Haramaya University

College of Education and Behavioral Sciences

Department of Psychology
M.A in Social Psychology

Course tittle: Social Policy Analysis and Program Evaluation, (Spsy6042)

Group Assignment on: Substance Abuse Problems

Group members ID No:

1. Sabah Mohammed K/PGP/324/11
2. Jafar Alii K/PGP/417/11
3. Ahmed Muktar K/PGP/416/11

Submitted to: Bahar Adam (PhD)

October, 2021

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 Table of contents
1. Definition of the Substance Abuse
1.1 The Expandable level of Substance Abuse
1.2 Parts of Society that Affected by Substance Abuse
2. History of the Substance Abuse
2.1 When Substance Abuse was identified as a problem.
2.2 The Criteria to Identify Substance Abuse as a problem
2.3 Role of Social Movements Affected Evolution of these Problems
3. Why Substance Abuse is a Problem?
3.1 Psychological Theories of Substance Abuse
3.2 Sociological Theories of Substance Abuse
3.3 Values and Community attitudes toward substance abuse
References

1. Definition of the Substance Abuse problems

From time immemorial, human beings have looked for substances or have practiced
methods to make life more pleasurable, and to avoid or decrease pain, discomfort and
frustrations. For the purpose of changing his mood, primitive man looked for substances around
him to take, particularly in the plant kingdom. Any substance that, when taken into living
organism, may modify one or more of its function. All known substances of abuse change mood
and feeling. Many substances such as alcohol or marijuana that possess psychoactive properties,
but may not have any approved medical uses, have also been used for abuse purposes. Although
drugs in the usual sense of term are mainly intended for medical uses.

Substance abuse isn’t something you should take lightly. It occurs when you use alcohol,
prescription medicine, and other legal and illegal substances too much or in the wrong way.
Substance abuse differs from addiction. Many people with substance abuse problems are able to
quit or can change their unhealthy behavior. Studies show that drug use increases risk of mental
health issues such as anxiety, depression and psychosis. People with mental health issues also
have a higher rate of drug use problems. People who have experienced physical, emotional, or
sexual abuse or trauma are more likely to develop a substance use disorder.

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In Ethiopia alcohol and khat are the most frequent substances of abuse, followed by cannabis and
solvents. Hard drugs such as heroin and co-caine are rarely used. Traditional medical
practitioners mostly implement herbs, spiritual healing, bone-setting and minor surgical
procedures in treating disease. Ethiopian traditional medicine is vastly complex and diverse
varies greatly among different ethnic groups. Substances that are commonly abused in Ethiopia
are:

 Alcohol and Khat

 Tobacco and Hashish
 Benzene sniffing/Inhalation
 Pethidine and Benzodiazepines

1.1 The Expandable level of Substance Abuse

According to different studies conducted in Ethiopia, similar factors have been mentioned to
explain khat, tobacco and alcohol use behaviours. These include family history of substance use,
peer pressure, poor wealth quintile, employment/unemployment, stressful life events,
celebrations and addiction. Among the young segment of the Ethiopian population, college and
university students are at the highest risk of substance use. Joining university often leads to new
opportunities, independence from family control, self-decision-making and peer pressure to use
or abuse drugs.

Factors Associated with Substance Abuse and Dependence

Many variables operate simultaneously to influence the likelihood of any given person becoming
a drug abuser or an addict. These variables can be organized into three categories: agent (drug),
host (user), and environment.

1. Agent/Drug Variables: Drugs vary in their ability to produce immediate good feelings in
the user. Drugs that reliably produce intensely pleasant feelings (euphoria) are more
likely to be taken repeatedly. Reinforcement refers to the ability of drugs to produce
effects that make the users wish to take them again. The more strongly reinforcing a drug
is, the greater the likelihood that the drug will be abused. The abuse liability of a
substance is enhanced by its: -
 Availability /cost: easily available and low cost substances are likely to be abused.

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  Purity/potency: the more potent the drug, the more it is abused.
 Mode of administration: the possible modes of administration of substances of
abuse are chewing, PO, intranasal, subcutaneous, IM, IV, and inhalation.
 Speed of onset and termination of effects: effects that occur soon after
administration are more likely to initiate the chain of events that lead to loss of
control over drug taking.
2. Host/User Variables: In general, the effects of substances/drugs vary among individuals.
This depends on:
 Genetic predisposition and vulnerability.
 Psychiatric disorders.
 Prior experience or expectation.
 Propensity for risk-taking behaviour

2. Environmental Variables: Social setting and community attitude, Peer influence, Paucity of
other options for pleasure and diversion, Low employment or educational opportunities.

