The Most Important Precipitating Factor in Drug Abuse - Case Study Example

Low Self-Control, Gender, and Prescription Painkiller Abuse Introduction As in other fields of medicine and the behavioral sciences, an interactionalapproach to the etiology, epidemiology, psychopathology, and treatment of drug addiction or abuse implies the operation of multiple causality within the person, in the environment, and in the interaction between them. One must consider both long-term predisposing factors and more immediate precipitating factors. The most important precipitating factor in drug abuse is degree of access to these drugs. In contrast to common belief, by drug abuse or addiction, it does not necessarily have to be narcotic or other well-known substances of abuse. In many cases other prescription drugs such as psychotropic medications, narcotic analgesics, and even non-narcotic analgesics are also substances of abuse. Wide accessibility of analgesics over the counter and without prescription has led to a situation where these drugs are very commonly abused and often unnoticed, mainly due to cultural attitudinal tolerance. This points to the fact that no matter how great the prevailing degree of cultural attitudinal tolerance for addictive practices is, or how strong individual personality predispositions are, nobody can become addicted to these drugs without access to them. The crucial and determinative predisposing factor, which, therefore, constitutes the most acceptable basis for the nosological categorizing of these analgesic addicts, is the possession of those idiosyncratic or developmental personality traits for which these drugs could have adjustive properties. Chief among these effects is euphoria, which is highly adjustive for inadequate personalities, that is, motivationally immature individuals lacking in such criteria of ego maturity as long-range goals, a sense of responsibility, self-reliance and initiative, volitional and executive independence, frustration tolerance, and the ability to defer the gratification of immediate hedonistic needs for the sake of achieving long-term goals. Studies have uncovered in the life histories of such addicts, overpermissive or underdominating, overprotecting, and overdominating parents that tend to foster the development of the inadequate personality syndrome. Psychosocial and psychopharmacological research has pointed to several factors that may predispose to such addictions in suitably vulnerable population, and in this review, several relevant articles will be critically reviewed in order to update knowledge and evidence in this area of study. Recent literature in this area of study has been selected and reviewed with the expectation that new information can be synthesized so some factors towards interventions can be known with clarity. McGinnis and Foege (1999) review the data on mortality and morbidity due to use of addictive substances in the United States. Apart from huge mortality of 590,000 annual deaths, 39,000 is from addictive drugs. Addiction causes almost 40 million illnesses in the United States with immense economic impacts. It has also impact on the crime scenario since crime and addiction go hand in hand. There are also social costs to families and communities with addiction. Children with addicted parents may be addicted in future. Therefore this is an important social problem with various implications on the social life and the community (McGinnis and Foege, 1999, 109-118). Beaver et al. (2009) in their study on genetic and environmental influences on levels of self-control and delinquent peer affiliation attempted to find out the causes of self-control. The authors have commented that low self-control and exposure to delinquent peers are two of the most robust and consistent predictors of crime, delinquency, and antisocial behaviour. Studies thus far have failed to reveal the causes and pathways of development of self-control and the relationship of its deficiency in the youth when they befriend antisocial peers. It has been well known that environmental or genetic factors play important roles in the levels of self-control. Genetic factors play substantial roles, and it has been suspected that it may be polygenic, and this genetic bearing may play a role in environmental modification through the use of drugs of abuse. Abuse is invariably associated with immediate unearned form of gratification and ego enhancement. When a distinguishable difference between individuals is under genetic control, it is known as genetic polymorphism. Some drug responses have been found to be genetically determined. This study estimated the relative effects of environmental and genetic factors on level of self-control and contact with delinquent peers in a sample of twins taken from the National Longitudinal Study of Adolescent Health. The authors conducted a DeFries-Fulker analysis of this data and found that both self-control and contact with drug-using peers. It has been established that these drug using friends