Alcohol, Other Drugs, and Behavior

Psychological Research Perspectives

John R. Jung

• Publisher: SAGE Publications, Inc
• Year: 2009
• ISBN:
  9781483389455
• Edition: 2
• Topic: Psychologie
• Subtopic: Klinische Psychologie

Providing a psychological perspective on the use and abuse of alcohol and other psychoactive drugs, this Second Edition includes more coverage of the theories of alcohol and other drug use and abuse, as well as broad conceptual issues related to the nature of addiction and recent developments in research methods. Key Features

• Focuses on alcohol, which is used more widely than any other drug, and the one that is associated with the most societal harm
• Evaluates important studies on major issues, concepts, and theories rather than providing exhaustive literature reviews
• Teaches students to become educated consumers of research findings, rather than passive or uncritical recipients

Ancillaries

• A Student Study Site at www.sagepub.com/jungstudy with chapter summaries, multiple-choice quizzes, flashcards for glossary items, an annotated list of relevant Web sites, informational QuickTime movies, and SAGE journal articles.
• A password protectedInstructor?s Resource Site at www.sagepub.com/jung2einstr includes PowerPoint slides and test questions.

Intended Audience
This text is appropriate for upper-level undergraduate courses in Drugs and Behavior, Psychology of Addiction, and Drug Abuse Counseling. It can also be used in graduate-levelcourses in Drugs and Behavior and Addiction courses taught in health science, social work, criminal justice, and nursing.

CHAPTER 1

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Psychology of Alcohol and Other Drugs

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Focus and Goals of This Book

History of Drugs in America

Origins of Licit Drugs

Origins of Illicit Drugs

Some Central Questions

Summary

Stimulus/Response

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Here’s to alcohol: the cause of, and solution to, all of life’s problems.

—Homer Simpson

Booze, pot, dope, coffin nails, horse, crack, bennies, reds, coke, speed, ice, Ecstasy, speedball, junk—the list of colorful names for psychoactive drugs is a long one that continues to grow. Throughout recorded history in most societies, people have discovered and used substances capable of altering normal experiences and consciousness. Most of these substances have come from natural sources such as plants, seeds, mushrooms, yeast, and grains, but in modern times synthetic products such as heroin and amphetamines have been added to the list. For a variety of reasons ranging from curiosity to boredom to stress, people are motivated to seek variations in mood, going from high to low as well as from low to high activation. Psychoactive drugs are a potent means of producing these mood states. In addition, many of them, including alcohol, nicotine, hallucinogens, opioids, and marijuana, have been used for medicinal and healing purposes.

Alcohol, tobacco, marijuana, cocaine, heroin, amphetamines, hallucinogens, crack—the list of psychoactive drugs used by humans throughout history is, as already noted, rather extensive. In the present book, we will consider all chemical substances as drugs if they are voluntarily consumed for social and recreational purposes to alter mood and conscious states as opposed to being used medicinally to treat, for example, physical and psychological disorders.

Using this definition, alcohol would be classified as a “drug,” contrary to a longstanding distinction between alcohol and drugs held by the public as well as many professionals working in the field of addictions. This separation of alcohol and other drugs into their own domains appears at the highest levels of the federal government, as reflected by the creation in the early 1970s of separate governmental agencies to deal with funding for treatment and prevention research on alcohol (National Institute on Alcohol Abuse and Alcoholism) and drugs (National Institute on Drug Abuse). This separation of alcohol from other drugs has perpetuated the failure of many research, treatment, and prevention activities to acknowledge the reality that many users of psychoactive drugs started with—and usually continue—the use of alcohol. A more accurate understanding of substance use needs to recognize the central role that use of alcohol plays in the development of the use of other drugs.

FOCUS AND GOALS OF THIS BOOK

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This book will examine the major legal psychoactive drugs of current concern to society due to their widespread use and/or because of the potential harm to the users and to society that may occur from excessive use. Considerably more coverage will be devoted to alcohol because for most American adults it is the psychoactive drug of choice, consumed by more people, in larger volume and on more frequent occasions, than any other drug. Our society approves of—and even expects and encourages—drinking in many situations.

