Drugs, Alcohol, and Tobacco: Is Addiction a Disease - Essay Example

Drugs, Alcohol, and Tobacco: Is Addiction a Disease? Introduction There are a number of instances where in it is reasonable to consider addiction a disease. The denotative definition of a disease is a “departure from a normal condition in a negative way that can be identified by a characteristic group of signs or symptoms” (Brownsberger & Heymann, 2009, p. 99). Nevertheless, by the same principles, patterns of behaviour that most people regard as ‘bad habits’, such as drinking, smoking, and taking drugs, eventually become diseases. Why do addicts keep on abusing drugs, alcohol, and tobacco? The answer is this: addiction is a disease. The disease of substance abuse is distinguished by compulsivity, or the irrational, negligent, uncontrollable act of resorting to drugs, alcohol, and tobacco (French et al., 2010). This essay tries to prove that addiction is a disease through a thorough examination of the nature and extent of alcohol, tobacco, and drug use in the United Kingdom. Some people consider addiction a disease because a number of occurrences can be associated with a biological tendency and because addictive substances alter the brain. Nevertheless, every goal-directed action is moderated by the brain, and acquired behaviour is largely influenced by changes in mental functioning (Pates & Riley, 2012). For instance, genetic research suggests a biological tendency towards different kinds of criminal activities, and it appears probable that later studies will reveal that particular environmental phenomena change the brain in ways that raise the possibility of aggression or violence (Ghodse et al., 2011). Hence, by the principle of biology, criminal acts would in time develop into a disease. The assumption that addicts abuse substances against their will has been fluently explained by researchers and medical practitioners. Miller and Chappel (1991 as cited in Brownsberger & Heymann, 2009, p. 100) stated that addiction is a disease because addicts have an uncontrollable urge to abuse substances. Yet, the assumption that behaviour is ‘uncontrollable’ does not appear to involuntarily make it a disease. Moreover, the argument that addicts are not capable of controlling their substance use is incorrect (Barton, 2012; Rassool, 2008). For instance, DSM criteria classify people who smoke one pack a day as addicts, but ever since the 1964 statement of the Surgeon General on the health impacts of smoking, tens of millions of heavy smokers have stopped smoking (Brownsberger & Heymann, 2009, pp. 100-101). Furthermore, majority of them quit without clinical support; they stopped smoking on their own. Critics then ask the question, if addiction is uncontrollable, how is this phenomenon possible? In contrast, it is not easy to stop taking addictive drugs. Hence the issue of whether addiction is actually spontaneous or involuntary substance use continues to be contentious (Brownsberger & Heymann, 2009). However, the nature and extent of substance use in the United Kingdom tells a different story. Substance Abuse in the United Kingdom The nature and extent of substance use is difficult to determine because substance use of individuals will differ significantly over time. Moreover, it is likely that individuals miscalculate the extent of their substance use or the quantity of substances they use, specifically with regard to alcohol. The yearly surveys of the United Kingdom of drug use, smoking, and drinking offer the most current measurements of the pervasiveness in the population (Gill, 2002). The following figures are obtained from the most current survey on the consumption of alcohol. In general alcohol consumption has dropped from 2000 to 2002 and a larger number of individuals are abstaining than in earlier periods. However, 29 percent of women and 37 percent of men are consuming more than the suggested daily amount per day (Galvani, 2012, p. 3). Males still consume a larger amount of alcohol than females, and this is especially apparent in populations aged 65 and above, where the standard weekly alcohol consumption of men significantly surpasses that of women’s (Galvani, 2012, p. 4). People with higher income are also heavier drinker than people with lower income. Lower-income individuals experience more alcohol-related harms in terms of their consumption (Marshall, Humphreys, & Ball, 2010; Barnard, 2006). This indicates that higher income or socioeconomic standing provides greater access to support services. On the other hand, new drugs are being reported continuously in the EU, roughly one every week. In 2011, 49 new psychoactive drugs were formally reported through the early-warning system of the EU. This state of affairs continued until 2012, with more than 50 new drugs now identified (Malmstrom, 2012, para 10). As expected, the Home Office provided annual information about drug abuse, as a component of the the British Crime Survey in England and Wales. Overall drug use had dropped from 2009 to 2010: 8.8 percent of adults reported that they had taken drugs in the earlier year. With regard to specific drugs, cocaine use dropped to a certain extent (Galvani, 2012, p. 4; Malmstrom, 2012). As in earlier years, cannabis is still the most widely used drug, then ecstasy and cocaine. In spite of dropping levels of drug use of young individuals, one in five of those aged 16-24 had taken drugs in the earlier year (United Kingdom Drug Situation, 2011). With regard to surveys of general population, the yearly countrywide British Crime Survey (BCS) presented by the Home Office offers the finest information on the drug use of different socio-demographic population (Plant, Robertson, & Miller, 2010). The 2009-2010 data