File Name: effects of substance abuse on individual family and community .zip
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Actions of an addicted individual affect not only themselves, but those closest to them. Addiction can take its toll on the friends and family surrounding an addicted individual making a tough situation even more difficult.
Economic and sociocultural poverty in drug abuse: from individual to sociopolitical responsibility. E-mail: anaerikagalvao gmail. Escola de Psicologia. Braga, Portugal. E-mail: lsaavedra psi. Porto, Portugal. E-mail: cameira fpce. In this study, we wanted to hear their voice on the reasons and motives why they engaged in drug abuse, and on the consequences this behavior had on their lives.
Data were collected in Portugal from interviews with fifteen people under treatment for addictive behavior relative to alcohol and illegal drugs.
The interviews were analyzed through Thematic Analysis and revealed the existence of several structural factors impacting on the lives of the participants, namely, gender discrimination, poor schooling, socioeconomic marginalization and exclusion associated to insufficient and inadequate public policies.
As a conclusion, we call attention to the need for an integrated public policy in the educational, health and justice areas, and the implementation of awareness-raising actions aimed at the general public, in order to attenuate the impact of structural factors on the lives of current and potential drug addicts.
Drug abuse is a highly prevalent, complex individual behavior, with implications to several administrative, juridical and public policy areas, such as Healthcare, Justice and Employment. For these reasons, drug abuse is particularly disruptive for families and, often, communities. These features, together with the generalized belief of the intentionality of drug abuse, have led to the development of highly negative societal attitudes and beliefs in regard to drug addicts, added to their already problematical lives.
Since in scientific and layman discourses drug abuse is often regarded as an individual problem, having little to do with the social context in which it emerges Chen; McElderr, , in this paper, we reinstate the need for a shift of focus when addressing the drug abuse issue. We shall begin by briefly presenting some key concepts, stigma, structural violence and social suffering, created by authors, such as Ervin Goffman or Johan Galtung, to address similar problems based on their socio-structural dimensions.
When necessary, we introduce brief notes regarding the specificity of the Portuguese context, relevant to a better understanding of the narratives.
Additionally, genetic factors may have a role in the onset of the disease Sloboda; Glantz; Tarter, However, this medical view has not been able to dismiss the widely shared belief that addicts are fully accountable for their condition, i. Stigma is a fundamental concept in the discussion of drug addiction. The author provides examples of addiction and alcoholism together with mental disorder, imprisonment, and homosexuality Goffman, , p.
In addition to these personal and social hardships, and because many drugs were formally criminalized, drug addicts started to face the increasing threat of police persecution and imprisonment. In Portugal, drug use was criminalized in , but, in , legislators established a clear difference between drug trafficking and drug consumption, so that the punishment for the latter was merely symbolic, relatively light Agra, Consequently, instead of being arrested, drug users are referred to the local Commission for the Dissuasion of Drug Use, who determines the respective administrative sanction Agra, Nonetheless, the possession of illegal substances in trafficking amounts continues to represent a substantial portion of police indictments - This situation leads to the third problem: the strong relationship between drug consumption and economic destitution.
Taking into account the life stories of these participants, with crossed paths of addiction, crime, and economic and sociocultural poverty, we believe that the concepts of structural violence and social suffering are particularly useful for the analysis and discussion of the obtained data.
These concepts have been used to interpret and discuss innumerous forms of social discrimination and exclusion Galtung, ; Kleinman; Das; Lock, , but, to our knowledge, they have never been applied to the problem of substance abuse. Structural violence and social suffering: causes and consequences of addiction.
Structural violence can be seen both as the cause and consequence of drug addiction. As a cause, it can be identified in the destitute backgrounds of many consumers, and the social inequality and injustice they have continuously experienced throughout their development, prior to becoming addicted. As a consequence, structural violence is visible in the way drug addicts are treated by the justice system, health services, and by their families and communities, after being socially and institutionally labelled.
Structural violence is thus characterized by persistence, and can act either manifestly or latently, intentionally or unintentionally, and physically or psychologically. It undermines basic needs, including survival, welfare, identity and freedom Galtung, As we will argue, for many of our interviewees, both poverty and gender discrimination were important causes for becoming addicted to drugs.
The notion of social suffering, a political concept that designates the subjective consequences of all forms of social injustice Kleinman; Das; Lock, , is also an important tool in the analysis of drug addiction. Moreover, it entails the duty of exposing hidden responsibilities, which, we believe, is particularly relevant in the case of drug addiction. Specifically, the effective comprehension of the subjective aspects of social suffering allows the identification of its socio-structural component and, conversely, to see that this component is indispensable in the understanding of its subjective aspects Kleinman; Das; Lock, The internalization of social suffering, and the acceptance of its causes as normal facts, lead to marginalized and vulnerable minorities that, even unintentionally, become complicit in their own subordination Kleinman; Das; Lock, The above-described notions guided the questions we formulated for the interviews, as well as the analysis of the accounts.
