Major Paper – FINAL

DUE: May 19, 2019 11:55 PM

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Apr   1, 2019 12:05 AM





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Assignment Instructions

Major Paper Assignment Instructions and Grading Rubric

This assignment meets the following Course Learning Objectives:

– Articulate basic drug terminology and drug taking behavior
– Identify the various addictive substances – legal and illegal – and their classifications
– Analyze the reasons people commonly abuse substances
– Analyze how substances affect the mind and body and society

In 2010, The American Academy of Pediatrics (AAP) released a policy statement addressing the complex relationships among children, adolescents, substance abuse, and the media. This assignment requires a critical examination of the AAP publication and a critique of a media portrayal of substance use, with links made to the AAP statement and course material. Conclusions about the implications of the media portrayals and the policies recommended by the AAP also should be made. Successful completion of this paper will require work over multiple weeks.  A two paragraph summary of the proposed example of substance use portrayal in the media was due by the end of Week 3. The full paper is due at the end of Week 7.


This is part one of the assignment that you did


This assignment proceeds in four steps: 


 Step One: Read the AAP Policy Statement located below. Make some notes for yourself about points of agreement or disagreement you have with the statement and specific findings regarding media depictions of substance use that you want to assess when you write the paper. 


 Step Two: Find a current example of substance use portrayal seen in the media; for example, scenes from a movie, a television show, or a commercial; print ads; or portrayals found in “new media” as discussed in the AAP article. The Internet is a good tool for finding film or television portrayals of substance use as well as examples of print ads if ready access to first-hand media is not available. A two paragraph summary of the proposed example of substance use portrayal in the media that will be used for the paper is due by the end of Week 3. This proposal is a separate assignment and is worth 10 points.


 Step Three: Write the paper. Begin the paper with an introduction that summarizes the main findings of the AAP article and previews what will be covered in the coming pages. Next, compare and contrast the portrayal of substance use found in the media with the information learned about that substance in the class and course readings. What messages about the substance are being portrayed? How accurate are those messages relative to the actual data on substance use? Be sure to cite the course readings as needed.

 Continue by comparing and contrasting the portrayal of substance use found in the media with the criticism of media portrayals found in the AAP paper. Does the media example match their arguments or contradict them? What links and connections can be made? Be sure to cite the article as needed. 

 Next, draw some conclusions about the portrayal of substance use found in the media, addressing the following: What are the implications of this type of portrayal? What messages are being sent and to whom? Are those messages an accurate representation of the use of this substance? Should media portrayals be required to be accurate in their depictions of use, showing both positive and negative consequences? 

 Finally, review the guidelines suggested by the AAP at the end of their policy statement and address the following: Although directed specifically at pediatricians, which of those recommendations is most important? Why? Are these recommendations necessary? If followed, will they be effective in addressing the concerns raised earlier in the article? Be sure to cite sources as needed.

 Step Four: 

The required length of this paper is 11 pages, plus a required a cover page and a reference list. Papers must comply with APA formatting rules, including font size and margins, and must have a scholarly focus and tone.  Quoting of published material and use of the first-person “I” are not permitted and will result in point loss. All source material must be paraphrased into your own words and cited appropriately. 

 On submission your work will auto-run through’s plagiarism checker software.    

 The grading rubric below details specific grading criteria.

The Final Major Paper document should be attached in the appropriate Assignment tab and will be evaluated using the rubric below: 





Needs Improvement 


Points Earned



15 Points Possible

Student provides a clear   introduction which summarizes the AAP article and previews the major points   to be covered in the paper.   

Student provides a mostly accurate   introduction which summarizes the AAP article and previews the major points   to be covered in the paper. At times description lacks coherence. 

Student provides a marginal   introduction which summarizes the AAP article and previews the major points   to be covered in the paper. Sufficient details and supporting evidence are   lacking.

Student does not provide an   introduction which summarizes the AAP article or preview the major points to   be covered in the paper.