from BCS show that at least one in three individuals under 16-59 age bracket stated having taken illegal drugs; to be exact, 12 million individuals aged 16 and above in Wales and England (Plant et al., 2010, p. 44). According to the World Drug Report (2012), it is assessed that almost 3 million individuals have taken drugs in the previous year and one in twenty adults had used drugs in the previous month. Cultural features of substance use in the UK have been linked to older populations. For instance, in a study of individuals aged 16-25, young Italians heavily disapproved of alcoholism, arguing that drunkenness was an adverse outcome of substance use, whilst for young British individuals, on the contrary, intoxication was one of the major purposes of social drinking (Saunders & Rey, 2011, p. 28; Liddle & Rowe, 2006). Qualitative research has substantiated this intense need among teenagers and young adults in the UK to attain malformed states of drunkenness, whether with illegal or legal alcoholic drinks. This form of drunkenness is embedded in the cultural framework of British ‘intoxicated weekends’ (Saunders & Rey, 2011, pp. 28-29; Anderson et al., 2009) in both drug-permeated and alcohol-filled leisure domain. The substance abuse problem has been described as an issue of social exclusion or poverty and a significant correlation exists between unemployment, income, and drug use (Stevens, 2010). A broad range of literature examines the complexities of the correlation between criminal activities, poverty, and substance use, with a specific focus on the correlation between materialistic crime and addiction which adopts the assumptions of the economic-compulsive theory of drug-oriented offending through which addicts engage in stealing to satisfy their ‘addiction’ (Paylor, Measham, & Asher, 2012). Although it appears that criminal behaviour for numerous users begin before their substance abuse and hence there is no direct causal description, there is still a significant correlation between these multiple determinants of marginalisation, poverty, and social exclusion (Ghodse et al., 2011; Hanson, Venturelli, & Fleckenstein, 2008). Meanwhile, the Scottish government in 2008 assessed that roughly 13,000 deaths annually in Scotland are due to tobacco use (Hothersall & Bolger, 2010, p. 354). Hence it may appear seem hasty to classify tobacco legislation as a success but important changes in trends of tobacco use indicate that its adverse effect on health will drop considerably in the near future (Hothersall & Bolger, 2010, p. 354). Roughly 9 million individuals use tobacco in the UK. Tobacco use in the UK is most prevalent among men, and individuals aged 20-24 and belonging to the lower class (NHS, 2013, p. 1). Bangladeshi and Pakistani males in the UK have especially high levels compared to the rest of the UK population. Bangladeshi and Pakistani women also use tobacco in various ways. Among Bangladeshi and Pakistani population in the UK, tobacco is used the form of bidis, pipes, and cigarettes (NHS, 2013, p. 1). Tobacco use is a kind of addiction in the UK. The National Health Service (NHS) provides assistance to those who want to quit smoking. In the UK in 1948, smoking was very widespread among males; 82 per cent used some type of tobacco. By 1970, the number of male smokers had dropped to 55 per cent (Cancer Research UK, 2012, para 9). Since the 1970s, the pervasiveness of tobacco use dropped quickly. From 2007 to 2009, the prevalence of smoking remained unchanged, and dropped further to 21 per cent in 2010. By 2007, the number of women who use tobacco had dropped to roughly 20 per cent and has remained stable from then on. There are approximately 10 million individuals in the UK who use tobacco (Cancer Research UK, 2012, para 9-10). Current studies show that self-reported tobacco use may miscalculate actual prevalence of tobacco use by 2.8 per cent in the UK (Cancer Research UK, 2012, para 11). The major challenge for addiction models is to clarify why individuals smoke in spite of being informed of the adverse effects of their behaviour. One theory explains that addiction develops from the weakening of self-control and rationality (Sevarino, 2002). The disease theory of addiction would hence claim that tobacco use is a clinical disorder that results in the development of uncontrollable behaviour because of defects brought about by smoking. Perhaps the most widely recognised theory of the reason people use tobacco is based on the social learning model that views smoking as a learned behaviour, acquired addiction through observational learning and operant and classical conditioning (Peckham & Hann, 2010). Beliefs about positive outcomes of tobacco use on weight and mood regulation, need to actualise or communicate a specific identity, curiosity, modelling (e.g. finding out from significant others how to smoke), and observational learning. Once individuals have started to use tobacco, there are numerous reasons why they keep on doing so (Griffiths, 2006). For example, tobacco users admitted that they gain pleasure from smoking and that it makes coping with pressure and stress easy. Unfortunately, according to Peckham and Hann (2010), there are very few empirical findings that substantiate the presence of these useful effects of tobacco use. Tobacco use is the most preventable cause of social disparity in life expectancy, impairment, and death in the UK. Smoking kills more individuals than alcohol consumption, drug use, and HIV combined. The adverse impacts of tobacco use stem from the consumption of a harmful combination of poisonous and lethal compounds such as human carcinogens (Cancer Research UK, 2012). These toxic compounds bring about an array of impairments and