Many prescription and over-the-counter drugs such as sedatives, tranquilizers, stimulants, and analgesics developed and intended for medical treatment unfortunately are also abused for nonmedical purposes. These drugs include barbiturates (e.g., Mebaral® and Nembutal®) used to treat anxiety, tension, and sleep disorders; benzodiazepines (e.g., Valium®, Librium®, and Xanax®) prescribed to treat anxiety, acute stress reactions, and panic attacks; stimulants (e.g., Dexedrine® and Ritalin®) used to treat depression, attention deficit hyperactivity disorder, and narcolepsy; and opioids (e.g., OxyContin®, Darvon®, Vicodin®, and Demerol®) prescribed to alleviate pain.

Although these are legal drugs for medical purposes, their increasing use to produce psychoactive rather than therapeutic outcomes represents a serious problem for society because of the risk of addiction to these substances and the dangers when their use is combined with use of alcohol. In 2006, 16.2 million Americans age 12 and older had taken a prescription pain reliever, tranquilizer, stimulant, or sedative for nonmedical purposes at least once in the past year (Substance Abuse and Mental Health Services Administration [SAMHSA], 2007). However, research on the misuse of these drugs is beyond the scope of this book, which focuses on alcohol and other drugs that were developed primarily for psychoactive effects.

Alcohol is more thoroughly researched than other drugs, a result in large part of the significant population of drinkers. Another justification for a focus on alcohol is that, like tobacco, it is widely assumed to be a gateway drug, which may lead to subsequent as well as concurrent use of illicit drugs. In contrast, relatively less research on illicit drugs is available due to the difficulty of identifying and recruiting large and representative samples of illicit drug users. Most of the research on illicit drug use comes from treatment samples, which may not be generalizable to other users. Unlike legal drugs on which controlled studies are available, there are major ethical and legal barriers to conducting experiments with illicit drugs so that findings from these studies are limited to correlational data, which do not permit firm causal conclusions.

A secondary goal is to show some of the similarities and differences among these drugs in their origins and their effects. The norms of use patterns will be compared across major demographic factors such as age, sex, and social class and/or ethnicity. By comparing different major drugs, we hope to identify some common factors underlying the causes and effects of drug use. Issues, methods, and theories of treatment of drug abuse and dependency will be examined.

A Psychological Emphasis

A psychology of alcohol and drugs needs no more justification than we require for the study of any other behavior whether it be watching movies, reading books, attending church, gambling, or working. People use alcohol and other drugs, and it is important to identify and understand the factors that influence such behaviors, especially since alcohol and other drug abuse and dependency develop for some users, with destructive and harmful consequences for them and others around them. This book will examine the central role of psychological causes, correlates, and effects of alcohol and other drug use and abuse. Understanding how adverse outcomes develop and how to treat them calls for a psychological approach. Furthermore, a psychology of alcohol and drug use is essential for designing effective methods for intervention and prevention of drug problems.

Psychology Precedes Pharmacology

Multiple factors are involved in alcohol and other drug use. First, the substance must be physically available. A complex process involving cultural, historical, legal, political, and economic factors determines the extent to which a drug is available in a particular society at a given time.

As we grow up, we form many beliefs and attitudes about alcohol and other drugs. We learn that these substances can exert powerful changes on our conscious states, behaviors, and experiences. Such beliefs may increase the desire to use drugs for some people. Without these psychological factors first leading to drug use, the potential pharmacological effects that drugs can produce on the nervous system to affect behavior and experience cannot occur. Subsequently, these pharmacological processes exert a reciprocal influence on the psychological processes and behavior of the user.

And although alcohol and other drugs may be readily available, not everyone will be attracted to them. Those more concerned about the risks and dangers of drugs than enticed by their possible benefits will be less likely to use them. Psychological beliefs and attitudes again are a critical determinant, in this case preventing the use of drugs. Without certain beliefs, motives, and personality characteristics, a person will not use a particular drug even if the opportunity is present. Understanding why people seek drugs, why they may not seek treatment, and why relapse is so common are important tasks of a psychology of drugs. Thus, psychology may help in developing methods for prevention of drug use by identifying what motivates users to engage in drug use as well as what deters nonusers.

A psychology of drugs is also useful for developing methods to convince users to want to reduce or stop their use of drugs. Thus, quitting—or at least the attempt to quit—may work best when it is perceived to be a choice rather than a mandate. But fear of failure may prevent some from even making the attempt. Such efforts may be more likely if positive consequences or alternatives are offered. These psychological considerations may be needed to design effective methods for improving success in quitting. Psychology can help reduce these setbacks by identifying the conditions, such as psychological state and social and physical environment, that are associated with relapse.

