The Social Construct of Drug Use

Written by Anjay Kumar, drug user activist in Nepal

Anjay Kumar KC, aka ‘The Impactivist’ (for impact + activist), is a drug user activist and advocate for health, human rights, and harm reduction for drug users and HIV related policy in Nepal and globally. Anjay is also a person living with HIV and Hep C co-infection and a proud family man supporting a wife and child who are also living with HIV. He has been fighting against social injustice and working with most at risk, vulnerable and key affected populations such as PWID, LGBT, FSWs, migrants and AIDS orphans since 2002.

According to the social constructionist school of thought, a social construct is a value, idea, notion or view that appears to be natural and obvious to people who comply with it, often subconsciously. It however may or may not represent reality, so it remains largely an invention or artifice or even pretense if you will, of a given society. It may be an unspoken rule, an unwritten law or even a common standard practice or differentiation.[i]

Drug use as a social construct, is driven by bias, a bias produced by a cultural dependency rather than the use of drugs itself. The desegregation of drug use has often been used as an instrument for survival of the most powerful[ii]; bearing in mind that power is not only relevant to decision making and resource allocation but also to the social construction and propagation of ideology and morality.

Sociologists and criminologists argue that we socially construct “the criminal” by selectively deciding which crimes to prosecute and which criminals to punish[iii]. As a society we selectively enforce our laws and selectively hold people accountable for their actions. Many people who engage in criminal behavior are not punished because as a society we don’t pursue them with the same ferocity we pursue the behaviors of others. Both crime and “the criminal” are socially constructed.[iv]

The whole point of criminalizing drug use is to stigmatize drug users. Consider why particular acts are seen as crimes in the first place. Behaviors are made illegal because they are seen as harmful or antisocial; the main idea is to deter people from engaging in them by using the law to draw a line. The law says: these actions are socially unacceptable, and anyone who violates them deserves shame, punishment, rejection and moral condemnation.[v]

Often, one will find that social constructs appeal to traditions or moral, ethical and religious beliefs which are implicitly and purposively focused on gaining the approval of the more influential part of society that holds the power. Social Constructs are thus developed according to the interests and tastes of people in power (a trend that is inescapable though may not be justified). Often, one will find that social constructs appeal to traditions or moral, ethical and religious beliefs which are implicitly and purposively focused on gaining the approval of the more influential part of society that holds the power. A number of interest groups that stand to gain or lose from a particular way of understanding the world, including corporations, governments, professions and, at a more detailed level, particular researchers or advocates groups play important roles in shaping this mainstream debate, the principal one being the State. On a more intrinsic level, relatives of patients, the medical and psychiatric profession, the pharmaceutical industry and the patients themselves[vi] must also be considered as key players within this Social Construct.

On the other hand, if addiction really is a disease, criminalizing it sounds absolutely insane. Rationally, one could reason that it should be treated like any other disease. Cancer patients, people with diabetes or depression patients are not arrested for being ill, are they ? No actual disease is treated this way.

Further, treatment given to people with addiction is unlike treatment for any other disease. Heavily moralistic, and often deliberately humiliating, it is a phenomena not seen anywhere else in the field of treatment. Was there ever a cardiac rehabilitation programme that made patients who could not walk for long, clean everyone else’s toilet ? Even today, such type of degrading treatment is common in drug treatment programs where intentional derisive counseling, continues to perpetuate the stigma.

You will often see that a defendant’s medical treatment for addiction is determined by prosecutors, a judge, and police, not by doctors. Punishment for relapse an acceptable part of the process. Something that doesn’t happen in diabetes care or high blood pressure treatment. Worse, despite clear medical evidence that maintenance treatment is known to save lives by reducing mortality by 50% or more as compared to other interventions, courts frequently ignore the evidence and restrict or entirely reject use of maintenance treatment with methadone or buprenorphine for opioid addictions.

Importantly, when courts deal with mentally ill defendants, there is no similar meddling. Because it is not a crime to be mentally ill, judges recognize that the expertise needed to cope with the issue is medical, not moral, and they defer to psychiatrists about what treatment and medications are best. With addiction, since drug possession is a crime, judges feel as though their expertise is what’s needed to stop it. [vii]

It may be important to note that whenever physical addiction is stressed exclusively as a moral depravity, without addressing the social, familial, economic and psychological as well as policy aspects, it is impossible to avoid a contradictory viewpoint.

Drugs have much to do with human behavior and experience, involving the self and the other on a continuum between pain and pleasure.[viii] The advent of HIV/AIDS is evidence that the epidemiology and significance of these Social Constructs with respect to human behavior and experience are all part of the fallible human condition.

[i]“Social Constructs.” International Encyclopedia of the Social Sciences. 2008. Encyclopedia.com. (February 21, 2016).http://www.encyclopedia.com/doc/1G2-3045302485.html

[ii]Cohen, Peter. 1990. Drugs as a Social Construct. PhD diss., Universiteit van Amsterdam, Amsterdam, Netherlands.

[iii]Western, Bruce. 2006. Punishment and Inequality. New York, NY: Russell Sage Foundation.

[iv]Socially Constructing Drug Users, Dealers, and Convicts-By Nathan Palmer, Sociology in Focus, http://sociologyinfocus.com/2012/11/socially-constructing-drug-users-dealers-and-convicts/

[v] Szalavitz Maia, 2016, Why we should de-criminalize all drugs, https://www.theguardian.com/us-news/commentisfree/2016/jul/05/why-de-criminalize-all-drugs-stigma

[vi]The social construction of drug debates, David Dingelstad, Richard Gosden, Brian Martin and Nickolas Vakas, Department of Science and Technology Studies, University of Wollongong, NSW 2522, Australia, Published in Social Science and Medicine, Vol. 43, No. 12, 1996, pp. 1829-1838.

[vii] Szalavitz Maia, 2016, Why we should de-criminalize all drugs, https://www.theguardian.com/us-news/commentisfree/2016/jul/05/why-de-criminalize-all-drugs-stigma

[viii] UNODC- Drugs, addiction, deviance and disease as social constructs, K. KLAUE, Researcher, Institutuniversitaire de médecinesociale et préventive, Lausanne, Switzerland, Bulletin On Narcotics, Volume LI, Nos. 1 and 2, 1999, https://www.unodc.org/unodc/en/data-and-analysis/bulletin/

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