Alcohol and Substance Abuse in Blacks and Whites - Coursework Example

Alcohol & substance abuse Etiology and Epidemiology of African Americans and Caucasians (Europeans) between the two races who have the highest addiction in alcohol and substances abuse Abstract The paper discusses the etiology and epidemiology of alcoholism and substance abuse among the African Americans and Caucasians. Through etiology, the paper describes initiation of substance abuse and alcoholism, and the associated factors. Epidemiological research provides information essential for defining the scope of the problem by identifying populations at risk. Epidemiological research provides insights into the etiology of drug initiation and use and the clinical effects associated with these addictions. Substance abuse and alcoholism have always invited debate on whether these are a medical problem or social problem. These addictions have been associated with serious medical conditions such as infections with HIV, and they have also been associated with social misbehavior. Substance abuse, also known as drug abuse, can be compared to a viral disease that spreads during an epidemic. Substance abuse is the addiction of an individual to consumption of alcohol or other drugs despite having the knowledge of problems related to such substances. Substance abuse and alcohol provide the individual with a temporary pleasure and gives a feeling of great happiness. A continuous use of such drugs makes the individual tolerant to its effects and may develop unusual withdrawal symptoms that may be detrimental to his/her overall health. The most useful and vibrant section of the society in the age group of 15-40 is widely affected by this grave and deadly habit. Types of drugs used by population in the United States also show ethnographic diversities such as alcohol-in-combination (32.7%), followed by cocaine (17.86%), and marijuana/hashish (14.64%). African-Americans have been found most commonly dosed with cocaine (56.53%), in emergency department cases, followed by alcohol-in-combination (40.21%), and heroine/morphine (23.37%). A specific report of 2000 on emergency department cases of cocaine overdose has revealed 43.39% of African-Americans and 34.2% Caucasians (Durrant, R & Thakker, J 2003; 147). A pattern of onset of substance use and alcoholism has been reported by many researchers. For example, it has been reported that Caucasians typically begin consumption of tobacco and alcohol at a younger age than African-Americans. Also, African-Americans have been found to develop cocaine and opiate dependence much after developing alcohol dependence, unlike Caucasians. Role of culture in consumption of alcohol has also been evidenced in these ethnographic groups. Alcohol consumption in certain cultures is allowed to a moderate extent, however these groups are, at the same time, under the influence of society, peers, environment etc and deviation from these norms has become a very common feature. For example, alcohol consumption by Caucasians in comparison to African-Americans in the United States has been found higher and is linked to norms relating to alcohol use (Durrant, R & Thakker, J 2003; 167). Etiology of substance abuse and alcoholism has shown diverse patterns throughout the world. Very often its initiation is linked to family, peer and environmental influences; and, impact of these influences have been seen to vary with the developmental status of the individual or dominant influence group whether family, peer, environment, ethnic group, socioeconomic status etc (Jones, C & Battjes, R 1985; 4). An extensive research on Caucasian population revealed that in adolescents of both sexes there were more parental than personal antecedents of age of onset of marijuana use. This, particularly in girls, showed that early onset was more often related to parental addiction and late onset had influences of parental firmness, responsiveness, self-awareness, demandingness, intellectual stimulation, and household help. In case of boys, it was related to parents’ conventionality, family intactness, and parental watch at home during their early childhood. In any case, emotional attachment played a vital role in keeping children away from substance abuse. In cases of alcoholism, similar trend was observed in these extensive researches, these trends related to constant parent observation, responsiveness, social position, and parental guidance through individuation and building self-confidence. Instances of tobacco abuse showed a slightly different pattern depicting an early onset of smoking in girls due to influence of peers or friends from non-responsive and disruptive families. Onset of more than one kind of substance abuse was very often related to being introduced to drugs by adults, almost all cases of close family members (Baumrind, D 1985; 24-27). Substance abuse habit has shown maladaptive pattern leading to destruction and/or suffering to the individual in the form of tolerance, increasing need of the substance to achieve the desired effect, and eventually lessened effect of continuous use of the drug leading to further increase in quantity of the substance. All these symptoms relate to their compulsion and obsession to the drugs, which makes the individual go to any length of activities to procure the desired drugs. Activities such as crime, robbery, or any other illegal