Month: May 2008

Inequality and Drug Use

By Mary Kate McNamara, Emily Schirack, Dana Sherry & Amy Vereecke

Close your eyes. Imagine a crack addict. What do you picture? A wealthy man in an Armani suit and tie? Or a poor man clothed in baggy jeans; violent, dark and dangerous? Is she seated behind a mahogany desk on the 22nd floor of an office building in Manhattan or is she standing on a graffiti-covered street corner in East Harlem?

We know that a person’s drug of choice is influenced by his or her social status, from the high-powered lawyer with a penchant for powder cocaine to the pill-popping rock star to the alcoholic factory worker to the unemployed crack head. Here we will show something more important about a person’s relationship with drugs: an individual’s decision to use drugs is embedded in an unequal social structure, a social structure that produces unequal outcomes for drug users contingent on their social status.

By being poor, under-educated and of a low-status ethnic group, a person is at a greater risk for not only social marginalization, but becoming a victim of addiction (Baer, Singer & Susser 2003: 131). As David Courtwright argues in Forces of Habit, social inequality is promoted by the elite to maintain control over a minority group of laborers. By suppressing the lower classes in a cycle of substance abuse and addiction, the wealthy are able to increase their own power and profits. At the expense of people they deem inferior—simply because these people lack the material means to rise from their position—the elite sustain their authority. “Next to profits and taxes, the utility of drugs in acquiring, pacifying and fleecing workers proved to be their greatest advantage to the elites…” (Courtwright 2001:135)

In analyzing society’s abuse of drugs, Courtwright comments that “a pattern of drug use can become so entrenched in a culture that it is impossible to permanently suppress and delegitimate it” (Courtwright 2001: 199). This entrenchment is facilitated by a cycle of poverty, inequality and addiction.

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The Genetic and Environmental Bases of Addiction

As Presented By: Reid, Takashi, Sheeva and Michael

A man with deep set eyes and a tired, drawn face wanders aisle to aisle, seemingly lost amongst the labyrinth of supermarket shelves. His bloodshot eyes, bent forward posture and slight stature are indicative of years of hard living. His pain is readily apparent as he nervously shifts his weight from one foot, to the other and then back again. He rolls up his sleeve to scratch an unseen itch, briefly revealing a patchwork of new and old needle marks along the veins of his forearms; intermeshed with a few cigarette burns and dry, yellowing skin. How did he get this way you might ask? What is it about this particular man that caused him to become an addict?

The Genetic Element

Today many people would say “his genes” predisposed him to become an addict. Addiction has historically been known as a disease that runs in families, and in the past 30 or 40 years, this long-standing belief has been verified using systematic scientific investigation. The bulk of the research suggests that drug dependence functions much like other diseases, with certain people having a genetic makeup that increases their risk.

This was the case for Caroline Knapp, an alcoholic who skillfully describes her battle and eventual victory over addiction in her book Drinking: A Love Story. Knapp struggles with her genetic predisposition saying, “It’s encoded in my DNA, embedded in my history, the product of some wild familial aberration.” This conclusion is not limited to Knapp. One study found that children of alcoholics were four times more likely to become alcoholics themselves.

Modern scientific inquiries tell us that the inheritance of these addictive tendencies cannot be attributed to a single gene, as is the case for some diseases. Its transmittance is much more complicated.

For instance, genes involved in the metabolism of alcohol can be implicated in increased risk of addiction. For instance a major study found that young men who required more alcohol to experience an effect had higher rates of alcohol problems later in life. However, other genes, including those known to affect behavior and mood, are thought to be connected with addiction as well (National Institute on Alcohol Abuse and Addiction). Currently, scientists point to differences in clusters of genes on chromosomes 1, 2, 3, 4, 7, 11, 15, and 16 as important in chemical dependence (Goldman Review).

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CeaseFire: Violence Prevention and Why Gary Slutkin Is An Anthropologist

Gary Slutkin, an epidemiologist and physician at the University of Illinois at Chicago, is treating violence like an infection. Stop its transmission; get at the highest risk cases. And he’s doing that by acting like an anthropologist, using experiences and ideas culled from years working on public health projects in immigrant communities in the United States and in several countries in sub-Saharan Africa. I just wish more anthropologists would act like him!

CeaseFire, a Chicago-based violence prevention program started by Slutkin, was featured in the New York Times Magazine yesterday, covered by Alex Kotlowitz in his excellent “Blocking the Transmission of Violence.” Kotlowitz focuses on the core feature that makes CeaseFire a different sort of program: the use of “violence interrupters.” These are men who have been through the streets, who have the contacts and know the code. They are men like Zale Hoddenbach, thirty eight, once active in gangs, then eight years in prison, now a fervent interrupter. These “hardened types” form the core of CeaseFire, living proof of change as well as men who can go places and talk to people that no public health PhD could ever imagine doing.

