Sociological Conceptions of Alcohol and Drug Problems:
1. The Objectivist Viewpoint
This course is about problems that people experience when they or others use drugs or alcohol. Because this is a course in sociology, we will be primarily concerned with the efforts of sociologists to describe, explain, and understand alcohol and drug problems. As seen from a sociological point of view, problems related to alcohol and drug use have a lot in common with other problems, such as crime, domestic violence, or psychiatric disorder. These are all examples of deviant behaviors that have become publically recognized and defined as social problems. So, before we deal with specific questions about the meaning and nature of drug problems, we should consider a broader question: What is a social problem?
Within sociology, there are two quite different answers to this question. On the one hand, sociologists who study deviant behavior have traditionally worked from an objectivist viewpoint, which conceptualizes social problems as harmful social conditions that can be scientifically identified and measured. On the other hand, many sociologists have adopted an alternative conceptual strategy, the constructionist viewpoint, which analyzes social problems as a process of claimsmaking and social definition by politicians, social movements, and other interest groups. Some constructionists go on to argue that "social problems" are not necessarily based on "real world" conditions, harmful or otherwise, a contention that objectivists view as preposterous. Despite their many differences, both of these conceptual viewpoints on social problems have proven to be useful in sociological research and theory. Let's take a look at each perspective and how it views the defining characteristics of alcohol and drug problems.
The Objectivist Viewpoint: Harmful Social Conditions
When most people use the term "social problem," they are referring to behaviors or conditions that are objectively harmful or threating to their own or others' well-being. For instance, people often refer to violent crime as a social problem because of the thousands of deaths that result from it each year. We can also add millions of injuries, billions in economic losses, and many other forms of measurable harm that result from various forms of violent crime in the United States. Similarly, as shown in the box on the right, Nora Volkow, Director of the National Institute on Drug Abuse (NIDA), describes heroin abuse as a problem with numerous measurable consequences that have a "devastating impact on society."
Sociologists call this way of thinking about social problems the "objectivist viewpoint" because it focuses on threatening or harmful conditions that can be empirically measured using objective, scientific methods. Conversely, if something isn't a condition or threat that can be empirically measured—such as invaders from Mars or the infamous Salem witches—then it doesn't qualify as a social problem.
It is important to note that, from this perspective, "social problems" consist of social, medical, or economic facts that exist independently of public awareness or social concern about these conditions. This means that sociologists and other scientists are potentially capable of identifying and measuring social problems even though the public or policy makers do not view these conditions as problematic. Thus, researchers might perform a valuable social function by discovering new and previously unknown problems through scientific inquiry. For example, researchers at the University of Michigan who conduct the Monitoring the Future project annually report on new or growing drug problems that they have detected in national surveys of high school students (http://www.monitoringthefuture.org). Later in the course, we will turn to the Monitoring the Future project as a reliable source of objective, epidemiological evidence on patterns and trends in drug and alcohol use among teenagers.
Another excellent example of the objectivist approach to the study of alcohol and drug problems is the work of a team of British researchers who endeavored to develop a "rational scale to assess the harm of drugs" (Nutt et al. 2007). Nutt and his colleagues asked groups of experts on drug problems (e.g., psychiatrists, pharmacologists, forensic scientists) to rate various drugs on nine dimensions of harm, including physical harms, risks of dependence, and social harms such as intoxication and health care costs. The experts scored each harm for each drug on a four-point scale: 0 = no risk; 1 = some risk; 2 = moderate risk; 3 = extreme risk.
The figure below shows the mean harm scores—the overall average of scores on all nine dimensions—for 20 different substances rated by a diverse group of drug experts. The colors of the bars in this graph provide additional information on the current legal status of these drugs in the United Kingdom. According to the U.K. Misuse of Drugs Act, the Class A designation (shown in red) is reserved for the most dangerous drugs whereas Class C drugs (shown in purple) are defined as the least harmful controlled substances. Legal substances, such as alcohol and tobacco, are not classified (shown in blue).
Heroin ranks as the most harmful drug by a clear margin, with an overall mean score of 2.78 that is near the maximum possible risk of harm. It is followed by another illegal, Class A substance, cocaine, whose overall risk rating of 2.33 places it closer to the "moderate risk" range. However, as is evident elsewhere in this graph, the legal classification of substances as dangerous does not correspond very well with their rankings in terms of objective harm. In particular, the placement of LSD and Ecstasy (MDMA) near the bottom of this list in the "some risk" range stands in sharp contrast to their legal status in the U.K. (and, similarly, in the U.S.) as Class A dangerous drugs. Equally interesting are the relatively high overall harm scores for the widely used legal substances, alcohol and tobacco.
The Nutt et al. study shows how objectivist inquiry can potentially inform and challenge social policy in the area of alcohol and drug problems. The researchers conclude that their findings raise questions about the validity of legal definitions of dangerous drugs and indicate that the current classification system is "arbitrary." However, the objectivist viewpoint does not shed much light on the political, cultural, and historical processes that created these seemingly arbitrary definitions of drug problems. To understand how LSD, Ecstasy, or other substances become socially defined as "dangerous," we need to examine how claimsmaking activity shapes the social construction of social problems.
Mean harm scores for 20 substances and classification under the UK Misuse of Drugs Act
Source: Nutt et al., Lancet (2007) 369:1050.