Drugs, Alcohol, and Society Social Structure, Process, and Policy RONALD L. A K E R S University of Florida Wadsworth Publishing Company Belmont, California A Division of Wadsworth, Inc.
Contents Preface xi About the Author xv PART I Major Concepts and Issues in Substance Abuse 1 C H A P T E R O N E The Problem of Alcohol and Drugs in Society: Social Structure, Process, and Policy 3 Introduction 3 Perspective on Alcohol and Drugs 4 Theories of Drug Behavior 5 Anomie/Strain Theory 7 Social Control/Bonding Theory 8 Labeling Theory 9
iv CONTENTS Self-Esteem/Derogation Theory 10 Selective Interaction/Socialization Theory 11 Social Learning Theory 12 Social Structure and the Social Learning Process 13 BOX Social Learning Theory of Drug Behavior 14 TWO Drugs, Drug Effects, and Drug Behavior 15 Concepts and Definitions of Drugs and Drug Behavior 15 Addiction: The Troublesome Concept 16 The Traditional Concept of Addiction 18 Newer Concepts of Addiction 20 BOX How Drugs Affect the Nervous System 21 A Useful Resolution: Stay with the Traditional Concept 22 Types and Effects of Drugs 23 Heroin and Other Opiates 23 LSD and Other Hallucinogens 28 Marijuana 29 Depressants 30 Stimulants 32 Inhalants 34 THREE Drug Use and Abuse in American Society: Social Patterns and Trends 35 Scary Drug of the Year: Myths and Realities 35 Quaaludes and PCP 36 Pentazocine, Fentanyl, and Designer Drugs 38 Cocaine: Crack and Otherwise 40 Ice-Hot 41 Lessons of the Scary Drug of the Year 42 Social Patterns and Trends in Drug Use 43 Prevalence and Trends 43
CONTENTS BOX The High School Senior Survey and the NIDA Household Survey 46 Social Characteristics of Users 51 FOUR Drug Use and Abuse in American Society: Work, Sports, and Crime 53 Drugs and Alcohol in the Workplace 53 Drug Testing and Employee Assistance Programs (EAPs) 55 Special Occupational Contexts 57 Drugs and Sports 58 Drugs, Alcohol, and Crime 62 Clarifying the Issues 63 Linking Drugs and Alcohol to Crime and Delinquency 64 Juvenile Delinquency and Adolescent Substance Use 64 Crime, Alcohol, and Addiction in Adults 67 Drug Abuse and Crime as the Result of Social Factors and Processes Common to Both 69 PART II Illegal Drugs 71 C H A P T E R F I V E Marijuana 73 Long-Term Effects: Is Marijuana Harmless? 73 Research on Effects of Marijuana 74 Possible Medical Applications of Marijuana 77 Social Patterns and Trends 77 Was Pot the Drug of a Whole Generation? 78 Social Characteristics of Users 80 BOX Multiple-Drug Use: Marijuana as a Gateway Drug 82
VI CONTENTS Social Learning in Use of Marijuana and Other Drugs 84 The Social Learning Process in Drug Use 85 The Boys Town Study 88 Community Context and Marijuana Use 89 The Myth of Peer "Pressure" in Adolescent Substance Use 90 SIX Heroin 93 Trends in Prevalence of Heroin Use and Addiction 93 Social Characteristics of Users and Addicts 94 Social Learning in Heroin Use, Addiction, and Relapse 96 Initial and Preaddictive Use 97 Opiate Addiction 103 Relapse to Opiates 108 SEVEN Cocaine 113 Are Cocaine and Crack Addictive? 113 Animal Studies 115 Studies of Cocaine Use on the Streets 117 Must Cocaine Be Addictive to Condemn It? 118 Social Patterns and Trends in Cocaine Use 119 Historical Trends 119 BOX Effects of Cocaine on Neurons and Neurotransmitters 120 Recent Trends: Images and Realities 121 Cocaine Abuse Continued to Increase for a While 126 Is Cocaine Abuse Even Worse Than We Think? 127 Are We Experiencing a Re-Ghettoization of Cocaine Abuse? 129
CONTENTS vii C H A P T E R E I G H T Social Control and Public Policy on Drugs: Law Enforcement 134 Components of Social Control and Public Policy 134 Law Enforcement 135 History and Changes in Law Enforcement 136 BOX Drug Enforcement Administration Schedules of Controlled Substances 139 Goals, Types, and Results of Drug-Law Enforcement 146 Foreign and Domestic Sources of Drugs 146 Drug Smuggling 149 BOX Drug Smuggling Routes 150 The Wholesale and Retail Drug Traffic 151 Results of Law Enforcement 153 Is Legalization the Solution? 156 NINE Social Control and Public Policy on Drugs: Treatment and Prevention 162 Drug Treatment 162 The Drug Treatment Industry 163 Types of Drug Treatment Programs 165 How Effective Is Drug Treatment? 175 Prevention and Education 177 Types of Drug and Alcohol Prevention/Education Programs 179 Success of Prevention/Education Programs 181 What Is Working? 183