1.2 Parts of Society that Affected by Substance Abuse

Adolescents and young adults were the most affected group; and those addictive substances were
easily obtainable in the country. The use of substances is becoming a major public health
problem worldwide. The extent of worldwide psychoactive substance use is estimated at 2 billion
alcohol users, 1.3 billion smokers and 185 million other drug users. Such substance use is an
important contributor to the global burden of diseases: alcohol and tobacco use contribute about
5.4% and 3.7% to the global burden of disease, respectively. In 2015, the magnitude of harm
caused by drug use globally was estimated to be 28 million lost years of ‘healthy’ life (disability-
adjusted life years (DALYs).

In Ethiopia, alcohol, khat and tobacco are the most common substances consumed. The overall
pooled prevalence of ever and current substance use is 33.84% and 25.2%, respectively, among
the youth population of Ethiopia. Of the substances used, alcohol is the main product consumed
(33.95%), followed by khat (24.82%) and cigarettes (18.53%). In a community survey in
Ethiopia, 4.2% of the adult population used tobacco products, and heavy episodic drinking and
khat chewing were significantly associated with tobacco use. Polysubstance use behaviour is
found among 39.3% of undergraduate students in one of the universities in Ethiopia.

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 Substance use behaviour is more prominent in males than females. The lifetime and current
substance use is 3.2 and 2.8 times higher among males compared to females. According to the
2016 Ethiopia Demographic and Health Survey (EDHS), 4% of males in Ethiopia smoke any
type of tobacco, and almost all are cigarette smokers. Among males who smoke cigarettes daily,
one quarter (25%) smoke five to nine cigarettes each day; 6% smoke or more cigarettes each
day. About half of Ethiopian males (46%) have reported drinking alcohol at some point in their
lives.

Regional distribution of current smokers of the total sample of males (12,688) in the 2016 EDHS
in Ethiopia, 7,931 (62.51%) were currently using at least one substance (alcohol, khat or
tobacco). As a result, 7,931 male current substance users were included in the present study.
The within region distribution of substance users indicated that Tigray (88.68%), Amhara
(87.06%) and Harari (80.03%) had the leading proportion of substance users, respectively. The
Among region distribution of current substance users showed that Amhara (18.5%), Tigray
(14.2%) and Oromia (12.8%) had the top three highest proportions of substance users,
respectively. Similarly, more current substance users were reported among rural residents
compared with their urban counterparts, both in the case of the within substance distribution and
among the total male sample distribution.

Types of problems of concern to the community

The extent and type of drug and alcohol problems also vary across societies and the range of
behaviours defined as such in turn affects the extent and type of services. At the same time, when
similar problems exist across societies, they are not always considered of equal importance. The
health care and social service institutions in a community and their relationships affect the
treatment of drug and alcohol problems as well. This includes:

 the alternative resources to the treatment system,

 the interaction and referral processes between different community systems,
 the availability of different types of health care and
 the influence of substance abuse programmes relative to other institutional systems.

Alternative resources: Treatment for drug and alcohol problems which is carried out in other
health and social services is generally not documented. Not to examine such resources, however,
is to ignore services in many countries. (For examples of Zambia and Mexico).

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  Some countries which do not have specialized treatment for substance abuse may have a
system of health services or welfare services that provides treatment for these problems
 The extent to which the public sees these agencies as appropriate ones for this care will
likely affect participation and attitudes toward specialized treatment.
 In addition to public institutions, in many countries such as Poland, Bulgaria, Britain and
France, voluntary organizations play an important role in treatment

The interaction between other health services: These interaction between social service
agencies and substance abuse treatment systems varies greatly from country to country. Some
have official policies which set forth lines of referral and definitions of cases for referral between
these institutions and alcohol treatment. To a great extent this is influenced by the organization
of health care services in the country:

 whether they are centralized/fragmented, or

 there is a large demarcation between public and private services,

This may have an important effect on treatment to the extent that treatment programmes can
predict their population and set up guidelines with other institutions regarding what problems
and individuals are appropriate for services.

