hart - drugs, society and human behavior - 15e, solutions manual and test bank 0073529745
Chapter 2
Drug Use as a Social Problem
Chapter Objectives
After finishing this chapter, students should be able to:
- Distinguish between the federal government’s regulatory approach before the early 1900s and now.
- Distinguish between acute and chronic toxicity and between physiological and behavioral toxicity.
- Describe the two types of data collected in the DAWN system, and know the top four drug classes for emergency room visits and for mortality.
- Understand why the risks of HIV/AIDS and hepatitis are higher among injection drug users.
- Define tolerance, physical dependence, and behavioral dependence.
- Understand that the scientific perspective on substance dependence has changed in recent years.
- Differentiate between substance abuse disorder and substance dependence disorder using diagnostic criteria.
- Debate the various theories on the causes of dependence.
- Describe four ways it has been proposed that drug use might cause an increase in crime.
Chapter Vocabulary (in order of appearance in chapter)
laissez-faire
toxic
behavioral toxicity
physiological toxicity
acute
chronic
Drug Recognition Expert
DAWN
“bath salts”
HIV
AIDS
tolerance
withdrawal syndrome
physical dependence
psychological dependence
reinforcement
catheters
DSM-IV-TR
substance dependence
substance abuse
dependence potential
Alcoholics Anonymous (AA)
biopsychosocial
Chapter Outline
I. Laissez-Faire
A. Like most countries, the U.S. had virtually no laws regulating drugs in the 1800s.
B. In the 21st century, hundreds of drugs are tightly regulated and the U.S. government spends more than $12 billion/year controlling sale and use.
C. What changed? Three main concerns aroused public interest and led to regulation of drugs:
1. Toxicity
2. Dependence
3. Crime
II. Toxicity
A. Categories of Toxicity
1. Behavioral toxicity vs. physiological toxicity
2. Acute toxicity vs. chronic toxicity
B. Drug Abuse Warning Network (DAWN)
1. This system collects data from hospitals on drug-related emergency room visits and from coroners on drug-related deaths.
2. Tracking includes information on illicit substances as well as improper use of prescription or over-the-counter drugs.
3. DAWN tracks alcohol-related problems only when alcohol is used in combination with another drug, unless the individual is under age 21.
4. Half of emergency room visits and 75% of reported deaths in DAWN involve more than one drug. It is rare to find a “single-drug” death. Thus, it is difficult to determine how much an individual drug contributed to the ER visit or death.
C. How Dangerous Is the Drug?
1. It is useful to look at different studies to evaluate the relative danger of a drug. For example, more people use marijuana, but cocaine is involved in more emergency room visits.
2. The number of deaths caused by cocaine, heroin, marijuana, and other illicit drugs is much lower than the number of deaths caused by alcohol and tobacco.
D. Blood-Borne Diseases
1. Viral diseases, including HIV and hepatitis, are concerns for users who inject drugs.
2. Transmission of infection is due to the sharing of infected needles, not the action of the drug itself.
3. Syringe exchange programs increase the use of clean syringes, lower infection rates, and pay for themselves in the long run.
III. Substance Dependence: What Is It?
A. Three Basic Processes
1. Tolerance: reduced effect of a drug after repeated use.
2. Physical dependence: drug dependence defined by the presence of a withdrawal syndrome (consistent set of symptoms that appear after discontinuing drug use)
3. Psychological (or behavioral) dependence: importance of reinforcement in continued drug taking; often accompanied by craving.
B. Changing Views of Dependence
1. Early medical models: true addiction involves physical dependence.
2. Positive reinforcement model: drugs reinforce drug-taking behavior; physical dependence not necessary for substance use disorder.
C. Which Is More Important, Physical Dependence or Psychological Dependence?
1. Psychological dependence is increasingly accepted as the real driving force behind repeated drug use.
2. DSM-IV-TR provides complex behavioral definitions for substance abuse and dependence; tolerance and physical dependence may be less important.
IV. Broad Views of Substance Dependence
A. Is Dependence Caused by the Substance?
1. Argument: some drugs are “evil” and war must be waged against the substances themselves.
2. Some drugs are more likely to result in dependence than others are.
3. However, method of use and other factors influence a drug’s dependence potential.
4. Placing all the blame on the drug itself ignores the potential beneficial uses of the drug and fails to account for why dependence does not develop in most users. Further, it has led the U.S. government to put most of its drug control funding into trying to limit the availability of drugs and too little funding into teaching people how to live in a world in which these drugs exist.