activities are committed in order to acquire money or simply the drug itself in bargain for their illegal service. Most of the criminals convicted and associated with substance abuse come form the African-American population according to statistics. Owing to many ill-effects, substance abuse has been termed illegal in almost all the nations, but only varies with the degree of effect it brings with itself. For example, a few drugs available in one nation or even grown legally may not form a part of illegal drugs in that geographic area, exemplified by growth of cocaine and its accessibility by the African-American population. There are many types of drugs that are available legally and illegally. Drugs that are used as prescribed medicines and are available over the counter are legal drugs. This category of drugs also form a part of drug abuse due to the effect they have on individual’s health if consumed in large quantities. Such drugs are usually prescribed by doctors to provide an immediate relief to the patients. Knowledge of such drugs leads the abused individuals to getting addicted. For example, anti-depressants and sleeping pills form this category of legal drugs. Illegal drugs are those that have been certified as harmful by the Food and Drug Administration (FDA), and are not available legally. These drugs are known to have medically more devastating effect. For example, nicotine, marijuana, cocaine, narcotics, heroin, PCP/Angel dust are a few illegally sold ‘street drugs.’ There have been epidemiological data suggesting highest use of heroine by Caucasians during 1999-2001 period. The Treatment Episode Data Set revealed highest number of heroin-related treatment admissions during this year, and the age group varied among different states. Besides other reasons of heroin abuse, one important contributing factor was inaccessibility of prescription abusers of diverted pharma products such as OxyContin and other opiates which were very scarce. This unavailability diverted these abusers to heroin abuse. This switch from prescription drugs to heroin has proven very dangerous due to the level of their desired drug in heroin being much higher than the prescription drugs (Abuse; 2003). As researched and proposed by Brunswick et al., (1992) African American substance abuse and alcoholism have also been related to deprivation of stable family and interpersonal relationships. Apart from these risk factors, peers also are seen to have significant influence on drug abuse in most of the African-Americans. In sufficient exposure to broader opportunities in majority of the African American communities also poses a social threat in terms of getting adapted to social norms and understanding the right behavior. Thus, individuals tend to show disconnection to rightful social norms from very early stages of life. Drug abuse has been evidenced in early adulthood in African American population besides not assuming their responsibilities. Researchers have also found that African American women in their New York State sample were more likely than white women to continue marijuana use. Low-income women of this category also have lower marriage rates than compared to white women. Similarly, young African American men have also shown very high unemployment rates In addition to this, research on substance use has shown significant impact of culture among adolescents on consumption of tobacco products in chewable forms or smoke. African American adolescents have shown relatively lower consumption of tobacco than their white counterparts. Ambiguous reasons such as influence of the Church, cultural consensus against use of tobacco by youth, or lack of effective advertisers etc have been quoted. (Committee of Opportunities in Drug Abuse Research, 1996; 125-135). Researchers, however, quoted that smoking is found to be more prevalent among African Americans than Caucasians (Whitefield, K et al., 2003; 561) Epidemiological study has been extended to alcoholism and substance abuse more recently, related to the outbreak of heroin abuse in late 1960s. These studies are required to obtain an insight on the nature and severity of consequences Data on drug availability and demographics allow prevention and treatment programs to target the needs of those populations identified as at risk for increased alcohol and illicit drug use. For example, high abuse of cocaine by the African-American population, heroin by the Caucasian public, marijuana use by the youngsters in the US, abuse of prescription drugs by psychiatric patients etc will help in identifying the causes of epidemiology of these drugs among the population at large. According to epidemiological research to understand the scope of the problems underpinning the populations at risk, African-American populations have been proven to be the most affected lot. A study based on racial and demographic metrics reported that African Americans under the age of 25 tend to report illicit drug usage that is less than or equal to other populations in that area, while those above 25 reported highest usage of illicit drugs (Committee of Opportunities in Drug Abuse Research, 1996; 98). Research has proven that the annual consumption of alcohol by an average American is about two gallons a year, and that this has been remarkably steady over the past 140 years, with only two exceptions for short duration in between. Whereas