Archive for April, 2011

Spreading the word

Posted: April 27, 2011 in Uncategorized

Had an interesting afternoon, I was helping deliver a course looking at how to work with young people, and initially it was like pulling teeth, but the session ended with a really good theoretical discussion on the differences , positive and negative,  about the twelve step model. We also ended up discussing the need for more specific services for young people that provide hard clinical intervention , an interesting twist was when I threw in the concept of IEP (needle exchange) services for 16 or under, this usually degenerates into screams of moral indignation as people stick their heads in the sand and pretend that young people don,t know about and don’t indulge in IDU, this group however discussed this in a very mature way, there is hope me thinks of actually getting a good level discourse on changing our view towards policy around these topics, and this contentious area.


Here is an essay i wrote as part of my course work, please feel free to leave any comments or thoughts you have about this subject.

The Essay

This essay will explore the concepts that influence and dictate how we as a society have been influenced by cultural factors which colour our view with regards to alcohol/substance use, and the problems which rightly or wrongly are associated with the use of these substances.

Historical Context of Cultural Influence on Substance misuse,

It has long been assumed that the act of using substances is “inherent” ( Barclay et al, 2000) within the human make up, and that human beings have for centuries attempted to alter their perceptions of the world around them for various reasons, linked in to local socio–religious practice with societies becoming increasingly drug focused as they develop. (Ghodse H.    1995).  There is also good evidence by looking at anthropological studies that the use of substances within “primitive cultures” is not automatically associated with negative outcomes, which suggests that  the effects of substance are cultural specific.  (MacAndrew & Edgerton 1969)

More recently within our own History of the Post Industrial Revolution, Hogarth’s Etchings of alcohol use and misuse in Beer Street & Gin Lane, highlight that there were issues developing around substance misuse, and societies perceptions of this and  as early as 1729 the government, backed by religious leaders, began to tax gin.  Coming up to date to the here and now, the rise of new psycho stimulant substances reinforces this concept that human beings are always on the lookout for ways to alter their perception.

 Hogarth published his images of what were then contemporary scenes of life within London, or indeed any city of the time.  His now famous Gin Lane and Beer Street pieces highlighted the social differences between those who drank the cheap and readily available gin, and those who drank the more upmarket beer. Within these images, specifically Gin Lane, you can see the traces of the moral model , which suggested  that  those who were addicted to alcohol, especially spirits, were ethically and morally weak, a concept reinforced by the anti social behaviour recorded in the image, the main object being the intoxicated women letting her baby fall, as she reaches for a substance from the tin in her hand, and this image is compounded by the fact that she has bare breasts ,which would be not only a social taboo in what was a deeply conservative society, but could also indicate a woman of loose virtue and morals.  This has striking similarities , to the way contemporary society views female intravenous drug users who are mothers, and prostitute themselves to fund their addiction.

 The advent of control of substances, indicated another more sublime factor now emerging in the politics, and social world, that of the control of populations sanctioned by professionals, the Gin Act for example was forwarded by the political & religious establishment of the time, as a way to prevent Laziness and Criminal behaviour, ( Barclay et al,2000) within the growing masses of people now flocking to the cities for work in the new industrial complex which was growing rapidly.  Again if we look at the moral model, both laziness and criminality are moral weaknesses, therefore the control of the substance that caused these weakness was the logical step to “protecting “the population.  This gradually permeated throughout the next century with various acts being passed. the 1862 Pharmacy act to control the availability of opium, the 1912 Hague Convention, the Harrison Act of 1914 all related to control of opium, alcohol was also beginning to be controlled, with the Defence of the Realm Act in 1915, and previously on a more localised basis the Temperance Act Scotland 1913, which aimed to control the sale of alcohol, thus limiting its effect on the war effort and laterally the society in general. In more recent times, it could be argued that the introduction of the Misuse Of Drugs Act in 1971, which made injecting any substance, or the preparation of any substance for injection illegal, among other things, and classified certain substances, and attached specified legal tariffs for possession of these was a another move down this route.

 All introduced at a time when the disposable syringe, a relatively new development (1968), was becoming common place, and injecting practice was a common route for utilising drugs for recreational purposes.

 Social context of Cultural Influence on Substance misuse

 As Noted previously, mankind has had a long if not chequered history with substances, utilising their psychoactive elements to alter perception.

The human being is also the only animal that actually seeks these substances for this particular effect, “mankind is the only species that actively seek out and ingests the psychoactive substance in its environment.” (, Barclay et al, p.24 2000), and this behaviour has led to a whole collective of different concepts of what a culturally acceptable substance is. 

