Transcript Why do we need a sociology of addiction?

IMAGES CONSORTIUM MEETING
St Petersburg 25-28 April 2010
Agenda of the concluding session:
What Next?
• What did we learn?
• Publication plans?
• Funding issues: after 2010?
• Further meetings?
Why do we need a sociology of
addiction? What we have learned.
Theories of Addiction
• State of the art
• Why does not brain science do the job?
– Because the effects of cultural interaction (Hacking) are real
(e.g. People die, go to prison, feel pain, defect babies) because
of them
• Why does not ordinary social constructionism (labelling,
social definitions of the problem ) do the job?
– because the cultural interaction effects on the addicted desire
itself are also real
• Why does not the public health point of view do the job?
– Because addictions are not only a policy issue but a social
phenomenon in a wider sense
Images and representations
• the Moskowici aproach
• the Images approach
• Sulkunen, P. Between culture and nature: intoxication in
cultural studies of alcohol and drug use. Contemporary Drug
Problems 29, Summer 2002 24, 7/2002.
• Sulkunen, P. & Rantala, V. : Is Problem Gambling Just a Big
Problem Or Also an Addiction? Addiction Res. & Theory,
submitted Feb 2010.
•  are not contradictory but complementary
– images are not representations
– representations are often relevant
culture
culture
elaborated
”us”:subjects
progression
”other”: non-adult
nature raw
regression
”other”:non-subject
rotten
nature
Sulkunen, P.: Images of Addiction. Representations of Addictions in
Films. Addiction Res. & Theory 2007, Vol. 15 Issue 6, pp. 543-559.
Representing Passions without a Name
(Varpu)
• A paradox
• Historicity vs. production of cinematic
”effects”
• The role of ”the mental moment” in
production of effects on irresistible desire,
fear and disgust (the abject)
Difference and equality (Irina et al.)
• Focus groups: substance use is part of identity
construction
• Agency: free will!
• Autonomy contra intimacy, esp. tobacco!
• Sickness vs. own responsibility, esp gambling
& internet
The Images Theory (Maija &…)
• The imagery of ”learning”: agency, progress
• (Endotactic) modalities and the issue of agency
• A. Magical skills to control the game
– Attribution of logic
– attribution of agency
• B. How to control oneself
• CONCLUSION: to be a good player involves a competence
(and a will)  addicted behaviour involves a LEARNING
process i.e. is a product of culture, which dissipates in the
addiction process
– In the eyes of others
– In the experience of the addict
The Images Theory ctd.(…Matias & …)
• Different kinds of money
– are different vehicles of will, competence, ability and obligation
• Chance games
– controlling one’s budget
– controlling chance and fate (magical skills)
• Skill games
– in the game
– managing money
–  CONCLUSION: the imaginary dimensions of the fascination of
play are VERY diverse! But the same dissipation of their cultural
articulations are most likely to take place in the addictive
process
The Images Theory ctd.(…& Virve)
• The addict is the Other:
– who is described as someone who has lost the
modal quality that gives meaning to the activity
– which involves a loss of agency
• But it still is a complicated semiotic process
which involves always a point of view
Fear theory(Anja & Irina)
• Familiarity reduces fear, in general
(immigrants, religion, ethnicity, etc. )
• Legal OR media attention increases fear to
the extent that personal experience increases
rahter than decreases fear
• Older people and women see substance use
as a threat
• Professionals less opitmistic than lay about
healing in RU!!!
Fear theory (Kari)
• Two factor model:
– A threats to security;
– B social equality.
All addictions belong to A! So they are frightening,
rather than public health issues
This is why addiction probems are not about rational
planning but imaginary images; they are therefore
sensitive to imaginary ”facts”, political conjunctures
etc.
Note: Baltica study by J Simpura. There are other surveybased studies on rank orders of social problems (ask
Olli Kangas)
Help Theory
• Finns are afraid of substances
– both lay and professionals doubt help and self-help in the case of
alcohol, opiates, prescription drugs and amphetamines but not
tobacco
– Compulsory treatment more acceptable and number of dont know
answers was higher among lay than prof
• Ignorance increases stress of treatment motivation and compulsory
treatment?
• Urgency (motivation + compulsory) is associated with the fact that
addictions are felt to be a threat to security
• Lay people think that professionals should be in charge, not
themselves (who are victims)
• OBS! The above points towards the victims theory, which again
couples it with the contradiction between autonomy and intimacy
Help theory contd.
• In Ru professionals are in favour of isolation of
addicts, more strict than lay persons
Sickness Theory (Laurence)
• Heroine, cocaine, cocaine are considered dangerous;
others considerably less
• Still few people believe that drug free society is
possible
• Stereotypes: heroine users are sick, lack will and have
family problems, have no place in society, are parasite,
are dangerous
• Insecurity is the most important problem (49%);
poverty 33.6%, unemployment 32%
•  even strongly medicalised view of addictions does
not eliminate the threat they present to society (cf.
contagious diseases)
The Materialist Tradition (Arto)
• ”medicalisation” in the Illich/Foucault sense does
not apply to early 19th c approach to alcohol
• ”alcoholism” as an enitity does not apply either:
causative loss of reason, a. in the etiology of
different ailments, alcohol as part of materia
medica
• Empirical science of man since the mid 18th c.:
holism, mind&body, medicine pushed into society
(?), typologies of humans
The Materialist Tradition contd.
• Symptomatology, etiology, sense of history
(civilization critique, alcohol historicized,
• Trotter: drunkenness a disease, causing other
diseases and a disease of the mind
• Huss: availability, beliefs and customs, moral
corruption; acquired desire; physical ailments;
therepeutic pessimism; ”alcohol policy”
• clinics, specialised institutions, heredity, bad
nature, laboratory chemistry (cf. interest in the
liver)
The Institutional Theory: Clinical Gaze
in France and Finland (Michael)
• Minor quantitative differences between FR and FI
• Clear difference in emphasis in what GPs say:
alcoholic as a patient vs social problem
• Peer help vs professional medical help
• Work, friends, family as ”therapy” vs. Medical
help
• the psychiatric black box for both
• Abstinence: no pronounced differences
•  longue durée?
The Medical Ambivalence (Chantal)
• The patients’ suffering: medical ethics concerning
the GP’s role
• Debate on whether we can do, but not whether
we should
• Policy opinions are often Hussian: availability
theory,
• Involuntary treatment/tutelage is a real option
• Help for helpers! Training, specialists, institutions,
the Police, the Legislator, Associations
The Gender Aspect (Chantal)
• Danger, clear awareness of the gendered
consequences of alcoholism
• What about other addictions?