B. Is Dependence Biological?
1. Argument: All compulsive behaviors might have some common physiological or biochemical action in the brain
2. Thus far, no genetic, physiological, or biochemical marker has been found that strongly predicts drug dependence.
C. Is There an “Addictive Personality”?
1. Argument: Some people become dependent but others do not because of differences in personality
2. The personality trait of sensation-seeking is statistically associated with early substance use and abuse.
3. Researchers are studying complex relationships between impulsivity and drug use.
D. Is Dependence a Family Disorder?
1. Alcohol dependence often exists within a dysfunctional family.
2. Evidence suggests that dysfunctional relationships play a role in the development of dependence, but such relationships are not the sole factor.
E. Is Substance Dependence a Disease?
1. Founders of AA characterized alcohol dependence as a disease.
2. Others argue that substance dependence doesn’t have all the characteristics of a disease.
3. Biopsychosocial perspective implies that dependence is related to dysfunctions of biology, personality, social interactions, or a combination of these factors.
V. Crime and Violence: Does Drug Use Cause Crime?
A. The belief that there is a causal relationship between drug use and crime probably forms the basis for many drug laws.
B. The relationship between crime and illegal drug use is complex.
C. Possible connections between drug use and crime:
1. Drug use may change an individual’s personality in a lasting way, turning the individual into a “criminal type.”
a. However, it would be incorrect to conclude that any particular drug makes someone a criminal.
2. Acute effects of a drug may temporarily make the person more likely to engage in criminal behavior.
a. Evidence indicates that alcohol is associated with crime.
3. Crimes may be carried out for the purpose of obtaining money to purchase drugs.
4. Illicit drug use is a crime.
VI. Why We Try to Regulate Drugs
A. Laws to control drug use have a legitimate social purpose: to protect society from the dangers of some types of drug use.
B. Some laws are not developed as part of a rationally devised plan and may not be realistic or effective.
Key Points
- Overview–there are two main categories of drug problems discussed in the chapter: 1) problems directly caused by taking the drug; and 2) problems related to the social problem of the deviant act of taking drugs.
- In the 1800s, there were no laws covering the sale or use of drugs in the United States; this changed in the 20th century.
- Three main concerns changed how the government felt about drugs: toxicity, dependence, and crime.
- Drug toxicity is complex: in many cases, it is how the drug is taken that makes it toxic. Other times, a drug is toxic because of what the person does while taking the drug or the effect intoxication has on the person’s behavior. Drugs can also be toxic because of the amount taken or as the result of long-term use.
- The DAWN system covers the misuse or abuse of illicit, prescription, or over-the-counter drugs. DAWN collects data on emergency room visits and mortality.
- DAWN collects data on alcohol only in combination with other drugs. Exception: if the individual is under 21, alcohol is counted even if it is the only drug present. If alcohol were included in every DAWN mention, the data on other drugs would look insignificant.
- Blood-borne illnesses like AIDS, HIV, and hepatitis are deadly diseases that are easily passed by sharing needles used to inject drugs.
- There are no outright rules for quantity or frequency of use to separate “normal” or “recreational” users from someone who has developed a substance use disorder.
- Tolerance is the reduced effect of a drug after repeated use.
- Withdrawal syndrome is the consistent set of symptoms that appears after discontinuing drug use. Symptoms of withdrawal can be mild (such as a headache) or severe (such as a seizure).
- Psychological dependence is defined in terms of observable behavior. It can be indicated by the frequency of drug use or the amount of time engaged in drug-seeking behavior.
- Early medical models focused on physical dependence and the treatment of withdrawal symptoms.
- In the positive reinforcement model of drug dependence, drug use reinforces the behavior and serves as the basis for psychological dependence. The user does not have to experience withdrawal symptoms to be considered dependent.
- The American Psychiatric Association developed the Diagnostic and Statistical Manual (DSM-IV-TR), which outlines the diagnostic criteria for the substance use disorders: abuse and dependence.
- Some substances have a greater “dependence potential” compared to other drugs; how a drug is taken also affects the likelihood of the drug being abused.
- There are several broad views of dependence including: 1) the drug is responsible for the addiction; 2) dependence is biologically-based; 3) dependence is personality-based; 4) family dysfunction contributes greatly to dependence; and 5) dependence is a disease.