are heavily influenced by genetic factors and the non-shared environment. The authors, in this relation, discusses the implications of self-control theory and social learning theory and attempts to establish the large and consistent effects of genetic bearing and shared environments. The authors have used a justified methodology to prove their point (Beaver et al., 2009, 41-60). Burton et al. (1998) empirically assesses Gottfredson and Hirschis general theory of crime. The idea of crime derived from the classical theory of human behavior, which asserted that people pursue self-interest by avoiding pain and seeking pleasure. According to this conception, crimes too are events that satisfy self-interest. Criminal events therefore can be explained using principles that explain all other human conducts. The general theory of crime emanates from the concept that criminal acts have certain general qualities and they are connected to analogous noncriminal acts and the targets involved in them have certain qualities. In this article, the authors analyze this theory using references from rival theories (Pratt & Cullen, 2000, 931-964). Rival theories can explain criminal behaviour for both males and females. The authors have used a sample of 555 adults to find that there is a gender gap in crime. However, the most significant determinant is self-control (Burton et al., 1998, 123). When the factor of self-control is utilized in analysis, the relationship of gender to crime diminishes. When males and females are analysed separately, self-control is related in a somewhat different manner to male and female involvement in criminal activities. In this way with an appropriate methodological design, the authors establish that Gottfredson and Hirschis general theory of crime can have substantial impact in empiric assessment of crime as it is applicable to the variability demonstrated by genders (Burton, Jr., 1998, 123-147). Cretacci (2008) in his study on a general test of self-control theory presents the results of these tests. The author before presenting the study provides adequate background of his work based on the concept of self-control. The basic self-control hypothesis states that crime is the result of low self-control. The second element of general theory of crime is the biographical production and consequent stability of such self-control. According to this theory, it is produced by strict parental control during childhood, and if it is achieved during that time, it is stable afterwards (Meldrum, 2008, 244-251). The self-control effect is general in the sense that it is applicable to all forms of crime and analogous behaviour. Despite repeated testing, the results of tests of self-control theory have presented mixed results and measurement problems, and as a result, the true utility of this theory has not been understood. In this study, the author addresses recent concerns, and in the design, the author incorporates variables, namely, risk, consequences, criminal opportunity, an interaction term, and bond controls in one completely designed test. The author also addresses the generalist view of the concept of self-control in that this theory can explain different forms of crime. It would appear exaggerated when one considers the support this theory has gained from the researchers, but according to the author, it would be worthwhile to examine whether this support is due to this theory. The author has appropriately designed this study with cross-sectional and semi-longitudinal tests. The results indicate that self-control indeed significantly predicts a higher probability of involvement in property and drug crime. It should be acknowledged that self-control theory cannot explain violence. Although it is expected that support for the theory wanes over time, the other accessory concepts such as opportunity, risks, consequences, and bond controls may be involved in conceptualization of crime as a phenomenon (Cretacci, 2008, 538-553). This concept has also been supported by Kernis et al. (1993) in their study. The general theory of crime has been mentioned earlier. The basic assumptions of this theory applied to crime and all forms of analogous behaviour. The first generalist assumption on crime theory is confirmed by several real life examples, whereas in the other two, evidence is generally regarded to be not fully consistent. It has been a widely held belief that the other two assumptions of the general theory of crime is not backed up by enough evidence and the proof is not consistent uniformly. In some cases, the first assumption has been termed as tautology and has striking similarity to popular legal assumptions about crime, and more about criminals, they lack self-control. The popular assumption is that lack of self-control means problems with self indulgence, instead of psychopathology and ability deficit. In their study, Grasmik et al. (1993) examines these concepts proposed by Gottfredson and Hirschi, which states that low self-control in interaction with