What has drug trade contributed to
tremendous wealth and political influence of societies (commodities)
What were the uses of drugs?
medicine, spiritual, concerns about addiction and misuse
What are ways of viewing someone struggling with addiction
- illness
- moral failing
- lack of control
what is addiction
repetitive consumption of a substance, or repetitive engagement in an activity considered problematic
What are the core concepts of addiction even as it evolved over time
harmful to the individual and/or the people around them
Why is drug use a better term than addict
addict = lacks precision and clarity, stigma
Drug use = transparent, neutral, free of judgement
What are illicit drugs
controlled/prohibited substances (heroin, cocaine) and diverted pharmaceuticals (prescription opioids)
What is harmful/problematic/drug misuse?
consumption that causes social, psychological or health problems for individuals or society
What is drug dependence?
- impaired control of use
- increased tolerance
- continued use despite negative consequences and withdrawal symptoms
- replaced drug addiction in ICD
Substance use vs Substance abuse
subjective distinctions and value judgements based on particular understandings of physiology, psychology, law, and history
When was a distinction made between normal drinking and abnormal drinking
18th century
What is inebriety
Late 19th century
- concept that likened abnormal drinking to physical illness…
When was the term alcoholism made what does it mean
1940’s, problem drinking and physiological dependence
What are the two parallel models of addiction developed in 19th century
- disease model
- addiction from physiological or psychological predispositions
- contributed to theory of individual degeneracy
-institutionalization and sterilization - Addiction from characteristics of the substance itself
- temperance movement
-restrictions or prohibitions
*both impact current responses
What is the temperance movement
identified substance as source of problem and advocated for severe restrictions or prohibitions
What are some consequences of medicalization?
- reduce individual responsibility and imperative to improve
- decrease emphasis on social, economic, cultural contexts
- less attention to systemic and underlying issues
What do opioids do
act on nervous system to relieve pain
what does cannabis do
produce feelings of euphoria, lightness of limbs, increased appetite, tachycardia, and impaired judgement
what does cocaine do
feelings of elation, exaggerated confidence… acute toxic reactions
what are the key components of dependence
- physiological syndrome involving tolerance
- withdrawal
What do behavioural addictions have in common with substance use disorders
compulsion, loss of control, continued use/behaviour despite negative consequences
What are some ways addiction is thought to be medical?
- neurological changes in brain/reward systems
- hijacked brain model of addiction
What are the risks of expanding definition of addiction to behaviours and making it as a disease?
- difficult to view behaviours as diseases
- downplays personal agency
- de-emphasizes social factors shaping behaviour
- need to re-examine the disease model
What is the 3 criteria for substance dependence?
- impaired control
- overriding priority
- tolerance to / withdrawal symptoms
2/11 within 12 month period