Within Europe, alcohol has been ingrained into our social structure, where alcohol is used to mark almost every landmark within a person’s life, and is utilised in various religious ceremonies.This social acceptance of alcohol, has led to a form of social normalisation around its use, and induction of non-users into the socially accepted patterns of use. 
 If for example a young man is seen to become involved in anti social elements of consuming alcohol,  it is said that he “can’t hold his drink”  and is dismissed as being foolish and immature by our society, possibly receives a police caution, and is seen to “learn from his mistake” (Barclay et al,2000). If however the same young man continues to persist in his anti social behaviour, especially under the influence of alcohol, he becomes more and more isolated, eventually is said to be displaying socially abnormal, or deviant behaviour and is deemed as suffering from Alcohol Dependence Syndrome, or has become an Alcoholic. This behaviour could be seen by society to be non-compliant with the acceptable social norm, therefore this was “deviant” behaviour, and needed some kind of intervention.

This concept highlights a second strand of social normalisation, the reinforcement of culturally acceptable behaviour through the use of behaviour models, namely the disease model, (Jellinek, E. M. 1960), and how this concept can influence how our concepts around alcohol are shaped. 

 The disease concept ,which suggests that a person with an alcohol problem has a disease, also suggests the issue can be treated using a medical intervention, or cured by abstinence,was challenged by MacAndrew & Edgerton (1969), with their research around drunken comportment.
MacAndrew & Edgerton, examined how various primitive societies viewed alcohol within their societies, and discovered that although the universal effects of alcohol, slurring, staggering and sleepiness, affected everybody, the way the culture of the specific tribe reacted to it was different. The studies highlighted that the negative “anti-social effects “noted in the west were often absent.   Out of 46 societies/cultures, studied, a link between alcohol and violence was only found to be present in  one fifth of the societies. (MacAndrew &Edgerton 1969) This suggested that reaction to alcohol was culturally specific.

 One of the other social issues that effects how a society views substance use is the availability of the substance, and what that culture uses as a substance of choice. (Gossop  M. 2007) Many cultures will choose to use a substance that is readily available in their culture, for example in areas of South America, Cocoa is the substance of choice because it is readily available in the surrounding environment, and has historically been used by the indigenous population, and has therefore become that societies drug of choice. It is when these drugs of choice enter a new culture, that they become “Alien Substances” and become viewed with suspicion and become problematic, with any adverse side effects only reinforcing the substances intrinsic dangers. “(Barclay et al 2000).

 This can be illustrated by looking at historical events over 300 years ago, throughout Europe, there was a backlash towards the new drug of the time Tobacco. In Russia, and  the UK ,the ruling classes passed legislation to control the use of the substance . In the UK  King James issued his “counterblast” at Tobacco calling it a “loathsome”, imposing a tax on it,  and  Czar Mikhail Federovitch  executed smokers.  (Barclay et al,2000) . The other way a culture can react to the introduction of an “Alien Substance” is by adopting the social rules and etiquettes around the use of the substance as demonstrated by the introducing culture.  This cultural adaptation or  the Dominant Culture Theory was also discussed by MacAndrew & Edgerton, (1969) who cited the case of the Papago or Tohono O’odham, who eventually adapted the drinking etiquettes of the Anglo American population, mostly  trappers , cowboys and soldiers, who at the time according to historian J.E Levy were the “worst drinkers in the American Nation.”` (Levy J.E.  1996)

 Psychological context of cultural effects on substance use

Different cultures also have different psychological constructs around substances and how the substance is used, and accepted within that society. We have seen how a culture can dominate a lesser culture, and imposes it’s social rituals around the dominant cultures chosen substance on the lesser culture, as it gradually becomes assimilated into the dominant one, but how can a societies psychological reactions differ, how can  one society demonstrate what are deemed to be negative reactions like violence and lack of control, whilst another does not.

The anthropological experiments had suggested that there was more to these reactions than the pharmacological effects of the drug. Marlatt & Rohsenow (1980) designed and conducted an experiment utilising what was described as a Balanced Placebo, which was designed to discover if a subjects behaviour could be manipulated by influencing their expectations with regards to using alcohol. These experiments proved that if people were expecting vodka and tonic, then they would behave in the way society expected them to behave, they also proved that people who were expecting vodka and tonic but received only tonic, still behaved as though they had received alcohol. (Marlatt, G. A., and Rohsenow, D. J. 1980). This experiment indicated that a person’s expectations on how to react with a drug could be learned. This discovery reinforced the idea that a culture/society will reinforce its own normalisation around its chosen substance, by socialisation, and learned behaviour.

 If for example a societies only expectation of using a substance is positive ,e.g it allows them to communicate with spirits, or allows some positive religious experience ,as is the expectation in primitive cultures then they will react accordingly, if however the society expectations are primed to expect unpredictable behaviour, or negative outcomes, the same will be true. If you then add into the mix, that societies moral attitudes, and beliefs around their chosen substance, and the infiltrating “Alien Substances”, then a cultures influence on substance whether alcohol or other substances can often be mixed, and inconsistent.

