Societal Causes of Addiction
There are numerous stakeholders in addiction, including substance abusers, their loved ones, addiction treatment professionals, and society at large. The field of addiction treatment is mainly dominated by the theory of addiction as a disease. This thinking is relatively new; in its earliest days of recognition as a societal ill, addiction was considered a matter of personal choice, and those who “chose” to abuse drugs were considered morally corrupt. Although today it is critical for Americans to understand that addiction is a disease, it is also important to consider other factors contributing to this illness. From a sociological standpoint, there are numerous societal forces at play in addiction. This article looks at those forces.
Bruce K. Alexander, psychologist and Professor Emeritus at Simon Fraser University, takes a rather radical position in the addiction debate and formally objects to what he calls the “official view of addiction” (i.e., the disease model). For Alexander, the disease model of addiction is counterproductive because it places undue emphasis on the neurological underpinnings of addiction, an explanation that is highly specialized and therefore inaccessible to laypeople. Alexander believes that the emphasis on addiction as a disease does not help to mitigate the drug epidemic in America, but rather helps to perpetuate it. For instance, Alexander argues that focusing on drugs as the cause of addiction is essentially singling out one culprit when there are in fact many. As Alexander points out, addiction is not limited to drugs but includes other destructive behaviors, including gambling, obesity, power mongering, and promiscuity.
Bruce K. Alexander is the author of The Globalization of Addiction: A Study in Poverty of the Spirit, a work that summarizes over four decades of his work in the psychology of addiction.
Alexander, in his scholarly exposition on the topic of addiction, does something many clinicians do not – he puts addiction into a world-culture perspective. Alexander sets forth a “Dislocation Theory” of addiction, which he points out is non-pharmacological and takes into account the causes of addiction globally. For Alexander, Dislocation Theory should replace the official view of addiction as a disease.
Dislocation Theory of Addiction
According to Alexander, the main supporters of Dislocation Theory are addiction professionals who work on the frontlines, addicts, recovering individuals, and academics in disciplines such as sociology. As Alexander frames the proponents and opponents, the “bottom-up” stakeholders (such as addiction counselors working at ground level) have a stronger grip on the true nature of addiction compared to the “top-down” stakeholders, such as medical researchers who work at a sanitized remove from it.
But differing theories on the causes of addiction aside, what exactly is Dislocation Theory? To help streamline the discussion, the following are some important main principles of Dislocation Theory:
Addiction is an individual response to societal pressures: The manifestation of addictive behaviors is an adaptation to the fragmentation and social isolation characteristic of the modern world.
Expansiveness: Dislocation Theory looks at all types of addictive behavior and substances, and it does not give any special weight to drug addiction.
World perspective: Dislocation Theory’s starting point is that nearly all societies across the world have undergone fragmentation in the last five centuries, which has caused a mass dislocation of individuals (including breaking up the nuclear and extended family model).
Dislocation causes suffering: Societal fragmentation causes a loss of identity and undermines relationships, resulting in individuals turning to destructive behaviors to fill an emotional void.
Opponents of Alexander’s thinking may take greater issue with his approach than Dislocation Theory itself. Alexander would have Dislocation Theory replace the disease model whereas a more middle-of-the-road view is a blended theory that takes into account both the biological and sociological factors associated with addiction. Regardless, Alexander’s arguments are valiant in that he attempts to improve existing thinking on addiction and address the reality that America does not seem to be winning the war on drugs.
Research into addiction cuts across several different professional fields of study, including psychology, sociology, anthropology, epidemiology, psychiatry, pharmacology, and public health. The multitude of specialized approaches involved in understanding and remedying addiction is a testament to the complexity of substance abuse and the need for multidisciplinary treatment approaches.
Social Factors Influencing Addiction
As a research paper published in Oxford Journals explains, substance abuse most always has a social dimension, and for this reason, the need to study the social factors underpinning substance abuse is not only obvious but also critical. The researchers focused on the social factors that shape substance abuse behaviors in order to better understand the social dimension of addiction. The researchers reviewed several relevant studies conducted after 1970. The findings were organized into three main categories: initiation into drug abuse, drug misuse, and cessation of drug intake. The researchers further divided their analysis by type of drug of abuse. For purposes of this discussion, the focus will be on research findings related to different phases of marijuana use.
