This Document Contains Chapters 7 to 8 CHAPTER 7 The Sex Trade in Canada CHAPTER SUMMARY Prostitution, the sale of sexual services for money or goods, has existed throughout recorded history and today is part of a global sex industry. The past three decades have seen the industrialization, normalization and globalization of prostitution. Prostitution, although never illegal in Canada, is often regarded as criminal or, at least, as deviant behaviour. Many people, mainly women and girls, are trafficked into Canada as sex workers every year from various parts of the globe. Human trafficking is one of the fastest growing components of organized crime today. Sex tourism, or travelling to other destinations in order to engage in sexual practices one may not while at home, is becoming more popular with Canadians as well. The way the sex industry plays out internationally reflects the economic disparity between the world’s poorest nations and the world’s richest. Functionalists believe a certain amount of deviance (including prostitution) contributes to the overall stability of society by acting as a mechanism of social control, in effect, establishing and publicizing boundaries between deviance and “normal” behaviour . Interactionists examine questions such as why people become prostitutes. Conflict and feminist theorists highlight the unequal relationships of power between different groups in society and within the sex-industry itself, with some conflict theorists also maintaining that sex work is a victimless crime. Sociologists have identified five tiers of prostitution, ranging from high priced, autonomous escorts to drug-addicted women who exchange sex for drugs or other means of survival such as a place to sleep. Most sex workers are women between the ages of 17 and 24, although older and younger women, and some men, also are prostitutes. Globally, the vast majority of customers are males and in Canada most “johns” are mid-20s to mid-40s, White, married and gainfully employed. LEARNING OBJECTIVES After reading Chapter 7, students should be able to: 1. Discuss sex trafficking as a global phenomenon and the role Canada plays. 2. Discuss what sex tourism is and how travelling outside one’s own country creates a liminal space where things become possible that would not be at home. 3. List and describe the categories of sex work that sociologists have identified. 4. Describe the societal locations that are the most likely to put a person “at risk” for entering the sex trade. 5. Discuss the common characteristics and attitudes of “johns” and what kinds of strategies have been used in Canada to deal with them. 6. Discuss the legality of prostitution in Canada, today and historically. 7. Contrast functionalist, interactionist, conflict and feminist perspectives on sex work. KEY TERMS prostitution social control victimless crime CHAPTER OUTLINE I. PROSTITUTION IN HISTORICAL AND GLOBAL PERSPECTIVE A. The World’s Oldest Profession? 1) Systems of prostitution refer to any industry in which women’s or children’s (and sometimes men’s) bodies are bought, sold, or traded for sexual use (e.g., prostitution, pornography, live sex shows, and international sexual slavery). 2) Prostitution has been referred to as the “world’s oldest profession” because accounts of prostitution have existed throughout recorded history. Over the past 4000 years, prostitution has neither been totally accepted nor completely condemned. However, it is not Canada's oldest profession since it was not introduced until Europeans began to settle here. 3) In the nineteenth century feminist movement, women for the first time had an opportunity to voice their divergent opinions about prostitution. Some advocated the eradication of prostitution due to the moral degeneracy of male promiscuity, but others urged that society should provide prostitution with legitimacy as an expression of female sexuality outside of marriage. Today, advocates suggest that prostitution should be viewed as a legitimate career choice for women (prostitute as sex worker), but opponents argue that prostitution is rooted in global gender inequality (prostitute as victim of oppression). B. The Global Sex Industry 1) Over the past three decades, prostitution has been industrialized (e.g., commercialized sex), normalized (i.e., treated as merely a form of entertainment), and globalized (i.e., the sex industry has become global in scope as people’s lives have become increasingly linked on a global basis). 2) Trafficking in humans is one of the world’s fastest growing components of organized crime. The risks are relatively low (of getting caught) while profits are high. Estimates of global profitability vary somewhere between US$5 billion and US$12 billion. The United Nations estimates that approximately 4 million people are trafficked every year, with up to 16 000 people, mainly women, coming into Canada. The traffic into Canada is estimated to be worth $4 million. 3) On a global basis, the demand for prostitution is greatest when large numbers of men are congregated for extended periods of time in the military or on business far from home. 4) The global sex industry reflects economic disparities between the poorest regions of the world (where women and children tend to be bought, sold, or traded like any other commodity) and the richest, regions of the world (Europe and North America), where many of the industry’s consumers reside. 5) Recent Canadian research on sex tourism suggests that sex tourists are able to engage in “exotic” or “forbidden” activities when away from home because they enter a kind of “liminal space” when they do not feel bound by the social conventions and mores of their home country or of the host country. 6) Some governments promote sex tourism as a way of boosting their economies. 7) The global sex industry, particularly prostitution, contributes to the transmission of HIV worldwide. 8) Rich nations supply the sex tourists while poor nations supply the people to meet the demand. Rich nations also increasingly import the sexual services of people from poorer nations. II. PROSTITUTION IN CANADA A. Prostitution in Canada 1) Prostitution, among consenting adults, has never been illegal in Canada. However, sections 210-214 of the Canadian Criminal Code do prohibit many transactions that are quite necessary to prostitution such as: (1) communicating in a public place for the purpose of buying or selling sexual services; (2) procuring or soliciting a person to exchange sexual services for money and living off the avails; (3) being involved in a common bawdy house. 2) While not illegal, it is nearly impossible to engage in prostitution-related activities without breaking some law. Canada’s system of quasi-criminalization of sex work puts sex workers unnecessarily at risk for violence and victimization. 3) The existing moral-political marginalization that sex-trade workers endure increases the risks of the work. Most sex trade workers do not go to police to report a “bad date”. Instead they and social service agencies and others catering to street workers circulate “Bad trick Reports.” Most “bad tricks” are White men in their 20s and 30s. B. Some Characteristics of Prostitution in Canada 1) Top tier prostitutes typically are referred to as escort prostitutes or “call girls” and “call boys”; many do not think of themselves as prostitutes. a. They are considered to be “top tier” because they earn higher fees and have more selectivity regarding their working conditions. b. They typically have more years of formal education than other types of prostitutes, and many dress nicely so as to not call undue attention to themselves at luxury hotels, clubs, and apartment buildings. c. Escort prostitutes work “on call,” going out to see customers who are referred to them by their escort service, pimp, or other procurers, who receive a percentage of their fees. Some encounter abusive customers and sexually transmitted diseases. 2) The second tier of prostitutes is comprised of hustlers and some strippers and table dancers who engage in prostitution on the side. a. People in this tier primarily work out of nightclubs, bars, and strip joints. b. Hustlers are sometimes referred to as bar girls or bar boys because they are supposed to hustle customers to buy drinks. Most hustlers are not paid by the bar and earn their livelihood by negotiating for “sexual favours” with customers who often are lonely and want someone to talk to as well as to have sex. 3) The third tier is “house girls” who work in brothels (houses of prostitution) run by a madam or a pimp who collects up to half the fees earned by the women. a. Customers choose “dates” from women lined up in a parlour or receiving room. House prostitutes are not allowed to turn down a customer. b. Since operating a bawdy house or living off the avails of prostitution is illegal in Canada, houses of prostitution typically operate as body painting studios, massage parlours, or as other legal businesses. There have been recent controversial propositions about opening legal brothels in Canada, with people on both sides of the debate offering a range of opinions. 4) Near the bottom tier are “streetwalkers,” who publicly solicit customers and charge by the “trick.” Most work a specific location. Pimps are important for streetwalkers, furnishing status and some protection; however, the relationship is often exploitative and violent. 5) The bottom tier of prostitution is occupied by women who are addicted to crack cocaine, heroin, or other drugs and engage in drugs-for-sex exchanges. Researchers have found that many crack-addicted women have unprotected sex with men in crack houses in exchange for hits of crack. 6) Although less research has been done on levels of male prostitution, it appears to follow patterns similar to female prostitution except that most customers are of the same sex as the prostitute (e.g. males hire males). While many male sex trade workers allow sex with other males, they do not necessarily define themselves as gay. Work is work. Most males work in private residences or work the party circuit. C. The Extent of Prostitution in Canada 1) There are no reliable estimates of the extent of prostitution in Canada for several reasons: (1) the activity is quasi-legal, and hence much activity is clandestine or otherwise hidden behind massage parlours and escort services; (2) criminal charges, basically the only quantifiable data source on prostitution, almost entirely deal with street prostitution; (3) many people drift into and out of prostitution, considering it temporary work between full-time jobs or as part-time work while attending school (post secondary). D. Prostitution and Age, Class, Education, Racialization, and Ethnicity 1) The vast majority of prostitutes are young women between the ages of 17 and 24. Some prostitutes are as young as 8 or 9 and some as old as 45. The peak earning age is about 22. 2) While a small percentage of teenagers enter prostitution through coercion, most are runaways who left home due to sexual abuse or other family problems; others were thrown out of their homes by parents or other family members. Regardless of their prior history, many become prostitutes because prostitution is the best—or only—job they can get. 3) Lower-income and poverty-level women and men are far more likely to become prostitutes than are more affluent people. Some people with little formal education and few job skills view prostitution as an economic necessity. Many women who are not street workers however, have college educations or university degrees. 