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Social Problems in a Diverse Society, 3Ce
Kendall/Nygaard/Thompson
CHAPTER 8
Addictions
CHAPTER SUMMARY
A wide variety of people are affected by drugs and gambling. Drugs are used either for
therapeutic or recreational purposes; they may be either legal or illegal. Drug addiction has two
essential characteristics: tolerance and withdrawal. In Canada, use of alcoholic beverages is
considered an accepted part of the dominant culture. Social scientists have identified four long-
term categories of drinking patterns. Abuse of alcohol may cause health problems, accidents, and
family problems. Despite what is known about tobacco’s dangers, just less than one-fourth of all
adults in Canada today smoke. People who do not smoke may be harmed by environmental
tobacco smoke. Prescription drugs benefit millions of people, but some people become
dependent on them; even over-the-counter drugs are subject to abuse and can be dangerous if not
taken as directed. People in this country also use illegal drugs, including marijuana, cocaine,
amphetamines (“uppers”), depressants, narcotics such as heroin, and hallucinogens. Gambling
has recently become a billion-dollar business in Canada, resulting in a greater awareness of
gambling addictions. Sociologists using an interactionist framework believe that addiction
behaviour is a learned behaviour. From a functionalist perspective, increased drug abuse and
problem gambling result from social institutions no longer keeping deviant behaviour in check.
From a conflict perspective, people in privileged positions criminalize the drugs that are abused
by the poor and powerless but not the ones abused by the privileged. From a feminist
perspective, drug abuse by women has to do with women’s vulnerability and disadvantaged
position in society. Two different types of programs exist for dealing with drug and alcohol
programs: prevention programs and treatment programs.
LEARNING OBJECTIVES
After reading Chapter 8, students should be able to:
1. Describe the four categories of long-term drinking patterns that social scientists have
identified, and discuss alcohol-related social problems.
2. List the major hazards associated with tobacco use.
3. Distinguish between licit and illicit drug use, pointing out ways in which they are similar and
dissimilar.
4. Explain the state of problem gambling in Canada, with an emphasis on variables such as
gender, age, marital status, income and region.
5. Describe the purposes and methods of primary, secondary, and tertiary prevention methods,
giving examples of each.
KEY TERMS
codependency drug subculture primary prevention
drug environmental tobacco smoke tolerance
drug addiction fetal alcohol spectrum disorder withdrawal
drug dependency (FASD)
CHAPTER OUTLINE
B. Although the overall proportion of smokers in the general population has declined
somewhat since the 1964 Surgeon General’s warning that smoking is linked to cancer
and other serious diseases, tobacco is still thought to be responsible for about 37 000
deaths per year in Canada.
1) People who smoke have a greater likelihood of developing lung cancer and cancer
of the larynx, mouth, and esophagus because nicotine is ingested into the
bloodstream through the lungs and soft tissues of the mouth. It is estimated that
about 10 cigarettes a day on average reduces a person’s life expectancy by 4
years; more than 40 cigarettes a day reduces it by 8 years.
2) Even people who never smoke are harmed by environmental tobacco smoke.
Children who grow up where one or both parents smoke are more likely to suffer
from frequent ear infections, upper respiratory infections, and other health
problems.
C. Teenagers are the group most likely to start smoking. Smoking has been used by youth as
a form of rebellion and method of showing solidarity with peers.
1) Abuse of aspirin and other analgesics can cause gastric bleeding, problems with
blood clotting, complications in surgery patients and pregnant women in labour
and delivery, and Reyes syndrome (a potentially life-threatening condition that
arises when children with flu, chicken pox, or other viral infections are given
aspirin).
2) Sleep aids are dangerous when combined with alcohol or some cough and cold
remedies because they are depressants that slow down the central nervous system.
C. Caffeine, a relatively safe drug, is a dependency-producing psychoactive stimulant. It is
an ingredient in coffee, tea, chocolate, soft drinks, and stimulants such as NoDoz and
Vivarin. Coffee drinkers drank 86 litres in 2006, up 6.5 litres from 1997.