Traditional health care in a community: Traditional methods of healing are an important part
of health care throughout the world. In India and Nigeria, for instance, a substantial part of the
total health care is carried out by traditional services. When belief systems of the populace fit
with ideologies of traditional healing, drug and alcohol treatment programmes and methods will
be affected in order to effectively attract clients to treatment and keep them there.

Influence of the Institution system: The power relationships among different Institutional
systems in a community are important to consider when examining extra-treatment influences on
drug and alcohol treatment. The status of treatment in relation to mental health, criminal justice,
welfare and other relevant institutions varies across communities. Even within communities
these power relationships often shift over time. This affects both:

 The amount of resources and how they are allocated. This has not been documented
comparatively across countries;

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  However in the USA in recent years the focus on the "drug war" and drunk driving has
made the influence of the criminal justice system on government policy far stronger than
that of the public health/treatment system.

Prevention and Control: The community health agent should be able to:

a. Inform and educate community about the harmful consequences of substances of abuse
such as the health, social and economic impact.
b. Try to prevent young people from smoking, chewing and drinking
c. Promote restriction of smoking in public places
d. Train youth about substance abuse and form peer counsellors and
e. promote prevention works in schools, and in the community.

2. History of the Substance Abuse

Substance abuse is a disorder characterized by repetitive drug use that results in social, health or
economic problems. Substances of abuse are becoming a worldwide problem especially in
adolescents and young adults. Some of these substances include alcohol, khat (chat in Amharic),
tobacco, Hashish, and benzene. The effects on the different organs of the body produce
behavioural effects that get altered as the dose of the substance is increased in the blood.

Substance abusers, if these substances are removed develop an increased need for the substance
of abuse and sometimes leading to theft or robbery. The harmful consequences of substance
abuse are numerous. They can be:

 Health related, e.g. hepatitis, dental caries, loss of teeth, cancer of the oral mucosa, lung
cancer, malnutrition, depression, memory loss, suicide, tolerance, and dependence
 Social problems (crime, delinquencies, family problems, divorce]
 Economic consequences.

From time immemorial, human beings have looked for substances or have practiced methods to
make life more pleasurable, and to avoid or decrease pain, discomfort and frustrations. For the
purpose of changing his mood, primitive man looked for substances around him to take,
particularly in the plant kingdom.

Many substances such as alcohol or marijuana and Cannabis that possess psychoactive
properties, but may not have any approved medical uses, have also been used for abuse purposes.

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Although drugs in the usual sense of term are mainly intended for medical uses, some such as
narcotics and sedatives have also been used for non-medical purposes and are rampantly abused.

Cannabis abusers numbering some 29 million are reported from 120 countries, of which 25 from
the Asian, American, and European regions of WHO fall into the high use category. Mexico
continues to be a major producer of cannabis. Also Cannabis is the most abused drug in Africa.
Egypt remains one of the world’s largest consumers of cannabis resin, which is smuggled into
the country from Lebanon.

In many other countries of the region, there has been a marked increase in cannabis abuse,
frequently associated with the abuse of alcohol and /or psychotropic substances. Cannabis
continues to be cultivated throughout Africa. Large-scale cannabis cultivation has continued in
Morocco, which remains one of the world’s biggest sources of cannabis resin.

In the Ethiopian situation, Ethiopia is geographically situated in a very strategic place, where
there is easy access to Asia, Europe and other parts of Africa. Moreover Ethiopian frontiers are
vast and link it with about five countries, which increase the potential for drug smuggling. In the
past few years there has been movement of heroin from the Indian subcontinent to West Africa
and then to Europe and North America. Heroin traffickers have repeatedly been intercepted at
Addis Ababa International airport and a considerable amount of heroin (up to 20kg/year) has
been seized on different occasions.

The rail way connecting Addis Ababa, Dire Dawa and Djibouti creates a fertile ground for
smuggling and trafficking cannabis and exporting Khat. In the country Cannabis sativa is being
cultivated in central, western and eastern administrative regions. Some of the cultivation areas
are hidden among other groups or in wooden areas. This makes it difficult to detect and destroy
the plant. Young people consume the plant for recreational purposes and in certain monasteries
for religious as well as curative purposes.

