Globalization of Addiction - 2222 Lecture 2 PDF

The globalization of addiction Alexander, B. (2010)  The semantic problems that undermine everyday conversations also undermine Notable scholarly discourse. Scholars, like everybody Quotes else, use different definitions for ‘addiction’ and some...

The globalization of addiction Alexander, B. (2010)  The semantic problems that undermine everyday conversations also undermine Notable scholarly discourse. Scholars, like everybody Quotes else, use different definitions for ‘addiction’ and sometimes change definitions as the conversation proceeds. National Institute on Drug Abuse “Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control." American Society of Addiction Medicine “Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences." Harvard Medical School “Clinicians and scientists alike now think that many people engage in potentially addictive activities to escape discomfort — both physical and emotional. People typically engage in psychoactive experiences to feel good and to feel better. The roots of addiction reside in activities associated with sensation seeking and self-medication.” American Psychological Association “Substance abuse is a pattern of compulsive substance use marked by recurrent significant social, occupational, legal, or interpersonal adverse consequences, such as repeated absences from work or school, arrests, and marital difficulties. Addiction is a state of psychological or physical dependence (or both) on the use of alcohol or other drugs.” Notable Quotes This chapter will show why addiction3 best encompasses the most dangerous addiction problems of the globalising world and why it is best suited for precise analysis. Traditional meaning of the word ‘addiction’ Notable Quotes Prior to the mid 19 century, it had a simple two-part definition that came into the language before the time of Shakespeare. This traditional definition was remarkably similar to the ancient use of the Latin noun addictionem and the verb form, addicere. Means to assign, to enslave Notable Quotes Addiction … [ad. L. addiction-em, n. of action f. addic-ere; see ADDICT.] 1. Rom. Law. A formal giving over or delivery by sentence of court. Hence, a surrender, or dedication, of any one to a master. 2. The state of being (self-) addicted or given to a habit or pursuit; devotion Boils down to: ‘slavery’ Notable Quotes Notable Both in its destructive and non-destructive forms, ‘addiction’ could be a weighty word in its traditional meaning. Shakespeare, for Quotes example, used it with gravity in The Life of King Henry the Fifth, written around 1600 AD. “… his addition was to courses vain, His companies unlettered, rude, and shallow, His hours filled up with riots, banquets, sports;” Notable Quotes The weight that the word ‘addiction’ can have when used in a positive sense is seen in the King James Version of the Christian Bible, originally published in 1611. This was the standard Bible for English-speaking Protestants until the mid-20 century. English version of Bible (James I) Two editions printed in 1611 (he/she) Wicked Bible (1631): “Thou shalt commit adultery” Notable Quotes he urges them to emulate the members of the family Stephanas, whom he praises for their addiction, as follows: 16:15 I beseech you, brethren, (ye know the house of Stephanas, that it is the first fruits of Achaia and that they have addicted themselves to the ministry of the saints,) 16:16 That ye submit yourselves unto such, and to every one that helpeth with us, and laboureth. Notable Quotes Beyond Shakespeare and the learned translators of the King James Bible, David Hume, Jane Austen, Charles Dickens, and countless other masters of the English language used the word ‘addiction’ in the inclusive, traditional way. The idea that the concept should be pared down to a disease of drug or alcohol use had little currency before the 19 century. Like the Oxford English Dictionary, Webster’s American Dictionary defined addiction only in the traditional way from its earliest edition in 1806 at least through to the 1902 edition. https://youtu.be/7dNw6o17UJI Prohibition in Canada ”addicted to ” search Addiction1 Notable Quotes The traditional definition of ‘addiction’ was gradually obscured in the 19 and early 20 centuries during a period of intense public alarm over excessive drinking and, later, drug taking. During this period, the meaning of the word ‘addiction’ was simultaneously narrowed, moralised, and medicalised for many people. Notable Quotes Beginning early in the 19 century, a powerful mass movement in North America and Europe proclaimed that alcohol, which they characterised as ‘ardent spirits’, ‘hard liquor’, or ‘demon rum’, was a serious menace.  