In society, many people link abusing drugs or alcohol to an individual's lack of personal responsibility or morality. Prior to American model Anna Nicole Smith's death, which was from an apparently accidental overdose of several prescription medications, her son, Daniel, had died just months before from an apparent drug overdose. This incident poses the question of whether the son inherited a vulnerability to addiction from his mother or was the habit picked up from living with her over the years. Post should be at least 400-450 words in length.

Case study below.

To prepare for this week's Discussion, review the following sources in addition to this week's assigned Reading.

Harvard Health. (2004). The addicted brain, a Harvard review. Harvard Health Publications: Harvard Medical School. Retrieved from http://www.health.harvard.edu/newsweek/The_addicted_brain.htm

In the case studies in the Course Home Tab, read Case Study 3 Ellis: Substance Use Disorder: Opioid

Proceed with this week's Discussion by addressing the following about the nature of substance use disorders:

Provide an overview of the biological, psychological, sociocultural theories surrounding the causes of substance use disorders.

Next, select one of the theories (biological causes, psychological causes, or sociocultural causes) and defend and support how the selected approach can explain why people use psychoactive drugs, such as the individual in this week's case study.

Based on the selected cause, explain why it is difficult for a person to stop the drug or alcohol use and addiction.

The Case Study

Ellis is a 30-year-old mechanic who lives in a middle-class neighborhood in Philadelphia. He has been married for nine years to his wife, Denise, and has two daughters, ages 8 and 5. For the past seven years, Ellis has worked as a heating-ventilation-air conditioning (HVAC) mechanic at a large city hospital. 

Ellis demonstrated superior job performance when he first began working at the hospital. Her was known for his thoroughness and conscientiousness and had a way of motivating others. After only two years on the jog, the manager of the maintenance department promoted Ellis to supervisor on the first available opening. Over the past few years, however, Ellis's performance has gradually deteriorated. Starting in his third year at the hospital, Ellis began arriving late for work and leaving early, first only once or twice a month, but them once or twice a week. Verbal reminders went unheeded and eventually Ellis's supervisor issued a written reprimand. At this point, Ellis requested to work the night shift and the supervisor agreed, glad to have Ellis be someone else's problem. For a while, Ellis's performance at work improved but it gradually deteriorated to the point that he was rarely on time and then started missing work altogether. His relationship with coworkers has become very strained due to the fact that they often felt Ellis shirked his responsibilities. 

Ellis's supervisor has tried to understand, asking Ellis if there were any special health concerns or personal issued but Ellis was vague and even evasive. His supervisor finally became exasperated and told Ellis, verbally, that his job would be terminated unless he showed marked improvement in his performance. To date, there has been no improvement; therefore, the supervisor issued a written warning and two weeks later, after still no improvement, he was suspended from his job. Knowing that the next step would be termination, Ellis consulted the coordinator of his union employee assistance program (EAP) and described his addiction to heroin. The EAP coordinator contacted a residential treatment center and arranged to have Ellis admitted the following week. Without any explanation, he said that Ellis would be absent for one month and his performance should be reevaluated after his return. 

Not surprisingly, Ellis drug use has led to severe financial problems and problems with his family. Since he was on an hourly wage, his absentee rate resulted in his bringing home less and less money and soon, nearly all his money went to support his drug habit. Ellis has gone through his family's modest savings and recently began selling household items, including the wedding silver, the stereo and DVD player. When questioned by his wife Denise, Ellis stated that they had been stolen. Eventually, Ellis began to sell drugs to support his heroin habit. Although it was Ellis's declining work performance that directly precipitated his referral to the treatment center, his family had also suffered greatly over the past few years. He would come home from work, later and later, often missing dates that he and Denise made with friends and he forgets promised made to his children. Denis has become increasingly frustrated and depressed by his withdrawal from their children, demanding to know where he went all the time and where he spent all his money. She suspected that he had a problem with alcohol and perhaps other drugs but never realized the extent of his problem. Their relationship has deteriorated to the point where they fight constantly, often ending in violence. 

Childhood Background Ellis, the oldest of three brothers, grew up in a predominantly African-American working-class neighborhood in Philadelphia. His father was a moderately successful electrician who maintained steady work through one or another of the many contractors he knew. He was a long-time member of the electrician's union and had become increasingly involved in union politics over the years, but died suddenly of a massive heart attack a little more than 2 years ago. Ellis's mother never worked outside the home and is now supported by Social Security and a small monthly annuity from her husband's union death benefit. Ellis is the oldest of three brothers and is the only child who did not attend college. 

Ellis's father was a large man, prone to alcoholic binges. Occasionally, while drunk, he would beat his wife or one of his sons, but usually he was good natured and jovial. He rarely disciplined the boys for staying out late or drinking; in fact, he seemed more amused than angry when one of his sons came home drunk. Ellis's mother was a quiet, passive woman who abstained from alcohol and other drugs herself. She was often upset about her husband's drinking binges but never confronted him directly. She was alarmed when she began to notice signs of drug use in her children, but she did little to intervene. 

Ellis began experimenting with alcohol and marijuana when he was 11 years old. Drugs were readily available in his neighborhood and many of his friends were daily users. Ellis gradually increased his use of alcohol and marijuana throughout middle school; by the time he entered high school, he drank to intoxication on most weekend nights and sometimes up to 4 days a week. By the time he was in high school, Ellis was experimenting with a variety of drugs, including cocaine, barbiturates, hallucinogens, and heroin. Throughout the years, Ellis's use of hard drugs became more and more frequent culminating in his full-blown heroin addiction.