Drug use is often constructed as a social problem in and of itself. This chapter has shown that it is the consequences of some forms of drug use (and often by certain groups of people) that can be constructed as problems. The problems that arise from drug use must be solved collectively because they have structural roots.

These problems involve issues of racial and class inequality that are deeply rooted in our society and conflict with shared values of equity. Often lower-income communities and BIPOC face more penalties for drug use and have less access to resources to treat addiction, even though the prevalence of substance use is nearly equal between all groups in society.

What is considered a harmful drug, and thus, must be outlawed, is constantly changing. This is demonstrated by the recent decriminalization of the possession of small amounts of drugs in Oregon. The social construction of all types of drug use as a problem must be reconsidered and rethought on a societal level. It is structural inequality combined with drug policy that creates avoidable harm from drug use.

8.7.1 Key Terms

Addiction: a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.

criminalization: the act of making something illegal

decriminalization: the act of making something legal again

drug scares: a form of moral panic ideologically constructed to construe one or another chemical substance as the core cause of a wide array of preexisting public problems

drug use: the imbibing of substances, which can happen without addiction or physical dependence, but may lead to those outcomes.

four models of addiction: four ways to understand drug use that are dominant in U.S. society—the moral view, the disease model, a sociological approach, and a public health perspective.

harm reduction: a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.

harmful drug use: a person’s drug use negatively impacts their health, their livelihood, their family, their freedom, or any other aspect of their life that they deem important

opioid crisis: a surge of drug overdoses and suicides, both linked to the use of opioid drugs

racialized risk environments: a risk environment is racialized when racial/ethnic groups of [People Who Inject Drugs] PWID inhabit places that differ systematically in the availability of protective features (e.g., substance abuse treatment programs) and in the presence of harmful features (e.g., police drug crackdowns)

risk environment: the space—whether social or physical—in which a variety of factors interact to increase the chances of drug-related harm

rural: areas that do not contain cities or villages of more than 2,500 people.

social capital: the social networks or connections that an individual has available to them due group membership

substance use disorder (SUD): condition in which there is uncontrolled use of a substance despite harmful consequences. People with SUD have an intense focus on using a certain substance(s) such as alcohol, tobacco, or illicit drugs, to the point where the person’s ability to function in day to day life becomes impaired.

suburban: residential area outside of a city that is close enough for a daily commute.

urban: of, relating to, characteristic of, or constituting a city

8.7.2 Discussion Questions

• What’s the difference between illegal and legal drugs? Does everyone in society agree on these categories? Why or why not?
• Which of the four models of addiction best explains the opioid crisis?
• What are the advantages and disadvantages of legalizing any currently illegal drug?
• How can we see mass incarceration as a social problem related to the racialization of drug use?
• Where you live matters as much as who you are when it comes to harmful drug use. Agree or disagree?
• Please find a video, print, or social media ad that is selling or against selling a mind-altering substance. This could be prohibition, smoking in old movies, medical marijuana today, or other substances. How did this ad capture the beliefs or opinions of the drug at the time? How have the views changed over time?