Choice of Media Example

15 Points Possible

Discussion of chosen media   portrayal is clear, accurate, and related to the assignment. Sources are   credited and cited appropriately.   

Discussion of chosen media   portrayal is mostly accurate, and related to the assignment. Sources are   credited and cited. At times description lacks coherence. 

Discussion of chosen media   portrayal is marginally accurate, and related to the assignment. Sources   are credited and cited but not using appropriate formatting. Sufficient   details and supporting evidence are lacking.

Student does not chose a media   portrayal that is accurate and/or related to the assignment. Sources not   credited and cited.


Comparison of Media Example to   Class Material

25 Points Possible

Student provides a comparison of   media with information from class material that is clear and   thoughtful. Questions outlined in the assignment are   answered. Sources are credited and cited appropriately.   

Student provides a mostly accurate   comparison of media with information from class material that is largely   clear and thoughtful. Questions outlined in the assignment are mostly   answered. Sources are credited and cited appropriately. At times   description lacks coherence. 

Student provides a marginal   comparison of media with information from class material that is partial   clear and thoughtful. Questions outlined in the assignment are   marginally answered. Sources are credited and cited appropriately.   Sufficient details and supporting evidence are lacking.

Student does not provide a   comparison of media with information from class material. Questions   outlined in the assignment were not answered.


Comparison of Media Example to AAP   article

25 Points Possible

Comparison of media presented by   the student with information from the AAP article is clear and   thoughtful. Questions outlined in the assignment are   answered. Sources are credited and cited   appropriately.   

Comparison of media mostly presented   by the student with information from the AAP article is mostly clear and   thoughtful. Questions outlined in the assignment are mostly   answered. Sources are credited and cited appropriately. At times   description lacks coherence. 

Comparison of media marginally   presented by the student with information from the AAP article is mostly   clear and thoughtful. Questions outlined in the assignment are   marginally answered. Sources are credited and cited   appropriately. Sufficient details and supporting evidence are lacking.

Student did not compare media   presented with information from the AAP article. Questions outlined in   the assignment were not answered.  


Strength of Conclusion

40 Points Possible

Student provides an insightful and   creative conclusion, logically summarizing the main elements of the case   and the scholarly literature findings, articulating a personal reflection on   the case study analysis process

Student provides a mostly   cogent conclusion, logically summarizing the main elements of the case   and the scholarly literature findings, articulating a personal reflection on   the case study analysis process

At times description lacks   coherence. 

Student provides a   marginal conclusion, loosely summarizing the main elements of the case   and the scholarly literature findings, articulating a personal reflection on   the case study analysis process

Sufficient details and supporting   evidence are lacking.

Student does not provide a   clear conclusion or logically summarizing the main elements of the case   or reference scholarly literature findings; lacks a personal reflection on   the case study analysis process


Paper Format and Mechanics;   Spelling, Grammar and Punctuation

30 Points Possible

Work is presented in a logical and   coherent way. Writing is clear, articulate, and error free. Citations are   composed in proper format with few or no errors. Paper is the required   length, is double-spaced with 1-inch top, bottom, left and right margins, and   in Calibri or Times New Roman styles, size 12 font. Cover   page, paper body, citations and References are in the correct APA   format. There are few to no spelling, grammar, or punctuation   errors.

Work is grammatically sound with a   few minor errors. Citations are composed in the proper format with some   errors. 

Work contains frequent grammatical   errors. Citations are inaccurate or improperly formatted. 

Work does not demonstrate   appropriate graduate level writing. 


Summary Comments: 

Total Points:   (150   points total)

Supporting Materials





One of the most problematic, licit drugs in our society is alcohol. The simple process of fermenting sugar from a variety of naturally occurring fruits and grains has been ubiquitous across cultures and societies since the beginning of civilization. It is so pervasive within our society as to also seem to be a seamless part of it. One cannot easily characterize a particular type of person or group that is likely to be alcohol dependent; the affliction cuts across all imaginable demographics of society. Some people are able to drink on occasion for pleasure, whether alone or with friends. Others drink on a daily basis; others periodically binge. 