Cannabis (hashish) smoking is also escalating in the urban areas. In Addis Ababa, the police
already know some hashish selling areas and some of the dealers as well as abusers are
apprehended repeatedly. Substances that are commonly abused in Ethiopia are: Alcohol, Khat,
Tobacco, Hashish (Itse-fars), Benzene sniffing/Inhalation, Pethidine amd Benzodiazepines

2.1 When Substance Abuse was identified as a problem.

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Drug abuse is defined by the WHO Expert Committee on Drug Dependence as “persistent or
sporadic excessive drug use inconsistent with or unrelated to acceptable medical practice. From
this definition, it is clear that medical use of drugs, whether long term or not, and whether drug
reactions occur or not, is not “drug abuse”.

Substance Abuse occurs in all segments of all societies, which results in decreased work and
school performance, accidents, intoxication while working, absenteeism, violent crime, and theft.
Adolescents are the most vulnerable age group for developing substance abuse problems. Men
are more at risk than women.

Since 1990, Federal spending on drug law enforcement and treatment in the United States has
increased by over 65%. In 1993, the US Government planned to spend $12.7 Billion to fight
drug abuse, 44% on domestic law enforcement, 32% on drug demand reduction and 24% on
interdiction and international efforts. Substance Abuse is a maladaptive pattern of substance use
resulting in repeated problems and adverse consequences

In order to deal with the increase in drug abuse, the community of nations has since the early
20th century gradually evolved global control mechanisms intended to limit the availability of
drugs of abuse. Between 1912 and 1972, no less than 12 multilateral drug control treaties were
concluded.

2.2 The Criteria to Identify Substance Abuse as a problem

The fourth diagnostic and statistical manual (DSM-IV) of the American Psychiatric Association
uses the following criteria for substance abuse. If any individual has experienced one or more of
the following at any time for at least in the same one-month period:

a. Recurrent drug use resulting in failure to fulfil major responsibilities.

b. Recurrent drug use in physically hazardous situations.
c. Recurrent drug related legal problems.
d. Continued use despite drug related social or interpersonal problems.

Substance abuse may lead to dependence. The current definition of “dependence” given by the
WHO Expert Committee on Drug Dependence is “a cluster of physiological, behavioural and
cognitive phenomena of variable intensity, in which the use of a psychoactive drug (or drugs)

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takes on a high priority. The necessary descriptive characteristics are preoccupation with a desire
to obtain and take the drug and persistent drug-seeking behaviour”.

Determinants and problematic consequences of drug dependence may be biological,

psychological or social, and usually interact. The core concept of the WHO definition of “drug
dependence” requires the presence of a strong desire or a sense of compulsion to take the drug.
Clinical guidelines (ICD- 10) for a definite diagnosis of “dependence” drawn up by WHO
require that three or more of the following six characteristic features have been experienced or
exhibited:

1) A strong desire or sense of compulsion to take the substance;

2) Difficulties in controlling substance-taking behaviour in terms of its onset, termination,
or levels of use
3) A physiological withdrawal state when substance use has ceased or been reduced, as
evidenced by: the characteristic withdrawal syndrome for the substance; or use of the
same ( or a closely related) substance with the intention of relieving or avoiding
withdrawal symptoms;
4) Evidence of tolerance, such that increased doses of the psychoactive substance are
required in order to achieve effects originally produced by lower doses;
5) Progressive neglect of alternative pleasures or interests because of psychoactive
substance use, increased amount of time necessary to obtain or take the substance or to
recover from its effects
6) Persisting with substance use despite clear evidence of overtly harmful consequences,
such as harm to the liver through excessive drinking, depressive mood states consequent
to periods of heavy substance use, or drug related impairment of cognitive functioning;
efforts should be made to determine that the user was actually, or could be expected to
be, aware of the nature and extent of the harm.

Dependence can be categorized into psychological and physical dependence. Psychological

dependence is a compulsion that requires periodic or continuous exposure to a substance to
produce pleasure or avoid discomfort. Physical (physiological) dependence is an adaptive state
that develops through resetting of homeostatic mechanism to permit normal function despite the
continued presence of a substance.

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Physiological dependence is evidenced by either tolerance or withdrawal syndrome.

 Tolerance: is defined as the requirement for an increased amount of the substance to

achieve a desired effect or there is a markedly diminished effect with regular use of the
same dose.
 Withdrawal syndrome: is a substance specific syndrome that follows cessation of or
reduction in intake of the substance that was previously regularly used by the individual.