Notable Quotes In 1919, for example, on the eve of national alcohol prohibition in the United States, preacher Billy Sunday announced on a coast-to-coast radio hook-up that: The reign of tears is over. The slums will soon be a memory. We will turn our prisons into factories, our jails into storehouses and corncribs. Men will walk upright now, women will smile and the children will laugh. Hell will be forever for rent. US: 1920 to 1933; ON: 1916 to 1927; PEI: 1901 to 1948 Apropos of nothing (not sponsored by Carling J)  “A variety of names for excessive drinking were used in the temperance movement, although the word ‘addiction’ eventually became a preferred term along Notable with ‘alcoholism’” Quotes Notable Quotes It fundamentally narrows the traditional definition because it was limited to drinkers, it was always morally reprehensible, and it was akin to a progressive disease. This grim and restrictive way of using the word is called ‘addiction1’ in this book. The subscript ‘1’ is not meant to suggest that it corresponds to part 1 of the traditional definition—which it does not—but that it became the dominant image of addiction in Western society during the 19 and 20 centuries and remains so for many people today. Notable Quotes In non-religious terms, those who became addicted1 were so overwhelmingly involved with drinking that they became different people, alien to their own society and to their own previous identities.  Notable Quotes By the end of the 19 century, the sensational images of the temperance movement had become fearsome archetypes for new anti- drug movements, including the 19 - century anti-opium movement and later movements bent on ridding the planet of cocaine, heroin, marijuana, LSD, barbiturates, amphetamine, ecstasy, methamphetamine, etc. Find temperance + women’s rights; temperance + nativists Notable Quotes People hooked on drugs were given labels like ‘drug ends’, ‘junkies’, ‘opium drunkards’, and ‘hopheads’, as well as drug addicts. Such people were often understood to be possessed by a demonic intoxicant, and to be ‘lost’, ‘hopeless’, ‘ruined’, or ‘doomed’—as, indeed, the worst of them were. Simultaneously, they were said to suffer from the medical disease of addiction and to be in urgent need of medical treatment. Notable Quotes In North America, these images were most often associated with opium in the decades around World War I, heroin in the decades before and after World War II, ‘crack’ cocaine in the 1990s, and at the beginning of the 21 century with the stimulant drug methyl amphetamine, often shortened to ‘crystal meth’, ‘methamphetamine’, ‘crystal’, or ‘ice’. Notable Quotes When the definition of addiction1 finally appeared in the main text of the Oxford English Dictionary in 1989 (after its debut in the Supplement of 1933), it was appended as ‘2b’ to part 2 of the traditional definition. The original part 2 was renumbered ‘2a’. Definition 2b reads as follows: 2. b. The, or a, state of being addicted to a drug (see ADDICTED ppl a. 3b); a compulsion and need to continue taking a drug as a result of taking it in the past. Cf. drug-addiction s.v. DRUG sb.1 I b.  The new definition is medical because, unlike the traditional definition, it has the Notable qualities of a medical diagnosis: it is a Quotes ‘compulsion’ that has a specific cause— taking a drug—and is accompanied by ‘withdrawal symptoms’. Addiction2 Notable Quotes More and more people began using ‘addiction’ to encompass all socially unacceptable uses of alcohol or drugs, including, but not limited to, the overwhelming involvement that is the essential component of both addiction1 and the traditional definition. Notable Quotes Some people found themselves labelled ‘addicted’, in this loose sense, simply because they used a drug from time to time that had been labelled ‘addictive’ by their society, which seemed to imply that all users must be addicted. Notable Quotes This looser meaning of addiction will be designated ‘addiction2’ in this book. I have not found addiction2 in any dictionary. It is not a precisely definable term, but rather a grab-bag usage. It is best understood as the usage of a society that is preoccupied with drug problems, and loosely symbolises this heterogeneous collection of problems with the word ‘addiction’. Notable Quotes Similarly, the definition of ‘substance dependence’ in the DSM-IV (the standard American classification system for mental disorders ), which is widely taken to be equivalent to ‘addiction’, corresponds more closely to addiction2 than to addiction1, because it is possible to be classified as substance dependent without showing any signs of overwhelming involvement at all. Notable Quotes Throughout English literature, ‘addiction’ is almost always used in the sense of addiction1 and addiction2 in medical and political discussions.  In apparent opposition to the Oxford English Dictionary, the Oxford Dictionary Notable Quotes of Psychology defines ‘addiction’ exclusively as drug addiction. Addiction3 Notable Quotes The existence of a well-established, professional field of addictions that focused its attention on addiction1 and addiction2 for most of the 20 century has created a widespread impression that, strictly speaking, ‘addiction’ is limited to the use of alcohol and drugs, but this is not the case. Notable Quotes Moreover, landmark research showed convincingly that seriously compulsive love relationships and gambling habits had the same psychological dynamics as addiction1; could be every bit as overwhelming, intractable, and dangerous; and could be treated with the same type of therapy Notable Quotes The set of overwhelmingly involving, destructive addictions that includes, but goes far beyond, drugs and alcohol is designated addiction3 in this book. Notable Quotes The late 20 -century recognition of serious addictions3 in which drugs play no major part was not so