drug abuse increased post World War II, and has been almost steady since 1970s. Rates of drug abuse have been remarkably high in African Americans than in Caucasians. The National Alcoholic Survey’s comparison of drinking habits of a sample of 723 African Americans and 743 Caucasian men revealed that slightly poor African-American men experienced more drinking problems and adverse drinking consequences than slightly poor White men. Reasons for this, as explained by the researchers (Jones-Webb et al.; n.d) were related to the discrimination faced by the black men, societal pressures by police, inadequate health and social resources etc. In the more affluent African-American community, the negative consequences of drinking were found considerably lower than those in Caucasians, probably because the African-American population tends to be come more vigilant about surroundings and consequences of drinking as their socioeconomic status improves (Nathan et al 1999; 232). While family history of alcoholism and substance abuse is one of the causes of individuals inculcating these habits, it has also been the reason for spread of these habits through mediators. The familial transmission of alcohol dependence differs between European American and African American families. Caucasian families were found to have a greater clustering of alcohol dependence and habitual smoking, while African American families had the highest levels of cocaine dependence. Other findings suggest that a higher rate and on earlier onset of tobacco use is found among alcohol-dependent African Americans versus nonalcoholic African Americans (Miller, W & Carroll, K ; 110). This addiction has been proven as an evil to the individual himself, the society, the economy, and to the nation. Drug abuse makes an individual insane and its effects show through his/her behavior towards family, friends and the society. Due to the obsessive and compulsive nature instilled into the individuals, they tend to pay huge amount of money to obtain the drugs. Thus, the drugs business done illegally involves huge amounts of money and shows it’s after effects at the national and international levels. Investigation has shown that this trade generates large amounts of illegal money which is then used for illegal purposes through means of money laundering. These purposes include anti-national and terrorist activities, secret business of arms and ammunition, and drug trafficking itself. The enormous improvements in communication and transport systems have given a further push for such activities to flourish at a much faster rate. According to epidemiologic reports of certain medical illness studies of 1970s and 1980s, majority of African-Americans were diagnosed with diseases associated with the kidney, all of which were due to intravenous heroine intake. This was less prevalent in Caucasians. Though, there has been genetic history identified with this disease, researchers have found out that heroine or other drugs act as catalysts to expose the hidden disease (Schrier, R 2007.1122). HIV/AIDS has been reported to be 17 times higher in African women than in Caucasians, quite proportionate to substance abuse (Forstein et al., 2006; 225) Apart from this, this group has also been proven to have reported other sexually transmitted diseases 30 times greater than the Caucasians. Data from emergency room visits United States comprise of more African-American population than Caucasians, and they also form three times greater part of drug related deaths reported (Durrant, R & Thakker, J 2003 ;146). Enough evidences have been gathered to prove that the African-Americans face the highest risk of HIV/AIDS due to drug inject. Evidences and statistics have also proven that the most vulnerable age of drug and alcohol addiction has been the age preceding individual’s entry into the workforce, particularly in the African-American population. A number of causes have been associated with this such as pressures related to financial conditions, work, career opportunities, etc. It has also been noticed that most drug and alcohol addicts do not manifest any clinical conditions in the initial stages. The epidemiology gets exposed eventually over a significant period of time, leading from use to abuse. This use to abuse progression also varies according to individuals and the environment. In such cases, a variety of interventions can help in identifying the reasons and combating the deadly addictions. Very often, tobacco along with alcohol abuse has been the most common forms of substance abuse affecting individuals. Their clinical manifestations also relate to the ill effects of these drugs (Normand, J et al, s; 43). Understanding the differences is essential to provide benefit to the psychosocial problems faced by these two ethnic groups, ie., African-Americans and the Caucasians. Specifically, for many African American patients, employment-training programs may be particularly useful. Caucasians may be in greater need of treatment that focuses on concurrent cocaine and alcohol problems, as well as family and psychiatric difficulties. In conclusion, the prevalence of substance abuse and alcoholism among African-Americans is higher than the Caucasians, as evidenced by the reports of hospitals, rehabilitation centers, and researchers. Though, the overall numbers seem higher for a particular ethnic group, specificities