Substance Abuse: Fear and Loathing in Las Vegas demonstrate Pathology.

Some Guy

Generic College
 Abstract

Substance abuse is a common problem in the United States. We do not know exactly how many

people have this problem as not all of them seek treatment. The pathology associated with

substance abuse is demonstrated by the main character of the film, Fear and Loathing in Las

Vegas. Substance abuse is often treated in a group environment. While this is helpful to most

participants, the effectiveness of treatment can be further enhanced by relaxation therapy and

motivational interviews.
 Substance Abuse: Fear and Loathing in Las Vegas demonstrate Pathology.

Substance abuse is one of the most common psychological and biological problems

among Americans today. The DSM IV defines substance abuse as a maladaptive pattern of

substance use leading to clinically significant impairment or distress, as manifested by one (or

more) of the following. 1. Recurrent substance use resulting in failure to fulfill major role

obligations at work, school, or home. 2. Recurrent substance use in situations in which it is

physically hazardous. 3. Recurrent substance-related legal problems. 4. Continued substance use

despite having persistent or recurrent social or interpersonal problems caused or exacerbated by

the effects of the substance. The example of substance abuse which will be referred to from here

on is Johnny Depp’s character in the film, Fear and Loathing in Las Vegas. This character meets

all the requirements for a diagnosis of substance abuse. This example should help explain some

of the problems associated with substance abuse, complications with treatment, and suggest the

most effective treatment method.

The first criteria required for a diagnosis of substance abuse is the use of a substance in

such a way that it repeatedly interferes with everyday obligations. In Fear and Loathing in Las

Vegas, the main character is a drug addicted journalist. He meets the first criteria for substance

abuse 15 minutes into the film. He attempts to check into a hotel near the event he has been

asked to write about, and he in unable too due to the acid he has ingested. He hallucinates and

cannot communicate effectively with the woman working at the hotel. This inability to perform

the required functions of school or work is not uncommon for drug abusers. According to one

study, 11 percent of applicants for employment at a hospital were found to have some form of

narcotics in their bodies (Butcher, Mineka, and Hooley, 2006). Another study found that people

who use multiple types of addictive drugs have impaired work performance and below average
job satisfaction (Butcher et. al.). One group has developed a technique to determine how

impaired a person’s function is based on their job performance. This involves a survey of amount

of time worked in the past month, and complications related to work performance. This

information translates to a score of how much a person is affected by their substance abuse called

the employment problem severity score (Mackin, Horner, Harvey, and Stevens, 2005). This

could be useful to psychologists when evaluating a person for substance abuse.

The second criterion for substance abuse is the repeated use of a substance in a physically

dangerous setting. In the fore mentioned film, the main character drives a car multiple times

while under the influence of alcohol. This qualifies as a situation in which alcohol (the impairing

substance) use would be hazardous. Alcohol use while operating a motor vehicle is all too

common in the United States. More than half of all fatal and serious injuries from vehicle

accidents are the result of alcohol (Butcher et. al.). One of the problems with this criterion is that

many people who do not meet the other requirements of being a substance abuser still drive

under the influence of this drug. This suggests that this criterion alone is not sufficient to

diagnose someone with substance abuse.

The third criterion for substance abuse is recurring legal problems associated with the use

of the substance. Fear and Loathing represents the main character as someone who is paranoid

and avoidant of the police. Throughout the film, he worries about the police discovering his

narcotics or that he is under the influence of drugs. At one point he is pulled over by a police

office for driving while intoxicated. In America, there are very strict laws that attempt to prevent

people from using mind altering substances (other than alcohol and prescription drugs). These

laws are intended to keep people from abusing potentially harmful drugs. In most cases, it has

had the effect of overcrowding prisons with people who have minor marijuana offenses. The
purpose of this criterion for a diagnosis of substance abuse is that going to prison can have

serious consequences to a person and their family. It is not a disorder to use mind altering

substances. However, the DSM IV has labeled it a disorder if this use leads to the user being

punished by the legal system.

The final criterion for substance abuse is a continued use of a substance even though it

causes social or interpersonal problems. The main character in the film picks up a hitch hiker in

the first few minutes of the story. His erratic and paranoid behavior from drug use frightens the

hitch hiker into jumping out of the car and running away. This criterion is crucial for a diagnosis

of substance abuse. All people who abuse drugs eventually show signs of social problems or

conflicts. This is one of the reasons that substance abuse is such a problem. People who abuse

drugs may avoid friends or family in order to hide their addiction. Sometimes substance abusers

will become violent even toward people they love due to the effects of the drugs. This happens

because although people use these substances to make them feel better, they can often have a

negative effect by amplifying a person’s negative thoughts or mood. This violence is somewhat

linked to the third criterion, as it often leads to the abuser’s arrest.

Treatment for substance abuse comes in several forms. The first and most popular form is

group therapy. This type of treatment ranges from informal groups led by people that have or

have had a substance abuse problem. Some other groups are led by psychologists or therapists.

One example of such a group is Alcoholics Anonymous (AA). In this group members discuss

their own struggles with alcohol and the success they have or have not had in recovering from

addiction. While many reports suggest that people in group therapy have more success than those

who combat abuse on their own, some psychologists insist that their substance abuse programs

are inadequate. In one survey of 76 APA members, 79% reported that their treatment programs
for substance abuse could use some reform (Cardoso, Chan, Pruett, and Tansey, 2006). I agree

with the 73% who suggested that substance abuse training should be a mandatory part of their

training curriculum.

A different study examined the difference between relaxation therapy and motivational

interviews in the treatment of substance abuse. Patients involved in this study reported that

motivational interviews were less helpful to them in fighting their addiction than relaxation

therapy, but relaxation therapy made them feel more comfortable with treatment (Stein, Monti,

Colby, Barnett, and Golembeske, 2006). This suggests that perhaps if both relaxation therapy

and motivational interviews were used in conjunction, than treatment would be more successful.

This research coupled with the research regarding group therapy appears as though it would be a

useful technique in helping people with substance abuse problems.

The conclusions I have reached are as follows. 1. Substance abuse is a big problem in the

United States, and it continues to grow and threaten more lives. 2. Current forms of treatment

show promise for people with substance abuse, especially those with alcoholism. 3. These forms

of treatment can be enhanced by combining different techniques, and by requiring that graduate

education programs for psychology students require substance abuse training.

 References

Butcher, J. N., Mineka, S., & Hooley, J. M. (2006, May). S. Hartman, Ed.Abnormal

psychology (13th ed.). Boston, MA: Allyn and Bacon.

Cardoso, E. S., Chan, F., Pruett, S. R., & Tansey, T. N. (2006). Substance abuse

assessment and treatment: The current training and practice of APA division 22 members.

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Mackin, S. R., Horner, D. M., Harvey, R. T., & Stevens, L. A. (2005). The relationship

between neuropsychological measures and employment. Rehabilitation Psychology, 50, 158-163.

from

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Stein, L. R., Monti, P. M., Colby, S. M., Barnett, N. P., & Golembeske, C. (2006).

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