much a discovery as a rediscovery of a fact that had been known throughout history but had been lost in the glare of terrifying images of alcohol and drug addiction that burst forth in the 19 century. Notable Quotes Some of these ancient descriptions convey the same horrified recognition that surfaced in the 19 -century temperance literature— severe addiction3 entails not merely a destructive habit, but a kind of slavery, even the loss of a soul. When people become severely addicted3, they not only change what they do, but who they are. Notable Quotes Like addiction1 and the traditional definition, addiction3 does not refer to an ordinary habit, but to an overwhelming involvement. Gambling, love, power-seeking, religious or political zeal, work, food, video game playing, Internet surfing, pornography viewing, and so forth can take up every aspect of a severely addicted3 person’s life— conscious, unconscious, intellectual, emotional, behavioural, social, and spiritual —just as severe drug and alcohol addiction can. Notable Quotes At the severe end of the continuum, addiction3 can be totally overwhelming and unconcealable. The addicted3 person’s previous lifestyle can be destroyed. Irrevocable harm can be inflicted on other people. The overwhelming involvement of addiction3 can reach an unrelenting, hellish intensity, and may have fatal consequences. Notable Quotes Addiction3 is parallel to addiction1 in several important ways. Just as most people consume alcohol and drugs without becoming addicted1, most people engage in all of the activities that can be objects of addiction3 without becoming addicted3. Just as addiction1 can be treated with modest success by alcohol and drug counsellors and by self-help groups, all forms of addiction3 can be treated in a similar manner with the same modest success. Addiction4 Notable Quotes Non-destructive addictions will be called addiction4 in this book. Addiction4 designates overwhelming involvements with any habit or pursuit whatsoever when such involvements are not destructive either to the addicted person or his or her society. Notable Quotes The lives of Martin Luther King and Mother Teresa are contemporary examples. Notable Quotes Religion and romantic love are examples of familiar pursuits for which both addiction3 and addiction4 are well known. Figure 2.1 represents addiction4 as a mirror image of addiction3, at least hypothetically providing a positive counterpoint for every addiction3. The significance of addiction3 in the 21 century st Notable Quotes “Addiction3 entails a destructive transformation of a person’s life and identity. When severe, it can cause great harm to individuals and to society. Because the prevalence of addiction3 is increasing around the world, it poses a substantial and growing danger at the beginning of the 21 century.” Notable Quotes “Stanton Peele and others who see beyond the conventional wisdom on addiction have long been aware that the majority of severe addictions3 are to habits other than drug use.” Notable Quotes “Alcohol or drug addictions comprised only 19.3% of the most severe instances of addiction3. The most frequent severe addictions3 for our sample of university students were to romantic love and to eating (or dieting). The students described a great variety of other severe nondrug addictions3” “The desperate struggle to support an addictive3 lifestyle can provoke actions that cause self-loathing at the time or years later” “People who fail to maintain their addicted3 lifestyle (e.g. gamblers who have lost all their money) often live on the verge of depression, violence, or suicide. However, people who succeed in maintaining their addiction3 often feel guilty or empty nonetheless” (Alexander, p. 10) “People who are severely addicted3 have a tragic, engulfing problem, whether or not their addiction involves drugs or alcohol and whether or not it causes bodily damage.” (Alexander, p. 10) “The prevalence of addiction3 of all sorts is very large, and growing. The indications of increasing prevalence of addiction3 to drugs and alcohol are best known. The growth is visible geographically in the apparently inexorable spread of the intravenous drug-using population in the Hastings Corridor area of Vancouver’s Downtown Eastside.” (Alexander, p. 10) “Alcohol addiction3 also appears to be increasing substantially in the UK, especially among women, although addiction3 is only a portion of a national drinking trend loosely called ‘binge drinking’.” (Alexander, p. 11) Let’s try to find some numbers for Canada “In addition to stories of addiction, there is a huge literature of ‘recovery stories’, many of them written by people who have joined Alcoholics Anonymous or any of the ‘12-step’ organisations that have derived from it. Twelve-step programmes have spread from alcoholism to myriad other addictions, creating an alphabet full of active organisations modelled on Alcoholics Anonymous (AA), including BA (Bloggers Anonymous), CA (Cocaine Anonymous), DA (Debtors Anonymous), EA (Emotions Anonymous), FA (Fundamentalists Anonymous), GA (Gamblers Anonymous and Gamers Anonymous), and onward through the alphabet.” (Alexander, p. 11) “There is also a vast literature of inspirational books, self-help books, and websites advocating different methods of ‘recovery’ from addiction3 