Marijuana as a Research Example
According to the National Survey on Drug Use and Health, marijuana was the most commonly used drug in the US in 2013. In real numbers, the survey found that 19.8 million Americans had used marijuana in the month prior to the survey. In terms of the American population overall, 19.8 million equates to 7.5 percent of the population aged 12 or older. The 2013 number of marijuana users was similar to the rate for 2012, which was 18.9 million Americans or 7.3 percent of the population aged 12 or older. The 2013 rate was higher than in the years 2002-2011, which showed use of marijuana ranged from 5.8-7 percent of the population. Further, of all current users of illicit drugs in general, 80.6 percent reported that they use marijuana. In view of the popularity of marijuana, it is particularly useful to focus on research findings on the initiation, use, and cessation of this drug.
Regarding initiation into marijuana use, the researchers found that familial disadvantage, such as a being raised in a single parent home, was a predictor of marijuana use in males. For females, the single greatest predictor of marijuana use was having a history of victimization. Overall, living in an urban environment was a factor in the initiation of both males and females into marijuana use, but the researchers did not specify any type of urban environments in specific.
As far as the misuse of marijuana, several studies found a correlation between this activity and low socioeconomic status. The researchers noted that use of marijuana among family members or persons in one’s social network was a factor in marijuana use. For instance, a study of 996 youth in Sydney, Australia revealed that exposure to marijuana through siblings and friends was a primary indicator of marijuana use. Some studies have focused on the impact a neighborhood can have on marijuana and other drug use and identified a link. For instance, one study of 1,101 white and black American adults in Detroit, Michigan, found that neighborhood disadvantage, such as low socioeconomic status, related to a person’s propensity to use drugs. But, conversely, a positive influence can prevent drug use. For example, some studies show that having stable family relationships lowers the likelihood of marijuana use.
In terms of cessation of marijuana, one study of 706 marijuana users found that higher education was associated with quitting marijuana. In the family context, a study concluded that increased family responsibilities were associated with cessation of marijuana intake. For instance, a study showed that becoming a parent for the first time instigated an end of marijuana use. In addition, one study of 566 adolescents found that being a member of a social network that is less supportive of marijuana use influences users to stop.
The researchers found that cessation of drug use in general had less consistently to do with socioeconomic status than other factors, such as homelessness. Compared to the general population, homeless persons are generally less likely to seek treatment. Conversely, employed drug users are more likely to seek treatment. Additional relevant social phenomena that have been associated with ending drug use include:
- A reduction in family conflict
- A supportive social network
- Being a member of a social group that does not advocate drug use
- Having few or no drug users in one’s social network
It seems as if research supports much of conventional wisdom about drug use, namely, peer influence is considerable, and it is important to keep sober company. However, it is critical to learn from research and apply its findings compassionately. For instance, the negative impact drug abusers can have on others in their social network does not mean they should be condemned moralistically but rather highlights additional reasons to help them into recovery. When one substance abuser is helped into rehab, many people throughout his or her social network benefit.
Society & Drug Abuse in Television and Film
The individual drug abuser has long been a portrayed as a compelling character on the big screen, such as Al Pacino in The Panic in Needle Park (1971). But many screenwriters are also drawn to societal influences on drug manufacturers, dealers, and users. Some top television shows and films that have dealt with this subject matter include:
- Breaking Bad (TV series, 2008 – 2013)
- Traffic (2000, feature film)
- Cocaine Cowboys I (2006, documentary)
- Cocaine Cowboys II (2008, documentary)
- Blow (2001, feature film)
Societal Factors Contributing to Addiction in Youth
Many academics, clinicians, and researchers agree that identifying the root causes of addiction, especially among youth, is an important step toward stopping the drug epidemic in America. Research on substance abuse in youth helps to shed light on the historical factors that have contributed to the rise of addiction in our population. Considering how youth become addicted to drugs is a major step in understanding the causes of addiction society wide.
As research published in Psychiatric Clinics of North America discusses, the current proliferation of addiction does not owe to changes in the human gene pool (which is extremely slow to change) but rather to historical shifts in the way societies organize themselves. For this reason, it is critical to look at how American society has influenced and unwittingly spurred on drug abuse and addiction.
Beginning in the mid-20th century, industrialization began to create a new type of generation – the adolescent who had few work responsibilities and excessive free time, compared to earlier generations who worked and helped to support the family. As adolescents did not have the skills to work in industry, and their parents were called to work outside of the home, supervision of youth waned. Unfortunately, social institutions like schools, neighborhoods, and religious organizations often could not provide a stable substitute for the family model, which was beginning to disintegrate in the face of the demands of industrialization. The overall result was that adolescent populations experienced a crisis of identity because they were largely on their own. Having a considerable amount of free time without much supervision or effective guidance was, for some, a recipe for turning to destructive behaviors like drug abuse in order to quash internal anxieties.