of substance abuse can provide a clearer picture to control these deadly affairs. As evidenced, the number of cocaine users among both the groups, marijuana abusers, alcohol and tobacco addictions vary among these populations. Hence, interventions to deal with substance abuse and alcoholism have to be different at different levels or groups in order to control hazardous effects of these addictions. Factors relating to the cause of these addictions need to be addressed specifically, and only an individually focused issue can help in combating these addictions and the associated side-effects. For the prevention of drug abuse, many strong policies and punishments have been laid down at the national and international level to curb such activities, rehabilitation centers have been setup to help the drub-abused individuals to overcome addiction and lead a healthy life; however, evidences have shown that a lot more effort is required to prevent drug abuse. Efforts in spreading knowledge about the ill-effects of drug abuse, an intensified effort in identifying and punishing people involved in this activity, awareness among all citizens of the prevailing laws along with support from the internal law and order systems are required in order to minimize the effects of drug abuse and eradicate the habit of drug abuse Addiction to such drugs and alcohol cause chronic and progressive psychiatric illness which require special care and attention. Effective prevention programs that address risk factors such as social influences, normative beliefs, social skills, and expectations regarding use. Gender-specific approaches can help to a great extent to combat the ill effects of substance abuse. Designing the prevention and awareness programs should also be specific to the age groups ie., sensitization to the drug effects should be based on the extent of vulnerability to attain appropriate and optimum results. A great deal of effort from the government and social institutions to address facts such as societal status, socioeconomic differences, racial disparity, gender differences, etc can be quoted as of utmost importance owing to the causes and risk factors of substance abuse and alcoholism among the entire population of the US. References Books Committee of Opportunities in Drug Abuse Research (1996) Pathways of Addiction: opportunities in drug abuse research. Division of Neuroscience and Behavioral Health, Institute Of Medicine, National Academy Press. Washington, D.C. http://books.google.com/books?id=oGL19UXqvHsC&printsec=frontcover&dq=PATHWAYS+OF+ADDICTION+opportunities+in+drug+abuse+research#PPA117,M1 Durrant, R and Thakker, J. (2003) Substance use and abuse. Published by SAGE http://books.google.co.in/books?id=vCYyDZE2umcC&pg=PA148&dq=Types+of+substance+abuse+African+Americans+Caucasians&lr=#PPP7,M1 Forstein et al., (2006) Guidance watch: practice guideline for treatment of patients with HIV /AIDS. In American Psychiatric Association practice guidelines for the treatment of psychiatric disorders. Published by American Psychiatric Pub. http://books.google.co.in/books?id=zql0AqtRSrYC&pg=RA1-PA1163&dq=substance+abuse+african+americans+caucasians+epidemiology+medical+issues#PPA225,M1 Miller, W and Carroll, K (2006) Rethinking Substance Abuse: What the Science Shows, and what We Should Do about it. Published by Guilford Press http://books.google.co.in/books?id=7KjfYkxiEOsC&pg=PA109&dq=Types+of+substance+abuse+African+Americans+Caucasians&lr=#PPA157,M1 Normand, J, Lempert, R, O’Brien, C. (1994). Under the influence? Drugs and the American Work Force. Published by National Academies Press. http://books.google.co.in/books?id=_1uZZN1E-MgC&pg=PA73&dq=Epidemiological+data+on+trends+in+illicit+drug+use#PPA43,M1 Nathan, P, Skinstad, A, Langenbucher, J. Substance Abuse Diagnosis, Comorbidity, and Psychopathology. (Ed) Million, T, Blaney, P, Davis, R (1999) In Oxford Textbook of Psychopathology Published by Oxford University Press US http://books.google.co.in/books?id=61gdxlJX5iEC&pg=PA231&dq=Alcoholism+and+drug+abuse+African+Americans+Caucasians#PPA232,M1 Schrier, R. (2007). Diseases of the kidney & urinary tract. Published by Lippincott Williams & Wilkins. http://books.google.co.in/books?id=ERqtOZMAiw0C&pg=PA1122&dq=Substance+abuse+causes+epidemiology+african+americans+caucasians Whitefield, K, Weidner, G, Clark, R, Anderson, N.(2003) Cultural Aspects of Health Psychology. Eds Weiner, I, Freedheim, D, Schinka, J, Velicer, W.(Eds) In Handbook of Psychology. Published by John Wiley and Sons, 2003 http://books.google.co.in/books?id=ystubnCmMHQC&pg=PA546&dq=usage+of+tobacco+in+Caucasians Journals Jones, C & Battjes, R. (1985) The context and caveats of prevention research on drug abuse. Etiology of drug abuse: implications for prevention. Research analysis and utilization system. National Institute on Drug Abuse. DHHS Publication. 293 (4) http://www.drugabuse.gov/pdf/monographs/56.pdf Baumrind, D (1985) Familial antecedents of adolescent drug use: A developmental perspective. Etiology of drug abuse: implications for prevention. Research analysis and utilization system. National Institute on Drug Abuse. DHHS Publication. 293 (22-35) http://www.drugabuse.gov/pdf/monographs/56.pdf Website Abuse, Heroin in the North-East, A Regional Drug Threat Assessment. (2003). National Drug Intelligence Center. http://www.usdoj.gov/ndic/pubs5/5787/abuse.htm Read More