Drug and Alcohol Use: Issues and Factors

378 Pages·1989·14.08 MB·English

by  Stanley Einstein (auth.)

Drug
AIC~hol
Use
Iss~:J
FACTORS
Drug
AIC~hol
Use
ISSUES
AND
FACTORS
Edited by
Stanley Einstein
Middle Eastern Summer Institute on Drug Use (MESIDU)
Jerusalem, Israel
Springer Science+Business Media, LLC
Library of Congress Cataloging in Publication Data
International Congress on Drugs and Alcohol (lst: 1981: ]erusalem)
Drug and alcohol use.
"Proceedings ofthe First International Congress on Drugs and Alcohol, held ... 1981
in]erusalem,Israel"-P.
Includes bibliographical references and index.
1. Drug abuse-Congresses. 2. Alcoholism-Congresses. 3. Substance abuse
Congresses. 1. Einstein, Stanley. [DNLM: 1. Substance abuse-Congresses. 2.
Alcoholism-Congresses. WM 270 D79365]
RC564.I575 1981 362.2'9 83-19098
ISBN 978-1-4899-0890-2 ISBN 978-1-4899-0888-9 (eBook)
DOI 10.1007/978-1-4899-0888-9
Proceedings of the First International Congress on Drugs and Alcohol,
held September 13-18, 1981, in]erusalem, Israel
© 1989 Springer Science+Business Media New York
Originally published by Plenum Press, New York in 1989
Softcover reprint ofthe hardcover Ist edition 1989
Ali rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfUming,
recording, or otherwise, without written permission from the Publisher
PREFACE
This book is the outcome of the First International Congress on Drugs
and Alcohol to be held in Israel. Both the conference and this volume grew
out of the need to overcome the specious man-made barriers which continue to
separate intervention plans and efforts in the broad field of substance use
and misuse. This need demands that all of us become aware not only of the
differences which may separate our concerns, but also of the similarities in
our goals and endeavors. We are obligated to draw together toward a common
effort for the common good.
The conference was designed to facilitate the exploration ot generic
~ssues. This volume is designed to document a variety of factors which are
basic to the defining, selection, planning, implementation, and evaluation
of substance use and misuse intervention.
This book is not a traditional proceedings volume. Because the needs
of a listening audience are quite different from those of the solitary
reader, and the roles of a workshop or plenary session participant are also
dissimilar from those of the reader, not all of the Congress presentations
are included, and the articles that are included have undergone major revi
sions. Current intervention needs and options demand a broad spectrum of
clearly defined roles for all who are or should be involved. Hence these
issues, among others, served as guidelines in the preparation of the revised
articles.
An attempt was made to pinpoint some of the more critical issues in the
broad area of substance use and intervention. This was done from a theoret
ical as well as from an empirical perspective. The joining together of
theses, experiences, data, and programs offers the reader an opportunity to
determine the functional relationships between them and their most effective
interfaces. The resulting volume is intended to be more than just a passive
document. The reader is asked to go beyond the built-in limitations of
paper and ink and to partake of the uncertainties of ideas. A meaningful
reading of any article or of the entire volume should not result in closure.
Each ending should lead to an ongoing beginning. If it does not, the editor
must assume responsibility for adding yet another static object to a world
which continues to be inundated by a flood of paper and paralyzed by con
ceptual impotence.
The contributors to this volume are to be thanked for their time and
effort in rewriting their articles. What began as a standard Congress
proceedings has become a volume which must be judged on its own merits. The
reader who becomes engaged by the printed materials and their many implica
tions will have to decide how best to use this book. Its most traditional
use will be that of a resource volume. It surely can serve as a catalytic
tool for planning and carrying out needed efforts and programs in the broad
area of substance use intervention. It can also serve as a guide for the
development of much-needed future conferences.
v
By permitting their articles to be published, the contributors have
invited the reader to become part of their professional life space. In so
doing, each has invited evaluation of his or her concerns, ideas, positions,
and efforts. Presentation to the Congress provided the contributors with
an opportunity for feedback. Readers may choose to write to contributors
in order to clarify issues, share opinions, ask for advice, or for a myriad
of other reasons, thus providing ongoing feedback, which will serve to min
imize the stultifying conditions which are all too often associated with
substance use intervention.
After finishing this volume, the reader may wish to consider the pos
sibility that his or her views regarding drugs, their use, and their users,
as well as the views of the contributors to this volume, are inadequate,
wrong, or irrelevant, and may wish to explore the implications of such a
conclusion. However, certainty in an uncertain area such as substance use
and misuse, in an uncertain and unstable world, is surely an unneeded man
made barrier to much-needed solutions.
Stanley Einstein
Jerusalem, Israel
vi
CONTENTS
Intervening in the Use and Misuse of Drugs and Alcohol:
Critical Issues -- Specious Actions • • • • • • 1
Stanley Einstein
Self-Esteem and Drug Abuse • • • • • • • • • • • • • • • • • • • 25
R. A. Steffenhagen
The Multiple Risk Factors Hypothesis: An Integrating
Concept of the Etiology of Drug Abuse • • • • • 37
Brenna H. Bry
Developmental Aspects of the Motivation to Drink:
A Cross-Sectional Investigation • • • 45
L. Gliksman
Sensation Seeking, Anxiety, and Risk Taking in the