4) Racialization is also an important factor. Sociologist Patricia Hill Collins suggests that African-American women are affected by the widespread image of black women as sexually promiscuous, potential prostitutes; she traces the roots of this stereotype to the era of slavery when black women-and black men and children were at the mercy of white male slave-owners and their sexual desires. Indigenous women are affected by similar stereotyping, which has been used to justify sexualized violence against them by White men. Many of the street workers identify as Aboriginal, a fact that can be attributed in part to poverty and in part to young people’s experiences in the foster care system. E. A Closer Look at “Johns” 1) The lack of comprehensive studies on sex trade customers is an example of the power differential between workers and customers in this area. 2) What little information is available indicates that most johns are men in their mid20s to mid-40s (although older is also common), White, married, and gainfully employed. 3) Strategies to stop prostitution by focussing on the customers have resulted in things like “shame the johns” campaigns and “john” schools. When charged with a criminal offence, most “johns” receive discharges or negligible fines. 4) Possible reasons for seeking out a prostitute include loneliness, sexual problems at home, the desire for specific sexual acts that partners will not perform, the desire for sex without obligation, and to “have a good time”. 5) Most “johns” surveyed believe that sex workers are “normal” hard working women, who perform a job and provide a valuable service. III. PERSPECTIVES ON THE SEX TRADE A. The Functionalist Perspective 1) Functionalists believe that the presence of a certain amount of deviance in society contributes to its overall stability. a. According to early sociologist Emile Durkheim, deviance clarifies social norms and helps societies maintain social control over people’s behaviour. b. By punishing those who engage in deviant behaviour, the society reaffirms its commitment to its sexual norms and creates loyalty in people as they bind together to oppose deviant behaviour. 2) According to sociologist Kingsley Davis, prostitution will always exist because it serves important functions in societies such as Canada that have restrictive norms governing sexual conduct: a. It provides people with quick, impersonal sexual gratification that does not require emotional attachment or a continuing relationship. b. It provides a sexual outlet for men who do not have an ongoing sexual relationship because they are not married or have a heavy work schedule. c. It provides people an opportunity to engage in sexual practices--such as multiple sex partners, oral sex, or sado-masochism—that regular sex partners or spouses might view as immoral or distasteful. d. It protects the family as a social institution by making a distinction between “bad girls” or “bad boys”—with whom one engages in promiscuous sexual behaviour—and “good girls” and “good boys”—with whom one establishes a family. e. It benefits the economy by providing jobs for people who have limited formal education and job skills. B. The Interactionist Perspective 1) Interactionists examine questions such as “why do people become prostitutes?” or “do some prostitutes like their work?” 2) According to sociologist Howard Becker, entering a deviant career such as prostitution is in many ways like entering any other occupation. The primary difference is the labelling that goes with a deviant career. a. Public labelling of people as deviant and their acceptance or rejection of that label are crucial factors in determining whether or not a person will build a deviant career. b. Some people are more willing than others to accept the “deviant” label or may believe they have no other option available. 3) Why do men seek out prostitutes? a. Research suggests that some young men may seek out prostitutes to fulfill what they believe is a necessary rite of passage from boyhood to manhood. b. Social analysts suggest that an important factor in seeking out prostitutes is the need for men of all ages to validate their sexual prowess or reaffirm their masculinity. C. Conflict and Feminist Perspectives 1) Conflict perspectives on prostitution highlight the relationship between power in society and sex work. From this approach, laws making prostitution illegal are created by powerful dominant group members who seek to maintain cultural dominance by criminalizing sexual conduct they believe to be immoral or in bad taste. 2) Conflict analysts using a liberal feminist framework believe that prostitution should be decriminalized: that laws making it a crime should be repealed. a. Prostitution can be seen as a victimless crime involving willing participants in an economic exchange. b. From this approach, prostitution is seen as sex work in the sex industry and issues should be treated as labour issues. 3) Conflict perspectives using Marxist feminist and radical feminist frameworks suggest that women become prostitutes due to structural factors such as economic inequality between women and men and patriarchy, which gives men control over women’s bodies. According to this approach, women’s bodies are viewed as commodities under capitalism and patriarchy. a. According to Marxist feminists, the only way to eliminate prostitution is to reduce disparities in income levels between women and men. b. According to radical feminists, prostitution will not be eliminated until patriarchy is ended. 4) Conflict theorists and feminists who focus on the interrelationship of racialization, class, and gender in examining social problems suggest that criminalizing prostitution uniquely affects poor women, and especially poor women of colour and Indigenous women, who are over-represented among street prostitutes. Discrimination in law enforcement also uniquely affects these women. IV. THE FUTURE OF THE SEX INDUSTRY A. Public opinion polls reflect that people in Canada are ambivalent about pornography and other components of the sex industry. 1) While they acknowledge that the sex industry may produce goods and services that serve as a “safety valve” for some, many people believe that the same goods and services can be a “trigger” for others. 2) The greatest consensus appears to be that children should be shielded from some materials. B. Controversy over sexually explicit materials is particularly strong in schools, where an array of books and audiovisual materials have been banned by some school boards. At home, many children have access to movies, television shows, and music videos from which many adults believe they should be shielded. ACCESSING THE REAL WORLD: ACTIVE ENGAGEMENT WITH PROBLEMS RELATED TO THE SEX TRADE Focus on Community Action Have students research laws on prostitution, including what penalties typically are assessed for these behaviours, and whether both customers and sex trade workers can be charged with engaging in prostitution. If possible, students should also visit a sex trade workers’ rights organization and interview a staff member or volunteer. They could also go online and try to read blogs or forums written from the perspective of sex trade workers. Identify what the barriers are for exiting the sex trade. What current resources are available in your community for people in the sex trade or those who are at risk of getting involved? What age do most people enter the sex trade and why? What are most people’s gender, class, and ethnicity? Where does most of the sex trade work happen in your community? Are there male sex trade workers? How do their experiences compare with the females’? Have them put together a small presentation of their findings to share with the rest of the class. In light of their findings, have students also debate whether they think Canada’s current laws on prostitution protect the sex trade workers in their communities or put them more at risk for violence and other social problems. How could Canada’s laws be changed to better protect the rights of sex trade workers and prevent social problems such as survival sex and the abuse of sex trade workers? Focus on Theoretical Analysis Have students become experts on one theoretical perspective and analyze why women don’t use sex trade workers on par with the levels that men use sex trade workers. Do they think this trend is changing? Why or why not? In addition to the gendered dimensions of the purchasing of sex work, how do class, racialization, sexual orientation, and age influence the buying and selling of sex? Have students prepare a report on their analysis and share their findings with the class. Focus on Media Engagement Select a video or DVD that depicts some form of sex trade work, such as Pretty Woman, L.A. Confidential, Risky Business, My Own Private Idaho, or Moulin Rouge. Preview it and select brief segments that glamorize prostitution to show to the class. Have a class discussion about the movie clip(s). Why do films such as these tend to depict prostitution in an unrealistic manner? How does the glamorization of sex trade work influence people’s perceptions of sex trade workers? Based on what the students have read in the text, what would a more accurate portrayal of sex trade work look like? How does this film’s depiction of sex trade work differ from that of most television crime dramas such as CSI, Law and Order, or Criminal Minds? Are sex trade workers any more realistically depicted in these shows? Why or why not? What can the text suggest about the differences between the movie depictions and certain other television shows? APPLYING CRITICAL THINKING THROUGH DISCUSSION 1. Why has sex trafficking become such big business globally? What kinds of strategies could be put in place to stop it? Who would benefit most from these strategies? Answer: Sex trafficking has become a lucrative global business due to various interconnected factors. These include globalization, which has facilitated the movement of goods and people across borders, as well as economic disparities, political instability, and social vulnerabilities that make individuals susceptible to exploitation. Additionally, advancements in technology have made it easier for traffickers to operate discreetly and connect with potential victims online. Strategies to combat sex trafficking should be multifaceted, addressing both supply and demand sides of the issue. This includes robust law enforcement efforts to dismantle trafficking networks, prosecute perpetrators, and rescue victims. Prevention efforts should focus on addressing root causes such as poverty, inequality, and lack of education, while also raising awareness about the tactics used by traffickers. Providing support services for survivors, including shelter, counseling, and legal assistance, is crucial for their rehabilitation and reintegration into society. Collaboration between governments, law enforcement agencies, NGOs, and international organizations is essential for coordinated action against sex trafficking. Ultimately, the primary beneficiaries of these strategies are the victims, whose lives are profoundly impacted by trafficking. By preventing exploitation, protecting vulnerable individuals, and holding perpetrators accountable, these strategies aim to restore dignity and autonomy to survivors and prevent future victimization. Additionally, society as a whole benefits from a reduction in crime, exploitation, and the promotion of human rights and dignity for all individuals. 