Problems Associated with Substance Abuse and Dependence

The abuse liability and dependence potential as well as the ill effects of a substance form an
important scientific basis for scheduling of substances under the single convention on narcotic
drugs in 1961, and the convention on psychotropic substances in1971. The harm that results as a
consequence of abuse is primarily attributable to the pharmacological, toxicological, and
dependence producing properties of a substance including its impurities.

The dependence producing properties of substances that reinforce the user for continuation of
the substance-taking behaviour are responsible for ill effects of a substance on the abuser and the
society. Virtually, all substances that produce dependence can cause varying degree of health,
social and economic problems. The degree of harm produced in general depends on:

 The quantity of a substance consumed per occasion.

 The frequency with which it is consumed at that quantity and
 The duration of consumption in months or years.

1. Health related problems categorized as:

i. Acute Toxicities: Acute toxicity of substances of abuse often becomes the cause of
death and/or ill health. For example, respiratory and cardiac failure may occur due to the
acute toxic effects of barbiturates, opioid analgesics, alcohol, and
ii. Chronic Toxicities: Expectedly, substances of abuse produce chronic toxicity on
various organ systems with CNS being among the most vulnerable systems. For
example, chronic abuse of alcohol causes liver damage; and chronic use of tobacco
(nicotine) is associated with coronary heart disease, chronic obstructive lung disease and
lung cancer.

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 iii. Withdrawal Effects: The withdrawal of some substances of abuse such as barbiturates
and ethanol can by itself cause a life threatening condition characterized by fever,
increased heart rate, increased blood pressure and occasionally seizures that may prove
fatal with abrupt cessation of the use of the abused substance.

2. The negative economic consequences

Since substances of dependence should be taken regularly usually at increasing amounts when
tolerance develops in order to prevent withdrawal symptoms, the negative economical
consequences are evident. Additionally, the abuser spends much of his/her time searching for
and then consuming the abused substance. The negative economical consequences are:-

 Unemployment resulting in decreased national productivity.

 Increased expenditure by drug abusers for buying the substance of abuse.
 Increased cost of violence, accidents and property crimes associated with drug abuse
 Proliferation of producers of substance of abuse that may occupy vast areas of the land
that otherwise be used for the cultivation of useful crops and food.
 Proliferations of criminal networks that make a huge profit from trafficking substances
of abuse most of them being illicit substances.
 Transfer of illicitly acquired assets to other countries
 Increased expenditure for health related problems.

3. Social consequences of substance abuse

The social consequences of substance abuse or dependence include:

 Divorce → Broken families → prostitution

 Unemployment and Crime (theft, hijacking, rape, forgery, etc.)
 Violence and Accident e.g. Road traffic accidents.

2.3 the Role of Social Movements Affected Evolution of these Problems

The report of WHO was emphasizes the importance of the social and cultural context in
determining the definition of drug and alcohol problems, as well as the response to those
problems. The differences between groups of countries and even between countries within the

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same region cannot be overemphasized. Any plan of action which fails to take account of this
diversity cannot hope to meet the real needs of particular populations.

Shaw et al, ( 1978) argue that "the nature and extent of the response to a problem is determined
by how the problem is perceived and how prevalent it is estimated to be". The social and cultural
factors which affect alcohol and drug treatment are reviewed here in terms of the
sociodemographic characteristics of the community and related patterns of use and levels of
problems, the availability of alcohol and drugs, attitudes to alcohol and drug use, types of
problems and populations of concern and the extent of combined alcohol and drug problems in
the community.

1. Sociodemographic characteristics of the community

Sociodemographic characteristics of the community and related patterns of use and levels of
problems. Although much remains to be learned, the cross-cultural research on drinking and drug
use patterns is expanding and shows very different patterns from society to society. Such
differences have numerous implications for treatment. Drug and alcohol use patterns, as well as
types of drugs used within and across countries, often affect the targeting of individuals for
treatment. These patterns can place treatment in different contexts:

 making it fundamentally either therapeutic or a method of social control. They can affect
the decision of whether to include medical intervention as a large component of
treatment.
 In regard to alcoho~ countries such as Italy which have high daily consumption also
have high levels of health problems and their system of treatment is largely medically
based.
 Conversely, countries with "binge drinking" patterns, such as Finland and Mexico, have
high levels of social problems and less medically-oriented treatment.
 In regard to other drugs, countries such as Germany and Italy, where heroin use is a
primary, increasing problem have a different set of factors to consider in developing
treatment strategies.

