Narcotics+Anonymous+-+Otherness+with+Others

Mark Carlaw n8841209 Michelle Newcomb
 * THE ARTIFACT **

On Friday the 25th of October I attended a Narcotics Anonymous online meeting. These meetings serve as a place where drug addicts can speak and be heard, as they attempt to overcome drug addiction.


 * THE PUBLIC HEALTH ISSUE **

Narcotics Anonymous relates to the the public health issue of drug addiction and treatment and the negative effects of drug addiction on individuals and society. Due to privacy issues regarding the personal and vulnerable nature of the discussions that took place during the meeting, I will not be mentioning any specifics of the conversations. Instead my wiki will focus on the chemistry behind drug addiction and the social theory surrounding the issue.


 * LITERATURE REVIEW **

My literature review will focus on published information pertaining to the neurobiological process behind addiction. I believe setting a solid foundation describing addiction a chemical process that can be scientifically measured should reinforce the notion that drug addiction is a pertinent social health issue.

In August 2013, the journal of Current Opinion in Neurobiology released a special issue entitled Addiction. This special issue is composed of several articles drawing upon major advances in the scientific understanding of addiction that have taken place over the last 25 years. The authors discuss a variety of molecular and cellular mechanisms that induce and maintain the addicted state, providing detailed, scientific explanation for the manifestation of such phenomena as dependence, withdrawal and craving. This journal is a peer reviewed publication of noteworthy repute and as such provides quality material for review. In their contribution to the Addiction special issue, Lutz & Kieffer (2013) describe drug addiction as a progressive adaptation of the brains chemical composition in response to repeated drug exposure. The actual changes to brain chemistry are identified in the article through referencing various quality publications, one of which was penned by Koob & Volkow (2010), who describe the brains natural reward system, specifically endogenous mu opioid receptors, as the site through which many illicit drugs take effect.

Lutz & Kieffer postulate that repeated manipulation of mu opioid receptors through ingestion of illicit drugs can result in a “hedonic imbalance”. In the interest of defining drug addiction as a social health issue, the notion of this imbalance is important to understand. The natural reward system, as described by Koob & Volkow (2010), is a function of the brain that serves to reinforce behaviours that contribute to a person’s success or survival. One example of this natural process, as provided Trezza, Baarendse & Vanderschuren (2010) is social reward. After completing positive social actions, such as forming new friendships, the reward center of the brain triggers a chemical process beginning with the activation of mu opioid receptors and ultimately resulting in pleasant feelings and reinforcing the behavior. Lutz & Kieffer suggest that the process of repeatedly flooding mu opioid receptors with un-natural, exogenous agonists such as illicit drugs can result in activity reward and reinforcement only being able to occur through drug intake, with usual actions such as social interaction producing no reward system response.

In writing their article, Lutz & Kieffer drew upon a wide range of quality references, all published within the last five years. While their findings help to explain anti-social drug seeking behavior, the process behind the transition from recreational drug use to a state of altered brain chemistry consistent with addiction is not clearly detailed. Fortunately, Belin, Belin-Rauscent, Murray & Everitt (2013) address this process in their article, also published in the Journal of Current Opinion in Neurobiology Addiction special issue.

Belin et al consider the psychological processes behind acute and chronic drug use, with a focus on impulsivity and compulsivity. Initially, the article draws upon observational data from reputable sources to determine that once addicted to certain illicit drugs, a person may lose executive inhibitory control over their drug seeking behavior. A similar notion is expressed by other theorists who view addiction as disease like affliction, and those affected as victims with little or no personal agency (Hyman, 2005). Interestingly, Belin et al probe a little deeper into this idea, as they discuss the loss of executive inhibitory control as a neural process taking place in the brain’s ventral tegmental area. Belin et al draw upon recent empirical research to provide evidence of progressive changes not only in brain chemistry post exposure to certain drugs, such as neurotransmitter concentrations, but also changes in the physical structure and functioning of certain areas in the brain. This process of change is shown to begin with acute exposure and compounded with increased, chronic exposure. While the language used by the authors is often quite hard to understand, such as their description of the active agent in the change being related to the “recruitment of striato-nigro-striatal dopamine-dependent loop circuitry”, it is quite clear that Belin et al have pinpointed a measurable series of changes in a brain during progression from recreational drug use to addiction.

This foundation of solid, scientific research describing addiction as a real and measurable process that takes place in the human brain and affects human behavior helps to explain why drug addiction is a social health issue. The changes in chemical motivation resulting from chronic drug use can lead to addicts displaying anti-social behavior, as they place diminished value on natural, reward-center encouraged actions such eating, working and social interaction (Lutz & Kieffer, 2013). Unfortunately, research of this nature does not explain why some people are statistically more likely to become addicted to illicit drugs than others. The following section will provide a cultural and social analysis that may help to explain this occurrence.


 * CULTURAL AND SOCIAL ANALYSIS **

When describing his experience as a former drug addict, the devilishly good looking rogue Russell Brand declared “Drugs and alcohol are not my problem — reality is my problem. Drugs and alcohol are my solution.” When examined under the broad umbrella of structural-functionalism theory, as ruminated upon by Comte, Durkheim, Talcott-Parsons and many other handsome minded persons, those who do not flourish under the complex systems of society, and through their actions do not contribute to the unity, cohesiveness, stability and order deemed necessary for social existence, are considered undesirable. Therefore, by expressing dissatisfaction with society and pursuing an activity that has been determined illegal by society, drug addicts are placed on the outside, considered undesirable and labelled a problem.