2. Why do some analysts believe that prostitution is a “victimless crime?” Is there such a thing as a “victimless crime?” Why or why not? Answer: Some analysts argue that prostitution is a "victimless crime" because they perceive it as a consensual transaction between adults engaging in a service for payment. They contend that as long as all parties involved are consenting adults, no harm is done, and therefore, there are no victims. However, this perspective overlooks the systemic factors that often contribute to individuals entering into prostitution, such as economic inequality, lack of viable employment options, coercion, trafficking, and exploitation. Prostitution is rarely a choice made freely and without coercion. Many individuals, particularly marginalized and vulnerable populations such as women, LGBTQ+ individuals, and those experiencing poverty or homelessness, are forced into prostitution due to circumstances beyond their control. They may face physical violence, emotional trauma, substance abuse, and exploitation at the hands of clients, pimps, or traffickers. Moreover, the criminalization of prostitution can further victimize individuals involved in the sex trade by pushing them into more dangerous and clandestine environments, where they are at greater risk of violence, exploitation, and harm. Therefore, while some may argue that prostitution is victimless, the reality is far more complex, with individuals often facing profound vulnerabilities and experiencing significant harm as a result of their involvement in the sex trade. The concept of a "victimless crime" is contentious and debated. While certain activities may appear consensual on the surface, they can still perpetuate harm and contribute to broader systems of exploitation and inequality. The term "victimless crime" implies that no harm is inflicted upon anyone involved, which overlooks the underlying power dynamics, coercion, and exploitation that often characterize these activities. Ultimately, the notion of victimless crimes fails to account for the complex social, economic, and ethical considerations inherent in understanding and addressing issues such as prostitution. 3. What do you think about the idea of legalized prostitution as in the recent proposals for legal brothels? Identify the “pros” and “cons” of creating legal brothels in Canada. Answer: Legalizing prostitution and establishing legal brothels in Canada presents a complex issue with various pros and cons. On the pro side, legalization could lead to increased safety and protection for sex workers. With regulations in place, workers could access healthcare, legal support, and protection from exploitation. It could also help reduce violence against sex workers by providing a safer and more controlled environment. Legal brothels may also generate tax revenue and create job opportunities within the industry. Moreover, legalization could shift societal attitudes toward sex work, reducing stigma and empowering workers to advocate for their rights. However, there are also significant cons to consider. Critics argue that legalizing brothels may perpetuate the objectification and commodification of sex, reinforcing harmful societal norms. There are concerns about potential exploitation and trafficking within legal establishments, as regulations may not adequately prevent abuses. Additionally, legalization may not address the root causes of sex work, such as economic inequality and social marginalization. Some fear that legalizing brothels could lead to an increase in demand for commercial sex and contribute to the normalization of the industry, particularly among vulnerable populations. Ultimately, the debate over legalizing brothels in Canada involves balancing considerations of public health, safety, human rights, and societal values. It's essential to carefully weigh the potential benefits and risks while considering the perspectives and experiences of sex workers and other stakeholders. 4. Think about the idea of “liminal space” proposed by Maticka-Tyndale, Lewis and Street (2005). Have you experienced or witnessed this type of liminal space they discuss on a holiday? What images or programs do we see in mainstream media that suggest these researchers are correct in their analysis? Answer: The concept of "liminal space," as proposed by Maticka-Tyndale, Lewis, and Street (2005), refers to a transitional phase where individuals or groups experience ambiguity and uncertainty, often during significant life events or rites of passage. Holidays can indeed serve as instances of liminal space, particularly when individuals are removed from their everyday routines and familiar environments, allowing for reflection, exploration, and transformation. During holidays, people often find themselves in between their usual roles and identities, experiencing a sense of detachment from their everyday lives. This can lead to a heightened awareness of oneself and one's surroundings, fostering opportunities for personal growth, cultural immersion, and new experiences. In mainstream media, we often see representations of liminal holiday experiences in various forms. For example, travel documentaries or reality shows depict individuals embarking on transformative journeys to unfamiliar destinations, where they confront new challenges and encounter different cultures. These narratives emphasize the transformative potential of travel and the liminal space it creates, where individuals undergo personal growth and self-discovery. Similarly, in fictional narratives such as movies or television shows, holiday-themed episodes or storylines often revolve around characters experiencing moments of reflection, introspection, and transformation. These narratives highlight the liminal nature of holidays, where characters grapple with their past, present, and future selves, leading to moments of epiphany or self-realization. Moreover, advertisements promoting holiday destinations often portray scenes of relaxation, adventure, and self-discovery, appealing to the idea of escaping the ordinary and entering a liminal space where individuals can redefine themselves and their experiences. Overall, mainstream media representations of holidays often align with the concept of liminal space, emphasizing the transformative potential of these experiences and their role in fostering personal growth, reflection, and cultural immersion. 5. Have you or someone you know ever engaged in sex work? Do you think that the characteristics of education, racialization, class and so on discussed in the text are accurate, in terms of people most who engage in sex trade work? Why or why not? Keep in mind that only about 1/5 of sex work occurs on the street where we can see it. Answer: The characteristics of education, racialization, and class discussed in the text can indeed be accurate to some extent in terms of the demographics often associated with sex work. Research suggests that individuals from marginalized communities, including those with lower levels of education, racial minorities, and individuals from lower socioeconomic backgrounds, may be overrepresented in the sex trade. Factors such as limited economic opportunities, systemic discrimination, and social inequalities can contribute to the vulnerability of these populations to engaging in sex work. However, it's important to recognize that the demographics of sex workers are diverse and complex, and generalizations can be misleading. Not all sex workers fit into the stereotypical image perpetuated by media or societal perceptions. Many individuals engage in sex work for various reasons, including financial need, personal choice, or survival, and their backgrounds and circumstances can vary widely. Additionally, as you mentioned, only a fraction of sex work occurs visibly on the streets. Many individuals, including those with higher levels of education, from different racial backgrounds, and varying socioeconomic statuses, may engage in sex work in less visible or clandestine settings, such as through online platforms or in the context of private arrangements. Therefore, while certain characteristics may be associated with some individuals in the sex trade, it's essential to approach the issue with nuance and avoid oversimplification. Understanding the complexities of sex work requires considering a range of factors, including economic, social, and cultural dynamics, and recognizing the diversity of experiences within the sex worker community. 6. Why are most customers (“johns”) male, regardless of the sex of the sex worker? Why are most sex workers female? Answer: The predominance of male customers, or "johns," in the sex industry, regardless of the sex of the sex worker, can be attributed to complex societal factors shaped by gender norms, power dynamics, and cultural attitudes towards sexuality. Historically, men have been socialized to assert dominance and seek sexual gratification, often without facing the same level of stigma or consequences as women. This societal expectation can manifest in the form of seeking out commercial sexual services as a means of fulfilling desires or fantasies. Additionally, the sex industry has traditionally catered to male clientele, with a focus on heterosexual male desires and fantasies. This marketing and cultural emphasis on male pleasure can contribute to the disproportionate representation of male customers in the sex industry, regardless of the gender of the sex worker. On the other hand, the majority of sex workers being female is influenced by a combination of economic, social, and structural factors. Women, particularly those from marginalized communities, may turn to sex work as a means of financial survival due to limited economic opportunities, wage disparities, or systemic inequalities. Moreover, societal norms often dictate that women are responsible for caregiving and domestic duties, leading to limited employment options and economic vulnerability, which can push some women into sex work. Furthermore, the objectification and sexualization of women in media and popular culture contribute to the perception of women as commodities for male consumption, reinforcing the demand for female sex workers. This demand, coupled with the systemic marginalization and economic hardships faced by many women, perpetuates the overrepresentation of females in the sex industry. Overall, the prevalence of male customers and female sex workers in the sex industry reflects broader patterns of gender inequality, societal expectations, and economic disparities, highlighting the need for comprehensive approaches to address systemic issues and support the rights and well-being of all individuals involved in the sex trade. 7. In what ways does Canadian culture support or promote the sexual exploitation of children and youth, despite the often highly vocal abhorrence we apparently have for such things? Answer: Despite Canada's vocal stance against the sexual exploitation of children and youth, there are several ways in which Canadian culture inadvertently supports or contributes to this issue. One significant factor is the proliferation of sexualized imagery in media and advertising, which can desensitize individuals to the sexualization of minors and perpetuate harmful stereotypes about youth and sexuality. Additionally, the normalization of pornography and its widespread availability online can contribute to the objectification and exploitation of children and youth, as they may be coerced or manipulated into participating in sexually explicit material. Moreover, gaps in education and awareness about healthy relationships, consent, and sexual boundaries leave children and youth vulnerable to exploitation. The reluctance to discuss taboo topics such as child sexual abuse and exploitation can contribute to a culture of silence and denial, making it easier for perpetrators to operate with impunity. Furthermore, systemic issues such as poverty, homelessness, and lack of access to support services can make children and youth more susceptible to exploitation, as they may be more willing to engage in risky behavior in exchange for basic necessities or validation. Additionally, the normalization of power imbalances in relationships, particularly between adults and minors, can contribute to the exploitation of young people. This can manifest in situations such as child marriage, grooming by authority figures, or the glamorization of age-gap relationships in media and popular culture. Finally, the inadequate support and resources available to survivors of child sexual exploitation can perpetuate cycles of abuse and trauma, as survivors may struggle to access the help they need to heal and rebuild their lives. Overall, addressing the sexual exploitation of children and youth in Canada requires a multi-faceted approach that addresses cultural attitudes, systemic inequalities, and gaps in education and support services. It requires a collective effort to challenge harmful norms and behaviors and to create a society where all children and youth are valued, protected, and able to thrive free from exploitation and harm. AUDIO-VISUAL MEDIA FOR FURTHER EXPLORATION Bad Girl—In New York, Los Angeles, Paris and Montréal, women are claiming the right to hard-core pornography, made by women, sometimes for women, and are revolutionizing a business which up to now has been controlled by men. 2002. 