Here’s a quick, 9-minute history of the science, creation and use of alcohol across cultures, courtesy of

At present, it has been estimated that approximately 18 million Americans have a serious problem related to the use of alcohol. These 30% of all consumers of alcohol account for about 80% of all alcohol consumed. Men outnumber women in heavy alcohol use by a ratio of around three to one.

The heaviest users of alcohol, in turn, directly or indirectly impact an even larger percentage of the population with their subsequent behaviors while intoxicated. The costs of alcohol abuse and dependence are significant: this drug is the third leading cause of death and is implicated in over half of all deaths and injuries in car accidents and half of all physical assaults and homicides. Further, it has been estimated that at least four family members are directly affected from the maladaptive behaviors that follow from the alcohol-abusing individual; you can quickly begin to see extensive the social, familial, occupational, and emotional impact of this disorder. 

What’s the difference between alcohol abuse and alcohol dependence?

The initial psychiatric diagnosis that could be made for an individual that habitually uses alcohol to excess would be alcohol abuse. This diagnosis is characterized by the continued use of alcohol for at least a period of one month, despite having a recurrent physical problem or some serious personal problem in one’s social or occupational functioning because of the excessive drinking or the repeated use of alcohol in situations (e.g., driving) when consumption is physically hazardous.

The diagnosis of alcohol dependence reflects an even greater degree of impairment in individuals compared to alcohol abuse. Alcohol dependence typically involves at least three of the following serious circumstances: (1) drinking alcohol in greater amounts and over a longer period of time than intended by the individual; (2) a strong desire by the individual to reduce consumption and several unsuccessful attempts to do so; (3) spending a great deal of time drinking or recovering from the negative effects of excessive drinking; (4) continued drinking even though physical and/or psychological problems are apparent and problematic in the individual’s life; (5) social, work, or recreational activities have been significantly reduced or abandoned because of excessive drinking; (6) the development of marked tolerance for alcohol; and (7) consumption of alcohol specifically to avoid the symptoms of withdrawal. About 15 percent of men and 10 percent of women in the United States have met the diagnostic criteria for alcohol dependence during their lifetime.

How does alcohol affect the brain?

Alcohol, as a drug, acts as a depressant on the individual’s central nervous system. It is a small molecule and is quickly absorbed in the bloodstream. Alcohol is linked to inhibiting receptors for the neurotransmitter GABA. In low doses, alcohol depresses the inhibitory functions of the brain, including those areas of the brain that typically adhere to the social controls and inhibitory rules that people typically follow in society. As the alcohol concentration increases in the bloodstream, the depressive function of alcohol extends from the cerebral cortex to areas of functioning that are further (and deeper) into the brain’s primitive and reflexive areas of functioning. In extreme dosing, inhibition of respiratory and motor centers can occur with other symptoms that include stupor or unconsciousness, cool or damp skin, a weak rapid pulse, and shallow breathing. It should be noted that alcohol can only be metabolized and leave the body at a specific rate, regardless of how quickly (or how much) alcohol has been taken in by the individual, so attempts to quickly “sober up” an individual will be unsuccessful.

For more illustration of the science and physical problems associated with habitual alcohol consumption, check out this 4-minute video:

What are the behavioral effects of using alcohol?

Individuals experiencing alcohol intoxication will exhibit a variety of maladaptive changes in their behavior and psychological functioning. Examples include inappropriate sexual or aggressive behaviors, impaired judgment, quickly changing moods, incoordination, impaired gait, slurred speech, impaired attention and memory (sometimes to the point of blackout), stupor, and unconsciousness. The degree of symptoms is dose dependent with more pronounced symptoms occurring as the alcohol blood-level increases.

