CHAPTER - 2 THEORIES OF DRUG -TAKING BEHAVIOUR

Transcription

1 CHAPTER - 2 THEORIES OF DRUG -TAKING BEHAVIOUR

2 There are a number of psychological and sociological theories related to Drug- Taking Behavior (DTB) i e Chemical dependency. These are : (2.1) Psychological theories - (2.1.1) Trait theory (2.1.2) Psychoanalytical theory. (2.2) Behavioral theories - (2.2.1) Conditioning theory (2.2.2) Two factor theory (2.2.3) Learning theories. (2.3) Metabolic deficiency theory. (2.4) Psycho-Social theories. (2.5) Sociological theories - (2.5.1) Deviance Theory (2.5.2) Anomie. Here only, an overview of these current theoretical formulations are presented so as to explain the mechanisms underlying the initial use of drugs and subsequent process of development of psychological dependence on them. 2.1 PSYCHOLOGICAL THEORIES: theory. The psychological theories include (2.1.1) Trait theory and (2.1.2) Psychoanalytical Trait Theory: Trait Theory is concerned with identifying dimensions of personality upon which individuals may vary with respect to the amount of characteristic trait that they possess and with developing techniques for the identification and the measurement of such personality characteristics. While applying trait theory in the studies on chemical dependency, it is postulated that there are personality traits or constellation of characteristics that are associated with chemical dependency. These traits are supposed to be associated with a predisposition to chemical dependency and are easily identifiable at the early stages of chemical dependency. Such application of trait theory in identifying personality characteristics of drug addicts also pursued the notion of a single personality dimension like addictive personality as underlying addictions. Most of the researches so far available have largely paralleled the approach that attempted to isolate an alcoholic personality. But it has focused on explaining addictions more in terms of deviant behaviour or personal psychopathology than in terms of specific personality attributes. 10

3 Platt and Labate (1976), after an extensive review of personality trait researches, suggest that the most dependable conclusions based on available data is that although addicts generally exhibits pathologic traits, there is a little probability of some common traits to be present in all of them. Thus, any attempt to specify an addictive type or addictive personality in terms of other than a general level of disturbances will probably prove futile Psychoanalytic Theory: In general, early psychoanalytic literature has focussed on the perceived relationship between drug abuse and the libido. One of the Freud s few references to drug addiction was in a letter to Fliess in 1897 stating that addictions to morphine and to alcohol were simply substitutes for masturbation, which he considered to be primal addictions (Freud, cited in yorke, 1970). Rado (1993), a well known psychoanalyst, had formulated a similar explanation of drug addiction utilizing principles of psychoanalytic theory. He perceived all drug addictions to be a single disease based on the ability of certain drugs to affect an individual s emotions in distressing situations. According to Rado, a drug with abuse potential can have two effects, (i) reduction of pain and (ii) production of euphoria. Thus an addict takes drugs because these are pleasurable and provide relief from tensions. A potential addict is therefore characterized by a high degree of tension and intolerance to pain, and supposed to be in a state of what Rado terms tense depression. An individual experiencing such tense depression is especially susceptible to the effects of narcotics. As a result, he is relieved of his overwhelming tensions. According to Psychoanalytic theory, as a child develops from a stage of narcissism in which his wishes are immediately gratified to a stage where he assumes responsibility for coping with the environment, his ego begins to take over the function of sustaining his individuality. Disturbances of this development result in impairment of the ego s ability to cope with reality at a later stage of life. And, the original narcissistic state remains an ideal 11