52 mins. Inform Action Quebec. Beating the Streets—This film traces six years in the lives of Marilyn Bright eyes and Lance Marty, two inner-city Aboriginal teens struggling with the abuse and violence that drove them into prostitution and drug dealing. 1998. 48 mins. National Film Board of Canada, www.nfb.ca. Finding Dawn—Acclaimed Métis filmmaker Christine Welsh presents a compelling documentary that puts a human face on a national tragedy: the murders and disappearances of an estimated 500 Aboriginal women in Canada over the past 30 years. 2006. 73 mins. National Film Board of Canada, www.nfb.ca. Give Me Your Soul—This film examines the $8 billion world of commercial porn films, and the characters who pursue fame and fortune in the industry. 2000. 80 mins. National Film Board of Canada, www.nfb.ca. Live Nude Girls Unite!—Documentary look at the 1996-97 effort of the dancers and support staff at a San Francisco peep show, The Lusty Lady, to unionize. 2000. 75 mins. Constant Communication, San Francisco, Ca. Not a Love Story: A Film about Pornography —This is a film that explores pornography, why it exists, the forms it takes and how it affects relationships between the sexes. 1981. 69 mins. National Film Board of Canada, www.nfb.ca. Stolen Lives: Children in the Sex Trade—This film takes a hard look at boys and girls being exploited in the fast growing business of selling children for sex in North America. 1999. 46 mins. National Film Board of Canada, www.nfb.ca. The Victoria Day Shooter—This film follows the police investigations of the murders of three sex trade workers on the Victoria Day long weekend. 2005. 46 mins. National Film Board of Canada, www.nfb.ca. Tu as crie LET ME GO—This film focuses on a mother unearthing the past of a daughter who turned to drugs and prostitution, then was murdered. 1998. 96 mins. National Film Board of Canada, www.nfb.ca. Where Did You Sleep Last Night—This graphic drama examines the sexual exploitation and recruitment of teens into the sex trade. 2001. 22 mins. National Film Board of Canada, www.nfb.ca. CRITICAL READINGS Chapkis, Wendy. 1997. Live Sex Acts: Women Performing Erotic Labour. New York, NY: Routledge. Duggan, Lisa and Nan D. Hunter. 2006. Sex Wars: Sexual Dissent and Political Culture. New York, NY: Routledge. Farley, Melissa. 2004. Prostitution, Trafficking and Traumatic Stress. New York, NY: Haworth Publishers. Farr, Kathryn. 2005. Sex Trafficking: The Global Market in Women and Children. New York, NY: Worth Publishers. Hall, C. Michael. 2001. Sex Tourism: Marginal Peoples and Liminalities. London, GB: Routledge. Kempadoo, Kamala and Jo Doezema (Eds.) 1998. Global Sex Workers: Rights, Resistance and Redefinition. New York, NY: Routledge. Kingsley, Cherry and Melanie Mark. 2000. Sacred lives: Canadian Aboriginal Children and Youth Speak Out About Sexual Exploitation. Vancouver, BC: Save the Children Canada. Lowman, John. 2000. “Violence and the Outlaw Status of (Street) Prostitution in Canada in Violence Against Women. Vol. 6, No. 9, pgs. 987-1011. September. Malarek, Victor. 2005. The Natashas: Inside the New Global Sex Trade. New York, NY: Arcade Publishing. Whisnant, Rebecca and Christine Stark (Eds.). 2005. Not for Sale: Feminists Resisting Prostitution and Pornography. North Melbourne, AU: Spinifex Press. CHAPTER 8 Addictions CHAPTER SUMMARY A wide variety of people are affected by drugs and gambling. Drugs are used either for therapeutic or recreational purposes; they may be either legal or illegal. Drug addiction has two essential characteristics: tolerance and withdrawal. In Canada, use of alcoholic beverages is considered an accepted part of the dominant culture. Social scientists have identified four long-term categories of drinking patterns. Abuse of alcohol may cause health problems, accidents, and family problems. Despite what is known about tobacco’s dangers, just less than one-fourth of all adults in Canada today smoke. People who do not smoke may be harmed by environmental tobacco smoke. Prescription drugs benefit millions of people, but some people become dependent on them; even over-the-counter drugs are subject to abuse and can be dangerous if not taken as directed. People in this country also use illegal drugs, including marijuana, cocaine, amphetamines (“uppers”), depressants, narcotics such as heroin, and hallucinogens. Gambling has recently become a billion-dollar business in Canada, resulting in a greater awareness of gambling addictions. Sociologists using an interactionist framework believe that addiction behaviour is a learned behaviour. From a functionalist perspective, increased drug abuse and problem gambling result from social institutions no longer keeping deviant behaviour in check. From a conflict perspective, people in privileged positions criminalize the drugs that are abused by the poor and powerless but not the ones abused by the privileged. From a feminist perspective, drug abuse by women has to do with women’s vulnerability and disadvantaged position in society. Two different types of programs exist for dealing with drug and alcohol programs: prevention programs and treatment programs. LEARNING OBJECTIVES After reading Chapter 8, students should be able to: 1. Describe the four categories of long-term drinking patterns that social scientists have identified, and discuss alcohol-related social problems. 2. List the major hazards associated with tobacco use. 3. Distinguish between licit and illicit drug use, pointing out ways in which they are similar and dissimilar. 4. Explain the state of problem gambling in Canada, with an emphasis on variables such as gender, age, marital status, income and region. 5. Describe the purposes and methods of primary, secondary, and tertiary prevention methods, giving examples of each. KEY TERMS Code pendency drug subculture primary prevention drug drug addiction drug dependency environmental tobacco smoke fetal alcohol spectrum disorder (FASD) tolerance withdrawal CHAPTER OUTLINE I. DRUG USE AND ABUSE A. Defining Drug Abuse 1) Drugs are used for either therapeutic (e.g., to reduce a fever) or recreational (e.g., to achieve a “high”) purposes. Drugs can be either: a. Licit (legal) drugs such as vitamins, aspirin, alcohol, tobacco, and prescription drugs that are legal to manufacture, possess, and use, or b. Illicit (illegal) drugs such as marijuana, LSD, and cocaine, which are socially defined as deviant. 2) Drug abuse is the excessive or inappropriate use of a drug that results in some form of physical, mental, or social impairment. It has both objective and subjective components. The objective component is evidence that harm has been done to individuals, families, communities, or the entire society. The subjective component is perceptions about the consequences of drug abuse and what should be done to remedy the problem. B. Drug Addiction 1) Drug addiction (or drug dependency) has two essential characteristics: tolerance and withdrawal. a. Tolerance occurs when larger and larger doses of the drug are required to produce the effect that was originally produced with a small amount of the drug. Tolerance is a matter of degree. Some drugs produce immediate and profound levels of tolerance, whereas others produce only mild tolerance. b. Withdrawal refers to symptoms experienced by drug users when drug use is discontinued. An example of withdrawal is when a person quits after long-term, heavy drinking and experiences physical symptoms ranging from insomnia to DTs (delirium tremens) and psychological symptoms such as a reduced sense of self worth. II. ALCOHOL USE AND ABUSE A. Use and Abuse Generally 1) The use of alcohol is considered an accepted part of the dominant culture in Canada. Alcohol and alcoholic beverages are wine, beer, and liquor. a. Among people who drink, 10 percent could account for roughly half the total alcohol consumption in this country. b. Although alcohol can be purchased legally by adults, it is a psychoactive drug that is a depressant because it lowers the activity level of the central nervous system, resulting in impaired judgment. c. Alcohol affects mood and behaviour. Having 1 to 2 drinks often brings about a release from tensions and inhibitions. 3 – 4 drinks affects self control and judgement. 5 – 6 drinks affects sensory perception and a person may exhibit signs of intoxication. At 7 to 8 drinks, the drinker is obviously intoxicated and may go into a stupor. Nine or more drinks affect vital centres, and the drinker may become comatose or even die. Women are more adversely affected than men by the same number of drinks because they have a lower percentage of water in their bodies. 2) Chronic heavy or alcoholism drinking can damage the brain or other parts of the body. Social scientists divide long-term drinking patterns into 4 categories: a. Social drinkers consume alcoholic beverages primarily on social occasions. b. Heavy drinkers consume greater quantities and are more likely to become intoxicated. c. Acute alcoholics have trouble controlling their use of alcohol, and plan their schedule around drinking. d. Chronic alcoholics have lost control over their drinking and engage in compulsive behaviours. B. Alcohol Consumption and Gender, Age, Marital Status and Class 1) Alcohol is consumed by nearly 80 percent of the population. 2) Gender: More men than women drink. Women who drink tend to be lighter drinkers than men, and men are more likely than women to be labelled as problem drinkers or alcoholics. 3) Age: More young people than older are heavy drinkers (approximately 15 percent versus less than half of that). Binge drinking, at least five drinks at one sitting, is reported to be a major problem among postsecondary students. 4) Marital Status: Single and never-married people are much more likely to drink heavily than those who are married, partnered, separated, divorced or widowed. 5) Class: In Canada, the relationship between income and drinking is U-shaped, with people in the highest and lowest income brackets reported as the heaviest drinkers but there is actually very little difference between people based upon income. Those with university degrees tend to drink less than those with lower educational attainment. C. Alcohol-Related Social Problems 1) Health problems include: a. Nutritional deficiencies: chronic heavy drinking contributes to high caloric consumption but low nutritional intake. Adult onset diabetes is highly probable. b. Alcoholic dementia: difficulties in problem solving, remembering things, and organizing facts about one’s identity and surroundings. c. Cardiovascular problems: such as inflammation and enlargement of the heart muscle, poor blood circulation, reduced heart contractions, high blood pressure, and disorders such as stroke. d. Alcoholic cirrhosis: a progressive development of scar tissue that chokes off blood vessels in the liver and destroys liver cells by interfering with the cell’s use of oxygen. e. Shorter life expectancy: often as much as 10 to 12 fewer years than non-drinkers or occasional drinkers. f. Abuse of alcohol and other drugs by pregnant women can damage the unborn fetus. Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term used to describe the range of disabilities and diagnoses that result from drinking alcohol during pregnancy. 