A Sociologist Reflects on Addiction
Featured Article
When we think of addictions we often think at what Sociologists call the individual level. What personality issues or behavior problems are the cause of addictions and what needs to be done for the individual to facilitate the recovery process?
In Sociology we often think at what are called the Macro or Mezzo level. The Macro level refers to policies and practices at the general societal level that may impact the occurrence of or recovery from addictions. Tobacco is an excellent example of the impact of macro level policies. By 1970, tobacco was used by the majority of adults in the United States. Today this rate has been cut in half. While effective programs used by the American Cancer Society and the Seventh-day Adventist Church have contributed to this reduction, more of the reduction may be due to policy changes and changes in the general culture.
I can still remember as a young member of a National Institute of Health Grant Review Committee when a new Federal Regulation was instituted that prohibited smoking in federal government meetings. The Chair of the committee was a heavy smoker as was the federal government secretary of the committee. They ran the meeting at a conference hotel from the hallway so they would not be smoking in the room. It was their last meeting. Both resigned from the Committee rather than stop smoking. All other members chose to stop smoking to continue to serve the National Institutes of Health. I have seen policies in the U.S. move toward smoke free environments in the United State in all government offices as well as in so many public and private environments that the public visits. As a Child I remember, as an asthmatic, the trouble I had breathing at my beloved Chicago Cubs games and the haze that covered the field by the 5th inning. Now when I go for my annual game, the air remains clear and my breathing is easy not just because of individual decisions not to smoke but because of Policy that prohibited smoking in this public place. I was very pleased when my home state of Michigan went smoke free in 2010! Even economic policy has an impact on tobacco smoking. When states raise taxes, smoking decreases especially among youth.
Access to insurance that provides access to addiction treatment also has a strong relationship with use of these services and recovery. Many states have passed types of parity laws that require insurance companies to cover mental health and addiction recovery. These polices have provided access to recovery for thousands of addicts. While we must be cautious about the use of law and policy, we must also recognize their role in prevention, cessation and recovery.
The mezzo level involves relationships. A wide variety of research shows that addiction is often prevented or caused by our relationships. One of the best predictors of the use of substances is the substance use of our family and friends. Usually we are introduced to alcohol, tobacco, and illicit drugs by our family and friends. Our relationships are also one of the best protections against addictions. Research consistently shows that those youth who have a close emotional bond with their parents, whose parents know their friends, and whose parents know about their lives have a much lower rate of substance use than those who do not have these types of relationships with their parents.
The frequency of family dinners is positively related to lower rates of substance abuse. It may be that at these dinners is where the emotional bonding, monitoring and communication occur. These family and peer relationships are also a crucial part of the recovery process. Recovery is much more difficult without strong family and peer group support.
Among the greatest protective relationships is our relationship with Christ. Strong sociological research shows that faith plays a major role in prevention and recovery. Special issues of major scholarly journals in the substance abuse field have focused on the role of spirituality in prevention and recovery. As Adventists we have known that for a long time and now such a view is advocated by the best researchers and therapists.
The prevention of and recovery from addictions is a very complex phenomenon. It takes every level of focus to be effective. We have to be ready to work at the policy level, at the relationship level and at the individual personality and behavioral level. We must be cautious on the use of policy but we need to be ready to advocate for policies that prevent addictions and aid in recovery.