I’m taking a class this semester on working with people with substance/alcohol abuse. For the final paper, one of the options is to research a “controversial” topic in the world of alcohol or substances. Problem is, I can’t seem to think of anything besides legalization of marijuana or motivational interviewing. I come to you, oh wise Dopers, to propose other ideas. Your help is greatly appreciated.
Would completely decriminalizing personal recreational drug use, and treating it as a medical problem only, result in fewer or more addicts? Fewer or more deaths among addicts? If more in either or both cases, would the resultant drop in crime make it worthwhile anyway?
You could write an interesting paper about the influence (positive/negative, warranted/unwarranted) of religion in rehabilitation programs. It gets even trickier when you have court-ordered programs. Just a thought.
- Peter Wiggen
There is an ongoing debate about why alcoholism rates are so much higher in Native American population than in other groups. While there seems to be evidence that there is biology involved, some people insist that it is the result of some kind of cultural discordance. Related to this issue is the idea that a tendency toward alcoholism is mostly inherited rather than just learned.
Could you do something on needle exchange programs? That’s an interesting topic, too.
That is a pretty good idea.
I don’t know where it falls on the “controversial” line in academia versus the general population however. I am a recovering alcoholic who was also a PhD. student in behavioral neuroscience and psychopharmacology in an Ivy League school ten years ago. Even then, it was taken as a given that there was a strong inheritable component to alcohol abuse and several of the “downers” like barbiturates and benzodiazepines. They all work on GABA receptors and there is a lot of interesting work on the heritable differences on those receptors.
There is some interesting work on sons of male alcoholics. There are striking MRI’s differences between those sons at a very early age versus their more normal counterparts. The heritable component for alcohol addiction is fairly strong between males and their fathers even if the son has never met the father and was raised in a different environment through adoption.
The literature is fairly well developed in that area and it makes a really good paper. Plus, most people don’t realize the things that have been discovered in that area. There tends to be a ten year or more lag behind well-established science and general awareness.
I can think of plenty of controversy-
The varying of sentences between crack and cocaine- both of which are basically the same drug but used by different populations. Is this a sign of official race/class discrimination or a reasonable response to the “crack epidemic”?
The young woman who was arrested for giving birth to a crack-addicted baby. Should people be arrested in the hospital like that? Are pregnant women criminally culpable for the state of their children at birth?
Then there is the big stuff- does the US government have connections to the drug trade? How is our intference in drug producing countries (Columbia, Afghanistan) affecting thing? Did they really introduce crack into the ghettos to run down the Black Power movement? This stuff might get a little too controversial for a class, but there is some intersting stuff out there.
The above are better than mine.
What are the cross-cultural definitions of alcohol and/or drug abuse? Here in the Czech Republic, beer is still what’s for breakfast for many people (just a small one). In the USA, admitting you have 2 glasses of wine a day can have people raiseing their eyebrows at you, wondering when you are going to get help. How do cultural norms come into play when discussing chemical abuse?
-Tcat
How about, Is AA a cult?
Just google that phrase and you’ll find plenty of information.
Yes. What he said. (I make no claim one way or the other, but it is a controversy in the field of addiction treatment).
However, to put it another way (that might be better for a paper) you might write about the effectiveness of AA and other 12-Step groups. There are medical professionals that believe that AA does more harm than good, that it is not as effective as no treatment whatsoever (IOW-- more people who join AA relapse than people who quit drinking/using but seek no treatment program), and/or that at the very least that the recovery groups which are alternatives to AA need to be far more widespread and available to people who are not of a religious bent but who wish to quit drinking.
For that matter, that is an AA controversy in itself–is AA a religious group? Can 12-Step attendence be mandated by a Court?
You might start with Dr. Stanton Peele. Something else that Peele discusses but is a bit of a side-issue to the above topic (but also contoversial) is the “harm reduction” approach to treatment.
I believe that Peele has also questioned the “disease model” of addiction as well. Whether he questions it or not, certainly others have and that is yet another interesting and very controversial topic in the field of addiction.
I don’t want to get into too much here but I don’t think this is accurate or makes a good paper. I have been to AA many times but I am not a regular member.
What most people don’t realize is that AA has no leaders. It is just a completely decentralized series of groups, and there is little pressure for anyone to do anything. In AA you just show up, go over some common principles, discuss, talk, and ask for help from the successful members if you want or need it. There is only a suggested donation of $1 per meeting to help pay for incidentals.
That is in no way a cult in my mind.
I think most people respond to the “secret meeting” thing in a weird way. It is true that there are more meetings than the average person would ever know but that is just because there are alcoholics everywhere and they need a safe place to get help.
You could discuss harm-reduction strategy versus abstinence in the treatment of intravenous drug users.
i.e. methadone maintainence and needle exchanges versus cold turkey and NA.
It’s not too “out there” but it’s still a little controversial, and it certainly was when methadone first came on the scene. Plenty of research, plenty of people who feel very strongly one way or the other.
