Sex, Drugs and Young People

International Perspectives

Peter Aggleton, Andrew Ball, Purnima Mane, Peter Aggleton, Andrew Ball, Purnima Mane

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781134333097
• Edition: 1
• Topic: Medicina
• Subtopic: Malattie e allergie

Sexual practices and drug use among the young are examined in this book, calling into question mainstream assumptions about 'adolescence'.
Bringing together a range of cross-cultural and cross-national contributions, the book reveals both similarities and important differences that mark sexuality and drug use among young in different social and cultural settings. In doing so, it allows the reader to build up a clearer understanding of the challenges that must be faced in public health and education if we are to develop programs and interventions that really serve the needs of young people. The book will be of interest to professionals working with young people and is suitable for a wide range of multidisciplinary courses covering areas such as human sexuality, sex education, public health and social work.

Chapter I

Introduction

Peter Aggleton, Andrew Ball and Purnima Mane

Put together the words ‘sex’ and ‘young people’ and there are the makings of controversy. Add the word ‘drugs’, and there is a specially potent mix. In combination, the three terms – sex, drugs and adolescence – have laid the foundations for early twenty-first century understandings of young people, their circumstances and needs. On the television and in the news, it is not uncommon to hear the claim that young people are risk-takers who live only for the moment. In more academic literature and in government reports, young people are portrayed as sexually irresponsible and prone to alcohol and substance abuse. In the eyes of pundits, young people are said to be egocentric, unable to adjust to the wider demands of the family and community. As a result of this, doctors, health and social care professionals, families and friends face the difficult task of shepherding wayward individuals back to the safe and narrow.

But where did such ideas about young people come from and do they offer a reasonable portrayal of young people’s lives and needs? G. Stanley Hall, one of the founders of developmental psychology, was one of the first to write about such ideas in his book Adolescence: Its Psychology and its Relations to Physiology, Anthropology, Sociology, Sex, Crime, Religion, and Education (Hall 1904). This two volume 1,300 page tome, not only established ‘adolescence’ as a unique stage of development, but also imbued this period of life with negative and problematic characteristics. Hall’s somewhat deprecatory ideas were later taken up in the work of psychoanalytic writers such as Erik Erikson (1968/1974) who saw adolescence as a period of crisis resolving the tension between identity formation and ‘identity confusion’. For numerous writers thereafter, a key developmental task associated with adolescence was that of integration into the community. Without such integration there can only be maladjustment, disturbance and difficulty. Such are the historical foundations upon which numerous modern day understandings of young people have been built.

But do such images offer a realistic portrayal of young people and their needs? The assumption that adolescence is a universal stage of turmoil and confusion to be passed through en route to a more balanced adulthood has been deeply questioned by the work of anthropologists such as Margaret Mead (1928/1961). Her book entitled Coming of Age in Samoa questioned the inevitability of the ‘storm and stress’ (see Hechinger and Hechinger 1963) normally equated with adolescence. For Mead, the problems and conflicts associated with youth as a stage of life were as much a consequence of the economic and social organization of society in general, as the individual. In non-Western societies such as Samoa, youth and early adulthood were characterized by harmony and balance. In other societies such as the USA and Europe, they were associated with problems. For Mead and her followers the ‘problems of adolescence’ are cultural constructions with roots in history, the economy and the societal arrangements that deny young people opportunities and refuse to take their perspectives and experiences seriously.

In recent years, writers such as Manning (1983), Offer and Schonert-Reichl (1992), and Maira and Soep (2004) have pointed to some of the myths about adolescence that require critical scrutiny. These include the notion that normal adolescent development is tumultuous, when for many young people it is not. An over-reliance on evidence from clinical samples of severely disturbed young people led psychologists of the 1950s and 1960s (e.g. Freud 1958; Blos 1962) to conclude that all young people were disturbed.

Likewise, the idea that adolescence is a time of increased emotionality and frequent mood change is now questioned, with recent research showing that adolescents are on average no more moody than those who are younger (Larson and Lampman-Petraitis 1989). The notion that puberty is universally experienced as a negative event by young people has similarly been shown to be false (Brooks-Gunn and Reiter 1990), as has the belief that adolescent thought is immature and childlike (Keating 1990).

While negative images and attitudes towards young people persist, paralleling dominant discourses of sickness, deviance and difficulty are those of a quite different kind. In the writings of early twentieth century reformers such Jane Addams, for example, it is possible to find an altogether more sympathetic appreciation of young people. Where her other contemporaries saw difficulties and problems, Addams saw confidence and hope – the ability to stand free from fear, and the capacity to ‘create order out of casualty, beauty out of confusion, and justice, kindliness and mercy out of cruelty and inconsiderate pressure’ (Addams 1909). Such views have their parallel in the programmes and actions of modern day youth movements all over the world as well as internationally agreed upon human rights instruments such as the UN Convention on the Rights of the Child.

