11.6 Chapter Summary
Kelly Szott
Drug use is often mistakenly identified 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.
Structural racism and class inequality drive different outcomes for people who use drugs. White rich people are more likely to be perceived as having a medical condition that needs treatment. They are also more likely to access effective treatment. People of Color and poor people are more likely to be seen as criminals and receive punishment. They are much less likely to have access to effective treatment. It’s not the use of drugs that’s the social problem—it’s the deep injustice in the consequences of the behavior that is the social problem.
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. We must wrestle with defining drug use as legal or illegal, moral or immoral, individual or social.
Structural inequality combined with drug policy that creates avoidable harm from drug use. Social justice for people who have substance use disorder includes changing the laws, policies and practices related to harmful drug use. It includes increasing funding for effective community and inpatient treatment and services, particularly in rural communities. And it includes addressing the generational problems of racism and poverty reflected in the disproportionality of both the assignment of criminality and access to treatment.
11.6.1 Essential Ideas
Learning Objective 1: How can we describe drug use and misuse as a social problem?
Harmful drug use is a social problem because it affects different groups of people in different ways. People differ on whether they consider drug use a moral, psychological or structural problem. They disagree on what to do, reflecting a conflict in values. Our ideas about legal and illegal drug use, and the consequences of that harmful drug use are socially constructed. Finally, taking action to expand justice requires individuals to take action to pursue recovery and collective action by people in our society to change drug laws, support harm reduction programs, fund drug treatment, and fight racism. These interdependent actions increase social justice for people who use drugs in harmful ways.
Learning Objective 2: How does social location impact the experience of harmful drug use?
We see disproportionality and disparity when we examine the outcomes of harmful drug use based on race and ethnicity. Whites are disproportionately less represented in prison and jail populations. Black, Brown, and Indigenous people are disproportionately more represented in prison and jail populations. The reasons for this disparity include racist policing and disparate mandatory sentencing, among other practices. Generally, White people are perceived as needing treatment, and they more often have access to it. People of Color are more often seen as criminals and get punished.
Learning Objective 3: How do the five models of addiction differ in how they explain the causes and consequences of harmful drug use?
The five models of addiction are moral, disease, public health, sociological, and intersectional. The moral model focuses on the failings of an individual. While most sociologists don’t use this approach, it can be effective in peer-led recovery groups. The disease model focuses on substance use as a medical disorder, often based on neurological explanations. This approach is helpful in developing medical treatment but often minimizes the social determinants of health, which influence the differential outcomes of harmful drug use. The public health model focuses on minimizing the harm that occurs related to harmful drug use. This approach focuses on harm reduction strategies. The sociological approach focuses on how structural inequalities like racism or economic inequalities influence the consequences of harmful drug use. Finally, the intersectional approach looks at how historical and generational trauma is uniquely experienced in communities of color. Scholars examine how the deep roots of colonization continue to create unequal access to treatment resources. Finally, in this model, researchers look at how cultural capital can be used to make a difference.
Learning Objective 4: Which interdependent actions increase social justice related to problematic drug use?
Radical justice for drug use and misuse will take federal, state, community, and individual action to transform our society. Among the options are harm reduction, decriminalization of small amounts of substances, increased access to treatment options, and community collaborations. Recovery is social justice.
11.6.2 Key Terms List
- 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 reducing penalties for possession/use of small amounts from criminal sanctions to fines or civil penalties
- disparity: the unequal outcomes of one group compared with outcomes for another group. Disparity can be used to compare any groups with different social locations.
- drug use: the imbibing of substances, which can happen without addiction or physical dependence but may lead to those outcomes.
- five models of addiction: five ways to understand drug use that are dominant in US society—the moral view, the disease model, the public health perspective, a sociological approach, and an intersectional approach.
- 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.
- legalization: to make the possession and use of a drug legal
- mass incarceration: the overwhelming size and scale of the US prison population
- New Jim Crow: the network of laws and practices that disproportionately funnel Black Americans into the criminal justice system, stripping them of their constitutional rights as a punishment for their offenses in the same way that Jim Crow laws did in previous eras.
- opioid crisis: a surge of drug overdoses and suicides, both linked to the use of opioid drugs
- private prisons: for-profit incarceration facilities run by private companies that contract with local, state, and federal governments.
- risk environment: the space—whether social or physical—in which a variety of factors interact to increase the chances of drug-related harm.
- social capital: the social networks or connections that an individual has available to them due to group membership.
- substance use disorder (SUD): a 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.
- War on Drugs: The War on Drugs is an effort in the United States since the 1970s to combat illegal drug use by greatly increasing penalties, enforcement, and incarceration for drug offenders.
11.6.3 Discuss and Do
- Harmful Drug Use as a Social Problem: What’s the difference between illegal and legal drugs? Does everyone in society agree on these categories? Why or why not?
- Causes and Consequences: Which of the five models of addiction best explains the opioid crisis?
- Conflict in Society: What are the advantages and disadvantages of legalizing any currently illegal drug? Feel free to use an example from the textbook, or from your community.
- Mass Incarceration: How can we see mass incarceration as a social problem related to the racialization of drug use?
- Social Construction of Drug Use: 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 cannabis 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?
- Community Action: What drug treatment services are available in your community? Are they community-based, medical, or carceral? How might you access them? Are they effective?
11.6.4 Licenses and Attributions for Chapter Summary
Open Content, Original
“Chapter Summary” by Kelly Szott is licensed under CC BY 4.0.