As to the reason why some people do not thrive within society and subsequently develop drug addictions, it is important to examine statistics in order to identify patterns of illicit drug use. While obvious problems in gathering illicit drug use statistics should be acknowledged, such as an expected unwillingness for users to identify as such due to the reasons mentioned above, enough data has been recorded to indicate that certain patterns of illicit drug use within society are apparent. 33.8% of those considering themselves to be homosexual or bisexual are reported as being recent users of illicit drugs and 32.5% have used illicit drugs (AIHW 2011, p. 230). This is much higher than the corresponding numbers of heterosexual drug users. Also of high prevalence is the number of illicit drug users of indigenous origin (AIHW 2011, p. 230). 22.9% are recent users and 29.9% are ex-users compared to 14.3% of non-Indigenous recent users and 25.2% of ex-users (AIHW 2011, p. 230).

In comparison to the theory of structural functionalism, the social theory of symbolic interactionism originally postulated by Mead and Blumer takes a more micro level approach and can help to understand such disproportionately high occurrence of illicit drug use within minority groups (Hewitt, 2010). Symbolic interactionism accounts for social interaction in specific situations, viewing society as the product of the individuals within it and their interactions with each other. In essence, people determine their own society and reality. Harking back to the Russell brand quote earlier, and assuming a similar view is shared among other drug users, an interactionalist view of the micro construction of reality determines that activities such as illicit drug use are not naturally or objectively deviant, nor is the current macro level “society” universally desirable or undesirable. South (2000) describes the notion of overwhelming otherness occurring when those within society deviate at a micro level from what is considered the norm at a macro level. As LGBT people and indigenous Australian’s are determined at birth to be “other” than the majority, their micro construction of reality deviates from the macro, as a result they may seek solace in the chemical changes to the brain triggered by illicit drug use.


 * ANALYSIS OF THE ARTIFACT AND REFLECTION **

With the literature review detailing the neurobiological changes to the addicted brain and the social theories applied to some of the people most likely to use illicit drugs in mind, I reminisce upon my hour spent listening to the words of drug addicts with new perspective. During the meeting and for some days afterwards I was struck by a strong urge to shake my head in puzzlement. Due of the extremely personal nature of the conversations I will not go into any details, but I could not believe how or why someone would let themselves get on such a path, then continue to stay on it.

Now, with some small understanding of the actual, physical changes that take place in the brain when using drugs, coupled with some time spent pondering the notion of being born different, being raised differently, being considered from birth an outsider, I can begin to appreciate why some people are drawn toward illicit drug use - a means to an end, a way to override and transform the thought process of a prosecuted mind. I can see how, once sipping from the cup of neurochemical bliss, a mind seeking escape from an unjust society may tumble down the rabbit hole, life without drugs becoming a nightmare, life on drugs the only option.

Narcotics Anonymous provides a place for people who are addicted to drugs to come together, not as outsiders or others, or deviants seeking help, or as a problem to be solved, but as normal people with a shared, common goal. A goal to live their lives free from addiction, because they choose to do so, for their own reasons and on their own terms.

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 * COMMENTS ON OTHER WIKIS **

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**REFERENCE LIST ** Australian Institute of Health and Welfare. (2011). 2010 National Drug Strategy Household Survey Report. Drug statistics series no. 25. Cat. No. PHE 145. Canberra: AIHW.

Belin, D., Belin-Rauscent, A., Murray, J. E., & Everitt, B. J. (2013). Addiction: Failure of control over maladaptive incentive habits. //Current Opinion in Neurobiology//, 23(4), 564-572. doi:10.1016/j.conb.2013.01.025

Hewit, J. (2010). Symbolic interactionism. //Encyclopedia of group processess & intergroup relations//. (pp. 881-884). Thousand Oaks, CA: SAGE Publications, Inc. doi: http://dx.doi.org.ezproxy.library.uq.edu.au/10.4135/9781412972017.n272 Hyman, S. E. (2005). Addiction: A disease of learning and memory. //The American Journal of Psychiatry//, 162(8), 1414-1422. doi:10.1176/appi.ajp.162.8.1414 Koob, G. F., & Volkow, N. D. (2010). Neurocircuitry of addiction. //Neuropsychopharmacology// : Official Publication of the American College of Neuropsychopharmacology, 35(1), 217-238. doi:10.1038/npp.2009.110

Lutz, P., & Kieffer, B. L. (2013). The multiple facets of opioid receptor function: Implications for addiction. //Current Opinion in Neurobiology//, 23(4), 473-479. doi:10.1016/j.conb.2013.02.005

Trezza, V., Baarendse, P. J. J., & Vanderschuren, L. J. M. J. (2010). The pleasures of play : Pharmacological insights into social reward mechanisms. //Trends in Pharmacological Sciences//, 31(10), 463-469. doi:10.1016/j.tips.2010.06.008