- Biopsychosocial perspective: dependence might be related to dysfunctions of biology, personality, social interactions, or a combination of multiple factors.
Chapter Discussion Questions and Activities
Using DAWN, come up with five different misleading newspaper headlines. Then explain why they are misleading.
What are several different ways that alcohol can be toxic? Can food be toxic? Describe some examples of acute and chronic toxicity associated with alcohol and food.
Debate the benefits and limitations of syringe exchange programs. Why do people support or oppose these programs? How could such programs be improved? What are possible alternatives?
In terms of frequency and amount of alcohol consumption, what is the difference between a recreational alcohol user and someone who meets criteria for alcohol dependence? Is it possible for someone with alcohol dependence to drink less than a recreational user who has no alcohol-related problems? Does the type of drink matter? In general, what factors influence the determination of whether an individual’s alcohol consumption would be defined as use, misuse, or abuse of alcohol?
How would the early medical model and positive reinforcement model of dependence explain food “addiction,” Internet “addiction,” or nicotine dependence? If done as a group activity, each group could have a different topic.
Do you think the current drug laws reflect the relative dangers of various legal and illegal drugs? If you were to revise the current drug laws, what data would you use to decide which drugs should be tightly controlled and which could be freely available?
test bank
test bank
ch2 Key
| 1. | The U.S. government in the 1800s had few regulations on industry and in general took a "hands-off" approach to government that has been referred to by the term
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| Blooms Level: 01. Remember |
| 2. | The text lists three concerns that led to the adoption of the first U.S. laws regulating what we now call controlled substances. Which of these was NOT one of the three?
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| Blooms Level: 01. Remember |
| 3. | When using a substance makes normal activities such as driving result in harmful accidents, this is called
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| Blooms Level: 01. Remember |
| 4. | Acute drug effects are those that
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| Blooms Level: 01. Remember |
| 5. | Which is an example of chronic physiological toxicity?
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| Blooms Level: 01. Remember |
| 6. | The Drug Abuse Warning Network
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| Blooms Level: 01. Remember |
| 7. | According to recent DAWN data, which of these substances is near the top of both the emergency room visits and drug-related deaths lists?
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| Blooms Level: 01. Remember |
| 8. | What is a Drug Recognition Expert?
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| Blooms Level: 01. Remember |
| 9. | Which drug is responsible for the most drug-related deaths in the 2009 DAWN data set?
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| Blooms Level: 01. Remember |
| 10. | In comparing the relative toxicity of marijuana and cocaine, it is important to take into account
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| Blooms Level: 02. Understand |
| 11. | DAWN data provides all of the following EXCEPT
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| Blooms Level: 02. Understand |
| 12. | Since the 1990s, HIV transmission rates among intravenous drug users have been reduced from about 50% to about 10%. According to the text, which of these factors led to this decrease?
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| Blooms Level: 01. Remember |
| 13. | When repeated exposure to the same dose of a drug results in a lesser effect, this is called
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| Blooms Level: 01. Remember |
| 14. | The occurrence of a withdrawal syndrome is evidence of
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| Blooms Level: 01. Remember |
| 15. | The drugs with which people are most likely to develop psychological (behavioral) dependence are generally also found to have
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| Blooms Level: 01. Remember |
| 16. | The DSM-IV-TR does not define addiction as such, but has diagnostic criteria for
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| Blooms Level: 01. Remember |
| 17. | As views of substance dependence have changed based on scientific research, the real driving force behind repeated excessive drug use is now believed to be
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| Blooms Level: 01. Remember |
| 18. | Which of these substances is listed as having a "very high" dependence potential?
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| Blooms Level: 01. Remember |
| 19. | Brain scan studies with drug users
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| Blooms Level: 01. Remember |
| 20. | Those who are diagnosed with a personality disorder, such as antisocial personality disorder,
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| Blooms Level: 01. Remember |
| 21. | In determining whether using a drug causes people to become criminals, it is important to remember that
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| Blooms Level: 01. Remember |
| 22. | Which of the following drugs has been clearly linked to crimes and violence?
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| Blooms Level: 01. Remember |
| 23. | In an annual study done by the U.S. Justice Department, people arrested for various crimes are given urine tests to detect the presence of drugs. In 2010, about ____ percent of the adult male arrestees tested positive for at least one illicit drug.
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| Blooms Level: 01. Remember |
| 24. | About how many arrests are made in the U.S. each year for drug-law violations?
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| Blooms Level: 01. Remember |
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