1) Generally speaking, people ingest caffeine because they like the feeling of mental
alertness and reduced fatigue it produces.
2) Short-term effects include dilated peripheral blood vessels, constricted blood
vessels in the head, and a slightly elevated heart rate. Long-term effects of heavy
caffeine use (more than 3 cups of coffee or 5 cups of tea per day) include
increased risk of heart attack and osteoporosis—the loss of bone density and
increased brittleness associated with fractures and broken bones.
A. History
1) In the 19th and early 20th century, people in Canada had fairly easy access to
drugs, currently illegal, for general use. There were no licensed doctors or
pharmacists, and people sold patent medicines that contained such ingredients as
opium, morphine, heroin, cocaine, and alcohol.
2) Prescriptions became required for some drugs because of the rapidly growing
number of narcotics addicts. Some forms of drug use were criminalized because
of their association with specific minority groups. For example, in Canada, opium
could legally be consumed in cough syrup, but smoking the same amount was
declared illegal in 1908 because opium smoking was linked to Chinese people in
Canada.
B. Marijuana
1) Marijuana is the most extensively used illicit drug in Canada.
2) Marijuana with high delta-9 tetrahydrocannabinol (THC) content has existed for
years, but potency has increased recently because more marijuana plants are now
grown indoors in Canada. Indoor crops have THC levels up to 4 times as high as
plants grown outdoors and in other nations.
3) Marijuana is both a central nervous system depressant and a stimulant. Low to
moderate doses produce sedation; high doses produce a sense of well-being,
euphoria, and sometimes hallucinations. Driving a car or operating heavy
machinery is dangerous for a person under the influence of marijuana.
4) Heavy marijuana use can impair concentration and recall. Users become apathetic
and lose their motivation to perform competently or achieve long-range goals.
Studies have found an increased risk of cancer and other lung problems associated
with inhaling because marijuana smokers are believed to inhale more deeply than
tobacco users.
5) High doses of marijuana smoked during pregnancy can disrupt the development
of a fetus and result in lower birth weight, congenital abnormalities, premature
delivery, and neurological disturbances.
6) In 2001, Health Canada authorized the use of marijuana for medical purposes and
as of July 2008, 2812 people were permitted to possess dried marijuana.
C. Stimulants
1) Cocaine is an extremely potent and dependence-producing drug derived from the
coca plant.
a. Users typically sniff the drug into their nostrils, inject the drug
intravenously, or smoke it in the form of crack.
b. 0.7 percent of Canadians aged 15 and older had used cocaine in 1994, and
this figure has remained relatively stationary over time. For some, dealing
cocaine is major source of revenue and an entry point for other drug-
related crime.
c. Most cocaine users experience a powerful “rush” in which the blood
pressure rises and the heart rate and respiration increase dramatically.
When the drug wears off, the user becomes increasingly agitated and
depressed. Some become depressed and suicidal. Occasionally, cocaine
use results in sudden death by triggering an irregular heart rhythm. People
who use cocaine over extended periods of time have higher rates of
infection, heart disturbance, internal bleeding, hypertension, cardiac arrest,
stroke, haemorrhaging, and other neurological and cardiovascular
disorders than non-users.
d. Cocaine use is extremely hazardous in pregnancy. Children born to crack-
addicted mothers typically suffer painful withdrawal symptoms at birth
and deficits in cognitive skills, judgement, and behaviour controls.
2) Amphetamines (“uppers”) stimulate the central nervous system.
a. Diet pills and pep formulas are legal when prescribed by a physician, but
many people become physically and/or psychologically dependent upon
them because they believe they cannot lose weight or have enough energy
without the pills.
b. Chronic amphetamine abuse can result in amphetamine psychosis,
characterized by paranoia, hallucinations, and violent tendencies that may
persist for weeks after use of the drug has been discontinued. Overdosing
on amphetamines can produce coma, brain damage, and even death.
D. Depressants
1) The most commonly used depressants are barbiturates (e.g., Nembutal and
Seconal) and anti-anxiety drugs or tranquilizers (e.g., Librium, Valium, and
Miltown).