criminal opportunity causes crime, and this is the major factor in the etiology of any crime. The authors designed a study and tests the argument while examines the nominal definitions presented by these theorists. The study design was appropriate to their hypothesis in that they designed a factor analysis of items that dictate low self control. This trait is unidimensional. If crime is defined as fraud and force, the proposed interaction effect is found for self reported acts for both. However, the authors also found some inconsistencies such as criminal opportunity has a significant main effect, which goes beyond its interaction with low self control when the subjects reported crimes themselves. The other inconsistency is that substantial proportions of variance in crime are actually never adequately explained by the theoretical variables, and this calls for modification and expansion of the theory (Grasmik et al. 1993, 5-29). Gutierres et al. (1984) in their study involving women and their drug abuse habits on both heroin and prescription drug deal with the problem of female drug abusers who traditionally pose problems for therapists. The authors substantiate their study by stating the fact of limitation of information specifically regarding female drug abuse. If more information is available, the interventions can be improved at the levels of the therapists, programme planners, and the policy makers. The authors mention the fact that the bulk of the data available are based on descriptive studies and studies focusing on psychological and sociological components of the drug abuse in a womans life. These are mainly phenomenological data that reveal useful information, and the study designs do not support explanation nor prediction that can be available from empirical research. Therefore, there is a perceived need of theoretical formulations and application. There are several questions such as woman drug abusers have apathetic attitude toward treatment attempts, and this may be explained by an external locus of control. Thus if this concept is true, then invariably external forces control her life, and her own efforts have little if anything to do for her attempts on abstinence. If in such groups of patients studies are designed to extract such specific information, successful intervention strategies can be made (Gutierres et al., 1984, 354-359). Kelly and Parsons (2007) in their study on prescription drug misuse among club drug-using young adults found that nonmedical prescription drug use has recently increased. The authors did a time-space sampling to generate probability-based sample of young adults of age group 18 to 29, who go to clubs, and out of 400 participants, the available data on prescription drug misuse were collected. Analysis of these data showed that there is a high prevalence of misuse of prescription drugs among these adults. The drugs that were mostly used in profuse amount were painkillers or analgesics, sedatives, and stimulants. The highest majority indicated recent use of analgesic drugs (Ricketts & Higgins, 2007, 407-422). As expected there were variations among people with different genders and sexuality. The other important pattern that was unveiled was that young lesbian or bisexual women had the greatest propensity to abuse prescription drugs. An intense study of these patterns may lead to the context of this abuse, and it might be imperative to find out more contexts to design an effective intervention in this group of people (Kelly and Parsons, 2007, 875-884). Lagrange & Silverman (1999) tests the Gottfredson and Hirschis general theory of crime in their study to examine whether low self-control and opportunity are all to create delinquency. Previous studies have found that there is gender difference in delinquency. The authors performed a study involving 2000 Canadian secondary school students. In their study, they found that separate psychological factors do play important roles in causation of such delinquencies. These factors include preference for risk seeking, impulsivity, temper, present orientedness, and carelessness (Ritter, Strickler, & Simoni-Wastila, 2004, 1-23). Consequently, the authors incorporated these factors in their study design, and they were used as measures of self-control. Since other equivalent delinquent behaviors were associated with self-control, the authors also incorporated additional measures of the construct from the frequency of self-reported smoking and drinking. The opportunity of delinquent act is environmental, and in this age group, parental controls play important roles, and hence measures of parental/adult supervision were also included in the design. These measures and their respective interactions were used to predict self-reported delinquency, property offenses, violence, and offences related to drug abuse. The results were analysed to find partial support of the general theory, and this also revealed relationship between measures of self-control and delinquency that have magnitudinal