Diseasing of America - 6. What Is Addiction, and How Do People Get It? - Social Groups and Addiction

Written by Stanton Peele

Social Groups and Addiction

In the study of bulimia among college-age and working women, we saw that while many reported binge eating, few feared loss of control and fewer still self-induced vomiting.[20] However, twice as many of the college students as working women feared loss of control, while five times as many college women (although still only 5 percent of this group) reported purging with laxatives or through vomiting. Something about the intense collective life of women on campus exacerbates some women's insecurities into full-scale bulimia, while college life also creates a larger, additional group that has unhealthy eating habits that fall short of full-scale bulimia. Groups have powerful influences on people, as this study showed. Their power is a large part of the story of addiction. In the case of college women, the tensions of school and dating are combined with an intensely held social value toward thinness that many are not able to attain.

Groups certainly affect drinking and drug abuse. Young drug abusers associate primarily with drug abusers, as Eugene Oetting has clearly discerned in a decade's work with a wide range of adolescents. Indeed, he traces drug use and abuse primarily to what he calls "peer-group clusters" of like-minded kids. Naturally, we wonder why adolescents gravitate to such groups in the first place rather than joining, say, the school band or newspaper. But undoubtedly, informal social groups support and sustain much teen behavior. And some of these peer groups tend to be involved in a variety of antisocial activities, including criminal misbehavior and failure at school, as well as encouraging substance abuse.

One of the burdens of the disease movement is to indicate that it doesn't matter what social class one comes from—drug abuse and alcoholism are equally likely to befall you. Oetting disagrees strongly with this position. His opinion matters because he has studied fifteen thousand minority young people, including a great number of Hispanic and Native American youths. This is in addition to some ten thousand nonminority young people. Commenting on research that claims that socioeconomic status does not influence drug use, Oetting notes: "These studies, however, focus on middle and upper class levels of socioeconomic status and disadvantaged populations are underrepresented. Where research is conducted specifically among disadvantaged youth, particularly minority youth, higher rates of drug use are found."[21] These differences extend as well to legal drugs—18 percent of college graduates smoke, compared with 34 percent of those who never went to college.[22]

Middle-class groups certainly drink, and some quite heavily. Yet the consistent formula discovered in surveys of drinking is that the higher a person's social class, the more likely the person is both to drink and to drink without problems. Those in lower socioeconomic groups are more likely to abstain, and yet are much more often problem drinkers. What about drugs? Middle-class people have certainly developed broad experience with drugs in the last three decades. At the same time, when they do use drugs, they are more likely to do so occasionally, intermittently, or in a controlled manner. As a result, when warnings against cocaine became commonplace in the 1980s, cocaine use shrank among the middle class, while cocaine use intensified in ghetto areas, where extremely disruptive and violent drug use has become a major feature of life.

Those with Better Things to Do Are Protected from Addiction

My point of view, however logical, goes so much against standard antidrug crusade wisdom that I hasten to defend my assertion about controlled drug users. It is not that there is any question that the data I cite are correct. Rather, I have to explain why so much of the information presented to the public is misinformation. For example, we hear constantly that the 800-Cocaine hotline reveals great numbers of middle-class addicts. In fact, examining the rolls of facilities for cocaine addicts reveals everything we have already reviewed—that nearly all cocaine addicts are multiple-substance users with long histories of drug abuse. Whatever greater rates of middle-class "stockbroker" addicts there are now, these are dwarfed by the typical cocaine abusers, who resemble other contemporary and historical drug abusers by being more often unemployed and socially dislocated in a number of ways.

What about the masses of cocaine users who appeared in the 1980s? The Michigan group studying student drug use found that high school grads in the early 1980s had a 40 percent chance of using the drug by their twenty-seventh birthday. Yet, most middle-class users use the drug only a few times; most regular users do not show negative effects and only a few become addicted; and most who have experienced negative effects, including problems of controlling their use, quit or cut back without treatment. These simple facts—which run so counter to everything we hear—have not been disputed by any investigation of cocaine use in the field. Ronald Siegel followed a group of cocaine users from the time they began use in college. Of the 50 regular users Siegel tracked for nearly a decade, five became compulsive users and another four developed intensified daily usage patterns. Even the compulsive users, however, only "experienced crisis reactions in approximately 10 percent of their intoxications."[23]

A more recent study was published by a distinguished group of Canadian researchers at the Addiction Research Foundation (ARF) of Ontario—Canada's premier drug addiction center. This study amplified Siegel's U.S. findings. To compensate for the overemphasis on the small minority of cocaine users in treatment, this study chose middle-class users through newspaper ads and by referrals from colleagues. Regular cocaine users reported a range of symptoms, most often acute insomnia and nasal disorders. However, only twenty percent reported frequently experiencing uncontrollable urges to continue use. Yet even in the case of the users who developed the worst problems, the typical response of the problem user was to quit or cut back without undergoing treatment for cocaine addiction![24] How different this seems from the advertisements, sponsored by the government and private treatment facilities, that emphasize the incurable, irresistible addictiveness of cocaine.

Where do these media images come from? They come from some extremely self-dramatizing addicts who report for treatment, and who in turn are extremely attractive to the media. If, instead, we examine college-student drug use, we find (in 1985—a peak year for cocaine use) that 17 percent of college students used cocaine. However, only one in 170 college-student users took the drug on as many as twenty of the previous thirty days.[25] Why don't all the other occasional users become addicted? Two researchers administered amphetamines to students and former students living in a university community (the University of Chicago).[26] These young people reported enjoying the effects of the drug; yet they used less of the drug each time they returned to the experimental situation. Why? Simple: they had too much in their lives that was more important to them than taking more drugs, even if they enjoyed them. In the words of a past president of the American Psychological Association Division of Psychopharmacology, John Falk, these subjects rejected the positive mood effects of the amphetamines,

probably because during the period of drug action these subjects were continuing their normal, daily activities. The drug state may have been incompatible either with the customary pursuit of these activities or the usual effects of engaging in these activities. The point is that in their natural habitats these subjects showed that they were uninterested in continuing to savor the mood effects [of the drugs].[27]