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Book part
Publication date: 9 October 2012

Helena Hansen and Samuel K. Roberts

Purpose – To compare the histories of two opioid medications that are pharmacologically similar but subject to contrasting regulations in their use in treatment of opiate…

Abstract

Purpose – To compare the histories of two opioid medications that are pharmacologically similar but subject to contrasting regulations in their use in treatment of opiate dependence in the United States – methadone and buprenorphine – in order to analyze the role of racial imagery and racial politics in the legalization and clinical promotion of their use.

Methodology/approach – Historical methods of archival analysis of published articles and unpublished governmental records were used in researching methadone. Ethnographic methods of participant observation and semistructured interviews were used in researching buprenorphine.

Findings – Contrasting uses of racial imagery played a major role in shaping the current regulatory differences between the two treatments. The association of methadone with black and Latino heroin users has contributed to its increased federal regulation, while the association of buprenorphine with white, middle class prescription opioid users enabled its use in deregulated private physicians’ offices.

Originality/value of paper – Advocates of biomedicalization of behaviors and conditions thought of as social or moral, such as addiction, argue that biomedicalization reduces the stigma of the condition and imply that, in turn, it also reduces the racial inequalities associated with the condition. This study of the biomedicalization of treatment for opioid dependence indicates that the very process of biomedicalization depended on heightened racial imagery associated with each treatment and ultimately intensified, rather than reduced, the stigma of addiction for black and Latino low-income patients.

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Critical Perspectives on Addiction
Type: Book
ISBN: 978-1-78052-930-1

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Book part
Publication date: 9 October 2012

Luther Elliott, Geoffrey Ream and Elizabeth McGinsky

Purpose – To examine video gamers’ attitudes about and perspectives on the controversial topic of video game “addiction.”Approach – Ethnographic interviews and participant…

Abstract

Purpose – To examine video gamers’ attitudes about and perspectives on the controversial topic of video game “addiction.”

Approach – Ethnographic interviews and participant observation with a group of 52 regular video gamers, most also reporting considerable experience with substance use and/or dependence.

Findings – Gamers tended to endorse one of two explanations for video game addiction, either arguing that games operate on the same reward centers in the brain as drugs or that gamers who do become addicted are weak, unintelligent, or actively pursue an addictive state. Several rejected the category of addiction as applied to video gaming due to the lack of withdrawal symptomatology or the confusion of pleasure-seeking with pathology. None offered sociostructural explanations for the phenomenon, despite the relative oversampling of poor and minority participants with low degrees of education.

Research implications – Future research should attend to ideologies of causality and agency among populations affected by behavioral “addictions.”

Practical implications – The perspectives of video gamers themselves are critical to research and advocacy that departs from a position of slightly greater sensitivity, both to the formal dimensions of those games held to be most habit-forming and to the ideological dimensions of video gamers’ thinking about what constitutes “addiction.”

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Critical Perspectives on Addiction
Type: Book
ISBN: 978-1-78052-930-1

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Book part
Publication date: 23 September 2005

Ole-Jørgen Skog

It is argued that addicts, as people in general, are forward-looking and that they try to make the best of what they have got. However, this does not imply that they are…

Abstract

It is argued that addicts, as people in general, are forward-looking and that they try to make the best of what they have got. However, this does not imply that they are fully rational. Cognitive defects, instabilities in preferences, and irrationalities in the form of wishful thinking and dynamical inconsistency play an important role in addictive behaviours. These “imperfections” in people's rationality may not have very large consequences in the case of ordinary goods, but their effect can be dramatic in relation to addictive goods. In the first part of the paper, the rational addiction theory and the empirical evidence that have been presented in support of the theory is reviewed. Regarding the conventional tests of the theory by econometric methods, it is argued that the tests are misguided, both theoretically and methodologically. Furthermore, it is claimed that the definition of addiction implicit in the rational addiction theory is unrealistic, and that the theory makes unrealistic assumptions about human nature. Some empirical evidence for these claims is reviewed. It is concluded that although the theory has its virtues, it faces serious problems and must be rejected in its original form. Secondly, the socio-cultural embeddedness of addictive behaviours, and the social roots of individual preferences, are discussed. These issues are more or less ignored in rational addiction theory. It is argued that we cannot expect to obtain a proper understanding of many addictive phenomena, unless they are seen in their proper socio-cultural context.

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Substance Use: Individual Behaviour, Social Interactions, Markets and Politics
Type: Book
ISBN: 978-1-84950-361-7

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Book part
Publication date: 9 October 2012

Nancy D. Campbell

Purpose – The chapter examines the historical pattern of interconnections between drug policy, research, and treatment in light of recent theoretical developments in the…

Abstract

Purpose – The chapter examines the historical pattern of interconnections between drug policy, research, and treatment in light of recent theoretical developments in the medicalization thesis advanced in the sociology of medicine.

