All segments of US society are grappling with novel issues of substance use and misuse. University students are particularly at risk for developing substance use disorders, given the inherent stresses associated with college life and the importance of certain kinds of substances (e.g., alcohol) in non-sanctioned social events. Students are also targeted for substance use prevention programs, starting in their early teen years and extending to the college campus. The inevitable result is that students develop shared models for thinking about substance use and those who use drugs and alcohol.
Pioneering work by anthropologists has illuminated the political economy of addiction in the US and shown how substance use and drug dependency form a part of syndemics that impact many communities (e.g., Singer and Clair). Ethnographies of substance using populations have also provided significant insights (Bourgois). However, research has largely not examined the broader cultural dimensions of drug use—the shared, societal understanding surrounding substance use and misuse and the implications of that shared understanding for a variety of factors that accompany drug use.
One of these is stigma. As introduced into the anthropological lexicon by Goffman, stigma refers to a “spoiled identity.” Persons are negatively evaluated because of some attribute or set of attributes—such as substance use—that they possess. But, what underlies the attribution of stigma?
We investigated this from a cognitive cultural perspective, examining the ways college students organize their thinking about the risk of drug use. The university is an interesting community for this research and one that is rarely utilized in anthropological research. College can be an atmosphere that encourages experimentation and new experience. Students arrive at the university with new-found freedom, as conventional social controls—especially their parents—are no longer there. At the same time, they have been the targets of intensive efforts regarding drug education throughout their secondary school years. Yet, during university years, rates of substance use rise dramatically. How does this all fit together into a cultural model of drug use? And what are the effects of that cultural model on the attribution of stigma?
[pquote]The social processes and institutions originally created to reduce and control substance use may actually promote the stigmatization of drug-users.[/pquote]
We investigated this specifically in terms of how students understand the risk factors for substance use. Five broad themes organized students’ understanding of risk factors: (a) biological factors, such as a genetic predisposition to addiction and the addictive qualities of the drugs; (b) self-medication, or the use of substances as a way of coping with stressors; (c) familial influences, including early exposure to substance use and socioeconomic factors; (d) social influences, especially peer pressure; and, (e) hedonism, including curiosity about and enjoyment of drugs.
Using the cultural consensus model (a technique for determining if there is sharing or agreement within a cultural domain), we found that there was a fairly modest agreement about the relative importance of these various risk factors for substance use. More interesting, however, were the results of a residual agreement analysis. This form of analysis examines the degree to which there are subgroups within the sample that tend to agree more strongly with one another about some facet of the model, beyond the overall consensus. We found two such subgroups that formed opposite poles of the model. One subgroup placed a greater emphasis on biological factors and self-medication as risks for drug dependency, while the other group placed a greater emphasis on hedonism and social influences. It is important to emphasize that the entire sample of students agreed that each of these sets of factors were important; the subgroups, however, emphasized the importance of one or the other set factors above that of the overall agreement.
We then examined the degree to which these groups tended to stigmatize drug use, specifically in the sense that they perceived persons who used drugs as potentially dangerous and at fault for their addiction. Persons who emphasized hedonism and social influences as risk factors attributed significantly greater stigma, while persons who emphasized biology and self-medication attributed significantly less stigma.
There are several important implications of these findings. Substantial debates have taken place in anthropology in recent years over the degree to which cultural models are shared versus contested. Clearly, models are shared and contested. That is, the basic outlines of a cultural model can be shared, and then within the outlines of that overall consensus there can be contention over specific features. While this is logically clear, it is demonstrable empirically using the cultural consensus model in concert with the analysis of residual agreement.
Most educational programs that seek to reduce drug-use among children and teenagers advocate for what we have labeled a moral model. While these programs attempt to teach students not to use drugs, they also have the effect teach students to stigmatize people with substance use disorders. When viewed as a deviant and self-destructive behavior that goes against cultural norms, drug use and abuse become laden with moral judgments associated with choice and control. Thinking about substance use in this way may inevitably lead to increased stigma as it further marginalizes people who use drugs. In this way, the social processes and institutions originally created to reduce and control substance use may actually promote the stigmatization of drug-users.
Nicole L. Henderson is a 1st-year doctoral student in Biocultural Medical Anthropology at the University of Alabama.
Bill Dressler is a professor of anthropology at the University of Alabama.
Biocultural Systematics is written by members of the University of Alabama Biocultural Medical Anthropology program.
Feature image, CC0.
Cite as: Henderson, Nicole L and Bill Dressler. 2016. “Culture, Stigma, and Addiction on College Campuses.” Anthropology News website, May 15, 2017. doi: 10.1111/AN.425