Different understandings of ‘addiction’ exist and have existed at different times. Discuss such understandings and their strengths and weaknesses.
In contemporary discourse ‘addiction’ can be applied to any number of behaviours or activities. For example “[i]n today’s society, we have sex-aholics, choc-aholics, work-aholics, shop-aholics, and golf-aholics. We have self-help programs called overeaters-anonymous, gamblersanonymous, internet-sex-anonymous, and smokers-anonymous.” (Boyd, J. 1999) This recent discourse of addiction can be manipulated by ‘addicts’ to justify their behaviour, and to create sympathy towards them. Those claiming addiction may in fact not be an addict, however they now realise it is now more socially acceptable to be deemed an ‘addict’ than just participant in ‘addictive’ behaviors. This essay will concern itself with discourses of addiction to drugs. Understandings of addiction to substances such as narcotics, tobacco and alcohol have been conceptualised and re conceptualised throughout recent history. Early biological and pharmacological theories of addiction still dictate policy on ‘addictive’ substances, however social and psychological theories have gained momentum and explain aspects of addiction biological theories do not.
It is important to gain an insight into attitudes towards the concept of addiction before substances were conceptualised as being addictive. “Prior to the 19th century, the English word “addiction” had a traditional meaning...To be “addicted”, meant either to be legally given over to somebody as a bond-slave, or, more broadly, to have given oneself over, or devoted oneself, to somebody or something.” (Alexander, B. N.D) Addiction had nothing to do with substances, this however changed.
The work of Levine, H. (1978) gives an insight into American attitudes before alcohol was conceptualised as an addictive substance. He claims that “[d]uring the colonial period most people were not concerned with drunkenness; it was neither especially troublesome nor stigmatized behavior...” However many powerful colonials began to complain about the amount of drunkenness, and “[b]y the 1760s... Benjamin Franklin labeled taverns "a Pest to Society."“ (Levine, H. 1978) People who were found to be drunk on a regular occasion became stigmatised, “they called such people drunkards...Occasionally they described drunkards as addicted to drunkenness or intemperance... In the colonial period "addicted" meant habituated, and one was habituated to drunkenness, not to liquor.” (Levine, H. 1978) This distinction is important, as it can be seen that it is not the substances that were seen as addictive, it is the behavior attached to the consumption that is. “In the traditional view...the drunkard's sin was the love of "excess" drink to the point of drunkenness.” (Levine, H. 1978) Addictive behavior toward the consumption of alcohol was viewed as a choice. “Drunkenness was a choice, albeit a sinful one, which some individuals made.” (Levine, H. 1978) This understanding views addiction as a habit. This theory is problematic. ‘Love’ is seen as the reason for drunkenness, however psychological reasons may have affected the desire to drink. Also those who may feel as though their indulgence was a problem were not offered any help, instead they were seen as criminals, “[t]owns circulated lists of common drunkards, and landlords who sold liquor to them could be fined or have their licenses revoked. Some drunkards were punished severely.” (Levine, H. 1978) However addiction was seen as a choice, which is contrary to the later disease model.
The work of Dr. Rush. B (cited in Levine, H. 1978) could be described as the foundations for contemporary understandings of the disease model of addiction. “Rush organized the developing medical and commonsense wisdom into a distinctly new paradigm. According to Rush, drunkards were "addicted" to spirituous liquors; and they became addicted gradually and progressively...” (Levine, H. 1978) The shift from addiction to being drunk to addiction to the substance laid the foundations for medical theories of addiction. It also implied the pharmacological structure of the substance affected the possibility of becoming addicted. Rushs work has many similarities to modern discourses of addiction, for example “he clearly described the drunkard's condition as loss of control over drinking behavior – as compulsive activity; third, he declared the condition to be a disease; and fourth, he prescribed total abstinence as the only way to cure the drunkard...” The use of the medical term disease changed those seen as addicts from criminals into people who needed specialised medical help. These principles where adopted by the temperance movement and later by Alcoholics Anonymous, both went on to argue that “persons... have lost control over their drinking”. (Levine, H. 1978) The temperance movement shifted it’s focus from addiction to prohibition, and thus the disease model lost its popularity. “The drunkard came to be viewed less and less as a victim, and more and more as simply a pest and menace.” (Levine, H. 1978)
The disease concept of addiction re-emerged through alcoholics anonymous during the 1930s and 1940s. Its re-emergence was the catalyst for a new medical discourse of addiction. Hyman, S. et al, (2001:695) claims that “[a]ddiction can appropriately be considered as a chronic medical illness.” The brains reaction to addictive substances has been widely explored. Research into a “brain neurochemical called dopamine has revived interest in the possibility that a common brain mechanism may be involved in pleasure and reward.” (Gossop, M. 2007:29) “‘[t]he mesolimbic dopamine system... provides pleasure in the process of rewarding certain behavior’ (Blum et al. 1996 cited in Lende, D et al, 2001:448) Gossop, M. (2007:29) assesses research which shows dopamine is linked to “the ‘wanting’ component of motivation.” Hyman, S. et al, (2001: 696) explains “[a]ddictive drugs are both rewarding (interpreted by the brain as intrinsically positive) and reinforcing (behaviours associated with such drugs tend to be repeated)” Reward and reinforcement of drug effects lead the brain to want more. Gossops, M. (2007:29) explains this is because “a number of changes occur in the brain that make the reward system hypersensitive (sensitized) to the effects of drugs. The sensitized brain appears to play a central role in determining those aspects of reward that lead to the experiences of ‘wanting’ and ‘needing’.” These “[m]olecular changes in the brain promote continued drug taking that becomes increasingly difficult for the individual to control.” (Hyman, S. et al, 2001:696) This “powerful control over behaviour exerted by addictive drugs is thought to result from the brain’s inability to distinguish between the activation of reward circuitry by naturally rewarding activities, such as eating, and the consumption of drugs” (Hyman, S. et al 2001:697)
- Quote paper
- Gavin Hutchison (Author), 2015, Drugs and Drug Use. Understandings of the Term 'Addiction', Munich, GRIN Verlag, https://www.grin.com/document/288683