Methodology/approach – The chapter uses interpretive methods to examine how the social construction of addiction as a “chronic, relapsing brain disorder” converges with or diverges from the conceptual framework offered by sociological theorists of medicalization and biomedicalization.

Findings – The approach adopted shows how the meanings of the bio/medicalization of addiction shifted and circulated within and beyond the institutions developed to respond to drug addiction as a hybrid social, medical, and biomedical condition during the 20th century.

Social implications – Bio/medical frameworks for addiction are the outcome of historical attempts to influence public attitudes and develop effective methods to treat and prevent this “disease” in ways that would positively affect the quality of life of people living with addictions.

Originality/value – This original contribution addresses both strengths and limitations of bio/medical models, assessing how their influence has changed over time.

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Critical Perspectives on Addiction
Type: Book
ISBN: 978-1-78052-930-1

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Book part
Publication date: 17 October 2011

Julie Netherland

Neuroscientific technologies have begun to change the ways in which we understand, respond to, and treat drug addiction. According to addiction researchers, neuroscience…

Abstract

Neuroscientific technologies have begun to change the ways in which we understand, respond to, and treat drug addiction. According to addiction researchers, neuroscience marks a new era because of its potential to locate the causes of addiction within the brain and to treat addiction through altering neurochemistry. However, little is known about how addiction neuroscience and new neurochemical treatments shape individuals' experience of addiction and constitute new arrangements of knowledge and power that shape subjectivity and governance. This chapter addresses these domains by drawing on an analysis of scientific literature about addiction neuroscience and qualitative interviews with people being treated for addiction with buprenorphine, a pharmaceutical treatment for opioid dependence. The chapter charts four major themes in the addiction neuroscience literature (pleasure and the limbic system, rationality and the role of the prefrontal cortex, theories of plasticity, and the role of volition) and explores how each of these is incorporated, adapted, or rejected by individuals being treated for addiction with a pharmaceutical. This analysis demonstrates how neuroscientific ideas are mediated by the lived experiences of those being treated under a neuroscientific model. It also suggests that while neuroscientific interventions, like pharmaceuticals, shape the experience of those being treated for addiction, so too do many other forces, including social circumstances, moral frameworks, the drive for autonomy, and the quest to be “normal.”

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Sociological Reflections on the Neurosciences
Type: Book
ISBN: 978-1-84855-881-6

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Book part
Publication date: 9 October 2012

Mark Elam

Purpose – With reference to the long-term struggle to confirm cigarette smoking as a manifestation of nicotine addiction, this chapter explores the extent to which new…

Abstract

Purpose – With reference to the long-term struggle to confirm cigarette smoking as a manifestation of nicotine addiction, this chapter explores the extent to which new understandings of addictions as ‘appetitive disorders’ rather than ‘dependence disorders’ derive from treatment technology development as well as advances in basic scientific research.

Approach – Through historical analysis it is discussed how cigarette smoking only became widely accepted as a real drug problem in the 1980s after it had been shown to be amenable to treatment as such through the use of novel nicotine replacement therapies.

Findings – These replacement therapies succeeded in showing that the same drug that drew users into addiction could be redeployed to help draw up them out of it. Nicorette® could serve as at least the partial antidote to nico-wrong (cigarettes). However, as relapse to smoking has remained the most likely outcome of any smoking cessation attempt, so medicinal nicotine has also served to demonstrate that nicotine addiction is ultimately a problem of an uncontrollable appetite for cigarettes in excess of drug dependence.

Implications – Pharmaceutical incursion on cigarette smoking commencing in the late 1970s pointed to the need for a new mental disease model of drug-related problems while also providing valuable new tools and insights for ensuing brain research.

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Critical Perspectives on Addiction
Type: Book
ISBN: 978-1-78052-930-1

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Book part
Publication date: 9 October 2012

Jessie Daniels

Purpose – Reality TV shows that feature embodied “transformations” are popular, including Intervention, a program that depicts therapeutic recovery from addiction to…

Abstract

Purpose – Reality TV shows that feature embodied “transformations” are popular, including Intervention, a program that depicts therapeutic recovery from addiction to “health.” The purpose of this chapter is to address the ways whiteness constitutes narratives of addiction on Intervention.

Methodology – This analysis uses a mixed methodology. I conducted a systematic analysis of nine (9) seasons of one hundred and forty-seven (147) episodes featuring one hundred and fifty-seven individual “addicts” (157) and logged details, including race and gender. For the qualitative analysis, I watched each episode more than once (some, I watched several times) and took extensive notes on each episode.