 One of the issues that influences society and culture is the concept of deviance in relation to misuse of the chosen substance. Emile Durkheim stated that deviance is an integral part of all societies and serves four functions, (1) affirming cultural values and norms, (2) clarifying moral boundaries, (3) promoting social unity, and (4) encouraging social change, (Thio A. 2004 ) and a societies/ cultures idea of what a social norm is, can be influenced by these factors.  The culture can influence how a substance is used and accepted, it can influence how the substance is morally viewed and accepted and how an individual expects to react when using the substance, and the sanctions which are imposed both socially and personally if the behaviour is out with the accepted norm. Usually this label would be dependent on how the above factors have been integrated into the culture, and how these factors are then used within that cultures mechanisms of social control. A society may demonstrate an intrinsic acceptance to the moral and health issues caused by it’s chosen drug, but act in a totally opposite manner to the alien substance which causes similar issues being suspicious of it, and legislating against it to control these issues. In effect criminalising the Alien Substance “not for risks to health”, but for “moral  degradation, corruption and unbridled sexuality.” (Barclay et al,2000)

 Another major influence is the acceptance of substance misuse within a model designed to explain this behaviour.  These models basically reinforce the concepts of deviant behaviour not being the fault of the person, but indeed being caused, by moral weakness (the Moral Model), or a disease process.(The Disease Model). ( GH Rassool 2009)

These models in turn influence the basic perceptions of society around it’s chosen substance (Gossop 2007) which in the UK  is alcohol. These basic perceptions are also being reinforced by legislation and the highlighting of negative images, that cause moral panic, Hogarth’s images could be cited as historic examples of this, a contemporary example would be the negativity around methadone as often reported in the media.

 The initial question was “Discuss how culture might influence alcohol/drug use and problems.”On examination, culture can have a massive effect on how individuals look at alcohol/drug use.

We have seen how historical concepts can colour how a society looks at substances, and can influence the very learning process, that integrates individuals into a society. This learning process around using substances, can lead to an acceptance of a substance that is culturally specific, and the experiences around this substance can then influence how we view the substance, and in some cases accept its negative aspects. This acceptance of negative and positive aspects, can in turn lead to a cultural expectation of how to act, both in a socially acceptable manner, and in a “deviant manner”, and then influences the social and moral penalties that are utilised to enforce societies sanctions for displaying this behaviour. We have also discussed how these penalties can be applied when a new substance is introduced, to enforce compliance with the social construct developed around the original substance of choice. We have explored how dominant cultures can influence how lesser cultures look at substances and how the expectations of the dominant culture is assimilated by the lesser cultures.

 In conclusion culture has various effects on a societies use of alcohol & drugs, in simple terms this can be summed up in the phrase “I am told therefore I am”. Culture can influence the normalised use of an accepted substance, and also influences the expectations of the reaction to the substance. It also influences various social constructs designed to control the use of substances, and ingrains them into the legal and professional mechanisms to control the general population. This influences the societies views on the use and misuse of substances both accepted and alien. It also influences the beliefs a society has as to the meaning of deviance within this construct, and how this deviance is recognised treated and dealt with.  In other words “I am told therefore I am”

Reference list  

Barclay et al, Royal College of Surgeons  ( 2000) Drugs, Dilemmas and Choices, London Gaskell

Ghodse H.  (1995): Drugs and Addictive Behaviour : A guide to treatment  2nd  Edition London Blackwell Science Ltd

Gossop  M. (2007): Living with Drugs 6th Edition Aldershot, : Ashgate Publishing Ltd.

Hoxie  I.  and Frederick E. (1996):  Encyclopedia of North American Indians. : New York  :Haughton Mifflin Company

Jellinek, E. M. (1960). The disease concept of alcoholism. New Brunswick, NJ: Hillhouse Press

MacAndrew, C., and Edgerton, R. E. (1969). Drunken comportment: A social explanation. Chicago : Aldine.

Marlatt, G. A., and Rohsenow, D. J. (1980). Cognitive processes in alcohol use: Expectancy and the balanced placebo design. In N. K. Mello (Ed.). Advances in substance abuse. Greenwich, CT: JAI Press

Rassool G.H., (2009): Alcohol & Drug Misuse: A handbook for Students and Health

Professionals,  Abingdon: Routledge

Thio, A. (2004) Sociology : A Brief Introduction 6th Edition. New York: Allyn & Bacon;


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Jaffe, J.H.; Meyer, R. E.( 2001)”Disease Concept of Alcoholism and Drug Abuse.Encyclopedia of Drugs, Alcohol, and Addictive Behavior.. 08 Dec. 2010 <>.