You could also discuss various policies that harm-reduction leads to.
For example, in Dublin there is currently an 18 month waiting list to be prescribed methadone in an official clinic. You can skip the waiting list if you are under 18 or pregnant. Many family doctors could prescribe it, but won’t, because of fears about how this would impact on their practice.
If you are on methadone when convicted, the state will continue your methadone in prison, if you’re addicted to heroin, and not in a methadone programme the state will not put you in one while in prison. Essentially giving these people the choice of going cold turkey or of using contraband drugs in prison with highly unsafe injecting practices, high rates of HIV and Hep C and shared needles. There are no prison needle exchanges.
See, lots of issues for debate there.
I’ve planned on starting a GD thread on this very subject. There is a substantial amount of study which does seem to indicate that AA is a cult. I think this topic can easily justify a research paper.
There is no study to it (what does that sentence even mean 
. it doesn’t parse well). Have you ever been to a meeting? There are open meetings that anyone can attend. I am hoping you can honestly say you have since you are making those claims. Have you? Have you read any of the literature (not pamphlets)?
You don’t have to do anything at all to join AA except say to yourself that you want help with your drinking. They don’t want money. They won’t even take any money much over the usual dollar. In fact, there is no “they” except the current group of people that are attending the meetings to get help. There are no initiation rituals. The principles are just guidelines. There is no one to enforce following the principles and no leaders to apply them even if there were. Anybody can start a meeting anytime. AA is almost completely decentralized. IT IS JUST A SERIES OF INDEPENDENT SUPPORT GROUPS THAT PEOPLE START ON THEIR OWN.
If it is a cult, it is a piss-poor one in my opinion. In your defense, there are people that get wrapped up in AA because that is all the have left and they feel that they got “saved” by AA. That just means that certain people react in stronger way to things that helped them than others. You can find that in any voluntary organization.
Again, I don’t go to AA anymore. I went for a while when I first stopped drinking and people were more than helpful and supportive of me during those early, rough times. I heard their stories and shared some common experiences with them. People gave me their phone numbers to call and they were interested in me and how I was soing when I called. They sure as hell weren’t trying to get anything from me. I have never seen anyone that gives out so much altruistic help as people in AA.
AA doesn’t want anything from anyone. It is as pure an organization as you will ever find. It exists soley as a way for alcoholics to connect and help each other. That is it.
There’s the idea that one need not abstain entirely from alcohol; that it’s possible to have an occasional drink without returning to full-fledged alcoholism.
[Official Moderator Underoos]This is not a debate on AA. If you wish to start one, do so in Great Debates.
Thank you.[/Official Moderator Underoos]
Another idea. There was an article in Wired Magazine in January on the Waismann Institute, which has this 24-hour rapid detox method they’re claiming works great.
How about “SUBSTANCE ABUSE: WHY I’M FOR IT”.
There’s an extremely controversial minority view that AIDS is brought on far more from recreational drug use/abuse than from sexual contact or even IV needle sharing. Called the Duesberg Hypothesis, it’s leading propnent isPeter Duesberg, considered a bit of a nut by many but a nut with impeccable scientific credentials.
The recent bestseller Freakonomics has an excellent section on the economics of illegal drug sales that could provide some form of thesis or perhaps battle strategy for combatting drug violence. One of the findings was the reason most pushers reform and take “real jobs” is strictly money- they can’t make a living selling drugs, and when they marry or have kids they need the usual benefits, etc., and so for every Mercedes driving “Sweet Daddy Williams” stereotype rich drug dealer there’s an army of cats selling under them who can do better at an unskilled job.
A history of cocaine addiction might be interesting as well, with for controversy the argument that its legality far restricted it as a social problem.
How about heroin injecting rooms? I remember the outcry over them a few years back.
Likely they’ve been running long enough now to be able to tie in the past concerns with whether or not they’re working now.
How about the issue of states rights versus federalism in regards to the legalization of drugs?
Or the issue of heroin and marijuana as prescribed medicines?
Or the role opium played in forcing China to open its markets to the western world?
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A lady wrote a book about her experience as a heroin addict. She maintained a successful professional life and conducted her affairs the way most of us do, except as an addict. After I think almost 10 years of this, she decided she had outgrown it and so she stopped. Her book offends many who think it denies the conventional wisdom about what a horrible trap heroin addiction is. I don’t remember her name but she’s touring the radio talk shows now, just heard her interview the other day on NPR or PRI.
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Doctors have long noted that people taking addictive painkillers for real medical pain generally don’t have much trouble stopping when the pain is fixed, even though they’ve taken enough to get hooked. Not sure if this counts, but over the last 9 months I took more than 1200 Percocets for my back, and when I stopped it wasn’t much trouble, just a little edgy feeling for a couple days. Seems like an interesting point - is it true? How uniform is this view among doctors? What’s it say about ordinary recreational addiction?