Findings – The majority of characters (87%) are white, and the audience is invited to gaze through a white lens that tells a particular kind of story about addiction. The therapeutic model valorized by Intervention rests on neoliberal regimes of self-sufficient citizenship that compel us all toward “health” and becoming “productive” citizens. Such regimes presume whiteness. Failure to comply with an intervention becomes a “tragedy” of wasted whiteness. When talk of racism erupts, producers work to re-frame it in ways that erase systemic racism.

Social implications – The whiteness embedded in Intervention serves to justify and reinforce the punitive regimes of controlling African American and Latina/o drug users through the criminal justice system while controlling white drug users through self-disciplining therapeutic regimes of rehab.

Originality – Systematic studies of media content consistently find a connection between media representations of addiction and narratives about race, yet whiteness has rarely been the critical focus of addiction.

Details

Critical Perspectives on Addiction
Type: Book
ISBN: 978-1-78052-930-1

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Book part
Publication date: 9 October 2012

Zoë Meleo-Erwin

Purpose – This chapter explores how discourses of obesity as addiction are taken up by weight loss surgery patients and medical and scientific professionals.…

Abstract

Purpose – This chapter explores how discourses of obesity as addiction are taken up by weight loss surgery patients and medical and scientific professionals.

Methodology/approach – Based on 14 semistructured interviews, I discuss the ways in which bariatric patients partially account for their presurgical bodies and contemporary struggles with weight loss and regain by referencing food addiction. This work is part of a larger project involving 35 interviews and participant-observation work and therefore these results should thus be considered preliminary.

Findings – I argue that bariatric patients and bariatric professionals portray weight loss surgery as an extraordinary tool that allows the “out of control” to become controllable. However, bariatric patients also emphasize the hard work that is entailed in both losing weight and maintaining a weight loss even after surgery.

Social implications – I suggest that this portrayal, in addition to being an accurate assessment of the potential for regain following weight loss surgery, is a technology of stigma management.

Originality/value – This work contributes to the sociology of the body and medical sociology literatures by illustrating that, within a neoliberal and anti-fat social context, highlighting the hard work involved in weight loss and weight maintenance allows bariatric patients to demonstrate proper subjectivity and thereby reclaim “proper selves” as they work toward a “proper bodies.”

Details

Critical Perspectives on Addiction
Type: Book
ISBN: 978-1-78052-930-1

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Book part
Publication date: 3 August 2011

Sarah Whetstone and Teresa Gowan

Purpose – Since the mid-20th century, drug addiction in America has increasingly been redefined as a disease and diagnosed as a widespread yet treatable disorder. The…

Abstract

Purpose – Since the mid-20th century, drug addiction in America has increasingly been redefined as a disease and diagnosed as a widespread yet treatable disorder. The idiosyncrasies of addiction as a disease, however, have tended to block the journey of the addict from stigmatized moral failure to therapeutic reprieve. Centering in on the process of the “court-led diagnosis” of addiction, this qualitative case study uses ethnography and interviewing at a county drug court and one of its “partner” therapeutic communities to examine the process in detail, from the first negotiations between treatment and court personnel over the eligibility of the client, to the gradual inculcation of an addict identity by means of intensive cognitive education and behavioral modification.

Methodology/approach – Qualitative: ethnography and interviews.

Findings – We demonstrate that a shift from moral judgment to therapeutic sympathy is particularly unlikely for the fast-growing mass of criminal offenders whose diagnosis is spearheaded by the state in the form of the therapeutic jurisprudence of the drug court. For this group, the emphasis on the need for comprehensive resocialization and the close cooperation between the intimacies of therapeutic “rehab” and the strong arm of criminal justice “backup” not only maintains, but intensifies, moral tutelage, and stigmatization.

Social implications – The convergence of drug treatment and criminal justice tends to produce yet another stigmatizing biologization of poverty and race, lending scientific validity to new forms of criminalizing and medicalizing social hardship.

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Article
Publication date: 17 March 2021

Qianwen Yang and Xiang Gong

The engagement–addiction dilemma has been commonly observed in the information technology (IT) industry. However, this issue has received limited research attention in the…

Abstract

Purpose

The engagement–addiction dilemma has been commonly observed in the information technology (IT) industry. However, this issue has received limited research attention in the information system (IS) discipline. Drawing on the stimulus–organism–response (SOR) framework, this study explores the engagement–addiction dilemma in the use of mobile games and highlights the impacts of game design features, namely, mobile user interface and mobile game affordance.

Design/methodology/approach

The research model was empirically validated using a longitudinal survey data from 410 mobile game users in China.

Findings

The empirical results offer several key findings. First, mobile user interface and mobile game affordance positively affect telepresence and social presence, which lead to meaningful engagement and mobile game addiction. Second, a high-quality of mobile user interface positively moderates the effects of mobile game affordance on telepresence and social presence.

Originality/value

This study contributes to the literature by theorizing and empirically testing the impacts of game design features on the engagement-addiction dilemma.

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