to a broad spectrum of habits and pursuits, although the word ‘addiction’ is not applied in some cases.” (Alexander, p. 11) “Many quantitative studies have attempted to measure the prevalence of addictions3 that do not involve drugs or alcohol. However, this literature is unsatisfactory because there are too many different operational definitions of addiction and because the cut-off points that determine which addictions3 are serious enough to count are entirely arbitrary.” (Alexander, p. 11) “In a famous book entitled Bowling Alone, Robert Putnam showed that the community and religious affiliations of people in the United States, notably neighbourhood bowling leagues, are declining precipitously. Concurrently, however, AA and many of the other 12-step groups for addicted3 people are growing rapidly” (Alexander, p. 11) “The newest frontier for addiction is the computer. The phenomenal rise in popularity of computer games and of game companies with billions of dollars in annual revenues has been followed by a wave of accounts of gaming addiction” (Alexander, p. 11) “Three decades ago… people discretely labelled themselves addicted to consumer spending, dysfunctional love relationships, smoking tobacco, and so forth, rather than heroin… now, people identify themselves as addicts quite openly” (Alexander, p. 12) “An indirect indication of the growth of addiction is the astronomical increase in the prevalence of clinical depression and a great variety of other vaguely defined psychological states with depressive components, like chronic anxiety and chronic fatigue syndrome.” (Alexander, p. 12) “For example, corporations have learned to analyse and systematically cultivate addictive propensities of their customers behind the scenes. This has been documented most spectacularly in the manipulation of nicotine levels of tobacco by cigarette manufacturers,” (Alexander, p. 12) “In fashionable advertisements, clothing is sometimes modelled by people who deliberately affect the attitudes of junkies in a style that, at its most recent peak of popularity, was called ‘junkie chic’ or ‘heroin chic’.” (Alexander, p. 12) “Entertainment media fascinate us with the often painful and rarely funny addictions3 of stars such as Elvis Presley, Michael Jackson, Robert Downey Jr, and Britney Spears” (Alexander, p. 12) “Among the cleverest of these is the series of humorous books celebrating the life of ‘Couch Potatoes’ (i.e. people who devote themselves to watching particularly vacuous television programming for great amounts of time).” (Alexander, p. 12) “Having flaunted his addiction to Sudoku, the author of the book goes on to assure his readers that they too will be proud to be ‘compulsive Sudoku players’, once he explains himself. He then explains the rewards of Sudoku, many of which have an unmistakably addictive character: solving Sudoku puzzles puts people in a ‘meditative state’ of ‘ecstatic experience’; Sudoku produces a powerful sense of self-satisfaction” (Alexander, p. 13)  “Although the harm that addiction3 causes addicted individuals can be great, the social harm can be greater. As a single example, political and religious fanatics (i.e. people who are addicted3 to simplistic doctrines and creeds) are working serious destruction upon today’s world as this is being written.” (Alexander, p. 13) “Some people believe that today’s growing concern about addiction is overblown… This perception is reinforced when lawyers and expert witnesses hold forth on addiction3 in courtrooms with the most pretentious psychobabble and neurochemical puffery. A few opportunistic lawyers have had clients exonerated on the defence that their crime was caused by the disease of addiction.” (Alexander, p. 13)  The importance of distinguishing addiction2 from addiction3 “The consequences of overlooking this distinction can be grave. For example, adolescents who are caught using illegal drugs recreationally are sometimes forced into addiction treatment by their parents, although there is no reason to think that they are addicted3. In the United States, the consequences of this ill-considered treatment of adolescents have sometimes been tragic when ‘boot camp’ treatment agencies have employed brutal forms of ‘therapy’.” (Alexander, p. 14) A nameless form of addiction2 “Consider all of the people who regularly use one of the currently illegal or socially disapproved drugs and who, in addition, suffer from side effects, cannot be persuaded to quit, obtain their drugs illegally if they must, and continue their regular drug use for a prolonged period, even an entire lifetime. All of these people would be labelled ‘addicted’ within the conventional wisdom.” (Alexander, p. 14) “These regular, but non-addicted3 drug users rely on their drugs to keep themselves performing in normal, socially acceptable ways. They are definitely not addicted3, because they do not have an overwhelming involvement with their drug use, which does not alter their normal personality or alienate them from society, although it may injure their health.” (Alexander, p. 14) “Although a few people who use drugs in these ways lapse into addiction3, there are a great many fully documented instances where even a lifetime of regular use of marijuana, heroin, morphine, opium, cocaine, amphetamine or tobacco has