Chapter 5

Drugs and Social Issues

Use, Abuse, and Dependence

• Substance Use – one time or casual experience• Substance Abuse – heavier and more frequent use,

with adverse effects – based on the degree of hazard and impairment in functioning

• Substance Dependence – irresistible pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive usage

What Encourages Substance Use?

Psychological and Physical Effects

• Archeological evidence suggests psychoactive substances have been used for ages for inebriation or pain relief

• Interaction between attraction to intoxication and a youngster’s living situation

Acting Like Grown-ups

• Lure of adult status, power, and independence is strong

• Youngsters strongly drawn to emulate role models

• Tendency for youngsters to equate drug use with maturity leads some scientists to view substance use as a transitional fact of life.

Employment and Teen Drug Use

• Adolescent exposure to work experience can be helpful or harmful– Teens working more than 20 hours/wk in

danger of becoming cynical about work, alienated from school, parents, more likely to use alcohol and drugs

– Coworkers can be negative socialization agents

Predicting Drug Use

• No single personality type marks potential users, but some characteristics often accompany drug use (Risk takers craving excitement, for example)

• A combination of early drug use, conduct disorder, and encounters with the law increases an adolescents odds of abuse into adulthood

Being One of the Gang

• Adolescents tend to share the illicit substance use patterns of their friends

• Associating with a deviant peer group provides one of the strongest incentives to use drugs

• Can be difficult for parents to influence children’s choice of friends, especially immigrant parents who speak little English

Drug Use by Entertainers and Athletes

• Young people know that the rich and famous use illicit drugs, and they want to be like them

• Glamorization of life-styles based on drugs undoubtedly affects young people

Family Problems

• The exact nature of the association between the family and children’s drug use is not immediately obvious

• There are many ways in which families directly or inadvertently encourage children to use drugs

Drug Use by Other Family Members

• It is common for children to watch their parents using dangerous substances and illegal drugs

• Parents model the drug abuse they warn their children against

• Children more likely to follow parent’s actual example rather than their words

Monitoring and Supervision

• The more regularly children and parents eat dinner together, the less likely children are to smoke, drink or use drugs; however there is no clear correlation– Traditional values including abstinence may

coincide with families that eat together

• Changes in American family have decreased amount of time children spend with their parents especially after school

• Under-socialized peers take over from parents

Rejection and Harsh Punishment

• Harshness and rejection can be worse than lack of supervision

• Tendency for poor parenting practices, child drug use, and children’s antisocial behavior patterns to occur together

Poverty and Prejudice

• Children more likely to use drugs if they live in disadvantaged neighborhoods

Good and Bad Schools

• Teachers’ substance use affects students– When faculty cannot smoke in view of

students, students have lower smoking rates

• Positive relationships with teachers influences child’s behavior more so than class sizes or amount of teacher training

Segregation, Crime and Drug Abuse

• Diversity in socioeconomic composition of the student body is key

• Drug abuse happens in tandem with larger social issues of crime ridden communities and inequality

Cumulative Risk Model

• No single leading risk factor for abuse

• Drug abuse, like other negative developmental outcomes, is predicted by the number of personal and environmental risks more than by any one specific risk. – Abuse more likely in context of multiple risks

Some Frequently Used Substances

Alcohol

• Alcohol use in adolescents has always been high, but is increasing among young women– Heavy drinking pregnancy can produce lasting affects

such as fetal alcohol syndrome, which affects physical and cognitive development

• Physical facial abnormalities (widely spaced eyes, small head, short eyelid openings, thin upper lip, small upturned nose

• Cognitive abnormalities (mental retardation, poor motor coordination, memory deficits, attention and adjustment problems)

Cigarettes and Marijuana

• Smoking regularly during pregnancy can affect prenatal and child development – Low birth weight can cause slow learning

through childhood– Miscarriage or premature birth– Breathing abnormalities, infant death, and

childhood cancer

• Marijuana most popular illicit drug for adolescents– Inexpensive and relatively easy to obtain

• Some limit experimentation to marijuana while for others it is a gateway to stimulants, tranquilizers and narcotics

Stimulants

• Many stimulants are legal and commonly available – Coffee– Chocolate– Soft drinks– Nicotine– Over-the-counter and prescription medications)

Amphetamines

• Methamphetamine popular among young women– Inexpensive– Increases energy– Suppresses appetite

• Users describe high as stimulating, increasing feelings of self-esteem, and increases activity

• Increases activity of neurotransmitters, norephinephrine and dopamine causing hallucinations and delusions

• When dependency develops, more meth is required for high

• Sleep deprivation combined with drug’s effects can cause paranoia

• Ecstasy (MDMA) type of amphetamine popular among college students – Can cause overheating (potentially fatal) and

dehydration, panic attacks and fainting

Cocaine, Crack Cocaine and Heroin

• Cocaine’s effects on the brain similar to amphetamines– Dopamine accumulates in synaptic space

between neurons and continues stimulating the receiving neuron

• Cocaine use by pregnant women can adversely affect child– Low birth weight, addiction at birth, irritability

at birth

• But, cocaine use alone does not seem to cause obvious long-term cognitive or motor impairments as previously believed

Prescription Drugs: Ritalin

• One of most widely misused prescription drugs for children

• Often prescribed for ADHD (a common disorder), usually effective and few side effects

• Children may gave or sell their prescribed Ritalin to friends– Reform measures are needed to regulate distribution of

increasingly popular prescription medication

Prescription Drugs: OxyContin

• Powerful and effective painkiller used in cases of severe and chronic pain

• Oxycodone (active ingredient) extremely addictive and potentially lethal

Progress in Prevention

• Studies show professional knowledge of child psychology is necessary to devise successful prevention programs

• Straightforward commonsense approaches rarely work

DARE

• DARE (Drug Abuse Resistance Education) programs present police officers explaining the negative effects of drugs– Program very popular– No credible research evidence to show that

DARE or similar programs prevent abuse – Presents drug related information but does not

address reasons why youngsters turn to drugs

Multi-component solutions

• Programs that look beyond individual vulnerabilities of children to analyze many aspects that can lead to abuse may be more successful

Treatment

• Many types of treatment include

– Short hospital inpatient programs– Outpatient programs– Therapeutic community residential programs– Life skills-training programs

Outpatient family-based therapy

• May be most affective way to curb behaviors that go along with abuse and abuse itself especially in early stages of abuse– Family systems therapy focuses on parent, sibling and

extended family interactions that relate to drug abuse

– Multidimensional family therapy considers whole social system (school, peers, community, culture)

– Multi-systematic therapy