2) Relatively low oral doses produce a relaxing and mildly dis-inhibiting effect;
higher doses result in sedation. Users may develop both physical addiction and
psychological dependency on these depressants.
3) Rohypnol and GHB (gamma-hydroxybutyrate) are popular among young people
since they are inexpensive and produce mild euphoria, increased sociability, and
lowered inhibitions.
a. Rophynol (an anesthetic and sleep aid in other countries) is not approved
for use in Canada. It is known as “Roofies” and as the “date rape drug”
because a number of women have been raped after an acquaintance
slipped the drug into their drink.
b. Combining alcohol and Rohypnol or GHB has been linked to automobile
accidents and deaths from overdoses because it is difficult to judge how
much intoxication will occur when depressants are mixed with alcohol.
E. Narcotics
1) Heroin is the most widely abused narcotic but the percentage who use it is very
small.
2) Most heroin users inject the drug intravenously so they can experience an initial
tingling sensation and feeling of euphoria, typically followed by a state of
drowsiness or lethargy. Heroin users quickly develop a tolerance for the drug and
must increase the dosage continually to achieve the same effect. In high doses,
heroin produces extreme respiratory depression, coma, and even death. Shooting
up can cause users to contract hepatitis or HIV/AIDS from contaminated needles
and syringes.
3) Heroin and other opiates are highly addictive. Users experience intense cravings
for another fix and have physical symptoms such as diarrhoea and dehydration
from drug withdrawal.
4) Heroin use is linked more directly to crime than many other drugs.
F. Hallucinogens
1) Hallucinogens or psychedelics are drugs that produce illusions and hallucinations.
Mescaline (peyote), lysergic acid diethylamide (LSD), phencyclidine (PCP), and
MDMA (ecstasy or “E”) produce mild to profound psychological effects
depending on the dosage.
2) Mescaline or peyote was the earliest hallucinogen used in North America. Its
consumption dates back to early eras of Native American religious celebrations.
3) LSD is one of the most powerful psychoactive drugs; 10 mg of the drug can
produce highly unpredictable, dramatic psychological effects for up to 12 hours.
Users report experiences ranging from the beautiful (a “good trip”) to the
frightening and extremely depressing (a “bad trip”).
4) Among the most recent hallucinogens are PCP (“angel dust”) and MDMA
(“ecstasy”).
a. Initially, PCP was an anaesthetic used in surgical procedures, but it was
removed from production when patients showed signs of agitation, intense
anxiety, and hallucinations after receiving the drug.
b. MDMA (“ecstasy”), manufactured in illegal labs by inexperienced
chemists, is made from amphetamines that produce hallucinogenic effects.
Ecstasy or “E” has a high abuse potential and is often a part of “rave”
culture.
G. Inhalants
1) Inhalants are products such as gasoline, glue, paints, cleaning fluids, and toiletries
that people inhale to get high. Inhalant abuse is common because inhalants are
inexpensive, easy to obtain, and fast acting.
2) Inhalants contain poisonous chemicals that can make abusers sick damage their
A. Types of Gamblers
1) Psychologists in Ontario investigated the issue of gambling in Canada and
found that 54 percent of the population were non-problem gamblers, 6 percent
were at risk of problem gambling, 2.6 percent had moderate gambling problems,
and 0.8 percent had severe gambling problems.
2) Symptoms associated with problem gambling include making increased wagers,
returning to win back losses, borrowing money or selling something to gamble,
feeling guilty about gambling, experiencing financial problems, and developing
health problems such as stress and anxiety.
3) Severe problem gamblers participated more in every kind of gambling (tickets,
electronic, games with friends, casinos, horse racing, bingo, sports betting, and
speculative investment).
B. Problem Gambling and Province, Gender, Age, Marital Status, Education, and
Income
1) About 2 percent of Canadians were problem gamblers, ranging from 1.5 percent
of people in New Brunswick to 2.9 percent of people in Manitoba. A higher
percentage of men than women were severe problem gamblers, as well a higher
percentage of young people, as compared to older individuals, were severe
problem gamblers. Those who had completed post-secondary education were less
likely to be severe problem gamblers. A higher percentage of those who had the
highest level of income ($100,000+) were likely to be severe problem gamblers.