Rather than experience a reduction in self-doubt and greater emotional fulfillment, drug abuse often led to additional destructive behaviors and spiraling out of control, thus reducing a youth’s chances of being a functional and well-adjusted member of society. Youth who abuse drugs miss out on developing effective coping skills during a key time in their personal development. This problem is only compounded over time if the drug abuse or addiction continues.
Youth who have an alcoholic or drug-addicted parent are a greater risk of addiction – several fold – compared to those with drug-free parents.
Source: Westermeyer, P. 255.
In addition to the possibility of not having their needs met by social organizations, youth who belong to certain subgroups face additional risk factors. For instance, youth who grow up in poverty may turn to drugs to cope with a low-quality of life and may see drug dealing on the street as a real job prospect.
Additional factors that can directly increase the risk of a youth (or an adult) abusing drugs, include:
Immigrant status: Youth are more likely to abuse drugs common to the new culture, such as prescription pain relievers, compared to drugs abused back home. Immigrant youth do not likely have proper guidance from family about avoiding American drugs because the adult relatives may not have sufficient knowledge of America drugs to provide adequate warnings.
Abandonment: Compared to the general population, individuals who lose a parent through death or otherwise before the age of 18 are a greater risk of drug abuse.
Peer pressure: Youth most often form relationships with other youth who may be misguided about drugs yet invite participation in drug abuse as a form of social bonding. The desirability of grouping-up among youths lowers resistance to bonding over drugs.
Binge drinking culture: Members of certain institutions, such as college students at universities, may have a positive attitude toward drinking and drugs (at least of certain drugs, such as marijuana) that can promote abuse of these substances.
Exiting a familiar cultural group: In general, cultural groups that promote abstinence among members have a lower incidence of drug abuse compared to society at large. However, members who leave these groups are at risk for drug abuse at the same rate as the general population.
Youth who face substance abuse and do not receive adequate drug treatment often become addicted adults. As research makes clear, youth are particularly vulnerable to societal influences, which is a clear directive to adults and organizations to provide this group with education about the many pitfalls of drug abuse. It is also important to recognize that many organizations such as the Young Men’s Christian Association (YMCA), and efforts such as Drug Abuse Resistance Education (D.A.R.E.), are committed to providing drug education and life skills training to youth.
Where Do We Go From Here?
As the National Institute on Drug Abuse (NIDA) discusses, addiction is a treatable illness at the individual level. Some scholars may argue that society is in fact ill, and fueling addiction among its citizens, but a focus on the societal causes of addiction should never detract from treating persons suffering from addiction. As NIDA explains, an effective treatment plan should include detox to rid drugs from a person’s system and primary care treatment, including psychotherapy at the group and individual level.
Recovering persons have a relapse rate of between 40 and 60 percent. For this reason, NIDA, along with addiction specialists, recommends a strong aftercare program that can include attendance at group recovery meetings such as Narcotics Anonymous (NA) and residence in a stable home, such as a sober living facility.
Although professionals from several different disciplines may weigh in on the causes of addiction, ultimately everyone has the same goal – to end addiction. Irrespective of one’s particular viewpoint on why or how individuals become addicted to drugs, there is a general consensus on the need for treatment once a person becomes addicted. The destruction that drugs can cause in individual lives, neighborhoods, and society at large requires multidisciplinary efforts, and the work of frontline practitioners and scholars across varying fields of study. The key is to understand that addressing and healing addiction requires many different stakeholders to act in unison, combine their forces, and mount the most formidable opposition possible.
 Alexander, B., (July 3, 2014). “The Rise and Fall of the Official View of Addiction.” Bruce K. Alexander. Accessed April 23, 2015.
 Galea, S., et al. (Mar. 8, 2004). “The Social Epidemiology of Substance Use.” Oxford Journals. Accessed April 23, 2015.
 Substance Abuse and Mental Health Services Administration. (2013). “Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings.” NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Accessed April 23, 2015.
 Westermeyer, J. (July 1999). “The Role of Cultural and Social Factors in the Cause of Addictive Disorders.” Psychiatric Clinics of North America. Accessed April 23, 2015.
 “Principles of Effective Treatment.” (n.d.). National Institute on Drug Abuse. Accessed April 23, 2015.
 “Relapse Rates for Drug Addiction are Similar to Those of Other Well-Characterized Chronic Illnesses.” (July 2008). National Institute on Drug Abuse. Accessed April 23, 2015.