The cold, filthy pavement in an alley. Her only outfit – worn for years, ripped and stained by every bodily fluid. Memories of an abusive, rape filled childhood only magnified by the immense loneliness that fills her life. The remnants of a sexual favor performed to afford the five minutes of high still warm on her thighs. All of this is forgotten once she plunges the needle into her flesh.
Surely no one wants to live in the vignette painted above, yet many do in places such as New York City, Baltimore and Vancouver. The chase for the next high invades an addict’s life, leaving no room for family, friends or a future. Why would one make the choice to live this lifestyle?
The American Psychological Association’s magnum opus (albeit controversial) DSM-IV defines substance dependence as a “maladaptive pattern of substance use leading to clinically significant impairment or distress” relying on indicators such as tolerance, withdrawal, inability or failure of cessation, dedicating a great deal of time in pursuit of the substance, continued use despite negative physical and psychological side effects, and giving up important commitments (social, occupational, recreation) due to substance abuse.
Substance addiction has always fascinated me. Alcoholism runs in both sides of my family and I witnessed the toll that one family member’s addiction took on my relatives and experienced it myself. My father is a physician who used to supervise a methadone clinic, and still sees many opioid addicts in his office. Recently, I heard my father on the phone late at night yelling at someone. I thought it was a resident he supervised, but afterward he told me that it was a patient in his practice who paged him. She was hoping he would call in a narcotic prescription because she had misplaced hers. This was one of his partner’s patients, he had never seen her before.
I understood my father’s frustration, but the conversation that ensued between him and my mother (a nurse) troubled me. They both view these patients as selfish burdens who brought addiction upon themselves.
Ultimately, I feel that everyone (addict or not) is responsible for their actions and needs to understand the consequences of their decisions. Addicts will lie, steal and break the law to get their fix. Their behavior may be amoral, but drug addicts are still human beings. Human beings who have a chronic illness that desperately need treatment.
Anthropologists are interested in all of the factors that make up humanity. The biopsychosocial model is frequently used by addiction counselors and psychologists, a medical anthropologist would likely use something similar to that model while including a cultural element in order to understand someone’s substance dependence. A physician may only consider the addict’s current state and make his medical decisions based on context (drug seeker in an ER – get him out of here!) or by trying to manage dependence (prescribing a methadone regimen).
Bibliography
Danya Learning Center, "DSM-IV Substance Dependence Criteria." Accessed July 3, 2013. http://www.danyalearningcenter.org/bup/pdf/Dependence_DSM.PDF.
Surely no one wants to live in the vignette painted above, yet many do in places such as New York City, Baltimore and Vancouver. The chase for the next high invades an addict’s life, leaving no room for family, friends or a future. Why would one make the choice to live this lifestyle?
The American Psychological Association’s magnum opus (albeit controversial) DSM-IV defines substance dependence as a “maladaptive pattern of substance use leading to clinically significant impairment or distress” relying on indicators such as tolerance, withdrawal, inability or failure of cessation, dedicating a great deal of time in pursuit of the substance, continued use despite negative physical and psychological side effects, and giving up important commitments (social, occupational, recreation) due to substance abuse.
Substance addiction has always fascinated me. Alcoholism runs in both sides of my family and I witnessed the toll that one family member’s addiction took on my relatives and experienced it myself. My father is a physician who used to supervise a methadone clinic, and still sees many opioid addicts in his office. Recently, I heard my father on the phone late at night yelling at someone. I thought it was a resident he supervised, but afterward he told me that it was a patient in his practice who paged him. She was hoping he would call in a narcotic prescription because she had misplaced hers. This was one of his partner’s patients, he had never seen her before.
I understood my father’s frustration, but the conversation that ensued between him and my mother (a nurse) troubled me. They both view these patients as selfish burdens who brought addiction upon themselves.
Ultimately, I feel that everyone (addict or not) is responsible for their actions and needs to understand the consequences of their decisions. Addicts will lie, steal and break the law to get their fix. Their behavior may be amoral, but drug addicts are still human beings. Human beings who have a chronic illness that desperately need treatment.
Anthropologists are interested in all of the factors that make up humanity. The biopsychosocial model is frequently used by addiction counselors and psychologists, a medical anthropologist would likely use something similar to that model while including a cultural element in order to understand someone’s substance dependence. A physician may only consider the addict’s current state and make his medical decisions based on context (drug seeker in an ER – get him out of here!) or by trying to manage dependence (prescribing a methadone regimen).
Bibliography
Danya Learning Center, "DSM-IV Substance Dependence Criteria." Accessed July 3, 2013. http://www.danyalearningcenter.org/bup/pdf/Dependence_DSM.PDF.