We also gave particular attention to the subjective consequences of the internalized beliefs that drug addiction is an individual responsibility and a choice. Three main questions guided the semi-structured interviews. The first one dealt with chemical dependence history, the onset of excessive consumption and the reasons for this consumption. This allowed us to understand the perceived reasons for drug use, whether personal, sociocultural, economic or political, and the ideas that regulate these perceptions.
The second sought to understand family relationships in the context of drug addiction. Finally, we tried to understand the reasons that led the participants to seek institutional treatment and how they felt about it. After carefully reading all the transcripts, we selected and organized the more salient excerpts according to their latent meanings, similarities and differences. Finally, we chose the excerpts that best illustrated the identified themes.
The interviews were conducted in a therapeutic community in the North of Portugal, where users reside during the treatment. Even so, users are financially responsible for their personal expenses with tobacco and hygiene products.
We chose this institution due to the renowned quality of their work, as well as the receptiveness of its board to collaborate with the research.
We excluded candidates with cognitive impairment that could compromise the understanding of the interview. Fifteen users met the inclusion criteria and volunteered for the interview after being informed of its goal.
The interviews took place in the community and were recorded under informed consent. The analysis of the interviews and their discussion, which will be presented simultaneously, were guided by the two main themes previously identified in the transcripts:.
They were heterogeneous in terms of age and type of drug used legal or illegal , thus contributing to increase the diversity of experiences, meanings and realities under analysis Braun; Clarke, Reasons for substance abuse: from psychological difficulties to structural inequalities.
All participants were able to identify clear reasons for their addictive behaviors, invoking either personal or contextual forces as the main factors. Three participants mentioned that addiction had been a problem in their families, suggesting the existence of hereditary factors.
In Table 2 , we can see that the invoked reasons are generally multiple, except in four cases, where personal issues appear as the sole cause for the onset of abusive consumption. For Paul, whose parents lived abroad while he stayed with other relatives in unstable conditions, these personal issues included familial isolation; for Dianne, it was the death of her boyfriend in a road accident that led her to drinking. Notably, these participants have a higher educational level than the majority.
In all other cases, the invoked reasons are described as external forces emanating from the social structure.
This is the case of gender discrimination, by itself or associated with poverty, and social marginalization due to long-term poverty, or to sudden personal insolvency following a major economic recession. Like their male counterparts, most of our female participants were raised from disadvantageous social, educational and economic backgrounds. However, as their narratives revealed, many have experienced the harmful effects of traditional and oppressive gender norms, frequently including incidents of sexual harassment and intimate partner violence IPV.
According to Crenshaw , intersected forms of oppression have a multiplicative, rather than additive, effect; in other words, each condition significantly aggravates the others. First, women who abuse alcohol like all our female participants are seen as failures and a threat to traditional feminine roles and characteristics Ettore, I did not drink in front of people. People saw me and thought I was normal, because I was not falling to the floor Louise. The fact that most female participants preferred drinking alone suggests that internalized forms of repression Galtung, , or, in their case, traditional gender norms, have led them to isolate themselves from others or, in other words, self-marginalize.
Except for my son and my mother, no one has ever seen me in an altered state, as a drunkard, ever! When my husband was there, I did not drink. He knew that I drank [only] because my son told him; him and my mother. At that time, when he was there for three or four days, I did not drink. Moreover, the literature suggests the existence of strong correlations between drug abuse and gender discrimination Ro; Choi, , as well as IPV - in addition to other psychopathological alterations Jaquier; Flanagan; Sullivan, This participant had also been a victim of sexual harassment at work, after which she was fired and was still unemployed at the time of the interview.
Another case shows how sexual harassment may involve threats, subordination or difficult obligations at work, creating a hostile work environment, which can eventually lead to alcoholism Richman, After this happened too many times, she asked for a sick leave, and, ever since, started spending most of her time alone at home. Finally, she became depressed and started to drink.
Despite the absence of concurrent factors, such as poor educational or economic conditions, her disadvantage as a woman was sufficient to drive her to alcohol and isolation. Sexual harassment at work may be seen as a manifestation of structural violence against women since they are the most frequent victims , since male aggressors lean considerably on traditional norms to initiate their actions. This subtheme stresses the role of poverty, poor schooling, and marginalized social neighborhoods complex processes of healthcare and disease.
The role of the recent Portuguese economic crisis on the increase of drug and alcohol consumptions is also an important topic of this subtheme. This situation had dramatic effects on public health, particularly mental health loss of self-esteem, anxiety, depression , increasing the prevalence of risky behaviors, such as drugs and alcohol abuse.