variations across various genders and offense types (Lagrange & Silverman, 1999, 41-72). Longshore and Turner (1998) tested two hypothesis based on general theory of crime. The first hypothesis is that low self-control is a major cause of crime at the individual level. The second hypothesis is that the effect of self-control is contingent on criminal opportunity. A 23-item self report index was used to measure self control. The criminal opportunity was measured based on two proxy variables, gender and friends who were involved in crime. It was found that there was low self-control among offenders reporting more crimes based on self recall, but the variance explained by self report was low in each case. The relationship between self-control and fraud crimes was contingent on criminal opportunity, whereas the reverse was true about the relationship between self-control and force crimes. This could provide a new light to the general theory of crime (Longshore and Turner, 1998, 81-98). In his study, Ozbay (2008) studied the link between self-control theory and deviance in a sample of 974 Turkey University students. This study supported the theory and its impact on strain, deterrence, differential association, and social bonding theories. It was clearly established that the greater the self-control, the greater was the deviance. Risk seeking had greatest impact on deviance, but self-control was not proved to be the cause of deviant behaviour, although it played a similar role in both the males and the females (Özbay, 2008, 72-80). Conclusion This review suggests that general theory of crime can be utilized to explain the drug abuse behaviour, deviance, and delinquency of the population, which are mostly youth. Although there are debates which have been highlighted in this review in relation to the applicability of this theory on a general note, it can be safely stated that loss of self-control with or without a genetic link expressed in a suitable environment may predispose to the drug seeking behaviour. References Beaver, K. M., Schutt, J. E., Boutwell, B. B., Ratchford, M., Roberts, K., & Barnes, J. C. (2009). Genetic and environmental influences on levels of self-control and delinquent peer affiliation: Results from a longitudinal sample of adolescent twins. Criminal Justice and Behavior, 36(1), 41-60. Burton, Jr., Velmer S., Cullen, Francis T., Evans, T. David, Alarid, Leanne Fiftal, & Dunaway, R. Gregory (1998). Gender, self-Control, and crime. Journal of Research in Crime & Delinquency, 35(123) Burton V., Cullen F., Evans D., Alarid L., Dunaway G. (1998). Gender, Self-Control and Crime. Journal of Research in Crime and Delinquency. 35; 123-147. Cretacci, Michael A. (2008). A general test of self-control theory. International Journal of Offender Therapy and Comparative Criminology. ,52(5), 538-553 Grasmick, H., Tittle, C., Arneklew, B. (1993, February). Testing the core empirical implications of Gottfredson and Hirschi’s General Theory of Crime. Journal of research in Crime & Delinquency. 30(1), 5-29. Retrieved February 12, 2009 from Academic Search Premier Database. Gutierres, Sara E, Patton, Deanna S. , Raymond, Jonathan S., & Deborah L., Rhoads (1984). Women and drugs: the heroin abuser and the prescription drug abuser. Psychology of Women Quarterly, 8(4) Kelly, B.C., Parsons, J.T. (2007). Prescription drug misuse among club drug using young adults. American Journal of Drug & Alcohol Abuse, 33(6), 875-884. Kernis, M. H., Cornell, D. P., Sun, C. R., Berry, A., & Harlow, T. (1993).  Theres more to self-control than whether it is high or low: The  importance of  stability of self-control. Journal of Personality  and Social Psychology, 65, 1190-1204. Lagrange, T., & Silverman, R. (1999). Low Self Control and Opportunity: Testing the General Theory of Crime as an Explanation for Gender Differences in Delinquency. Criminology, 37(1), 41-72.  Longshore, D., & Turner, S. (1998). Self-control and criminal opportunity. Criminal Justice and Behavior, 25(1), 81-98. McGinnis, J.M., Foege, W.H. (1999). Mortality and morbidity attributable to use of addictive substances in the United States. Proc Assoc Am Phys. 111(2), 109-118. Meldrum, Ryan Charles (2008). Beyond parenting: An examination of the etiology of self-control. Journal of Criminal Justice, 36(3), 244-251. Özbay, Ö. (2008). Self-control, gender, and deviance among Turkish university students. Journal of Criminal Justice,36(1), 72-80. Pratt , T.C., & Cullen, F.T. (2000). The empirical status of Gottfredson and Hirschis general theory of crime: A meta-analyis. Criminology. 38 (3), 931-964 Ricketts, M. L., & Higgins, G. E. (2007). A preliminary study of the factors that influence college student perceptions of the nonmedical use of prescription drugs: Criminal justice versus noncriminal justice students.20(4), 407-422. Ritter, G., Strickler, G., & Simoni-Wastila, L. (2004). Gender and Other Factors Associated with the Nonmedical Use of Abusable Prescription Drugs. Substance Use & Misuse, 39(1), 1-23. Read More