Drug Use Normalization: A Systematic and Critical Mixed-Methods Review

Affiliation.

  • 1 School of Public Health, University of Haifa, Mt. Carmel, Haifa, Israel.
  • PMID: 27588528
  • DOI: 10.15288/jsad.2016.77.700

Objective: Drug use normalization, which is a process whereby drug use becomes less stigmatized and more accepted as normative behavior, provides a conceptual framework for understanding contemporary drug issues and changes in drug use trends. Through a mixed-methods systematic review of the normalization literature, this article seeks to (a) critically examine how the normalization framework has been applied in empirical research and (b) make recommendations for future research in this area.

Method: Twenty quantitative, 26 qualitative, and 4 mixed-methods studies were identified through five electronic databases and reference lists of published studies. Studies were assessed for relevance, study characteristics, quality, and aspects of normalization examined.

Results: None of the studies applied the most rigorous research design (experiments) or examined all of the originally proposed normalization dimensions. The most commonly assessed dimension of drug use normalization was "experimentation." In addition to the original dimensions, the review identified the following new normalization dimensions in the literature: (a) breakdown of demographic boundaries and other risk factors in relation to drug use; (b) de-normalization; (c) drug use as a means to achieve normal goals; and (d) two broad forms of micro-politics associated with managing the stigma of illicit drug use: assimilative and transformational normalization.

Conclusions: Further development in normalization theory and methodology promises to provide researchers with a novel framework for improving our understanding of drug use in contemporary society. Specifically, quasi-experimental designs that are currently being made feasible by swift changes in cannabis policy provide researchers with new and improved opportunities to examine normalization processes.

Publication types

  • Systematic Review
  • Behavior, Addictive / diagnosis
  • Behavior, Addictive / epidemiology*
  • Behavior, Addictive / psychology*
  • Databases, Factual / trends
  • Forecasting
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / psychology*

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Thesis Paper on Drug Addiction

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Drug addiction has long been and still is a topical issue around the world. There are different reasons why people get addicted and various levels to which people become dependent on drugs. Some people start taking them because of pure curiosity, others so as to improve their athletic performance or reduce stress and get rid of depression. It doesn't matter why people start, the main thing here is to get help at the right time and not to ruin their life and health. When people start taking drugs, with time the way their brain functions and looks is altered. First of all, drug taking causes elevation of dopamine level in brain, which results in the feeling of pleasure. Brain remembers this event and wants it repeated. So, the drug a person takes eventually reaches the significance that other physiological needs have. As a result, the person's abilities to think clearly, control behavior, exercise good judgment and feel well without drugs intake becomes affected. This, in its turn, causes problems in relations with family, friends, at work or in university. It is extremely important to recognize drug addiction at the right moment, preferably in the beginning, so as not to spoil social relationships and health. It is necessary to understand that the sooner the problem will be attended, the better it is for the treatment progress. There are certain symptoms of drug abuse: when drug is getting people into legal trouble, if because of it people start neglecting their responsibilities, when they use drugs under dangerous conditions, and when they cause problems in relationships.

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Life throws up innumerable situations, which we greet with both negative and positive emotions such as excitement, frustration, fear, happiness, anger, sadness, joy etc. All human beings are not equipped to take on changes or difficult situations in life, naturally. Out of them, many don’t adapt to those situations. The result normally is— those situations and accompanying stress overwhelm people. The mind-boggling changes in every sphere of life—culture, profession, modes of transportation and rapid lifestyle changes put pressure on men to adjust with equal speed. Stress begins to wear them out and there is a loss of resiliency against adverse situations of life. Consequently, they begin to pull away from others and give in to depression. It is said that life acts and you react. Our attitude is our reaction to what life hands out to us. A significant amount of stress symptoms can be avoided or aroused by the way we relate to stressors. Stress is created by what we think rather than by what has actually happened. For instance, handling adopted children, adolescents, academic failures, retirements or sudden loss of money needs a relaxed attitude, focused will and preparedness to face the quirks of life positively. Otherwise one tends to feel stressed and reacts in anger and frustration. Children of stressed out parents are more likely to be ill equipped to handle stressors positively. They may suffer from emotional disturbances, depression, aggressive behaviour or confusion besides chances of weak physical constitutions, which again can be a source of anxiety. With a better control of attention one can feel that the world is a more congenial place to live in. A right attitude can make a resilient person out of us in the face of stressful situations. We can choose to stand aside; or to take weak and ineffective measures; or to implement robust and enduring measures to protect the health and wealth of populations.

Philosophy, Psychology and Psychiatry

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Philosophers and psychologists have been attracted to two differing accounts of addictive motivation. In this paper, we investigate these two accounts and challenge their mutual claim that addictions compromise a person’s self-control. First, we identify some incompatibilities between this claim of reduced self-control and the available evidence from various disciplines. A critical assessment of the evidence weakens the empirical argument for reduced autonomy. Second, we identify sources of unwarranted normative bias in the popular theories of addiction that introduce systematic errors in interpreting the evidence. By eliminating these errors, we are able to generate a minimal, but correct account, of addiction that presumes addicts to be autonomous in their addictive behavior, absent further evidence to the contrary. Finally, we explore some of the implications of this minimal, correct view.

Adrian Carter , Ruud ter Meulen , David J Dm Frcp Frcpsych Fmedsci Nutt , W. Hall

The potential developments mentioned in this report raise issues that are likely to become important for policymakers within Member States and will require careful consideration at European level in regard to the EU's role. They raise important questions for both drug policy and human rights and may have implications for the future regional role of the EU in developing policies, monitoring the activities of Member States and taking appropriate action with regard to Member States' policies.

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Neuroscience research is uncovering the neurochemical mechanisms that produce the behavioural and cognitive problems observed in those with an addiction. This includes: the pharmacological sites at which drugs act (eg receptors); the neurochemicals involved in the metabolism (eg enzymes) and trafficking of drugs (eg transporters) that regulate their activity within the brain; and the molecular changes that occur in the brain as a result of continuous use of addictive drugs over long periods of time (see Chapter 2).

Addiction and drug abuse exact an enormous toll upon European society, largely as a result of premature death, physical harm and increased health care costs, violence and crime. A significant proportion of the European population will become addicted to licit or illicit drugs during their lifetime. Given the health and social burden of addiction, there is strong public interest in preventing addiction and improving the chances that addicts will stop using drugs.

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