2) Alcohol in the Workplace: a. Lost productivity due to absenteeism, tardiness, and workplace accidents from alcohol use in Canada cost about $4.1 billion annually. b. Excessive consumption impairs the sensorimotor skills necessary to operate machinery and equipment, and studies show a relationship between alcohol and other drugs and many workplace injuries or fatalities. 3) Driving and Drinking: a. Drivers who have been drinking often do not realize how much alcohol they consumed or what its effects are on their driving ability. Many drive dangerously even when they are not legally drunk. In Canada, driving with a blood alcohol level over 0.08 percent is referred to as impaired driving. b. Alcohol-related motor vehicle crashes account for 13 percent of all alcohol-related hospitalizations and 12 percent of all alcohol-related days in hospital. In 1992, alcohol-related collisions in Canada resulted in direct costs for damage of $482.8 million. 4) Family Problems: a. For every person who has a problem with alcohol, an average of at least four other people are directly affected on a daily basis. b. Domestic abuse and violence are frequently associated with heavy drinking. Growing up in a family affected by alcohol can have profound effects on children. c. Many members of alcoholic families become enablers--people who adjust their behaviour to accommodate an alcoholic. When co-dependency occurs, family members take on many of the alcoholic’s responsibilities and keep the person from experiencing the full impact of his or her actions. III. TOBACCO (NICOTINE) USE AS A SOCIAL PROBLEM A. The nicotine in tobacco is a toxic, dependency-producing psychoactive drug that is more addictive than heroin. 1) It is a stimulant because it stimulates central nervous system receptors and activates them to release adrenalin, which raises blood pressure, speeds up the heartbeat, and gives the user a sense of alertness. 2) Just less than one in four Canadian adults smoke; over the age of 15, 25 percent of men and 20 percent of women smoke. B. Although the overall proportion of smokers in the general population has declined somewhat since the 1964 Surgeon General’s warning that smoking is linked to cancer and other serious diseases, tobacco is still thought to be responsible for about 37 000 deaths per year in Canada. 1) People who smoke have a greater likelihood of developing lung cancer and cancer of the larynx, mouth, and esophagus because nicotine is ingested into the bloodstream through the lungs and soft tissues of the mouth. It is estimated that about 10 cigarettes a day on average reduces a person’s life expectancy by 4 years; more than 40 cigarettes a day reduces it by 8 years. 2) Even people who never smoke are harmed by environmental tobacco smoke. Children who grow up where one or both parents smoke are more likely to suffer from frequent ear infections, upper respiratory infections, and other health problems. C. Teenagers are the group most likely to start smoking. Smoking has been used by youth as a form of rebellion and method of showing solidarity with peers. IV. PRESCRIPTION DRUGS, OVER-THE-COUNTER DRUGS, AND CAFFEINE A. Prescription drugs are dispensed only by a registered pharmacist upon approval by a physician or dentist. 1) Pain medication is probably the most abused prescription drug. Millions of people benefit from narcotics—opiates such as morphine (Duramorph and Roxanol), propoxyphene (Darvon), and codeine--that relieve pain, suppress coughing, control chronic diarrhea, and reduce heroin withdrawal symptoms. 2) Over time, users develop tolerance for the drug and begin to increase dosages to obtain the same effect. Drug dependency that results from physician-supervised treatment for a recognized medical disorder is called iatrogenic addiction. 3) Two widely prescribed drugs that are the subject of controversy are Ritalin and Prozac. a. Ritalin is a stimulant prescribed for children diagnosed with attention deficit hyperactivity disorder (ADHD). ADHD is characterized by emotionality, behavioural hyperactivity, short attention span, distractibility, impulsiveness, and perceptual and learning disabilities. In Ontario, 1.0 percent of students used drugs for ADHD in 2007. Critics argue that parents, doctors, and teachers see Ritalin as a “quick fix” for dealing with troublesome children. b. Prozac, a treatment for major depression, has become a “cure-all for the blues” for people who do not meet the criteria for clinical depression. It is one of the most widely abused prescription drugs. Advocates believe that Prozac enhances the quality of life for many people, freeing them from depression and suicidal thoughts. But there is some evidence that Prozac is associated with intense, violent suicidal thoughts in some patients. B. Over-the-counter (OTC) drugs are restricted only by the customer’s ability to pay. OTC drugs include analgesics, sleep aids, and cough-and-cold remedies. 1) Abuse of aspirin and other analgesics can cause gastric bleeding, problems with blood clotting, complications in surgery patients and pregnant women in labour and delivery, and Reyes syndrome (a potentially life-threatening condition that arises when children with flu, chicken pox, or other viral infections are given aspirin). 2) Sleep aids are dangerous when combined with alcohol or some cough and cold remedies because they are depressants that slow down the central nervous system. C. Caffeine, a relatively safe drug, is a dependency-producing psychoactive stimulant. It is an ingredient in coffee, tea, chocolate, soft drinks, and stimulants such as NoDoz and Vivarin. Coffee drinkers drank 86 litres in 2006, up 6.5 litres from 1997. 1) Generally speaking, people ingest caffeine because they like the feeling of mental alertness and reduced fatigue it produces. 2) Short-term effects include dilated peripheral blood vessels, constricted blood vessels in the head, and a slightly elevated heart rate. Long-term effects of heavy caffeine use (more than 3 cups of coffee or 5 cups of tea per day) include increased risk of heart attack and osteoporosis—the loss of bone density and increased brittleness associated with fractures and broken bones. V. ILLEGAL DRUG USE AND ABUSE A. History 1) In the 19th and early 20th century, people in Canada had fairly easy access to drugs, currently illegal, for general use. There were no licensed doctors or pharmacists, and people sold patent medicines that contained such ingredients as opium, morphine, heroin, cocaine, and alcohol. 2) Prescriptions became required for some drugs because of the rapidly growing number of narcotics addicts. Some forms of drug use were criminalized because of their association with specific minority groups. For example, in Canada, opium could legally be consumed in cough syrup, but smoking the same amount was declared illegal in 1908 because opium smoking was linked to Chinese people in Canada. B. Marijuana 1) Marijuana is the most extensively used illicit drug in Canada. 2) Marijuana with high delta-9 tetrahydrocannabinol (THC) content has existed for years, but potency has increased recently because more marijuana plants are now grown indoors in Canada. Indoor crops have THC levels up to 4 times as high as plants grown outdoors and in other nations. 3) Marijuana is both a central nervous system depressant and a stimulant. Low to moderate doses produce sedation; high doses produce a sense of well-being, euphoria, and sometimes hallucinations. Driving a car or operating heavy machinery is dangerous for a person under the influence of marijuana. 4) Heavy marijuana use can impair concentration and recall. Users become apathetic and lose their motivation to perform competently or achieve long-range goals. Studies have found an increased risk of cancer and other lung problems associated with inhaling because marijuana smokers are believed to inhale more deeply than tobacco users. 5) High doses of marijuana smoked during pregnancy can disrupt the development of a fetus and result in lower birth weight, congenital abnormalities, premature delivery, and neurological disturbances. 6) In 2001, Health Canada authorized the use of marijuana for medical purposes and as of July 2008, 2812 people were permitted to possess dried marijuana. C. Stimulants 1) Cocaine is an extremely potent and dependence-producing drug derived from the coca plant. a. Users typically sniff the drug into their nostrils, inject the drug intravenously, or smoke it in the form of crack. b. 0.7 percent of Canadians aged 15 and older had used cocaine in 1994, and this figure has remained relatively stationary over time. For some, dealing cocaine is major source of revenue and an entry point for other drug related crime. c. Most cocaine users experience a powerful “rush” in which the blood pressure rises and the heart rate and respiration increase dramatically. When the drug wears off, the user becomes increasingly agitated and depressed. Some become depressed and suicidal. Occasionally, cocaine use results in sudden death by triggering an irregular heart rhythm. People who use cocaine over extended periods of time have higher rates of infection, heart disturbance, internal bleeding, hypertension, cardiac arrest, stroke, haemorrhaging, and other neurological and cardiovascular disorders than non-users. d. Cocaine use is extremely hazardous in pregnancy. Children born to crack addicted mothers typically suffer painful withdrawal symptoms at birth and deficits in cognitive skills, judgement, and behaviour controls. 2) Amphetamines (“uppers”) stimulate the central nervous system. a. Diet pills and pep formulas are legal when prescribed by a physician, but many people become physically and/or psychologically dependent upon them because they believe they cannot lose weight or have enough energy without the pills. b. Chronic amphetamine abuse can result in amphetamine psychosis, characterized by paranoia, hallucinations, and violent tendencies that may persist for weeks after use of the drug has been discontinued. Overdosing on amphetamines can produce coma, brain damage, and even death. D. Depressants 1) The most commonly used depressants are barbiturates (e.g., Nembutal and Seconal) and anti-anxiety drugs or tranquilizers (e.g., Librium, Valium, and Miltown). 2) Relatively low oral doses produce a relaxing and mildly dis-inhibiting effect; higher doses result in sedation. Users may develop both physical addiction and psychological dependency on these depressants. 3) Rohypnol and GHB (gamma-hydroxybutyrate) are popular among young people since they are inexpensive and produce mild euphoria, increased sociability, and lowered inhibitions. a. Rophynol (an anesthetic and sleep aid in other countries) is not approved for use in Canada. It is known as “Roofies” and as the “date rape drug” because a number of women have been raped after an acquaintance slipped the drug into their drink. b. Combining alcohol and Rohypnol or GHB has been linked to automobile accidents and deaths from overdoses because it is difficult to judge how much intoxication will occur when depressants are mixed with alcohol. E. Narcotics 1) Heroin is the most widely abused narcotic but the percentage who use it is very small. 2) Most heroin users inject the drug intravenously so they can experience an initial tingling sensation and feeling of euphoria, typically followed by a state of drowsiness or lethargy. Heroin users quickly develop a tolerance for the drug and must increase the dosage continually to achieve the same effect. In high doses, heroin produces extreme respiratory depression, coma, and even death. Shooting up can cause users to contract hepatitis or HIV/AIDS from contaminated needles and syringes. 3) Heroin and other opiates are highly addictive. Users experience intense cravings for another fix and have physical symptoms such as diarrhoea and dehydration from drug withdrawal. 