These contrasting views of young people and their needs, the first pathological and vilificatory, the second more understanding of young people’s circumstances and needs, constitute the poles around which adults have been encouraged to understand the actions and behaviours of young people all over the world. Yet to our mind both perspectives run the risk of misreading the situation. Neither, for example, takes cognizance of the fact that not all young people are the same – the risks and opportunities facing individuals vary in relation to social background, gender, sexuality, culture and ethnicity among other factors (see, for example, Epstein 1998; Skelton and Valentine 1998). Neither approach has much to say either about the broader cultural and social context in which young people live their lives. Nor do such frameworks integrate the light and shade in young people’s lives by recognizing, for example, that the same young person may be vigorous, positive, constructive and forward looking at one moment in time, but negative, withdrawn and at risk, the next.

In responding to these concerns, and in offering the foundations for a new and more positive international health agenda, this book seeks to offer a more realistic portrayal of young people, their circumstances, experiences and needs – especially in relation to sex and drugs. Its starting point lies in recognition that young people are, above all, a heterogeneous group. They differ from one another in terms of social background, ambition, interests, opportunities and faith – sometimes in small ways and sometimes very considerably. Only rarely is their social behaviour – like that of adults – over-determined by their biology. More usually, their actions are influenced by political and legal factors, social meanings and motivations, and the economic opportunities available to them. Young people are however more than ‘individuals’ in the free-floating sense of being cut off and separated from society. Instead, their experiences and opportunities are deeply structured by gender, ethnicity/race, class, age and sexuality among other factors. In almost every country of the world, the circumstances and needs of young women differ systematically from those of young men; issues of age and class are important in making sense of young people’s experiences and responses; and sexuality, economic status, disability and other factors open up, and restrict, opportunities for health.

It is crucial to recognize also that young people are the bearers of rights. The rights enshrined in the UN Convention on the Rights of the Child and allied declarations should in our view be the starting point for policy and programme development. But taking these international commitments seriously carries with it major responsibilities for adults. It involves taking seriously what young people say and do, it involves providing opportunities for young people to express their views on matters relevant to their own lives, it involves listening carefully, and it involves taking young people’s perspectives into account when planning and providing services. Doing this encourages the adoption of what might be described as a positive approach to understanding young people and health, and to responding to their potential. Such a perspective is in contrast to the dominant paradigm, which persists in seeing young people as ‘collections of difficulties and problems’ that require treatment, supervision and intervention. This new more positive approach also calls for partnership and participation. As the contributions in this volume show, the promotion of young people’s health is best facilitated by a supportive and inclusive response. Too often in the past, programmes have failed because they have sought to blame young people rather than listen to them. In parallel, they have offered opportunities for tokenistic rather than genuine participation.

Via a series of linked chapters, and with a global focus, our goal is to explore the implications of the above premises for two key aspects of young people’s lives – their sexual and reproductive health and their engagement with both licit and illicit substance use. These chapters also aim to examine the inter-relationships between these two phenomena. We begin with a focus on what might be described as the structuring of vulnerability – or the manner in which young people systematically find it difficult to maximize their sexual and reproductive health and to cope in societies where drugs are prevalent.

Globally, the opportunities and choices available to young people are severely restricted by human poverty and by its intersections with gender. Lack of access to economic resources and the power that comes with these, is associated with a wide range of sexual health problems – especially for young women. These include early childbearing and sexually transmitted infections including HIV. For poverty, rural to urban migration and homelessness are also associated with substance use and involvement in sex work. In chapter 2, Kim Rivers, Peter Aggleton and Andrew Ball discuss these factors, exploring the interface between poverty, gender and education, among other factors, and their implications for substance use, and for sexual and mental health.

Issues of gender are taken up in more detail in chapter 3. Here, Rita M. Melendez and Deborah L. Tolman move beyond the individual to consider the patterned nature of young women’s social disadvantage and its implications for sexual health. Drawing on case study material from the USA and from Nepal, as well as on the academic and programmatic literature, they point to the systematically structured nature of this disadvantage to advance the notion of vulnerability in making sense of young people’s experiences. Their work points once more to the intersections between gender and poverty as determinants of the opportunities available to young people and the risks, including gender and sexual violence, that both women and men may face. They use case studies from Nigeria, the UK and the USA to point to heightened vulnerability for many young women and demonstrate how programmatic advances can be made to respond to diverse groups of young people’s rights and needs.