2. Gender, age and ethnicity often affect distribution of substance uses

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Gender, age and ethnicity often affect distribution of substance use within a country. For
example, types of drugs used often differ according to age of the users within and across
countries. Glue sucking and the use of inhalants in general often affect younger populations than
does use of other drugs. In some countries where heroin has been a major problem for many
years, the first couple of generations of the particular treatment population are growing older and
posing concomitant problems for treatment provision, such as the problems faced by their
children.

 Age is an important predictor of heavy drinking and related problems in most countries,
but the distribution of problems by age differs from country to country.
 The different drinking and drug use patterns of men and women and their variation from
country to country. In Mexico and Zambia, for example, women's drinking patterns differ
from men's
 Understanding ethnic and racial diversity is also crucial in this context. For example, the
Maori and nonMaori populations in New Zealand, the Native American, Black, Hispanic
and White populations in the USA, and Muslim and Christian populations in Nigeria
have been found to have significant differences in drinking and drug use patterns and
distribution of problems.

3. Availability of drugs and alcohol within communities

The availability of drugs and alcohol may be associated with the level of treatment need and
types of services. Availability of a substance is determined by all the interacting factors that
make it easily accessible to consumers, including price and proximity. While use of many types
of drugs is not legal in most countries, availability of various ·drugs fluctuates over time. For
example, drug epidemics in the USA have been attributed to availability.

 Researchers in Hungary, Nigeria and Mexico have suggested that increased availability
also indicates treatment need.
 Studies in Alaska and of Native American drinking in the USA as a whole have
demonstrated lower problem levels and corresponding need for treatment when
availability is reduced.
 Reports from India and Zimbabwe suggest that the existence of high consumption levels
of liquor from unregulated breweries and home brew may lead to acceleration of the

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 negative health effects of drinking. This would affect the type of treatment required,
indicating the need for a larger focus on medical intervention in the content of treatment.

3. Why Substance Abuse is a Problem?

The notion of substance abuse is highly problematic. There is considerable disagreement

amongst experts as to the relative hazards and addictive properties of both legally and illegally
available substances. There are also widely divergent sub cultural attitudes to the harmfulness or
benefit of drug use. One can assume no social consensus as to the nature of the contemporary
drug problem nor about the most appropriate means of dealing with it. However, there is a
considerable evidence that criminalization of drug use and harsh penalties against users and
suppliers. Other models of control need to be considered and in particular the merit and demerit
of the medicalization of drug abuse required examination.

Substance abuse is a problem. Because people become dependent on drugs. In attempting to

explain why people become dependent on drugs, a variety of different approaches have been
taken. The first concentrates on the neurobiological effects of drugs, and explains drug
dependence in biological terms. The second approach is psycho- logical, with explanations
concentrating on behavioural models and individual differences. The third approach is
sociocultural, with explanations concentrating on the cultural and environmental factors that
make drug dependence more likely.

3.1 Psychological Theories of Substance Abuse

Psychological approaches to the explanation of drug dependence have often been based on
concepts that are common to those of other syndromes of behaviour involving compulsive or
impulsive behaviours, such as obsessive-compulsive disorder or gambling (Miller, 1980). In
particular, emphasis is given to the fact that there is impaired control over use and continued use
despite usage problems. There are a variety of psychological approaches to the explanation of
drug dependence, including emphasis on learning and conditioning (behavioural models),
cognitive theories, pre-existing behavioural tendencies (personality theories), and models of
rational choice.

Behavioural theories

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Behaviourist models of addiction focus on directly observable behaviour. One group
concentrates on the fact that behaviour is maintained or made more likely by the consequences or
reinforces of such behaviour. Behaviourist says that “you are what you think”.

Cognitive theories

There are a number of theories that explain drug dependence in terms of cognitive constructs.
One theory proposes that self-regulation is an important factor in the development of drug use
problems. Self-regulation has been described as taking “plan full” action designed to change the
course of one’s behaviour.