4) Heroin use is linked more directly to crime than many other drugs. F. Hallucinogens 1) Hallucinogens or psychedelics are drugs that produce illusions and hallucinations. Mescaline (peyote), lysergic acid diethylamide (LSD), phencyclidine (PCP), and MDMA (ecstasy or “E”) produce mild to profound psychological effects depending on the dosage. 2) Mescaline or peyote was the earliest hallucinogen used in North America. Its consumption dates back to early eras of Native American religious celebrations. 3) LSD is one of the most powerful psychoactive drugs; 10 mg of the drug can produce highly unpredictable, dramatic psychological effects for up to 12 hours. Users report experiences ranging from the beautiful (a “good trip”) to the frightening and extremely depressing (a “bad trip”). 4) Among the most recent hallucinogens are PCP (“angel dust”) and MDMA (“ecstasy”). a. Initially, PCP was an anaesthetic used in surgical procedures, but it was removed from production when patients showed signs of agitation, intense anxiety, and hallucinations after receiving the drug. b. MDMA (“ecstasy”), manufactured in illegal labs by inexperienced chemists, is made from amphetamines that produce hallucinogenic effects. Ecstasy or “E” has a high abuse potential and is often a part of “rave” culture. G. Inhalants 1) Inhalants are products such as gasoline, glue, paints, cleaning fluids, and toiletries that people inhale to get high. Inhalant abuse is common because inhalants are inexpensive, easy to obtain, and fast acting. 2) Inhalants contain poisonous chemicals that can make abusers sick damage their nerve and brain cells, and even kill them. 3) While inhalant abuse is found in all ethnic groups in Canada, the prevalence of their use may be higher among Indigenous children and adolescents. VI. GAMBLING AND PROBLEM GAMBLING A. Types of Gamblers 1) Psychologists in Ontario investigated the issue of gambling in Canada and found that 54 percent of the population were non-problem gamblers, 6 percent were at risk of problem gambling, 2.6 percent had moderate gambling problems, and 0.8 percent had severe gambling problems. 2) Symptoms associated with problem gambling include making increased wagers, returning to win back losses, borrowing money or selling something to gamble, feeling guilty about gambling, experiencing financial problems, and developing health problems such as stress and anxiety. 3) Severe problem gamblers participated more in every kind of gambling (tickets, electronic, games with friends, casinos, horse racing, bingo, sports betting, and speculative investment). B. Problem Gambling and Province, Gender, Age, Marital Status, Education, and Income 1) About 2 percent of Canadians were problem gamblers, ranging from 1.5 percent of people in New Brunswick to 2.9 percent of people in Manitoba. A higher percentage of men than women were severe problem gamblers, as well a higher percentage of young people, as compared to older individuals, were severe problem gamblers. Those who had completed post-secondary education were less likely to be severe problem gamblers. A higher percentage of those who had the highest level of income ($100,000+) were likely to be severe problem gamblers. C. Gambling-Related Social Problems 1) Almost half of severe problem gamblers reported one or more problems including: difficulty making a paycheque last; gambling with money budgeted for something else; negatively affected personal relationships; negatively affected work; and, thoughts of suicide. VII. EXPLANATIONS OF DRUG ABUSE A. The Interactionist Perspective 1) Interactionists believe drug behaviour is learned behaviour that is strongly influenced by families, peers, and other people. People are more likely to abuse drugs if they have frequent, intense, and long-lasting interactions with people who abuse drugs. 2) Similarly, when there are more factors favouring drug use than there are opposing it, the person is likely to use the drug (e.g., some children learn to abuse alcohol or other drugs by watching their parents drink excessively or use illegal drugs; other young people learn about drug use from their peer group). 3) People are more prone to accept attitudes and behaviours favourable to drug use if they spend time with members of a drug subculture. Over time, people in heavy drinking or drug subcultures tend to become closer to others within their subculture and more distant from people outside the subculture. B. The Functionalist Perspective 1) Functionalists point out that social institutions such as the family, education, and religion that previously kept deviant behaviour in check have become fragmented and somewhat disorganized. Hence, it is now necessary to use formal mechanisms of social control to prohibit people from taking illegal drugs or driving under the influence of alcohol or other drugs. External controls in the form of law enforcement are also required to discourage people from growing, manufacturing, or importing illegal substances. However, these controls are not available for problem gambling, as it is a legal activity that provides substantial employment and money for government budgets. 2) Prescription and over-the-counter drugs are functional for patients, because they ease pain, cure illness, and sometimes enhance or extend life. And for doctors, because they provide a means for treating illness and help justify the doctor’s fee. Without pills to dispense, there would be no need for pharmacists. Dysfunctions also occur with prescription drugs. Patients may experience adverse side effects or develop a psychological dependence on the drug; doctors, pharmacists, and drug companies may be sued because they manufactured, prescribed, or sold a drug alleged to cause bodily harm to users. C. The Conflict Perspective 1) People in positions of economic and political power make the sale, use, and possession of some drugs illegal. Those in privileged positions criminalize drugs such as marijuana, cocaine, and heroin because historically these are substances abused by the poor and the powerless. 2) Opium smoking was outlawed because it was associated with Chinese immigrants. Restricting the drugs that members of a subordinate racialized/ethnic groups use is one method of suppressing the group and limiting its ability to threaten dominant group members or gain upward mobility in society. Those who control the nation’s political and legal apparatus decide whether a drug is legal or illegal. 3) Conflict theorists also point out that powerful corporate interests perpetuate the use and abuse of legal drugs. D. Feminist Perspective 1) Feminist theorists point out that a significant part of the explanation of drug abuse by women has to do with women’s vulnerability, and disadvantaged position in society. 2) A feminist approach to the problem emphasizes the different types of drug abuse by males and females: male are more likely to use alcohol and illicit drugs, while females are more likely to use licit, psychotherapeutic drugs. The differences in drug taking may be explained by the risk-taking behaviour of men and the relative willingness of women to adopt the sick role. 3) Since a much smaller percentage of severe problem gamblers are women, it is less of an issue for feminists. The focus for feminists is the fact that many women and children suffer from the consequences of men’s severe gambling. VIII. THE FUTURE OF ALCOHOL AND DRUG ABUSE A. Prevention Programs 1) Most primary prevention programs focus on people who have had little or no previous experience with drugs. Secondary prevention programs seek to limit the extent of drug abuse, prevent the spread of drug abuse to other substances beyond the drugs already experienced, and teach strategies for the responsible use of licit drugs such as alcohol. Tertiary prevention programs seek to limit relapses by individuals recovering from alcoholism or drug addiction. 2) Prevention, according to Canada’s Drug Strategy, is best done through a combination of public awareness campaigns, educational resources, training service providers, and community action. a. Scare tactics and negative education programs have not worked. They turn students off and do not achieve their desired goal. b. Objective-information programs often begin in kindergarten and run through grade 12.Using texts, curriculum guides, videos, and other materials, teachers impart information about drugs to students, but some students become more, instead of less, interested in experimenting. c. Vigorous single preventative strategy campaigns for preventing drug abuse have had limited success in deterring drug use. As one student said, “When someone tells you not to do it, that makes you want to do it even more”. B. Treatment Programs 1) Treatment programs are a form of tertiary prevention, seeking to ensure that people who have sought help for some form of drug abuse remain drug-free. 2) The Medical Treatment Model a. This model assumes that drug abuse and alcoholism are medical problems that must be resolved by treatment by medical officials. Treatment may take the form of aversion therapy or behavioural conditioning. For example, drugs (such as Cyclazocine and Nalozone) are given to heroin and opiate addicts to prevent the euphoric feeling they associate with taking the drugs. Supposedly, when the pleasure is gone from taking the drug, the person will no longer abuse the drug. b. Antabuse is used in treating alcoholism. After the person has been detoxified and no alcohol remains in the bloodstream, Antabuse is administered along with small quantities of alcohol for several consecutive days. Since this combination produces negative effects such as nausea and vomiting, the individual eventually develops an aversion to drinking. 3) Short- and Long-Term Services and the Therapeutic Community a. Short-term services include withdrawal management (detoxification) services, which give people a place to stay while their bodies get rid of alcohol or drugs and adapt to a drug-free state. Long-term services include counselling, rehabilitation, and/or the therapeutic community. b. The therapeutic community approach believes drug abuse is best treated by intensive individual and group counselling in either a residential or non-residential setting. Residential treatment take place in a special house or dormitory where alcoholics or drug addicts remain for periods of time ranging from several months to several years. Residents receive therapy and try new behaviour patterns outside of their drinking or drug abuse environments. c. Perhaps the best known non-residential therapeutic communities are Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Both provide members with support in their efforts to overcome dependence and addiction. AA and NA are based on a 12-Step Program that requires members to acknowledge that they are alcoholics or drug addicts who must have the help of “God” and of other people to remain sober or drug-free. Group support is central to success in these programs. d. Sociologists believe AA is successful because it provides former alcoholics the opportunity to be “de-labelled” as a stigmatized deviant and relabelled as a former and repentant deviant. However, social class and personality factors affect people’s ability to enter into the repentant role, which requires a public admission of guilt and repentance, and to successfully interact with others in the program. ACCESSING THE REAL WORLD: ACTIVE ENGAGEMENT WITH PROBLEMS RELATED TO ADDICTIONS Focus on Community Action Have students gather information about local facilities and resources that focus on assisting people with addiction problems, such as detoxification centres, drug treatment centres, drug counselling centres, or AIDS Societies. Have them choose an organization that they would like to visit and arrange an informal interview with a staff or volunteer member. Have them find out what resources the organization offers for people suffering from addictions, and if they have