4 for the ego. Through the pharmacogenic elation provided by some narcotics, the ego is allowed to retract to his narcissistic state, although there is concurrent disruption of ego functioning and destruction of the saliency of reality. Such illness is a narcissistic disorder, a destruction through artificial means, of the natural ego organization (Rado, 1933). Rado also observes that the phenomenon of tolerance is an important factor in repeated drug-seeking behaviour. As drug-taking continues, accompanied with the development of tolerance, the experience of elation becomes increasingly elusive. Savitt (1963) also refers to the role of ego in his formulation of an analytic theory of narcotic addiction. He believes that all addicts are characteristically in a state of intolerable tension originally due to maternal neglect and lack of love and also to passive ineffectual father figures. The role of ego in the development of addiction is viewed in a less exclusively psychoanalytic fashion by Khantzian, Mack and Schatzberg (1974). Although an egoimpairment is also a causal factor in heroin addiction in their model, the use of opiates is seen as a unique way of dealing with ordinary human problems. Addicts use drugs because they fail to adopt the usual adaptive defense mechanisms for dealing with stress and they substitute heroin use as a method of coping with a wide range of problems and also of resolving conflicts. Both societal and interfamilial influences interact to produce ego impairment, so that an individual fails to develop the normal coping mechanisms and later, resorts to drug abuse. Deprivations in life situations may also lead to such ego impairments. In general, psychoanalytic theories which began with the work of Sigmund Freud, emphasize the importance of childhood experiences in shaping one s personality. They contend that early experiences burned in the unconscious mind form the basis of one s motives and feelings of which the individual is unaware. Personality differences among individuals are the results of the unconscious motives that drive a person s conscious actions and behavious. 12

5 Fig. 2.1 Schematic Representation of Psychological Theory Of Drug Addiction As Proposed By Dole And Nyswander Social and Psychological deterioration 13

6 2.2 BEHAVIOURAL THEORIES: Behavioural theories explain personality differences as a resultant of learning through rewards and punishments. According to these theories, individuals differ in their learning experiences and for that reason develop different behaviours and different types of personality. Behaviour theorists do not try to explain an individual s antisocial personality by analyzing his feelings resulting from his unconscious childhood experiences. Instead, they look for explanations in observable events or situations, such as, the child-rearing practices of parents. The behavioural theories are less concerned with understanding the structure of personality than with predicting and controlling behaviours Conditioning Theories: Several attempts have been made to formulate models of addiction based upon the principles of both classical and operant conditioning. The most notable one is by Wilder. Some of these conditioning theories have accounted for a substantial number of phenomena observed in the process of drug addiction Two-Factor Theory: Expressing doubt that narcotic induced euphoria and fear of aversive withdrawal states are sufficient to account for addiction, Wilder (1965) has attempted to explain the self-maintenance of addiction to morphine in terms of learning theory. Two definitions (i) Pharmacological reinforcement and (ii) direct reinforcement are central to wikler s (1973) detailed conditioning theory of addiction. Pharmacologic reinforcement occurs as the result of interaction between certain pharmacological effects of the drug and sources of reinforcements i.e., organismic variables upon which the reinforcing properties of the drug are contingent. Such reinforcement is considered to be direct if its source is not engendered by the dmg itself and indirect if it is, Direct reinforcement may be related to the propraties of Central Nervous System (CNS) or to the characteristics acquired during the development of personality. 14

7 2.2.3 Learning Theory: Crowley (1972) has formulated a theory of drug addiction in terms of conditioning principles without attempting to delineate the underlying neural mechanisms to the extent as Wilder has done. The high degree of abuse potential of a narcotic such as heroin is derived from its properties as a primary reinforcer. Heroin provides reinforcement in terms of pleasurable subjective, sensation almost immediately following an intake. When reinforcement and operant behaviour (in this case drug-taking) are in close temporal proximity, the frequency of the behaviour is likely to increase more rapidly than if the reinforcement is either reduced qualitatively or delayed in presentation Crowley suggests that there are certain persons who are more susceptible to heroin reinforcement than others. They have come to believe consequent upon their past experiences that they can not expect reinforcement from their environment. The principle of negative reinforcement in which termination itself of an aversive stimulus is reinforcing, also operates to increase the probability of continued drug abuse. The abstinence syndrome is clearly aversive and the successful and immediate termination of this condition by taking additional drugs reinforces the drug-taking behaviour METABOLIC THEORY: Dole and Nyswander propose a theory of addiction based on metabolic deficiency in an addict. According to them, addicts are more neurologically susceptible to the effects of narcotics. Trying drugs out of mere youthful curiosity, they feel less nausea or more pleasure, keep on using and become addicted. Their addiction disease is neither temporary nor psychogenic, but entails persistent neurochemical disturbances (Dole & Nyswander, 1967; Dole 1972), i.e., the addicts undergo a permanent metabolic change. They need narcotics in a visceral way. 15

