Chapter Overview

With deep gratitude to the harm reduction community whose persistent critical and humane approach will change the societal understanding of drug use

– Kelly Szott

https://www.youtube.com/watch?v=pb8nFAGJGY4

When we consider the social problem of problematic drug use, we enter a challenging space. Like many social problems, opinions are often extreme and heartfelt. Where do we begin? As usual, we begin with another story:

Lynn has struggled with an addiction to heroin since 2018. When COVID-19 hit, she experienced isolation and other stresses of the pandemic. Public health officials fear that these stresses, coupled with isolation, may have caused relapses for those in recovery from addiction. Due to roadblocks caused by the pandemic, Lynn decided to taper herself off Suboxone, a pharmaceutical containing buprenorphine used to treat opioid use disorder. In late March of 2020, Lynn overdosed in her apartment after using heroin laced with fentanyl. She was revived by her boyfriend, who administered Narcan, a brand of the overdose-reversing drug naloxone.

In the 2020 optional-reading article, Don’t Forget the Other Pandemic Killing Thousands of Americans, author Kate Briquelet writes,“Amid social distancing, authorities nationwide are reporting a surge in fatal opioid overdoses. Addiction and recovery advocates say the US is now battling two epidemics at once. From 1999 to 2018, opioid overdoses involving prescription and illicit drugs have killed nearly 450,000 Americans.” We have not just one pandemic but two.

The COVID-19 pandemic has enabled us to see how social environments and conditions impact the consequences of drug use and addiction. For example, many experts worried about the negative impacts of social isolation on those with substance use disorders. Isolation might increase depression, and the related self-medication will employ illegal substances. In addition, individuals who use opioids alone and overdose would have no one there to call 911 or administer Narcan, the overdose reversal medication. The video in Figure 11.1 focuses on the importance of in-person group meetings and the struggles faced by those in recovery as they attempt to stay sober during a global health crisis. Beyond the individualized psychological view of drug use, a sociological perspective reveals the social conditions that can cause substance use, as well as make the consequences worse for certain structurally vulnerable groups.

Social scientists assert that people often seek to alter their consciousness deliberately. Sometimes people choose prayer or meditation. Sometimes they choose to dance or sing in a choir. Sometimes they choose a pound of chocolate or a runner’s high. And sometimes they choose alcohol, cannabis, or other mind-altering substances. Many find this altered state without it becoming either a personal or a social problem. In this chapter, we explore when and why getting high becomes a social problem.

Licenses and Attributions for Chapter Overview and Learning Objectives

Open Content, Original

“Chapter Overview” by Kelly Szott and Kimberly Puttman is licensed under CC BY 4.0.

All Rights Reserved Content

Figure 11.1. “Coronavirus and addiction recovery: Fighting isolation to stay sober” by The Washington Post is licensed under the Standard YouTube License.