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Prevailing Conceptions of Drug Abuse and Addiction

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Drug Abuse and Antisocial Behavior

Part of the book series: Palgrave's Frontiers in Criminology Theory ((FCRT))

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Abstract

In this chapter we focus on two contrasting ideas about understanding drug abuse and addiction. First, the moral model of addiction, which views drug abuse as a matter of choice and, to a large extent, conceptualizes addiction as a failure of individual character. Second, emphasizing the neuro-scientific foundations of addiction, the brain disease model of addiction, sees drug abuse and addiction like any other chronic medical condition and not as a moral failing. Next, we review ecological systems theory and how this broad contextually oriented perspective is fully compatible with the brain disease model of addiction and an overall bio-developmental perspective. Finally, we review how a public health approach to addiction and drug abuse can be usefully tied to etiological and epidemiologic findings to enhance prevention and treatment.

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Notes

  1. 1.

    The understanding of drug use initiation as a voluntary behavior is arguably more complex than at first glance. In subsequent chapters we will discuss the ways that biological and psychosocial factors profoundly influence the likelihood that young people will have access to drugs and, when presented with the opportunity, will elect to try them. While it is accurate to view drug use initiation as a voluntary behavior, the likelihood of being exposed to drugs and, in turn, choosing to try alcohol and other drugs is by no means the same for all people. That is, it can be argued that drug use initiation is more voluntary for some than for others.

  2. 2.

    Substantial research has examined these constructs in a very sophisticated and nuanced fashion. For instance, the transtheoretical model of behavior change has examined drug abuse and recovery and is dedicated entirely to understanding the complexities of motivation, willingness to change, and maintaining behavior change (DiClemente & Prochaska, 1998). Similarly, relapse prevention and other cognitive behavioral approaches to recovery are focused in large measure on the science of decision-making in the face of the biosocial challenges that addiction and recovery present (Marlatt & Donovan, 2005). Finally, the neurocognitive complexities of self-control have been studied in depth and will be examined repeatedly throughout this and other chapters.

  3. 3.

    The use of alcohol and other drugs at some point after drug abuse treatment is such the norm that influential voices in addiction treatment research have even called for “retiring” the construct of relapse altogether (Miller, 2015). The argument here is that, in conceptualizing recovery as the absolute maintenance of abstinence and viewing relapse as a critical violation of recovery, we are missing something very important about the nature of addiction and recovery. That is, the prevailing understanding of relapse is viewed as running contrary to the chronic disease understanding of addiction. As we will argue below, recovery may be better viewed as a long-term pattern of treatment adherence, even if that includes an occasional “relapse”.

  4. 4.

    Here we aim to simply highlight the connection between the disease conceptualization and the importance of prevention. However, we circle back to the importance of this insight in far greater detail in our discussion of “Prevention and Treatment” later on in the text (see Chap. 8).

References

  • American Public Health Association (APHA) (2016). What is public health? Retrieved 29 January 2016 from www.apha.org/what-is-public-health.

  • Barry, C.L., McGinty, E.E., Pescosolido, B.A., & Goldman, H.H. (2014). Stigma, discrimination, treatment effectiveness, and policy: Public views about drug addiction and mental illness. Psychiatric Services, 65(10), 1269–1272.

    Article  Google Scholar 

  • Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. American psychologist, 32(7), 513–531.

    Article  Google Scholar 

  • Bronfenbrenner, U. (1979). The ecology of human development. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Bronfenbrenner, U. (1988). Interacting systems in human development. Research paradigms: Present and future. In N. Bolger, A. Caspi, G. Downey, & M. Moorehouse (Eds.), Persons in contexts: Developmental processes (pp. 25–49). Cambridge, UK: Cambridge University Press.

    Google Scholar 

  • Bronfenbrenner, U., & Ceci, S. J. (1994). Nature-nuture reconceptualized in developmental perspective: A bioecological model. Psychological Review, 101(4), 568–586.

    Article  Google Scholar 

  • Cacciola, J.S., Dugosh, K., Foltz, C., Leahy, P., & Stevens, R. (2005). Treatment outcomes: First time versus treatment-experienced clients. Journal of Substance Abuse Treatment, 28(2), S13–S22.

    Article  Google Scholar 

  • Dackis, C. & O’Brien, C. (2005). Neurobiology of addiction: Treatment and public policy ramifications. Nature Neuroscience, 8(11), 1431–1436.

    Article  Google Scholar 

  • DiClemente, C.C. & Prochaska, J.O. (1998). Toward a comprehensive, transtheoretical model of change: Stages of change and addictive behaviors. New York: Plenum Press.

    Book  Google Scholar 

  • Carter, A., & Hall, W. (2012). Addiction neuroethics: The promises and perils of neuroscience research on addiction. New York: Cambridge University Press.