8 Fig 2.2 explains the schematic representation of metabolic theory. Fig.2.2 METABOLIC THEORY SOCIAL DETERIORATION 16

9 2.4 PSYCHOSOCIAL THEORIES: Besides the previously mentioned theories of addiction, the psychosocial theory is also considered to be one of the important theories in relation to dug-taking behaviour of a person concerned. Ausubel (1961) has attempted to integrate both the psychologic and the sociologic theories of narcotic addiction in the belief that neither is sufficient in itself to explain the observed phenomena. Ausubel s psychosocial theory is based on the percept that both internal and external factors are inherent in addiciton, and that each factor has precipitating or predisposing causes. The predisposing internal factors originate within the individual, while the precipitating external factors are essentially environmental. These interact in varying, degrees of effectiveness of other factors necessary to result in addiction. The likelihood of relapse following a period of abstinence is also a function of the intensity of each of the causal factors. The primary external precipitant factor is the availability of drugs. 2.5 SOCIOLOGICAL THEORIES: Sociological theories lay emphasis on the social, cultural, and social psychological variables not only in understanding the way people act, when they are really under or they are supposedly (by themselves) under the influence of drugs, but also in understanding differences in drug-taking patterns at both the group and individual levels. Whatever the other biological or personality factors and mechanisms may be involved, both conforming and deviant substance use are explained sociologically as products of the general social structure and culture and the more immediate groups and social situations with which individuals are confronted. Several authors have outlined general theories of deviance and anomie that have been applied to the phenomenon of drug addiction. The principal support for and interest in the formulation of these theories derive from the field of sociological investigation where group processes and social learning provide the primary foci. 17

10 2.5.1 Deviance Theory: Deviance refers to a socially defined standard of behaviour such that a given act of behaviour is labelled as deviance only with reference to societal norms. In this definition, norms,.. refer to those shared expectations or standards of appropriateness upon which members of social groups can rely for the orderly regulation of social behaviour. (lessor, Graves, Hanson and lessor, 1968). Deviance is a goal-directed learned behaviour for seeking success or for coping with failure. When conforming behaviour fails to achieve the desired goals, alternative behaviours are explored, some of which is probably deviant. Specifically with reference to drug use, valued goals exist that are both direct consequences and symbolic implications of its use. The direct outcomes are related to the pharmacologic effects of narcotics such as reduction of anxiety or fear, and euphoria Anomie: Anomie refers to a condition of society or some part of society in which there is disequilibrium, disorder, social disorganization, lack of social integration, or lack of normative consensus. Under conditions of anomie higher rates of drug abuse and other forms of deviant behaviour are expected. The best known theory in the anomie tradition is originally stated by Robert Merton (1938,1957) and is often referred to as strain theory. In strain theory, the form of anomie that produces deviant behaviour results from the malintegration of cultural ends (goals) and societal means. Individuals are thought to turn to drug use and eventual dependence as a result of the conditions in their social environment, which deny their oppurtunity for achievement. Other explanations for the causes of drug dependence are the use of drug as a statement of protest and separation from the mainstream values, and the support of this seperateness by some peer groups. The concept of peer pressure has attained major 18

11 importance in understanding why individuals engage themselves in deviant behaviour such as drug absue. The socio-cultural approach tries to explore manner in which a larger environment may support the continuation of substance abuse and foster dependency on it. The concept of deviance labelling, in which an individual through his/her use of non-permitted substances in non-permitted ways becomes labelled as a deviant. It attempts to explain drug dependence as an outcome of this labelling. The unique of this labelling theory is the proposition that when stigmatizing legal or social labels are applied to persons, believed to have committed deviant acts, they may contribute to the causation of the very behaviour they are meant to control. Through the labelling process and society s response to the labels, the drug use becomes the most important aspect of an individual s life due to exclusion of other alternatives by the society. No single theory mentioned so far can account for the physical, psychological and socio-cultural aspects of becoming a drug abuser. Some professionals are now examining the interactions of these theories as an explanation of drug-taking behaviour. Here in this study also, all these above-mentioned theories have been utilized, * although the trait theory has been emphasized a little more. Because of easy availability of such traits measuring instrument like Cattell s 16PF test. 19