape experience with drugs? • Class X Gender • What theories from class can explain their entry into use? • The differences in their addictions? • Their pathways out of addiction? • How did each woman’s class position enable her to control her drug use (or not?)

Murphy and Rosenbaum: “Two Women Who Used Cocaine Too Much” • Part of a classic study of female cocaine users, 1990 • Single comparative case studies • The intersection of race, class, and gender shape our experiences with drugs.

The rise of “binge drinking” or “drinking like a guy” • Drinking as a “rite of passage” in college • “Binge drinking” among undergraduate women on the rise • Data suggests more women are drinking more, as the gender gap is shrinking • Widest gender differences in drinking occur in societies with most traditional gender roles

Recap: Social Location and Addiction • Race, class, and gender shape drug experiences as much as the drugs themselves. • Poverty, racism, and sexism cannot be separated from drug use. • Individual consequences or outcomes from drug use are determined in part by the drug user’s social location.

Righteous Dopefiend – Intro Work in groups to find definitions for the following from the introductory chapter: Photo-ethnography and ethical dilemmas “Moral economy” among Edgewater homeless Cultural relativism “Theory of lumpen abuse” Symbolic violence & Structural violence Habitus

“How can they live like that?” CULTURAL RELATIVISM POLITICS OF REPRESENTATION

~Habitus~ Links a person’s position in social space with their practices Dispositions, shaped by early experience, that “generate & organize” practices throughout life, which become like enduring “habits” within the person Habitus is deeply embedded within the person Embodied – physically enacted! Flexible and durable– guides patterned action, but also improvisation The way society becomes deposited in persons in the form of lasting dispositions (tendencies toward action, thought, feeling) Examples: Career expectations, who to marry, how to raise kids, whether or not to talk about politics at dinner…

Righteous Dopefiend Drugs & Society – SPRING 2014

~Habitus: Interplay betweenstructure and practice Social positions in a field Habitus– deeply rooted, but flexible guidelines that “orient” the person toward a particular way of seeing and being in the world. Repeated experiences in the positions you occupy shape your dispositions throughout life… HABITUS Practices: actions, behaviors, choices, etc. that signal your social position The habitus mediates between positions and practices.

Understanding Habitus “In each one of us… is contained the person we were yesterday.” - Bourdieu Habitus is all of our past experiences, conditioned by the social environment, as they are expressed in our present practices. Habitus tends to reproduce dominant structural relations– why? Bourdieu’s notion of “social groups” cuts across class, race, gender, etc. to organize groups of people by similar types of “habitus.” Multiple forms of experience shape the development of the habitus.

Habitus is the way we see the world-- it shapes our expectations, hopes, and desires… “The art of estimating and seizing chances, the capacity to anticipate the future…or even to take a calculated gamble… are dispositions that can only be acquired in certain social conditions… Like the entrepreneurial spirit or the propensity to invest, economic information is a function of one’s power over the economy” (Bourdieu).

Recap: How do we make sense out of so much suffering, sociologically? • “Choice” operates in the context of culture and biology. • Social categories shape our experience. • Habitus: Addiction is the physical embodiment of social inequality, violence, histories of systemic abuse, and widespread suffering. • Normalization & socialization – Long-term suffering becomes “routine.” • Alexander: Addictive suffering is a product of large-scale economic and social transformations.

LOST ANGELS: Review • Social forces affecting Skid Row addicts: • Widening inequality • Gentrification • Destruction of low-income housing markets • Deinstitutionalization • Safer Cities Initiative – Broken Windows policing • Hostile police-community relations • Infringement on civil liberties • Relationship between mental illness, homelessness, poverty, and addiction • Agency and resilience in Skid Row community

BLACK TAR HEROIN: The Dark End of the Street Directed by Steven Okazaki

Black Tar Heroin: The Dark End of the Street --Reactions to the Film-- • Race/Age – mostly young, white scene • Class – struggled to find employment, but perhaps more social and economic capital than Righteous addicts • Context of inequality in San Francisco • Role of supportive families – housing and income • Gender • How did gender add another layer of marginalization to the experience of female addicts? • Multiple forms of marginalization: prostitution, violence, HIV/AIDS, homelessness, criminal status • “Loneliness” and lack of integration – Alexander? • Effect of prison/reentry on addiction? • Harm reduction?

Harm Reduction Philosophy • Focus is on reducing harm associated with drug use & increasing quality of life, not ending use. • Harmful behavior exists on a continuum. Progression in small, incremental steps. Abstinence is one goal among many. • Created by addicts, for addicts. Users set their own goals and are active participants. Toolkit • Disease/overdose prevention through syringe exchange & naloxone distribution • Education and case management • Non-judgmental, unconditional support. Remove stigma so more people seek help. • Social, political, & economic advocacy

Injection Drug Use, HIV, & Syringe Exchange • HIV spread through use of contaminated needles- Rates from 5% to 50% in one year in many IDU populations (UN Program on HIV/AIDS) • African Americans IDUs are ten times as likely to become infected with HIV from a dirty needle and Latinos 5 times as likely as their white counterparts. • Needle exchange programs (NEPs), substantially reduce the likelihood of HIV transmission through needle sharing • NY Programs: 52% of new AIDS cases to 5% (NY Dept. of Health) • No evidence that NEPs promote drug use • Connects a hard to reach population with services • Cost-benefit analyses-- NEPs reduce long-term healthcare costs • Legal status: funding ban, laws against purchase/possession of needles • 1988 – ban on federal funding for syringe exchange programs • 2009 – 2011 ban lifted

harm reduction continuum: what is “harm?” Public health harm reduction “Top-down” Radical harm reduction “Bottom-up” Disease prevention Case management Referral to drug treatment Clean needles Education Rights for drug users Change social attitudes Reform drug policy Decriminalization/legalization Alleviate social inequality

Five Links in the Chain of Destruction: • Identification – identify an unliked group and label them as the enemy • Ostracism – separate the group from society, mark them as outsiders • Confiscation – take away their rights, property, eventually their person • Concentration – forcible confinement and exploitation of bodies or labor • Annihilation—direct killing of the population, or indirect through withholding of food or medicine

Theories of Drug Use & Addiction