Withdrawing from alcohol intoxication (i.e., a hangover) is also dependent on recent dosing, history of chronic abuse, and involves a variety of symptoms which can include autonomic hyperactivity in the form of profuse sweating and rapid heartbeat, hand tremors, nausea or vomiting, fleeting illusions or hallucinations, psychomotor agitation, anxiety. At worst, grand mal seizures can occur following periods of prolonged and heavy use. Another significant withdrawal phenomenon that chronic, prolonged abusers of alcohol can experience is delirium tremens that is characterized by disturbances in cognitive functions (especially consciousness), autonomic hyperactivity, vivid hallucinations, delusions, and agitation.

Chronic alcohol dependence can lead to a medical condition known as Alcohol-Induced Persisting Amnestic Disorder (also known as Wernicke-Korsakoff’s Syndrome). This disorder is believed to be caused by deficiencies in thiamine and Vitamin B because their absorption in blocked with habitual alcohol consumption. Individuals afflicted with this disorders experience retrograde (the past) and anterograde (new knowledge) amnesia as well as confabulation, which is the tendency to attempt to compensate for memory loss by fabricating memories.

What are some of the life problems associated with heavy alcohol use?

The pervasive impact of chronic alcohol abuse can be seen across several important areas of in life that generally impair one’s ability to function adaptively (i.e., take care of oneself in a manner appropriate for one’s age) and experience a good quality of life. It is a complex problem in living with psychological, physical, and behavioral components. These include (1) demonstrating a preoccupation with alcohol and drinking; (2) demonstrating emotional problems (e.g., depression); (3) having overt problems at work, within one’s family, and other important social relationships because of alcoholism; and (4) associated physical problems that result from habitual alcohol consumption.

Given that alcohol is a central nervous system depressant, it shouldn’t be a surprise that depression can become a comorbid (or co-occurring) condition for some individuals. In general, the incidence of depression in substance abusers is quite high. People who drink alcohol heavily to the point of intoxication can experience very strong emotions and are frequently disinhibited (i.e., impulsive). Feelings of hopelessness, helplessness, and suicidal thoughts often accompany bouts of heavy drinking.

To review the relationship among amount (dosing) of alcohol consumed, blood alcohol levels, and effects on the central nervous system and behavioral performance, check out this five-minute Healthy McGill video here:

Who is at greatest risk for abuse or dependence?

Research has demonstrated that two risk factors can contribute significantly to the manifestation of alcohol abuse and dependence in the individual. The first risk factor is a family history of chronic alcohol abuse. Children of alcoholic parents have a higher statistical risk of becoming alcoholics themselves when compared to children of nonalcoholic parents. Whether this represents an increase genetic or environmental risk, however, is difficult to determine since both are intertwined in such instances. A second and independent risk factor that has been identified is those cases where an individual has a genetic predisposition to have low response to the psychoactive effects of alcohol (and, as a result, requires higher amounts of alcohol to become intoxicated). Individuals with this lower response to alcohol are more likely to abuse alcohol, as they require considerably more drinking to obtain the level of intoxication experienced by others who drink less to get the same effect.

When taken together, an adult child of an alcoholic who also possesses a low response to the effects of alcohol has an even higher statistical chance of developing a pattern of alcoholism. Keep in mind that all of these examples are just risk factors and statistically probabilities – none of these outcomes are written in stone. Further, research demonstrates that there are also protective factors (variables) in the environment that can also help promote resiliency in some individuals and lead them not to drink alcohol in an excessive or maladaptive fashion when they are present. Clearly, again, the path to alcoholism (and responsible drinking and abstinence) is multi-factorial.

What are some of the treatment options for Alcohol Dependence?