    Google Scholar 

  • Caspi, A. & Moffitt, T. E. (2006). Gene–environment interactions in psychiatry: joining forces with neuroscience. Nature Reviews Neuroscience, 7(7), 583–590.

    Article  Google Scholar 

  • Chandler, R. K., Fletcher, B. W., & Volkow, N. D. (2009). Treating drug abuse and addiction in the criminal justice system: improving public health and safety. JAMA, 301(2), 183–190.

    Article  Google Scholar 

  • Elder Jr, G.H. (1994). Time, human agency, and social change: Perspectives on the life course. Social Psychology Quarterly, 57(1), 4–15.

    Article  Google Scholar 

  • Elder, G.H. & Rockwell, R.C. (1979). The life-course and human development: An ecological perspective. International Journal of Behavioral Development, 2(1), 1–21.

    Article  Google Scholar 

  • Flynn, P.M. & Brown, B.S. (2015). Misrepresenting the accomplishments of treatment. Substance Use & Misuse, 50(8–9), 978–980.

    Article  Google Scholar 

  • Flynn, P.M., Joe, G.W., Broome, K.M., Simpson, D.D., & Brown, B.S. (2003). Looking back on cocaine dependence: Reasons for recovery. The American Journal on Addictions, 12(5), 398–411.

    Article  Google Scholar 

  • Friedmann, P.D. (2013). Alcohol use in adults. New England Journal of Medicine, 368(4), 365–373.

    Article  Google Scholar 

  • Galea, S., Nandi, A., & Vlahov, D. (2004). The social epidemiology of substance use. Epidemiologic Reviews, 26(1), 36–52.

    Article  Google Scholar 

  • Goldstein, R.Z. & Volkow, N.D. (2011) Dysfunction of the prefrontal cortex in addiction: neuroimaging findings and clinical implications. Nature Reviews. Neuroscience, 12(11), 652–669. doi: 10.1038/nrn3119.

    Article  Google Scholar 

  • Hall, W.G., Gartner, C., & Forlini, C. (2015) Ethical issues raised by a ban on the sale of electronic nicotine devices. Addiction, 110(7), 1061–1067.

    Article  Google Scholar 

  • Hawkins, J.D., Catalano, R.F., & Miller, J.Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112(1), 64–105.

    Article  Google Scholar 

  • Hammer, R., Dingel, M., Ostergren, J., Partridge, B., McCormick, J., & Koenig, B. A. (2013). Addiction: Current criticism of the brain disease paradigm. AJOB Neuroscience, 4(3), 27–32.

    Article  Google Scholar 

  • Heyman, G.M. (2013). Addiction and choice: Theory and new data. Frontiers in Psychiatry, 4(31), 1–5.

    Google Scholar 

  • Kendler, K.S., Chen, X., Dick, D., Maes, H., Gillespie, N., Neale, M.C., et al. (2012). Recent advances in the genetic epidemiology and molecular genetics of substance use disorders. Nature Neuroscience, 15(2), 181–189.

    Article  Google Scholar 

  • Koob, G.F. & Simon, E.J. (2009). The neurobiology of addiction: Where we have been and where we are going. Journal of Drug Issues, 39(1), 115–132.

    Article  Google Scholar 

  • Leshner, A.I. (1997) Addiction is a brain disease, and it matters. Science. 3;278(5335), 45–47.

    Article  Google Scholar 

  • Lewis, M. (2013). Memoirs of an addicted brain: A neuroscientist examines his former life on drugs. New York, NY: PublicAffairs.

    Google Scholar 

  • Lopez-Quintero, C., Hasin, D.S., de Los Cobos, J.P., Pines, A., Wang, S., Grant, B.F., et al. (2011). Probability and predictors of remission from life‐time nicotine, alcohol, cannabis or cocaine dependence: Results from the national epidemiologic survey on alcohol and related conditions. Addiction, 106(3), 657–669.

    Article  Google Scholar 

  • Marlatt, G.A. & Donovan, D.M. (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York, NY: Guilford Press.

    Google Scholar 

  • Maynard, B.R., Salas-Wright, C.P., & Vaughn, M.G. (2015). High school dropouts in emerging adulthood: Substance use, mental health problems and crime. Community Mental Health Journal, 51(3), 289–299.

    Article  Google Scholar 

  • McLellan, A.T., Lewis, D.C., O’Brien, C.P., & Kleber, H.D. (2000). Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. Journal of the American Medical Association, 284(13), 1689–1695.

    Article  Google Scholar 

  • McLellan, A.T., Weinstein, R.L., Shen, Q., Kendig, C., & Levine, M. (2005). Improving continuity of care in a public addiction treatment system with clinical case management. American Journal on Addictions, 14(5), 426–440.

    Article  Google Scholar 

  • Merikangas, K.R. & McClair, V.L. (2012). Epidemiology of substance use disorders. Human Genetics, 131(6), 779–789.