Daniel, a middle-aged participant with a long story of drugs and alcohol abuse, attributes the cause of his current relapse to alcoholism to his divorce, which happened at the beginning of the great economic crisis:. I think it has to do with money. I had a buck, and the money disappeared. Then, there was the crisis, too. I was receiving an unemployment wage… Until then, I never worried about money, but then I started to.
I closed myself off at home and started to drink… It was very hard for me to stop working… at first, it was a tremendous shock. Work began to decline even abroad, [and] I had no work in Portugal. I left a community and I went to live alone, but I only had my retirement income… and we were already in crisis, the country was already in crisis… and what I did was start getting my meals at St. Other narratives illustrate how the interaction of multiple forms of oppression Crenshaw, , such as poverty and marginalization, can act together to drive a person to abusive consumption.
It is the case of both John and David. When I left the house I would see people selling hashish and then I saw them smoking it. Family members also consumed. Likewise, David invokes the role of peers and the subcultures of marginalized neighborhoods in his personal and social downfall, that is, his commitment to the life of drug trafficking and consumption that would take him to prison more than once:. Finally, there is the interaction between poverty, low schooling and subcultures with obsolete traditions existing in rural environments, which are consensually considered strong predictors of alcohol abuse UNODC, :.
Drugs are chemicals that affect the body and brain. Different drugs can have different effects. Some effects of drugs include health consequences that are long-lasting and permanent. They can even continue after a person has stopped taking the substance. There are a few ways a person can take drugs, including injection, inhalation and ingestion. The effects of the drug on the body can depend on how the drug is delivered.
Substance abuse , also known as drug abuse , is use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases criminal or anti-social behaviour occurs when the person is under the influence of a drug, and long term personality changes in individuals may occur as well. Drugs most often associated with this term include: alcohol , amphetamines , barbiturates , benzodiazepines , cannabis , cocaine , hallucinogens , methaqualone , and opioids. The exact cause of substance abuse is not clear, with the two predominant theories being: either a genetic disposition which is learned from others, or a habit which if addiction develops, manifests itself as a chronic debilitating disease.
The UK has the highest rates of recorded illegal drug misuse in the western world. In particular, it has comparatively high rates of heroin and crack cocaine use. Substances that are considered harmful are strictly regulated according to a classification system that takes into account the harms and risks of taking each drug see the tables Nutt et al. The adverse effects of drug abuse can be thought of in three parts that together determine the overall harm in taking it: 1 the direct physical harm of the substance to the individual user, 2 the tendency of the drug to induce dependence, and 3 the effect of abuse of the drug on families, communities, and society Gable ,
- Они не преступницы - глупо было бы искать их, как обычных жуликов. Беккер все еще не мог прийти в себя от всего, что услышал. - Может, там был кто-нибудь. - Нет. Только мы трое. Было ужасно жарко.
И улыбнулся, едва сохраняя спокойствие. - Ты сочтешь это сумасшествием, - сказал Беккер, - но мне кажется, что у тебя есть кое-что, что мне очень. - Да? - Меган внезапно насторожилась. Беккер достал из кармана бумажник. - Конечно, я буду счастлив тебе заплатить.
- Я позвоню Стратмору и попрошу прислать нам письменное подтверждение. - Нет, - сказала Мидж, - игнорируя сарказм, прозвучавший в его словах. - Стратмор уже солгал нам. - Она окинула Бринкерхоффа оценивающим взглядом. - У тебя есть ключ от кабинета Фонтейна.
Она смотрела на обмякшее тело коммандера и знала, о чем он думает. Рухнул не только его план пристроить черный ход к Цифровой крепости. В результате его легкомыслия АНБ оказалось на пороге крупнейшего в истории краха, краха в сфере национальной безопасности Соединенных Штатов. - Коммандер, вы ни в чем не виноваты! - воскликнула. - Если бы Танкадо был жив, мы могли бы заключить с ним сделку, и у нас был бы выбор.
В дверях стояла Росио Ева Гранада.
Шаги неумолимо приближались. В голове у него не было ни единой мысли - полная пустота. Он не знал ни где он находится, ни кто его преследует и мчался, подгоняемый инстинктом самосохранения. Он не чувствовал никакой боли - один лишь страх. Пуля ударила в кафельную плитку азульехо чуть сзади.
Он стремительно развернулся и едва сдержал крик. Никого. Дэвид Беккер исчез. Тремя пролетами ниже Дэвид Беккер висел на вытянутых руках над Апельсиновым садом с наружной стороны Гиральды, словно упражняясь в подтягивании на оконном выступе.
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