        Unfortunately, flaws in methodology jeopardize much of the research on the effectiveness of alcohol treatment programs. That is, the studies aren’t well controlled in terms of error variance and it cannot be clearly determined whether the observed changes in the studies are due to the employed treatment or other, uncontrolled, factors during the study. For example, many studies do not use untreated comparison groups. One generalization that can be made from the available research is that formal treatments are not always adequate or even necessary. A positive outcome to treatment appears to be related more to the presence of certain psychosocial factors like specific threats to one’s physical or social well-being (i.e., hitting “rock bottom”) than any particular intervention. 

        There are, however, some treatments that have had some success. These treatments have several components in common, including covert sensitization and other forms of aversive counterconditioning. Antabuse, for example, is a medication that, when taken, will result in an individual becoming violently ill should they consume alcohol. Other treatments that put together broad-spectrum interventions such as social skills training, learning to drink in moderation, stress management techniques, and teaching coping skills and other self-control techniques help to teach the individual better, healthier alternatives methods when faced with environmental triggers to consuming alcohol.

        Many modern programs incorporate aspects of Alcoholics Anonymous and/or the drug Antabuse. However, the effectiveness of these treatments has not been empirically demonstrated. One criticism that has been levied on these treatments is that they do not take into account individual differences and the wide variety of psychosocial problems and/or lack of resources that can make successfully managing alcohol consumption. In general, individuals with severe problems with alcohol require more intensive treatments (e.g., inpatient hospitalization), while those who experience less pathological problems require more periodic, milder interventions.

        Another criticism that has been raised about some current treatment programs for alcohol abuse and dependence is that they tend to be based on the belief that failures in treatment are largely due to the individual’s denial of having a problem or otherwise not having an adequate level of motivation. Many therapists have not supported this line of thinking, however. Research on treatment outcome, alternatively, points to the importance of therapist factors such as their level of empathy toward clients and their attitudes about what constitutes healthy recovery as being more related to positive outcomes than client’s own motivation or personality characteristics. 

        Some experts in the field of alcohol research have emphasized the importance of the clients’ reaction to instances of relapse, especially from a cognitive (how they think) and emotional (how they feel) perspectives.  Researchers stress the need to get away from the idea that a relapse represents a “violation of abstinence” which can lead to anxiety, depression, self-blame and an increased likelihood of further alcohol consumption. Alternatively, relapses should be characterized as a mistake that came about from external, controllable factors and not the result of internal factors (e.g., personality characteristics) that are essentially thought to be out of one’s control.

Dually diagnosed individuals (those with a mental illness or personality disorder in addition to a substance abuse disorder) usually have a hard time finding treatment in one place. In many jurisdictions, they have to see a therapist at a mental health center and a separate therapist at a substance abuse center, or they are forced to make a choice of one over the other. You will find that there is often a lack of cross-training between mental health and substance abuse professionals, and that makes it harder for clients to get the treatment they need. Furthermore, in some places, you may find that the treatment support groups for substance abuse have an interpretation of sobriety that prohibits the use of psychotropic medication.

Legal Drugs in Our Society – Part II

        Hopefully, you have found the historical account to date of which drugs have largely been considered illicit, those that have typically been licit and readily available, and those that have switched from one designation to the other, to be an interesting review. Such distinctions among different groups of people and across different periods of time often speak to the changing cultural, social, religious, and scientific beliefs and morays of the time. This week, you will be studying two very popular and legally sanctioned drugs, tobacco and caffeine, that have been readily consumed by people since the beginnings of structured societies. 


From its use in religious ceremonies and purported medicinal herb thousands of years ago to the image of sophistication and modernism it has held in industrialized societies over the last few hundred years, tobacco has occupied a role of prominence among individuals and groups alike.  Think about it: what other drug has been so popularized in society as to be physically accommodated with lighters and ashtrays in automobiles and airplanes? What about spittoons in the restaurants and bars of the late 1800s and early 1900s? How about the smoking cars in trains and smoking sections at airports and restaurants? All these examples serve to demonstrate just how indoctrinated tobacco use has been in modern culture. 