Chapter 4, by Carol Jenkins, examines issues of race, culture and ethnicity in relation to young people’s use of licit and illicit drugs, as well as the links between sex and substance use. The use of mind-altering drugs has an ancient history. Societies all over the world have found that certain plants or other substances affect the mind in ways that are valued for their capacity to transform perceptions, moods or emotions. For the majority of young people, trying out different psychoactive substances is more of a social activity than anything else and may not be associated with low self-esteem, deviance or criminality. A better understanding is required both of normative patterns of substance use, the ‘functionality’ or otherwise of specific forms of use, and the factors associated with serious harm, both for the self and for others. Harm reduction for drug users has shown clear success in reducing health and social risks. But in many parts of the world, governments wish to enforce a ‘no drugs–no sex’ policy for young people. Yet, there is little in human history to suggest these are reasonable or attainable goals, and by denying young people access to the full range of options, such policies are in fact detrimental in terms of protecting young people from drug-related problems or sexually transmitted infections.

The second part of this book looks more specifically at young people’s sexual and substance use practices, as well as the relationships between them. In chapter 5, Deborah Keys, Doreen Rosenthal and Marian Pitts examine the links between sexual behaviour, sexual well-being and sexual vulnerability within a framework that stresses the positive potential of young people as sexual beings. They examine variations and trends in age of first sexual intercourse and the push and pull factors involved. Young people embark on sexual careers for many reasons, ranging from the affective to the financial. Cultural and gender factors exert significant influences on meaning, with young men being often more likely to cite pleasure, desire and physical satisfaction and women, love, intimacy or desire for a close relationship. The authors conclude that early sexual initiation is not necessarily a problem in itself. Rather, lack of information, education and/or support may lead to unwelcome outcomes for those who experience an early sexual debut. A broader definition of sex is called for in making sense of young people’s experiences, which recognizes the importance of masturbation and same-sex practices, as well as the potential of sex to be a pleasurable and positive aspect of a young person’s life.

In chapter 6, Neil Hunt shifts the focus slightly to look at patterns of substance use. All over the world, concern has been expressed about young people’s use of illicit drugs such as cannabis, inhalants, sedatives, amphetamine-type stimulants, cocaine and heroin. Social surveys consistently identify drug use as a widespread activity among young people. Usually, it occurs within a variably-sized minority of the population. However, studies of young offenders, children excluded from school, children in care or regular club-goers commonly find that drug use is, statistically, the norm rather than the exception. In this kind of situation, what should be our response? First, we need to understand the diversity of phenomena involved – and the range of factors that may lead to involvement in substance use. Second, there is a need for ‘intelligent intervention’, as Hunt describes it, programmes and actions provided in contexts and with a focus that responds to young people’s diverse circumstances and needs.

Chapter 7, by John Howard and Anthony Arcuri, builds upon such concern by examining the situation of drug use among same-sex attracted young people. The chapter emphasizes the ‘meaningfulness’ of different forms of substance use, and the need for focused programmes of different kinds. It also highlights the special circumstances of same-sex attracted young people, the discrimination that many experience, and the capacity of drugs to temporarily alleviate the pain of this abuse. While most same-sex attracted young people survive their teenage years minimally scarred and resilient, a minority do not, and some may find that substance use enhances vulnerability to sex-related risks. Exposure to a range of role models may decrease isolation by providing examples of resilience and coping, and both specialist and non-specialist youth services have an important role in educating individuals and promoting health.

In chapter 8, the focus shifts to patterns of alcohol use. Sandra Bullock and Robin Room examine three broad questions: what is known about patterns of alcohol consumption among young people around the world; how has the consumption of alcohol by young people been conceptualized in the literature; and how does drinking relate to other activities such as violence and sex? Their chapter reveals something of the diversity in drinking behaviour among young people internationally, as well as its relationship to societal norms, interpersonal relationships and societal level structural forces including regulation and the law. They find evidence however of an increasing similarity in young people’s drinking patterns across countries, linked to the rise of club and other recreational cultures. Yet alcohol-related changes in social behaviour vary considerably across countries and settings, making it foolish to link alcohol consumption unproblematically with violence and/or sexual risk-taking. Their chapter ends w...

Table of contents

• Cover Page
• Half Title page
• Series page
• Title Page
• Copyright Page
• Dedication
• Contents
• Contributors
• Acknowledgements
• 1 Introduction
• Part I The structuring of vulnerability
• Part II Young people, sex and drugs
• Part III Special circumstances, special needs?
• Index