Personality theories

Some theorists argue that certain people are more prone to addiction through a so-called
“addictive personality”. Hans Eysenck has discussed this in terms of a psychological resource
model, whereby the habit of drug taking is developed because the drug used fulfils a certain
purpose that is related to the individual’s personality profile.

Rational choice theories

One group of theories examines the problem of why people voluntarily engage in self-destructive
behaviour. One of the central elements of drug dependence is the fact that the individuals have
impaired control over their use of the substance. This may manifest itself in continued use
despite a wish to reduce or stop use of the drug, to use greater amounts of the drug than intended,
or to use the drug for longer periods than intended.

3.2 Sociological Theories of Substance Abuse

Sociological theories utilize broader and often more abstract phenomena and concepts to explain
drug and alcohol use and abuse. Sociological theories understand substance abuse as a societal
phenomenon, having largely cultural, social, and economic origins or ties. Many sociological
theories, often identify how other social problems, e.g., poverty, inequality, social
disorganization, explain the prevalence of drug use and abuse in society or individuals’
gravitation to it.

Sociologists tend to focus more on the social meaning of drugs and alcohol, norms and patterns
regarding their consumption in certain settings, and consequences resulting therefrom. They

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typically do not focus on genetic predispositions, chemical imbalances, neurological processes,
or personality traits.

For example, Anderson (1998) articulated the following points.

a. a pattern of regular and heavy use over a significant period of time,

b. a set of drug-related problems (at work, or with interpersonal relationships, one’s own
health, and formal social control agencies),
c. previous and failed attempts to terminate drug consumption, and
d. self-awareness as having a drug and/or alcohol problem.

Sociologist theory consider substance abuse as a form of deviance that can be explained and
understood by a more general deviance theory. The first few theories we review adopt this
general deviance approach in understanding substance abuse.

Origins of Substance Abuse Theories

It is useful to review the three major paradigms since their tenets shape the theories below and
offer us a way to identify both common ground and differences among them. At a basic level,
sociology categorizes theory into the structural-functional, social-conflict, and symbolic
interactionist paradigms.

Social Process Theories

Social process or socialization theories focus on how people or groups become involved with
drugs and alcohol, how their involvement changes over time, and what might initiate that
change. Process theories are developmental in the sense that they identify key factors over a
period of time, one demarcated by social boundaries and meanings leading to drug and alcohol-
related behaviours and consequences.

Social and Self Control Theories

A social process theory is Hirsch’s social control theory. Its focus has been almost exclusively on
deviant behaviours, such as delinquent acts (theft, vandalism, crime etc.) and drug use, rather
than deviant roles and identities. It does not address the transition from drug use to abuse
directly, but unlike interactionist theories, it does explain original or primary deviance.

3.3 Values and Community attitudes toward substance abuse

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Attitudes to drug and alcohol use vary among cultures as much as do use patterns. A 1962 WHO
survey of drug legislation found that "in some countries severe penalties for addiction were
considered appropriate whereas in others a 'habit' was considered 'normal". Many cultures have
different expectations about use for men and women and this affects treatment provision as well.

 The type of substance most popularly used may also affect attitudes. Regionalism, with
different areas of a country being relatively "wet" or "dry" or having higher or lower rates
of illicit drug use may also be a factor. This typically reflects both use patterns and other
aspects of local culture.
 The degree of tolerance of high levels of alcohol consumption and drug use also varies
from one society to another. As use patterns vary by population group, the variation is
more dramatic where illicit drugs and high levels of alcohol consumption are concerned.
 Drug use and drunkenness, for example, are tolerated for men much more than for
women in some cultures. This is likely to affect which persons are noticed for treatment
as well as the stage of problem at which they are targeted When examining treatment
systems, it is important to take into consideration overall public cultural attitudes toward
use patterns, as well as diversity within cultures.
 Community attitudes to drug and alcohol use directly affect when, why and which
individuals go to treatment. Communities do or do not support social policy that targets
problems for treatment depending on their degree of concern about alcohol and/or drugs.

References

Dan J., Mllie S., Helen W. (1980), Theories on Drug Abuse: selected contemporary perspective.

Daniela T., Heldi U. (2016), Youth: Realities and Challenges for Achieving Development with
Equalities: Economic Commission for Latin America and the Caribbean. Santiago, March 2016.

WNO Liberary (1991), Approaches to Treatment of Substance Abuse.

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