diseases. Most tobacco-related casualties across the globe are because of cardiovascular disease, chronic obstructive pulmonary disease, and lung cancer. Besides its impacts on physical health, tobacco use has also been proven to affect mental health. Tobacco users are almost twice as likely as non-tobacco users to display symptoms of mental disorder regardless of the form of illness (French et al., 2010). The public health consequences of smoking are aggravated by a major element; that is, its effect on non-smokers who are exposed to tobacco carcinogens. As mentioned by Griffiths (2006), epidemiological research from the UK shows that passive smoking or second-hand tobacco use may bring about deaths caused by tobacco use annually. Social Policy and Intervention in the UK The illegal drug use of young individuals in the UK and, more recently, alcohol consumption has slowly moved up to UK’s policy framework. Nevertheless, since the release in 1995 of the national drugs strategy, in 1996 of the substance of young needs, and in 2004 the initial national alcohol strategy, they have seemed to receive a great deal of public attention (Galvani, 2012, p. 162). Substance use, specifically illegal drug use, was included in the policy papers that comprised the Every Child Matters programme. The Department for Education and Skills released Every Child Matters: Change for Children, Young People and Drugs in 2005. It specifies the different current policy programmes and major performance markers that an array of services had to fulfil in relation to the substance use of young individuals. The government developed the Youth Alcohol Action Plan in 2008 with the intention of addressing the problem of excessive alcohol consumption among young people (Galvani, 2012, pp. 162-163). These emphases on the substance use of young individuals and the need to deal with it were adopted by the drugs strategy in 2010, which stressed that prevalence of binge drinking and use of cannabis by young individuals in the UK occupies the top spot in Europe (Great Britain: National Audit Office, 2010). One of the three main policy objectives of the strategy is to alleviate drug addiction. Further mention of the vulnerability of young individuals to the use of drugs and alcohol as a policy emphasis has surfaced in the White Paper, Healthy Lives, Healthy People: Our strategy for public health in England, together with other policy programmes addressing the alcohol consumption of young individuals as a component of public health programme (Galvani, 2012, p. 261). The National Treatment Agency for Substance Misuse (NTA) in England has been building up premium guidance for staff, services, and officials to enhance provision of a more individualised model of care for substance use (Great Britain: National Audit Office, 2010). In 2008, the Scottish Government made public its new policy to tackle substance use. The Scottish National Party (SNP), as a minority group, successfully gained approval for their proposed pragmatic policy (Hothersall & Bolger, 2010, p. 354). The paper adopted the new medium of recovery but apparently discarded the assumption that this was a deviation from harm reduction. They cited the United Nations Office on Drugs and Crime (UNODC) (Pates & Riley, 201, p. 35): Harm reduction has often been made an unnecessarily controversial issue, as if there were a contradiction between treatment and prevention on the one hand and reducing the adverse health and social consequences of drug use on the other. This is a false dichotomy. They are complementary. The strategy is innovative because of its pragmatic approach to tackling the evident insufficiency of available treatment for addiction. There was an assumption that service users must be motivated to take part in their own recovery (UNODC, 2012). The 2013-2020 EU drug strategy will lay out a far-reaching policy programme to address these problems (Malmstrom, 2012). The 2011/2012 NTA Business Plan centres on strengthening the creation and provision of useful local recovery-directed programmes. A major objective is to made public supervision and medical guidelines to move the focus from long-term treatment to a greater consideration for recovery and attainment of associated treatment outcomes (UK Drug Situation, 2011, p. 74). The Health of the Nation, released in 1992, was the earliest public health initiative in the UK with assessable objectives and outcomes. It emphasised that health education would be a major element in government efforts to address public health issues like tobacco use and lung cancer (Peckham & Hann, 2010, p. 67). Three other White Papers, namely, Smoking Kills in 1998, Saving Lives in 1999, and Choosing Health in 2004, all developed objectives and outcomes associated with lessening prevalence of tobacco use (Peckham & Hann, 2010, p. 67). As shown in the table below, the focus of major policy programmes for tobacco use is evidently on behavioural outcomes. *table taken from Peckham & Hann, 2010, p. 68 The government spent a large amount of resources for smoking cessation programmes (NHS, 2013). Education is a feature of several of these programmes; but it is notable that the focus on behavioural outcomes is at this point manifested in the interventions themselves. Conclusions This essay has proven that addiction is a disease through a comprehensive analysis of the past and current status of substance abuse in the UK. The prevalence of drug use, alcoholism, and tobacco use among adolescents and young adults in the UK demonstrates that addiction causes not only adverse physical, emotional, and mental effects on the part of the substance user, but public health issues, as well. 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