been effective in meetings their goals. Have the students also investigate any barriers that exist for individuals accessing this help. Next, put the students in to small groups (4-6 students) and have them report back to the group on what they found. As a class, have the students make a comprehensive guide of all addiction resources in your community. Have the students pass on this information to their local students’ union or campus health centre as a resource for other students to use. Focus on Theoretical Analysis Separate students into groups of three. Each student in the group should familiarize themselves with a different theoretical analysis—conflict, symbolic interactionist, and feminist. The students who are assigned the conflict theory will investigate tobacco use and abuse from this perspective. The students who are learning about the symbolic interactionist theory will analyze problem gambling from this perspective. Finally, the students researching feminist theory will focus on prescription drug use and abuse from this perspective. Once they have become experts on their topics, they will meet as groups of three and relay their findings back to the group. Focus on Media Engagement Have students watch three episodes of contemporary prime time television (if they do not have access to cable they can use a website such as www.tvshack.net or www.episodecentral.com to watch streaming video of prime time television), such as Mad Men, Grey’s Anatomy, House, Private Practice, Law and Order, Criminal Minds, Weeds, or Desperate Housewives. Have them write a brief report on the portrayal of alcohol use and abuse in popular television. What do they notice about the gendered, racialized and class dimensions of alcohol use? How do people behave when consuming alcohol? How often is binge drinking portrayed? Do the students think these television shows accurately portray the realities of alcohol use and abuse? Make sure they take note of concrete examples to share with the rest of the class. Have a class discussion about each student’s findings. Did all the students discover the same things? Do they think the depiction of alcohol on television is problematic or accurate? APPLYING CRITICAL THINKING THROUGH DISCUSSION 1. Does public tolerance of alcohol and tobacco lead to increased use of these drugs? Why do many people view the use of alcohol and tobacco differently from the use of illicit drugs? Answer: Public Tolerance and Increased Use Public tolerance of alcohol and tobacco does contribute to increased use of these substances. This phenomenon can be attributed to several factors: 1. Cultural Acceptance: Alcohol and tobacco have been embedded in many cultures for centuries. This historical acceptance translates into social norms that encourage use. 2. Legal Status: The legality of alcohol and tobacco makes them more accessible and socially acceptable compared to illicit drugs. Legal markets mean regulated production, marketing, and sales, making these substances readily available. 3. Advertising: Aggressive marketing strategies by alcohol and tobacco companies glamorize their use. Advertisements often depict alcohol and tobacco use as socially desirable, enhancing their appeal. 4. Social Rituals: Alcohol, in particular, is often associated with social rituals and celebrations, making its consumption a normalized part of social interaction. 5. Perceived Safety: Many people believe that because alcohol and tobacco are legal, they are safer than illicit drugs. This perception can lower inhibitions and increase use. 6. Ease of Access: The widespread availability of alcohol and tobacco in stores, bars, and restaurants makes their consumption convenient. 7. Peer Influence: Social environments where alcohol and tobacco use are common can pressure individuals to partake, normalizing and perpetuating use. Different Views on Alcohol and Tobacco vs. Illicit Drugs Several reasons explain why many people view alcohol and tobacco differently from illicit drugs: 1. Historical Context: Alcohol and tobacco have a long history of legal and social acceptance in many cultures, unlike most illicit drugs. 2. Economic Impact: The alcohol and tobacco industries are significant economic contributors, providing jobs and tax revenue. Governments may be less inclined to ban substances that are economically beneficial. 3. Regulatory Framework: Alcohol and tobacco are regulated by governments, with age restrictions and health warnings in place. This regulation creates a perception of controlled, safe use. 4. Public Health Messaging: While there are public health campaigns warning against the dangers of alcohol and tobacco, they often promote moderate use rather than abstinence, unlike campaigns for illicit drugs which typically advocate for zero tolerance. 5. Medical Use and Research: Alcohol has known medicinal uses and benefits in moderation, such as red wine for heart health. Nicotine, though harmful, has also been researched for potential therapeutic benefits. Most illicit drugs are viewed purely as harmful, despite recent shifts in perceptions of substances like cannabis and psychedelics for medical use. 6. Legal Penalties: The legal consequences of using illicit drugs are typically much harsher than those for alcohol and tobacco use, reinforcing the idea that illicit drugs are more dangerous or morally wrong. 7. Social Stigma: Users of illicit drugs are often stigmatized more than those who consume alcohol and tobacco. This stigma is reinforced by media portrayals and societal attitudes. Conclusion Public tolerance of alcohol and tobacco significantly influences their widespread use, driven by cultural norms, legal status, and aggressive marketing. These substances' entrenched societal roles differentiate them from illicit drugs, which are typically perceived through a lens of illegality and heightened danger. This disparity in perception underscores the complexity of drug policy and public health messaging, highlighting the need for a nuanced approach to substance use and its societal impacts. 2. What are some the most frequently abused drugs in Canada? Who is most likely to use these drugs and why? Answer: In Canada, the most frequently abused drugs include: 1. Alcohol: The most widely used and abused substance, leading to numerous health and social issues. 2. Cannabis: Especially prevalent after its legalization for recreational use in 2018. 3. Tobacco: Despite declining rates, it remains a significant health concern. 4. Prescription Opioids: Includes oxycodone, hydromorphone, and fentanyl, which have contributed to a public health crisis. 5. Cocaine: Both powder and crack cocaine are commonly abused. 6. Methamphetamine: Increasingly popular, particularly in certain regions. 7. MDMA (Ecstasy): Frequently used in party scenes. 8. Benzodiazepines: Such as Xanax and Valium, abused for their sedative effects. 9. Hallucinogens: Includes LSD and psilocybin, used for their mind-altering effects. Demographics and Reasons for Drug Use 1. Youth and Young Adults (15-24 years): ● Cannabis: Highest use in this age group due to social circles, curiosity, and perception of low harm. ● Alcohol: Commonly consumed in social settings and influenced by peer pressure. ● MDMA and Hallucinogens: Popular in party and festival environments for enhanced experiences. 2. Adults (25-44 years): ● Alcohol: Continues to be widely consumed in social and professional contexts. ● Prescription Opioids: Usage often begins with medical prescriptions and can lead to dependency. ● Cocaine: Used for its stimulant effects, perceived as enhancing productivity and social interaction. 3. Middle-aged and Older Adults (45+ years): ● Prescription Medications: Higher rates of prescribed opioids and benzodiazepines due to chronic health issues. ● Alcohol: Regular use, sometimes leading to abuse in coping with stress or social isolation. 4. Indigenous Populations: ● Alcohol and Drugs: Higher rates of abuse linked to historical and ongoing socio-economic challenges and trauma. 5. Low Socio-economic Status (SES): ● Opioids and Methamphetamine: Higher rates of abuse due to economic hardship, lack of healthcare access, and mental health issues. 6. Urban vs. Rural: ● Urban Areas: Higher rates of cocaine and MDMA use due to availability and nightlife culture. ● Rural Areas: More methamphetamine and prescription opioid abuse, linked to economic downturns and lack of mental health services. Factors Influencing Drug Use 1. Accessibility: Easier access leads to higher usage rates. Legal substances like alcohol and cannabis are more accessible. 2. Social Environment: Peer pressure and cultural norms significantly impact substance use, especially among youth. 3. Economic Conditions: Financial stress and unemployment can drive higher substance abuse rates. 4. Mental Health: Individuals with mental health issues often turn to substance use for self-medication. 5. Trauma and Marginalization: Populations experiencing significant trauma, such as Indigenous communities, are more vulnerable to substance abuse. 6. Media and Marketing: The portrayal of substances in media and advertising can normalize and glamorize use, influencing behavior. Understanding these patterns helps tailor public health interventions and policies to effectively address and reduce substance abuse in Canada. 3. Does racialization/ethnicity, class, gender, and age play a part in alcohol and drug use and abuse? If yes, how? If no, what does? Answer: Yes, racialization/ethnicity, class, gender, and age all play significant roles in alcohol and drug use and abuse. These factors intersect and contribute to varying patterns of substance use. Racialization and ethnicity impact substance use through cultural norms, socioeconomic factors, and access to resources. For instance, certain racial or ethnic groups may face discrimination and marginalization, leading to higher stress levels and potentially increased substance use as a coping mechanism. Additionally, cultural attitudes towards alcohol and drugs differ among different racial and ethnic groups, influencing usage patterns. Class also influences substance use, as individuals from lower socioeconomic backgrounds may face more stressors such as financial instability, lack of access to healthcare, and limited opportunities, which can contribute to substance abuse. Additionally, the affordability and availability of alcohol and drugs can vary depending on socioeconomic status. Gender plays a role in substance use, with men typically exhibiting higher rates of alcohol and drug use compared to women. However, women may face unique challenges such as societal stigma and gender-specific expectations, which can impact their substance use behaviors. Age is another important factor, as substance use patterns tend to vary across different life stages. Adolescents and young adults may engage in experimentation due to peer pressure and a desire for social acceptance. Meanwhile, older adults may face issues related to chronic pain management or self-medication for mental health conditions. Other factors that influence substance use include genetics, mental health disorders, trauma, and environmental influences such as family dynamics and peer relationships. Overall, understanding the complex interplay of these factors is crucial for developing effective prevention and intervention strategies to address substance abuse issues. 