So why do I say he’s an anthropologist? Three reasons, really. First, Slutkin is critical of received ideas, in this case that punishment drives behavior: “He was convinced that longer sentences and more police officers had made little difference… ‘Copying and modeling and the social expectations of your peers is what drives your behavior’.” He sees this approach as more akin to stigmatization and moral punishment than effective policy: people are afraid, so they turn to old reactions “like putting people away, closing the place down, pushing the people out of town.” This combination of a critical cultural take on present practices, and an informed social perspective, makes his approach inherently anthropological.

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‘Psychological kevlar’ and the burden of remembering war

I just read a fascinating piece by Clayton Dach, America’s Chemically Modified 21st Century Soldiers, on Alternet. Although there’s a sense in which Mr. Dach jumps to some of the worst possible outcomes when he looks at technology in the pipeline, on the whole, it’s a pretty well thought and concerned-but-not-hysterical account of some of the technology being brought to bear on soldiers, including the possibility of removing humans further from the ‘loop’ in combat decisions. I’m less interested with the latter — the robot warriors angle — not only because I think it’s been done better in science fiction movies, but also because I think it’s simply a more remote technology than some of the pharmaceutical work he discusses.

In particular, I found the discussion of ‘psychological kevlar’ to be interesting for neuroanthropology:

In the U.S., where roughly two-fifths of troops returning from combat deployments are presenting serious mental health problems, PTSD has gone political in form of the Psychological Kevlar Act, which would direct the Secretary of Defense to implement “preventive and early-intervention measures” to protect troops against “stress-related psychopathologies.”

Proponents of the “Psychological Kevlar” approach to PTSD may have found a silver bullet in the form of propranolol, a 50-year-old beta-blocker used on-label to treat high blood pressure, and off-label as a stress-buster for performers and exam-takers. Ongoing psychiatric research has intriguingly suggested that a dose of propranolol, taken soon after a harrowing event, can suppress the victim’s stress response and effectively block the physiological process that makes certain memories intense and intrusive. That the drug is cheap and well tolerated is icing on the cake.

With PTSD so prevalent among soldiers, can it be better treated, even if that means blocking the formation of traumatic memories? Daniel did a piece on PTSD rates in soldiers in April, Invisible Wounds of War, and he discussed a RAND Corporation estimate that treatment of soldiers with PTSD would cost ‘6.2 billion dollars in the first two years after returning from deployment.’ (Daniel also provided links to a number of articles on Iraq and its psychological effects in Wednesday Round Up #7.) The potential to use drugs to stop the development of PTSD, even if it also blocks normal memory formation, raises a number of ethical and moral questions as well as some interesting neuroanthropological ones.

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The Problem of Post-Conventional Outlaws



By Peter Ninneman, Andy Scott, Amanda Clark, and Paul Roman

What do Ken Kesey, an icon in the 1960s American acid scene, and Richard Nixon, who declared the first War on Drugs, have in common? These two cultural figures show us that the real problem with government attempts to control drugs is our culture’s problem with self-control. Our culture appears to increasingly value making up one’s own mind, making punitive measures more and more ineffective.

Temptation and the Need for Legislation

In his article “Dependence and Society”, Robin Room suggests the subjective experience of loss of self control is a cultural phenomenon. In traditional Navajo populations, for instance, drinking problems are seen at face value. There is no conception of lost self control; the explanation lies in simply drinking too much. In other words, “habitual drunkenness does not become alcoholism without a specific pattern of general cultural beliefs and norms.”

Room goes on to argue that 19th century middle-class Americans were having trouble controlling their own desires in the face of increasing temptations. For example, because of economic factors at the time, America became flooded with coffee that was sold at cheaper and cheaper prices. Living in a free society that valued individualism also meant that responsibility had to be put on people to take care of themselves at an individual level.

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David Brooks, Part Two: Demography Is King

In his editorial Demography Is King, Brooks describes how in recent decades in the US, “some social divides, mostly involving ethnicity, have narrowed. But others, mostly involving education, have widened. Today there is a mass educated class. The college educated and non-college educated are likely to live in different towns. They have radically different divorce rates and starkly different ways of raising their children. The non-college educated not only earn less, they smoke more, grow more obese and die sooner.”

He relates how Barack Obama has won “densely populated, well-educated areas” while Hillary Clinton has carried “less-populated, less-educated areas.” “For example, Obama has won roughly 70 percent of the most-educated counties in the primary states. Clinton has won 90 percent of the least-educated counties… This social divide has overshadowed regional differences. Sixty-year-old, working-class Catholics vote the same, whether they live in Fresno, Scranton, Nashua or Orlando.”

His argument? “In this election, persuasion isn’t important. Social identity is everything. Demography is king.”

What makes the editorial interesting is how he bucks the trend of buying into popular explanations about social identity. “Over the years, different theories have emerged to describe the educated/less-educated divide. Conservatives have gravitated toward the culture war narrative, dividing the country between the wholesome masses and the decadent cultural elites. Some liberals believe income inequality drives everything. They wait for an uprising of economic populism. Other liberals divide the country morally, between the enlightened urbanites and the racist rednecks who will never vote for a black man.”

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