Israeli Context 53
Steven E. Hobfoll, T. Rom, and Bernard Segal
Relationship between Heavy Drug and Alcohol Use and
Problem Use among Adolescents • • • • • • • • • 61
Helene Raskin White
The Social Networks of Drug Abusers before and
after Treatment • 73
J. David Hawkins and Mark W. Fraser
Drunkenness in the Old Testament: A Clue to the Great
Jewish Drink Mystery • • • • • 93
John Maxwell O'Brien and Sheldon C. Seller
Factors Governing Recruitment to and Maintenance
of Smoking • • • • • • • • • • • 101
J. F. Golding and G. L. Mangan
Social Pharmacology from a Macrosystematic Perspective • • • • • 119
Romuald K. Schicke
Cooperation between the Police and Social Care in the
Treatment of Alcohol and Family Violence Problems
in Finland •••••••••••••••••• 125
Teuvo Peltoniemi
The Parent's Movement: An American Grassroots Phenomenon • • • • 133
Carol Marcus
Self-Identified Presenting Problems of Drug Abusers
Entering Residential Treatment • • • • • • • • 139
L. Ball, D. Morgan, and G. Small
Stages in the Multifacet.ed Treatment of the Multiproblem
Drug Abuser • • • • • • • • • • • 155
Sam Lison, Ruti Saenger, and !lana Vinder
Staff and Treatment in a Statutory Outpatient Care
Agency for Alcoholics in Helsinki, Finland 163
Teuvo Peltoniemi
Genesa: An Adunct to Art Therapy in the Treatment of
Drug and Alcohol Abuse Clients • • • • • • • • 177
Robert B. Kent
Holistic Methods in Drug Abuse Treatment • • • • • • • • • • • • 189
Ethan Nebelkopf
Marathon Group Therapy with Illicit Drug Users • • • • • • • • • 203
Richard C. Page
Dealing with the Relapse: A Relapse Inoculation
Training Program • • • • • • • • • • • • • 209
Meir Teichman
Alcoholism -- A Response of Minority Communities to
Rejection of Their Cultural Identity by the
Dominant Culture • • • • • • • • • • • • • 215
Saul E. Joel
Problems of Community Denial on Recognition and Treatment
of Alcoholism among Special Ethnic Populations
in Los Angeles County • • • • • • • • • • • • • • • • 223
Marcia Cohn Spiegel
When Are Support Systems Support Systems: A Study
of Skid Row • • • •••••••••• 231
Steven E. Hobfoll, Dennis Kelso, and W. Jack Peterson
Family Treatment of Drug Abusers • 243
David K. Wellisch
Family Therapy: A Treatment Approach with Substance
Abusers in Inpatient and Residential Facilities 253
Edward Kaufman
Alcohol and Family Violence: The Treatment of
Abusing Families • • • • • 261
Jerry P. Flanzer
Alcoholism Treatment: A Family Disease Model with
Particular Reference to Inpatient Treatment
for Family Members • • • • • 275
Joyce M. Ditzler and James R. Ditzler
The Therapeutic Community Approach to Rehabilitation:
Perspective and a Study of Effectiveness 285
George De Leon
viii
The Therapeutic Community in Retrospect and Prospect • • • • • • 295
William B. O'Brien and Sy Halpern
The Availability of Alcohol and Alcohol Problems: Some
Theoretical Explanations and Empirical Consequences 303
Jerome Rabow and Ronald K. Watts
Evaluation as a Tool for Therapeutic Planning 313
Pritam S. Bhatia
Assessment of Prevention Efforts: A Focus on Alcohol
Related Community Damage •••••••••••• 329
Richard M. Earle
Metabolism through Alcohol Dehydrogenase Is Not a
Prerequisite for Fatty Liver Induction by Alcohols 349
R. Nordmann, R. Beaug~, M. Cl~ment, and J. Nordmann
Cerebral Atrophy in Chronic Alcoholic Patients • 357
Meir Teichman, Steve Richman, and Eric W. Fine
Gasoline Sniffing in Northern Canada • • 363
Gorden E. Barnes
INTERVENING IN THE USE AND MISUSE OF DRUGS AND ALCOHOL:
CRITICAL ISSUES -- SPECIOUS ACTIONS
Stanley Einstein
Jerusalem, Israel
The first documented case of drug misuse is well known to most of us.
Since it occurred a long time ago, the substance which was misused was an
easily available natural product and not a synthetic one. The user had been
forewarned not to use it, although the consequences of its use were unknown.
Nevertheless the "temptation," the "desire," the "inquisitiveness," the
"challenge" -- concepts well known to us-- to satiate man's complex
appetites could not be resisted. A "slimy sociopath," devious in his ways,
was the apparent drug connection. The first reported drug user was a woman.
She spread drug use to man. This is the earliest documented case of "drug
contagion." An endless epidemic was initiated. In this same documented
case study, signs and symptoms of a drug experience and projected withdrawal
are described. Paradise was lost by the ingestion of a natural chemical.
Since that awesome event conferences have been held, books and articles have
been written, and policies have been made which have resulted in the
following rather peculiar scenario.
An increasing number of the world's population has, over time,
undertaken to intervene, with questionable knowledge, in the lives of an
increasing number of the world's drug using population who use an increasing
number of natural as well as synthetic chemical substances in a relatively
unknowledgeable way. Apparently the half-life of the tree of knowledge,
notwithstanding its potent effect, was quite short.
An open, honest, and in-depth analysis of most past, as well as
current, drug use intervention may force us to acknowledge that these
efforts are, and always have been, a time-consuming, energy-consuming,
fiscal resource, and manpower-misusing ritualized myth.
The challenge facing all of us is whether we wish to continue to
maintain the mythology of intervention, and its relatively poor results, or
whether we can mobilize ourselves as well as others to plan and carry out
realistic intervention, if it is at all needed.
The following overview (Table 1) is designed to achieve two primary
goals:
1. To suggest why most drug use intervention efforts have to date
been specious in their formulation, have built failure into their
content and process, and have succeeded in continuing along in
this way irrespective of the state, nature, and meaning of drug
use at the specific time.