Midterm Exam

1. Addiction: difficult to define because it touches upon healthcare, politics, nationality
(immigrants) and wealth
- it has continuously been molded over time, primarily influenced by politics & health
care
- 1920’s definition by physicians=an action that opposes legal prohibition and thus
elicits social disapproval
- Other scientific definitions included=insatiably cravings FOR THE INTOXICATION
ITSELF (i.e. drunkard), increased bodily tissue tolerance, and withdrawal symptoms
- TODAY=”A NEW BILLABLE DIAGNOSIS” which allows “addicts” (often viewed
as criminals for the acts they commit under influence) to be come PATIENTS. They
receive healthcare coverage for their “ailments” paid for by other citizens because of
their poor choices (smoking)
Vice : immoral wicked behavior/ weakness of character itself/ sinfulness
One can argue our medicalization is excusing addicts of their habits. It is becoming a
cyclic process.
Statistically, the same percentage of relapse exists based on who is forced and who
willingly accepts treatment
These addictions are CHOICE, followed by a voluntary action. Today, medical science
and chemical research have proven that specific chemicals are addictive and pose side
effects. If people are aware of genetic issues such as alcoholism, they should stay away
from alcohol and not succumb to a low lifestyle, casting blame on relatives. They should
be held responsible for their actions because they were aware of side effects before
shooting up. Perhaps during the age of patent medicines, people could be held less
accountable for the detrimental side effects, as many were iatrogenic addicts.
Addictions/ vices are the same as habits, sins, amusements by way of “PROCESS
ADDICTIONS”
- “internet addictions” and “sex addictions” can be classified as such because they help
to fill a void, such as loneliness or boredom. BUT, from a scientific outlook, they
should not be classified as addiction because the levels of dopamine are not
synthetically produced, beut produced in natural concentrations. Therefore, these
should not present withdrawal symptoms.
- If routine exercise and AA meetings can quell heroine addicts, as indicated in the
TIME article, then mere process addictions are simple habits that should be able to be
overcome
Addiction affects society through criminalization and medicalization.
- people who abuse substances and drive drunk are criminals and can hurt others
- yet, medical attention should be available for people with genetic or psychological
disorders, or iatrogenic addicts
- EX: ASAM is making med students study addictions (1988 Am. Soc. Of Addic. Med)
Until late 1900s, drug addicts were primarily treated as criminals – 1/3 of US budget
was allocated to medical treatments and recovery programs. We are just paying to
send them to jail. But it wont matter cuz the relapse rate is the same
- to term “addiction” until end of 19
th
C./ Addictus=debt slave
- the dope fiend chose that life, like Chinese to smoke, but addicts were advised by
doctors and ads to help cure diesases
- “Dependency” implies choice / “abuse” applies fault or blame
Diagnostic and Statistical Manual of Mental Disorders
- correlation between mental disabilities and addiction
- Determines criterion to get medical help
- DSM 4 does not use “addiction”, just abuse
- DSM 5 in May this year uses “addiction” and nonsubstances like gambling
NIDA and Nora Volkow – Dopamine theory (addictions are due to a insufficient
production of dopamine or reception of dopamine in pleasure center of brain)
Treatments:
a. Prevention- taxes and laws
b. Incarceration
c. Treatment- AA meetings, Rehab, Keeley Cure?
3. Psychoactive Revolution 1492-1789
global production, trade, distribution of tea, spirits, coffee, sugar
Sailors exploit natives
- Age of discovery 1490s-1800
- Militant Expansionism 15
th
-16
th
C
Portuguese 1490s
- Africa in 1425: ivory, gold, and SLAVES/ WINE from Madeira Is. 1435 / Sugar
cane the sweet drug medicine (China to India to Africa) / India spice trade 1498
/ 1500s Sugar from Brazil / Coffee from Ethiopia in 1600s

Spain 1492
- Columbus exploration Oct. 12, 1492 / Route to Indies to find opium
OPIUM: primarily produced in Afghanistan; Primary painkiller; narcotic (slow
you down, like diarrhea); suppression of cough like in Mrs. Winslow’s syrum
Distilled spirits originated in SPAIN 11
th
c. BRANDY
- alcohol-> Acetaldehyde in liver (Indians lack a few enzymes)
Spanish Sailors had cards on them for gambling when they got lost, and threw them
overboard. The next day, they found land.
Spanish bring slaves to New World in 1503
1492-1600 Tobacco across globe!
Tobacco: Ease hunger and pain and fatigue “Heathens drinking smoke”
Perhaps the best advertising started with Dr. Nicholas Monardes’ Joyful News,
which advertised all fo the new products of the new world, including tobacco
- International prescription drug
Dr. Jean Nicot 1559 – Doctor to French Royal Family, who cured Catherine de
Medici’s migraines using tobacco
Tobacco was advertised as “Dry Drinking” to prevent all the side effects of hangover,
which is caused by a buildup of acetaldehyde







Significant Laws and Such:
1619 – VA colony enacts law against dice, cards, drunkenness, or idleness, and
requires drunkards be reproved by ministers
1785- First temperance movement in US
1785- Benjamin Rush’s ardent spirit paper
1826- Rev. Lyman Beecher’s sermon
Rush wants: higher taxes, fewer taverns, and denial of civil rights to control
temperance
1886- John Gough compares drinking to being caught in rapids of Niagara River
before the Falls