C. Gambling-Related Social Problems
1) Almost half of severe problem gamblers reported one or more problems
including: difficulty making a paycheque last; gambling with money budgeted for
something else; negatively affected personal relationships; negatively affected
work; and, thoughts of suicide.
A. Prevention Programs
1) Most primary prevention programs focus on people who have had little or no
previous experience with drugs. Secondary prevention programs seek to limit the
extent of drug abuse, prevent the spread of drug abuse to other substances beyond
the drugs already experienced, and teach strategies for the responsible use of licit
drugs such as alcohol. Tertiary prevention programs seek to limit relapses by
individuals recovering from alcoholism or drug addiction.
2) Prevention, according to Canada’s Drug Strategy, is best done through a
combination of public awareness campaigns, educational resources, training
service providers, and community action.
a. Scare tactics and negative education programs have not worked. They turn
students off and do not achieve their desired goal.
b. Objective-information programs often begin in kindergarten and run
through grade 12.Using texts, curriculum guides, videos, and other
materials, teachers impart information about drugs to students, but some
students become more, instead of less, interested in experimenting.
c. Vigorous single preventative strategy campaigns for preventing drug
abuse have had limited success in deterring drug use. As one student said,
“When someone tells you not to do it, that makes you want to do it even
more”.
B. Treatment Programs
1) Treatment programs are a form of tertiary prevention, seeking to ensure that
people who have sought help for some form of drug abuse remain drug-free.
2) The Medical Treatment Model
a. This model assumes that drug abuse and alcoholism are medical problems
that must be resolved by treatment by medical officials. Treatment may
take the form of aversion therapy or behavioural conditioning. For
example, drugs (such as Cyclazocine and Nalozone) are given to heroin
and opiate addicts to prevent the euphoric feeling they associate with
taking the drugs. Supposedly, when the pleasure is gone from taking the
drug, the person will no longer abuse the drug.
b. Antabuse is used in treating alcoholism. After the person has been
detoxified and no alcohol remains in the bloodstream, Antabuse is
administered along with small quantities of alcohol for several consecutive
days. Since this combination produces negative effects such as nausea and
vomiting, the individual eventually develops an aversion to drinking.
3) Short- and Long-Term Services and the Therapeutic Community
a. Short-term services include withdrawal management (detoxification)
services, which give people a place to stay while their bodies get rid of
alcohol or drugs and adapt to a drug-free state. Long-term services include
counselling, rehabilitation, and/or the therapeutic community.
b. The therapeutic community approach believes drug abuse is best treated
by intensive individual and group counselling in either a residential or
non-residential setting. Residential treatment take place in a special house
Next, put the students in to small groups (4-6 students) and have them report back to the group
on what they found. As a class, have the students make a comprehensive guide of all addiction
resources in your community. Have the students pass on this information to their local students’
union or campus health centre as a resource for other students to use.
2. What are some the most frequently abused drugs in Canada? Who is most likely to use these
drugs and why?
3. Does racialization/ethnicity, class, gender, and age play a part in alcohol and drug use and
abuse? If yes, how? If no, what does?
4. As a sociologist, how would you propose to deal with the drug problem in Canada? If you
were called upon to revamp existing drug laws and policies, what, if any, changes would you
make in them?
5. What are the main issues surrounding safe injections sites, such as the Insite program in
Vancouver? Should Canada support them? Why or why not?
6. What is the profile of the typical severe problem gambler in Canada? Why do you think that
gambling has become so problematic for some Canadians?
7. Why do you think that scare tactics and negative-education programs do little to deter youth
from engaging in illegal drug use? What kind of preventative strategies do you think would
be more effective for deterring youth from drug use?
Donna’s Story—An intimate portrait of a fiercely determined survivor, this film profiles a Cree
woman who left behind a bleak existence on the streets, and has re-emerged as a powerful voice
counselling Aboriginal adults and youth about abuse and addiction. 2001. 50 mins. National Film
Board of Canada, www.nfb.ca.