    Article  Google Scholar 

  • Miller, W.R. (2015). Retire the concept of “relapse.” Substance Use & Misuse, 50, 976–977.

    Article  Google Scholar 

  • Miller, W.R., Walters, S.T., & Bennett, M.E. (2001). How effective is alcoholism treatment in the United States? Journal of Studies on Alcohol, 62(2), 211–220.

    Article  Google Scholar 

  • National Institute on Drug Abuse (2016). DrugFacts – Understanding drug use and addiction. Retrieved from: https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction.

  • O’Brien, K., Salas-Wright, C.P., Vaughn, M.G., & LeCloux, M. (2015). Childhood exposure to a parental suicide attempt and risk for substance use disorders. Addictive Behaviors, 46, 70–76.

    Article  Google Scholar 

  • Pescosolido, B.A., Martin, J.K., Long, J.S., Medina. T.R., Phelan, J.C., & Link, B.G. (2010) A disease like any other? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. American Journal of Psychiatry, 167(11). 1321–1330. doi: 10.1176/appi.ajp.2010.09121743.

    Article  Google Scholar 

  • Reingle Gonzalez, J.M., Salas-Wright, C.P., Connell, N.M., Clipper, S.J., Kassarjian, K., & Businelle, M.S. (2016). The long-term effects of school dropout and GED attainment on substance use disorders. Drug and Alcohol Dependence, 158(1), 60–66.

    Article  Google Scholar 

  • Rosa, E.M. & Tudge, J. (2013) Urie Bronfenbrenner’s theory of human development: Its evolution from ecology to bioecology, Journal of Family Theory & Review, 5(4),243–258.

    Article  Google Scholar 

  • Salas-Wright, C.P. & Vaughn, M.G. (2014). A refugee paradox for substance use disorders? Drug and Alcohol Dependence, 142, 345–349.

    Article  Google Scholar 

  • Salas-Wright, C.P., Olate, R., & Vaughn, M.G. (2013a). Religious coping, spirituality, and substance use and abuse among youth in high-risk communities in San Salvador, El Salvador. Substance Use and Misuse, 48(9), 769–783.

    Article  Google Scholar 

  • Salas-Wright, C.P., Olate, R., Vaughn, M.G., & Tran, T.V. (2013b). Direct and mediated associations between religious coping, spirituality, and youth violence in El Salvador. Pan American Journal of Public Health, 34(3), 183–189.

    Google Scholar 

  • Salas-Wright, C.P., Vaughn, M.G., Clark, T.T., Terzis, L., & Córdova, D.(2014). Substance use disorders among first and second-generation immigrants in the USA: Evidence of an immigrant paradox? Journal of Studies on Alcohol and Drugs, 75(6), 958–967.

    Article  Google Scholar 

  • Salas-Wright, C.P., Clark, T.T., Vaughn, M.G., & Córdova, D. (2015a). Profiles of acculturation among Hispanics in the United States: Links with discrimination and substance use. Social Psychiatry and Psychiatric Epidemiology, 50, 39–49.

    Article  Google Scholar 

  • Salas-Wright, C.P., Robles, E.H., Vaughn, M.G., Córdova, D., & Figueroa, R.P. (2015b). Toward a typology of acculturative stress: Findings from a national sample of Hispanic immigrants. Hispanic Journal of Behavioral Sciences, 37(2), 223–242.

    Article  Google Scholar 

  • Salas-Wright, C.P., Vaughn, M.G., Todic, J., Córdova, D., & Perron, B.E. (2015c). Trends in the disapproval and use of marijuana among adolescents and young adults in the United States: 2002–2013. The American Journal of Drug and Alcohol Abuse, 41(5), 392–404.

    Article  Google Scholar 

  • Salas-Wright, C.P., Vaughn, M., Ugalde, J., & Todic, J. (2015d). Substance use and teen pregnancy in the United States: Evidence from the NSDUH 2002–2012. Addictive Behaviors, 45, 218–225.

    Article  Google Scholar 

  • Schaler, J.A. (2000). Addiction is a choice. Chicago: Open Court Publishing.

    Google Scholar 

  • Schwartz, S.J., Lilienfeld, S.O., Meca, A., & Sauvigné, K.C. (2016). The role of neuroscience within psychology: A call for inclusiveness over exclusiveness. The American Psychologist, 71(1), 52–70.

    Article  Google Scholar 

  • Simpson, D.D. & Sells, S.B. (1990). Opioid addiction and treatment: A 12-year follow-up. Malabar: Krieger Publishing Co.

    Google Scholar 

  • Sobell, L.C. (2007). The phenomenon of self-change: Overview and key issues. In H. Klingemann & L.C. Sobell (Eds.), Promoting self-change from addictive behaviors (pp. 1–30). New York: Springer.