How did tobacco, the plant, get to be such a big deal? Check out this 8-minute history and science video from DNews Plus:

How have patterns of tobacco use changed over the decades in the United States and the world? What are some of the reasons for these changes?

Tobacco is interesting and noteworthy in that it is one of the only drugs that has been commercially available, openly accessible, and integrated within the culture of many societies for hundreds and hundreds of years. Further, it has been monetized as a commodity with economic value for the purposes of trade and payment of debts. In some circles, over time and across cultures, tobacco was even used as its own form of currency. In fact, one could certainly argue that the colonization, formation, and military defense of the United States of America occurred largely in part through the economic power generated through tobacco cultivation, sale, and distribution to other European countries.

It is interesting to note the relationship between the amount of government regulation that exists with the tobacco industry and the resultant use by population. There is a clear relationship between the growing regulation in the United States that began in the early 1970s and the eventual decline of tobacco use among large segments of the U.S. population. This can be especially seen in new generational cohorts; that is, the adoption of chronic smoking habits by younger people. Many other European and South American countries do not employ such heavy restrictions on the advertisement, marketing, and accessibility of cigarettes and other tobacco products upon their population. As a result, the decreases in use and dependence that have been realized in the United States have not been generalized to other countries across the world. The zenith of tobacco use in the United States has come and gone. The preponderance of research has clearly demonstrated its pathological effect on the body and that information, plus rigorous regulation, has helped contribute to the decline in its use.

There are a variety of ways to consume tobacco products as a vehicle by which to introduce the drug nicotine into the bloodstream and the brain. Smoking (via cigars, pipes, and cigarettes), chewing, and snuffing are all legitimized drug-using behaviors whose differing favorability has waxed and waned over the years. Over the years, most individuals were shaped into eventually preferring the use of tobacco cigarettes, which could be mass-produced in very high volumes inexpensively.

The intense and intentional role of marketing has been very significant in shaping the appeal to certain demographic groups of the population. The aggressiveness of early mass marketing campaigns also extended themselves, ultimately, to the denial and cover up by corporate America with regards to the deleterious effects of tobacco use. It wasn’t until 1964 that the federal government began to formally investigate the health effects and cost of tobacco use and to institute policies that would eventually lead to the restriction of marketing and sales in the United States. 

What are some of the adverse consequences of smoking?

The deleterious effects, both physically and psychologically, that result from chronic tobacco use have been well documented. The three-fold combination of carbon monoxide, tar, and nicotine can produce a wide variety of lifelong physical ailments, including a higher risk for cardiovascular disease, respiratory disease, and lung cancer than for nonsmokers. As is widely popularized, there are literally thousands of chemical found in cigarette smoke, including ones commonly used in pesticides. Additionally, other forms of cancer have also been implicated with chronic tobacco use. In fact, the vast majority of deaths each year that can be attributed to drug use and dependence are the result of tobacco use and nicotine dependence.

The primary psychoactive drug in tobacco, nicotine, has been determined by research trials to be a dependence-producing substance. As you recall from previous lectures, drug dependence is defined by continued use of a drug even in the face of obvious occupational, physical, familial, and social problems that one experiences in direct relation to its use. This also includes the psychological experience of craving and high drug-seeking behaviors. The rate at which nicotine is absorbed into the blood stream and penetrates the blood-brain barrier certainly speaks to its strong psychoactive properties. Withdrawal symptoms begin as early as six hours after the last dose. Within 24 hours, common complaints can include headache, irritability, problems concentrating, and sleep disturbance. Finally, in the late 1990s, the tobacco industry finally conceded publically that the products they were producing were not only physically harmful to individuals but also that the nicotine contained within then was a dependence-inducing substance.

What are some of the best strategies to employ when attempting to stop using tobacco products?

    You know just how difficult it is to treat nicotine addiction in terms of a smoking cessation program. The research has demonstrated, much like successful treatment programs for other types of drugs, that have a high degree of dependence, that a multimo