East Side Showdown—Middle-class homeowners, angry radicals, desperate drug addicts and
people simply looking for a place to lay their head: all are players in a bitter struggle in the
downtown Toronto neighbourhood of Dundas and Sherbourne. 1999. 46 mins. National Film
Board of Canada, www.nfb.ca.
Fix: The Story of an Addicted City—This is the story of Vancouver’s struggle to open Canada’s
first safe injection site for drug users. 2002. 93 or 45 mins. Canada Wild Productions.
www.canadawildproductions.com
Pieces of a Dream: A Story of Gambling—Set in St. Paul, Alberta, this documentary focuses on
Philip Wong, who committed suicide at the age of 36 as a result of his problems with a gambling
addiction. 2003. 48 mins. National Film Board of Canada, www.nfb.ca.
The Tobacco Conspiracy—This documentary takes a hard hitting behind the scenes look at the
enormously powerful tobacco industry and the corruption and manipulation that are part of it.
2005. 52 mins. National Film Board of Canada, www.nfb.ca.
Through a Blue Lens—This film tells the story of a unique group police officers who formed a
non-profit group dubbed the Odd Squad, and their relationship with addicts in Vancouver’s
Downtown Eastside. 1999. 52 mins. National Film Board of Canada, www.nfb.ca.
Flipping the World: Drugs Through a Blue Lens—Inspired by the hit documentary Through a
Blue Lens, Flipping the World is an honest look at the world of youth and drug addiction, as told
by those who have been there. Seven culturally diverse high school students meet with members
of the Odd Squad – Vancouver police officers who, since 1998, have been filming people
addicted to drugs. 2000. 30 mins. National Film Board of Canada, www.nfb.ca.
CRITICAL READINGS
Brady, Kathleen T., Sudie E. Back, and Shelly F. Greenfield. 2009. Women and Addiction:
A Comprehensive Handbook. New York, NY: Guilford Press.
Courtwright, David T. 2004. Dark Paradise: A History of Opiate Addiction in America. London,
GB: Harvard University Press.
Csiernik, Rick. 2003. Responding to the Oppression of Addiction: Canadian Social Work.
Toronto, ON: Canadian Scholars Press.
Langton, Jerry. 2007. Iced: The Crystal Meth Epidemic. Toronto, ON: Key Porter Books.
Levinthal, Charles F. 1999. Drugs, behaviour, and Modern Society (2nd edition). Boston, MA:
Allyn and Bacon.
Marlatt, G. Allan (Ed.). 2002. Harm Reduction: Pragmatic Strategies for managing High Risk
Behaviours. New York, NY: The Guilford Press.
Maté, Gabor. 2009. In the Realm of Hungry Ghosts: Close Encounters with Addictions.
Toronto, ON: Vintage Canada.
McCown, William G. 2007. Treating Gambling Problems. Hoboken, NJ: John Wiley & Sons.
Pearce, Debbie, Deborah Schwartz and Lorraine Greaves. 2008. No Gift: Tobacco Policy
and Aboriginal People in Canada. Vancouver: British Columbia Centre of
Excellence for Women's Health.
Thombs, Dennis. 2006. Introduction to Addictive Behaviours (3rd edition). New York, NY: The
Guilford Press.
(Note du traducteur.)
LE COMTE DE CRABS.
Et sur l’autre, en caractères moins imposants :
La comtesse de Crabs.
Dédicace 1
Préface 3
PREMIÈRE PARTIE. — LE MARI DE Mlle SHUM.
I. Une Famille intéressante 13
II. Quel est donc ce mystère ? 16
III. La lune rousse 33
IV. Le pot aux roses 43
DEUXIÈME PARTIE. — UN PARFAIT GENTILHOMME.
I. Je coupe, atout et atout 51
II. Impressions de voyage 87
III. Laquelle des deux ? 112
IV. Honore ton père 125
V. Intrigues 140
VI. L’âne choisit sa botte de foin 159
VII. Une anguille sous roche 170
VIII. Le duel 181
IX. Métamorphose 200
X. Grippart prend sa revanche 211
XI. La noce 250
XII. La Lune de miel 255