been compatible with a reasonably happy, productive, socially acceptable life and has not led to addiction3, even after many decades.” (Alexander, p. 14) “One well-documented example is Dr William Halsted, a brilliant American surgeon and medical school professor, who injected a minimum of 180 mg of morphine daily during most of his long and distinguished career. This fact was known only to his very closest friends and only became public knowledge after his death. His life story, including his reliance on morphine, was published in the Journal of the American Medical Association 50 years after his death. Dr Halsted may properly be called ‘addicted2’ in the terminology of this book, but he was not addicted3. On the other hand, it is possible to become ruinously addicted3 on 180mg of morphine per day, or less” (Alexander, p. 15)  “This form of addiction2 could be labelled ‘self-medication’, although this term is too narrow because not all of these drug users have a medical disease. It is also sometimes called ‘functional addiction’, but this term is not widely accepted either.” (Alexander, p. 15) “‘Self-medicators’ take pains not to alienate their families with their drug use. Sometimes their families and closest friends are unaware that they smoke marijuana every night, or take a painkiller like heroin from time to time through the day, or need daily stimulants or anti-depressants to keep functioning, or sneak away for cigarettes more than once each hour, and so on.” (Alexander, p. 15) “Naturally, ‘self-medicators’ use as little of their socially disapproved drug as they can in order to keep their lives together. However, this minimum is often much larger than the amount used by recreational users and may be as large as the amounts used by some people who are truly addicted3” (Alexander, p. 15) “‘Self-medicators’ are indistinguishable in every way—except in the symbolic meaning of their drug—from millions of other people who regularly use a multitude of legal drugs, such as SSRI (selective serotonin reuptake inhibitors) anti-depressants to control incapacitating depression or multiple cups of coffee to endure the boredom of their work.” (Alexander, p. 15) “Like the illegal drug habits described above, these legal drug habits can be called addiction2, but not addiction3” (Alexander, p. 15) “It has come to seem odd that a person could use a drug whose side effects may shorten his or her life without being labelled ‘addicted’ in the strongest sense of the word.” (Alexander, p. 16) “Non-addicted people do many things regularly to enhance their well-being, some of which may shorten their lives, without being labelled ‘addictions’.” (Alexander, p. 16) “This form of addiction2 is simply ‘dependence’ in the normal English meaning of the word. Many people are ‘dependent’, in this sense, upon their jobs, their families, their recreational sports, their cars, their times of prayer or meditation, or on one or more drugs in order to carry out their lives in successful ways.” (Alexander, p. 16) “It is important to distinguish dependence from addiction1 for very practical reasons. The most obvious one is that it is cruel not to prescribe drugs to dependent patients who cannot live normal, productive lives without them. This distinction is recognised in the logic of methadone maintenance programmes, which have been traditionally designed to provide methadone to heroin users who can stabilise their lives by becoming dependent on methadone, but to withhold it from heroin users who may simply sell the methadone or use it to supplement their addiction1” (Alexander, p. 16) “they recognise that they can perform an important service by regularly providing restricted drugs to patients who are dependent on drugs other than opioids, although this practice is generally illegal. I have personally known a few courageous Canadian GPs who have conscientiously broken laws that prevented them from caring for their dependent patients in this way. There may be times when it is desirable to prescribe these drugs to people who are addicted3 as well, as is currently being proposed by mayor Sam Sullivan of Vancouver, but the outcome of this is harder to predict.” (Alexander, p. 16) “However, under most conditions, drug dependence is a stable condition that lasts as long as there is a need that can be controlled pharmacologically, often for a short period, sometimes for a lifetime. Whereas some people do drift from dependence to addiction3, others drift from addiction3 to dependence, the most familiar example being those heroin users who establish stable and socially acceptable lives while still taking methadone every day.” (Alexander, p. 17) Prospects for theoretical analysis “Theoretical analysis of addiction3 is sorely needed, for the same reason that theoretical analysis of addiction1 is. In its most severe instances, addiction3 entails a mysterious personality metamorphosis that can be extremely harmful, whether drugs are involved or not. This harmful metamorphosis is a spreading menace in the globalising world. Addiction3 is easier to study than addiction1 because people are generally willing—in fact, eager—to discuss their own experiences with legal addictions.” (Alexander, p. 17) Create a table for addictions1-4 with examples https://www.youtube.com/watch?v=d- 0KfwFCMRM