HISTORY OF DRUGS IN AMERICA

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An overview of the history and background of major psychoactive drugs currently used in the United States is essential for understanding contemporary alcohol and other drug issues and problems. Prior to about 1900, although many states passed drug control legislation, there were no federal laws against any psychoactive drugs in the United States, and such drugs were widely available and consumed. How this situation changed and what determined which drugs were regarded as more dangerous than others and thus warranted penalties for possession and use is an intriguing tale of politics, prejudice, and propaganda more than one informed by persuasive scientific evidence.

Alcohol consumption prior to the 20th century was quite extensive, and heavy levels of use were commonplace. The immigrants who settled the American colonies in the late 17th century came from European countries with long histories of alcohol use, and they continued their drinking-related cultural traditions and practices after they settled. In colonial America, drinking was a widespread, generally tolerated, and accepted activity. Alcohol was not only widely available as a beverage but also served as a home remedy for many medicinal purposes. Drunkenness was commonplace, but it was not considered a social problem for the society of that era (Gusfield, 1963). However, from the early 1700s to the mid-1800s, drunkenness and alcohol problems increased, generating greater societal disruption as the nation changed from an agrarian economy to an urban industrial society.

The widespread social problems such as poverty, crime, and disorderly public conduct created by excessive use of alcohol led to reform movements by religious groups such as the Quakers and many Protestant denominations. Organized efforts against alcohol were formed, including the American Temperance Society in 1833. As the movement gathered strength, by the late 1800s calls for temperance yielded to efforts to eliminate alcohol entirely as organizations such as the Woman’s Christian Temperance Union (WCTU) and the Anti-Saloon League led the fight against the evils of alcohol, tobacco, and other drugs (Gusfield, 1963).

Tobacco was, in contrast, completely unfamiliar to Christopher Columbus in 1492. However, the Native Americans who met him had been chewing and smoking tobacco in pipes for a long while. By the time the American colonies were settled a little over a century later, smoking tobacco was also an established and acceptable drug for the early European immigrants.

Morphine was widely used during the Civil War on the battlefield as an anesthetic for the wounded and dying. Unfortunately, many who survived their battle wounds with the aid of morphine later succumbed to morphine addiction. Interestingly, cocaine injections were initially used to treat morphine withdrawal before it came to be recognized that cocaine itself was an addictive substance. The widely used patent medicines, supposedly cure-alls for “whatever ails you,” contained alcohol and cocaine. They became drugs of abuse, especially by women.

American cities suffered increasingly from child labor, excessive drug use, crime, and violence, leading social reformers to launch vigorous moral reform campaigns. Many of the poor urban living conditions stemmed from or were exacerbated by alcohol and other drug abuse, but economic oppression, prejudice, and social injustice were also contributory factors. In addition, some substance abuse may have been the effect, rather than the cause, of poverty and oppression. Nonetheless, political and social pressures encouraged a focus on drugs as the major culprit of society’s ills, and the social reformers helped make many of them illegal in the early part of this century.

In contrast to the 19th century when drugs were unregulated for the most part, state and federal legislation to control drugs increased in the 20th century. Thomas Szasz (1985), a prominent psychiatrist and critic of many social policies restricting choice, contended that drugs served as a convenient scapegoat for the social ills of urban life. He observed that a double standard was used in setting drug policy and suggested that because alcohol and tobacco are so well ingrained in Christian and English-speaking cultures, we regard them as good while drugs such as opium and marijuana, which originated in foreign countries, are viewed as bad. Thus, consider the different labels and terms used in connection with legal and illegal drugs: “People who sell liquor are retail merchants, not ‘pushers’; and people who buy liquor are citizens, not ‘dope fiends.’” The same goes for tobacco, coffee, and tea (Szasz, 1985, pp. 52–53).

Table 1.1 identifies some major developments in drug legislation and other aspects of drug control in America over the course of the 20th century. One of the earliest drugs to be controlled in America was opium, banned in San Francisco in 1875. At the federal level, the Pure Food and Drug Act was passed in 1906 due to increasing concern about impurities from opioid drugs in foods and patent medicines. It did not make drugs illegal but required labels to specify the contents.

In 1914, the Harrison Narcotic Act was passed as part of an international effort to reduce the widespread and increasing use of opiate drugs as well as cocaine (Musto, 1987). This law did not make these drugs illegal but required that heroin and morphine be prescribed by a physician. During this era, the federal government was prevented from passing national laws...