    Chapter  Google Scholar 

  • Szapocznik, J. & Coatsworth, J.D. (1999). An ecodevelopmental framework for organizing the influences on drug abuse: A developmental model of risk and protection. In M. Glantz, & C.R. Hartel (Eds.), Drug abuse: Origins and interventions (pp. 331–366). Washington, DC: American Psychological Association Press.

    Chapter  Google Scholar 

  • Szapocznik, J., & Williams, R. A. (2000). Brief strategic family therapy: Twenty-five years of interplay among theory, research and practice in adolescent behavior problems and drug abuse. Clinical child and family psychology review, 3(2), 117–134.

    Article  Google Scholar 

  • Szapocznik, J., Prado, G., Burlew, A.K., Williams, R.A., & Santisteban, D.A. (2007). Drug abuse in African American and Hispanic adolescents: Culture, development, and behavior. Annual Review of Clinical Psychology, 3, 77–105.

    Article  Google Scholar 

  • Szapocznik, J., Schwartz, S.J., Muir, J.A., & Brown, C.H. (2012). Brief strategic family therapy: An intervention to reduce adolescent risk behavior. Couple and Family Psychology: Research and Practice, 1(2), 134–145.

    Article  Google Scholar 

  • Terry, C.E. (1914). Drug addictions, a public health problem. American Journal of Public Health, 4, 28–37.

    Article  Google Scholar 

  • Vaughn, M.G., Maynard, B.R., Salas-Wright, C.P., Perron, B.E., & Abdon, A. (2013). Prevalence and correlates of truancy in the U.S.: Results from a national sample. Journal of Adolescence, 36(4), 767–776.

    Article  Google Scholar 

  • Vaughn, M.G., Salas-Wright, C.P., Kremer, K.P., Maynard, B.R., Roberts, G., & Vaughn, S. (2015a). Are homeschooled adolescents less likely to use alcohol, tobacco, and other drugs? Drug and Alcohol Dependence, 155, 97–104.

    Article  Google Scholar 

  • Vaughn, M.G., Salas-Wright, C.P., Underwood, S., & Gochez-Kerr, T. (2015b). Subtypes of non-suicidal self-injury based on childhood adversity. Psychiatric Quarterly, 86(1), 137–151. Advance online publication.

    Article  Google Scholar 

  • Volkow, N. (2015) Dr. Nora Volkow on Addiction: A Disease of Free Will. Washington, DC: National Institute on Drug Abuse. www.drugabuse.gov/videos/dr-nora-volkow-addiction-disease-free-will

    Google Scholar 

  • Volkow, N.D. & Baler, R. D. (2014) Addiction science: Uncovering neurobiological complexity. Neuropharmacology. 76 Pt B, 235–249. doi: 10.1016/j.neuropharm.2013.05.007.

    Article  Google Scholar 

  • Volkow, N.D. & Koob, G. (2015) Brain disease model of addiction: why is it so controversial? Lancet Psychiatry. 2(8), 677–679. doi: 10.1016/S2215-0366(15)00236-9.

    Google Scholar 

  • Volkow, N. & Li, T.K. (2005) The neuroscience of addiction. Nature Neuroscience. 8(11), 1429–1430.

    Article  Google Scholar 

  • West, R. (2001). Theories of addiction. Addiction, 96(1), 3–13.

    Article  Google Scholar 

  • West, R. & Brown, J. (2013). Theory of addiction (2nd ed.). Hoboken, NJ: John Wiley & Sons.

    Book  Google Scholar 

  • Winstanley, E.L., Steinwachs, D.M., Ensminger, M.E., Latkin, C.A., Stitzer, M.L., & Olsen, Y. (2008). The association of self-reported neighborhood disorganization and social capital with adolescent alcohol and drug use, dependence, and access to treatment. Drug and Alcohol Dependence, 92(1), 173–182.

    Article  Google Scholar 

  • World Health Organization (2016). Public health. Retrieved 5 February 2016 from www.who.int/trade/glossary/story076/en/.

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Authors and Affiliations

  1. Boston University, Boston, USA

    Christopher P. Salas-Wright

  2. Saint Louis University, Saint Louis, USA

    Michael G. Vaughn

  3. School of Public Health, University of Texas, Texas, USA

    Jennifer M. Reingle González

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  1. Christopher P. Salas-Wright
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  3. Jennifer M. Reingle González
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Salas-Wright, C.P., Vaughn, M.G., González, J.M.R. (2016). Prevailing Conceptions of Drug Abuse and Addiction. In: Drug Abuse and Antisocial Behavior. Palgrave's Frontiers in Criminology Theory. Palgrave Macmillan, New York. https://doi.org/10.1057/978-1-137-55817-6_2

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  • DOI: https://doi.org/10.1057/978-1-137-55817-6_2

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