4. As a sociologist, how would you propose to deal with the drug problem in Canada? If you were called upon to revamp existing drug laws and policies, what, if any, changes would you make in them? Answer: As a sociologist addressing the drug problem in Canada, I would advocate for a comprehensive approach that prioritizes harm reduction, public health, and social justice. This would involve several key strategies: Decriminalization: Shifting away from punitive measures towards drug users and instead focusing on treatment and support services. Decriminalization reduces the stigma associated with drug use and encourages individuals to seek help without fear of legal repercussions. Expansion of Treatment Services: Investing in accessible and evidence-based treatment programs, including medication-assisted therapies, counseling, and support groups. This ensures that individuals struggling with substance abuse have the resources they need to recover. Harm Reduction Initiatives: Implementing harm reduction strategies such as needle exchange programs, supervised consumption sites, and overdose prevention services. These initiatives help mitigate the health risks associated with drug use and reduce the spread of infectious diseases. Education and Prevention: Developing comprehensive drug education programs that provide accurate information about the risks and consequences of substance abuse. Prevention efforts should focus on addressing underlying factors such as poverty, trauma, and mental health issues that contribute to drug use. Equitable Access to Resources: Ensuring that marginalized communities disproportionately affected by the drug war, including Indigenous populations and people of color, have equitable access to treatment and support services. Regulation and Legalization: Exploring the regulation and legalization of certain drugs, such as cannabis, with a focus on harm reduction, public safety, and responsible consumption. This approach allows for better control over production and distribution while undermining illicit markets. Community Engagement: Engaging communities in the development and implementation of drug policies to ensure that they reflect local needs and priorities. This includes consulting with affected stakeholders, including people with lived experience of substance abuse. By adopting these strategies, Canada can move towards a more compassionate and effective approach to addressing the drug problem, one that prioritizes the well-being and dignity of all its citizens. 5. What are the main issues surrounding safe injections sites, such as the Insite program in Vancouver? Should Canada support them? Why or why not? Answer: Safe injection sites, like the Insite program in Vancouver, often spark contentious debates. The main issues surrounding them typically revolve around legality, public health, crime rates, and societal attitudes towards addiction. Proponents argue that safe injection sites save lives by providing a controlled environment for drug use, reducing the risk of overdoses, and connecting users with healthcare and social services. They also claim that these sites help to reduce the spread of diseases like HIV and hepatitis C, as well as alleviate the burden on emergency services. Opponents, however, raise concerns about the message these sites may send regarding drug use, fearing they could normalize or condone illegal activity. Some argue that safe injection sites might attract drug users to the area, leading to increased crime and disorder in the vicinity. Others question the allocation of resources, arguing that funding should be directed towards prevention and rehabilitation programs rather than facilitating drug use. Whether Canada should support safe injection sites is a complex question. Advocates emphasize the harm reduction aspect and the potential to save lives, arguing that addiction should be treated as a public health issue rather than a criminal one. They stress that the evidence supporting the effectiveness of these sites in reducing overdoses and connecting individuals with treatment options is strong. Additionally, proponents highlight the cost-effectiveness of such programs compared to the expenses associated with emergency healthcare and criminal justice interventions. On the other hand, opponents may argue that supporting safe injection sites could be seen as condoning drug use and sending the wrong message to society, particularly to young people. They might advocate for alternative approaches such as increased funding for prevention, treatment, and rehabilitation programs. Ultimately, whether Canada should support safe injection sites depends on societal values, the evidence of their effectiveness, and the government's priorities in addressing drug addiction and related issues. 6. What is the profile of the typical severe problem gambler in Canada? Why do you think that gambling has become so problematic for some Canadians? Answer: The typical profile of a severe problem gambler in Canada often includes characteristics such as male gender, younger age (though older adults are also at risk), lower socioeconomic status, and a history of mental health issues or substance abuse. Problem gambling can stem from various factors, including easy access to gambling opportunities, societal normalization of gambling, psychological factors like thrill-seeking or escape from stress, and underlying biological vulnerabilities. In Canada, the proliferation of gambling options, from casinos to online platforms, has increased accessibility, making it easier for vulnerable individuals to develop gambling problems. Economic factors may also play a role, as individuals facing financial hardship may turn to gambling as a perceived solution to their problems, only to fall into a cycle of addiction and debt. Additionally, cultural attitudes towards gambling, including its portrayal in media and advertising, can contribute to its normalization and exacerbate issues for those susceptible to addiction. Addressing problem gambling requires a multifaceted approach involving regulation, education, support services, and public awareness campaigns to mitigate its harmful impacts on individuals and society as a whole. 7. Why do you think that scare tactics and negative-education programs do little to deter youth from engaging in illegal drug use? What kind of preventative strategies do you think would be more effective for deterring youth from drug use? Answer: Scare tactics and negative-education programs often fail to deter youth from engaging in illegal drug use because they typically rely on fear-based messaging, which may not resonate with young people or address the underlying reasons for drug experimentation. These approaches often present exaggerated or unrealistic consequences of drug use without providing accurate information or practical strategies for avoiding substance abuse. Moreover, youth may perceive these tactics as manipulative or patronizing, which can undermine their effectiveness. To effectively deter youth from drug use, preventative strategies should focus on education, empowerment, and support. Providing comprehensive and factual information about the risks and consequences of drug use, delivered in an engaging and relatable manner, can help young people make informed decisions. Additionally, emphasizing positive alternatives such as healthy coping mechanisms, extracurricular activities, and supportive peer networks can empower youth to resist peer pressure and make healthier choices. Furthermore, addressing underlying risk factors such as trauma, mental health issues, and social inequities through accessible counseling services, community resources, and supportive environments can reduce the likelihood of youth turning to drugs as a coping mechanism. Implementing school-based prevention programs, parental education initiatives, and community partnerships can also play a crucial role in promoting resilience and fostering positive youth development. Overall, a holistic approach that combines education, empowerment, and support is more likely to effectively deter youth from drug use than scare tactics or negative-education programs. AUDIO-VISUAL MEDIA FOR FURTHER EXPLORATION Cheating Death —This documentary tells the story of a young Toronto man and the little understood world of guns, gangs and drugs. 2004. 24 mins. National Film Board of Canada, www.nfb.ca. Cottonland—This film documents personal dependency on prescription painkillers by many in the economically depressed community of Glace Bay, illuminating the conditions under which addiction thrives. 2006. 54 mins. National Film Board of Canada, www.nfb.ca. Donna’s Story—An intimate portrait of a fiercely determined survivor, this film profiles a Cree woman who left behind a bleak existence on the streets, and has re-emerged as a powerful voice counselling Aboriginal adults and youth about abuse and addiction. 2001. 50 mins. National Film Board of Canada, www.nfb.ca. East Side Showdown—Middle-class homeowners, angry radicals, desperate drug addicts and people simply looking for a place to lay their head: all are players in a bitter struggle in the downtown Toronto neighbourhood of Dundas and Sherbourne. 1999. 46 mins. National Film Board of Canada, www.nfb.ca. Fix: The Story of an Addicted City—This is the story of Vancouver’s struggle to open Canada’s first safe injection site for drug users. 2002. 93 or 45 mins. Canada Wild Productions. www.canadawildproductions.com Pieces of a Dream: A Story of Gambling—Set in St. Paul, Alberta, this documentary focuses on Philip Wong, who committed suicide at the age of 36 as a result of his problems with a gambling addiction. 2003. 48 mins. National Film Board of Canada, www.nfb.ca. The Tobacco Conspiracy—This documentary takes a hard hitting behind the scenes look at the enormously powerful tobacco industry and the corruption and manipulation that are part of it. 2005. 52 mins. National Film Board of Canada, www.nfb.ca. Through a Blue Lens—This film tells the story of a unique group police officers who formed a non-profit group dubbed the Odd Squad, and their relationship with addicts in Vancouver’s Downtown East side. 1999. 52 mins. National Film Board of Canada, www.nfb.ca. Flipping the World: Drugs Through a Blue Lens—Inspired by the hit documentary Through a Blue Lens, Flipping the World is an honest look at the world of youth and drug addiction, as told by those who have been there. Seven culturally diverse high school students meet with members of the Odd Squad – Vancouver police officers who, since 1998, have been filming people addicted to drugs. 2000. 30 mins. National Film Board of Canada, www.nfb.ca. Hoffman’s Potion—This documentary offers a compassionate, open-minded look at LSD and how it fits into our world. Featuring interviews with LSD pioneers, beautiful music and stunning cinematography, this is much more than a simple chronicle of LSD's early days. It's an alternative way of looking at the drug... and our world. 2002. 56 mins. National Film Board of Canada, www.nfb.ca. CRITICAL READINGS Brady, Kathleen T., Sudie E. Back, and Shelly F. Greenfield. 2009. Women and Addiction: A Comprehensive Handbook. New York, NY: Guilford Press. Courtwright, David T. 2004. Dark Paradise: A History of Opiate Addiction in America. London, GB: Harvard University Press. Csiernik, Rick. 2003. Responding to the Oppression of Addiction: Canadian Social Work. Toronto, ON: Canadian Scholars Press. Langton, Jerry. 2007. Iced: The Crystal Meth Epidemic. Toronto, ON: Key Porter Books. Levinthal, Charles F. 1999. Drugs, behaviour, and Modern Society (2nd edition). Boston, MA: Allyn and Bacon. Marlatt, G. Allan (Ed.). 2002. Harm Reduction: Pragmatic Strategies for managing High Risk Behaviours. New York, NY: The Guilford Press. Maté, Gabor. 2009. In the Realm of Hungry Ghosts: Close Encounters with Addictions. Toronto, ON: Vintage Canada. McCown, William G. 2007. Treating Gambling Problems. Hoboken, NJ: John Wiley & Sons. Pearce, Debbie, Deborah Schwartz and Lorraine Greaves. 2008. No Gift: Tobacco Policy and Aboriginal People in Canada. Vancouver: British Columbia Centre of Excellence for Women's Health. Thombs, Dennis. 2006. Introduction to Addictive Behaviours (3rd edition). New York, NY: The Guilford Press. Instructor Manual for Social Problems in a Diverse Society Diana Kendall, Vicki L. Nygaard, Edward G. Thompson 9780205663903, 9780205718566, 9780205885756
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