INTRODUCTION

Sick role concept (part ehsan)

Drug Addiction
Drug addiction is a chronic, often relapsing brain disease that causes compulsive
drug seeking and use, despite harmful consequences to the drug addict and those
around them. Drug addiction is a brain disease because the abuse of drugs leads to
changes in the structure and function of the brain. Although it is true that for most
people the initial decision to take drugs is voluntary, over time the changes in the brain
caused by repeated drug abuse can affect a person's self-control and ability to make
sound decisions, and at the same time create an intense impulse to take drugs. Like
many mental health disorders, several factors may contribute to development of drug
addiction and dependence. The main factors are environment. Environmental factors,
including your family's beliefs and attitudes and exposure to a peer group that
encourages drug use, seem to play a role in initial drug use. Besides, genetics, once
you've started using a drug, the development into addiction may be influenced by
inherited (genetic) traits, which may delay or speed up the disease progression.

Research has shown that the key risk periods for drug abuse are during major
transitions in childrens lives. The first big transition for children is when they leave the
security of the family and enter school. Later, when they advance from elementary

school to middle school, they often experience new academic and social situations,
such as learning to get along with a wider group of peers. It is at this stage early
adolescence that children are likely to encounter drugs for the first time.
When they enter high school, adolescents face additional social, emotional, and
educational challenges. At the same time, they may be exposed to greater availability of
drugs, drug abusers, and social activities involving drugs. These challenges can
increase the risk that they will abuse alcohol, tobacco, and other substances. When
young adults leave home for college or work and are on their own for the first time, their
risk for drug and alcohol abuse is very high. Consequently, young adult interventions
are needed as well.
Within the medical institution stigma can play a role in determining the attitude of
medical expert towards the patient. Stigmatized patient (drug addiction), might be
ignoring when asking question or seeking to clarify information about their treatment.
The result is medical dominance by doctor and other staff over patient. Stigmatization
group is one way in which society control their behavior. In some cases, stigma is never
removed and the person is never fully accepted into society. This was true when a drug
abuser is who separated from being part of the society and society itself forces them to
live alone. Stereotype which can be define oversimplified belief or image, often
concerning a group, an individual, or a form of behavior. Usually, society believe that if
that person addicted toward the drug is a bad person, beside those who are addicted
toward drug are from broken family, low socio-economic group because they influence
by improper lifestyle which they attained, but not to say rich people is not addicted to
drug, they also being addicted to drug to overcome their stress especially in working
place.

DISCUSSION
a. Sick person requires legitimation from physician to be exempted from normal
social responsibilities.
From our point of view, drug addiction is not applicable in the sick role concept.
This is because first component of sick role that posited by Parsons is that ill people are
exempt from their normal social responsibilities such as go to school, work or domestic
labour. However, this exemption requires some form of legitimation from physicians or
those in medical authorities. It means that an official or legitimate medical certificate is
important and required so that the ill people can enter the sick role. From this point of
view, people with drug addiction problems cannot enter the sick role as ill people. This is
because they are not getting ill due to nature of any other relevant reasons. There
might be some factors that cause them to be addicted with drugs. So, physicians or any
other experts cannot give the legitimation to people with drug addiction and considered
as patient. They cannot absent from school or work due to drug addiction. This sick role
has been prevented drug addicted people or any malingerers from entering the sick
role. To prevent this issue, the ideology and values of the sick role must be maintained
by physicians or accepted experts. Hence, the sick role has no relation in drug addiction
problems.
b. The sick person is not responsible for their condition and they has right not to be
blamed for their illness.
Besides we can also see that the second component of sick role theory states
that the sick people are not held responsible for their condition. This component
describes that a person who is diagnosed by an illness, or being suffered by an illness
is not to be blamed and is not necessary to take responsibility of it. In other words, they
have rights not to be blamed for their illness. This is because, it is not the person's
intention, plan or will to get a particular disease. It just happens naturally which
sometimes due to idiopathic reasons and the individual's illness is thought to be beyond
their control. Although unhealthy lifestyle may lead to diseases such as hypertension

and diabetes, these cannot be the factors to put a blame on the patient because the
patient had never want or expect to suffer any kind of diseases.
In the case of drug addiction problem, the second component of the sick role is
neither applicable nor relevant for several reasons. Firstly, before the person decides to
take drugs, he or she must have already knew the consequences that might happen as
nowadays there are many awareness regarding this matter. Despite that, they chose to
be abused by drugs. Hence in our opinion, it is the person's own fault and nobody
should be blamed for their conditions except themselves. Secondly, the drug addicts
should also be responsible for their own decision, which is to start taking drugs no
matter why the reasons were. May it be because of their friends' influences, or may it be
due to their own self decision, still the responsibility lies upon them. Furthermore, drug
abuse is illegal and considered as crimes. Hence, just like other crimes, the person
should be charged for what he or she had done, and any relevant authority has rights to
take actions on them. Based on these evidences, it is clear that the second component
of the sick role is not applicable for drug addiction problems.
c. The sick people must want to try to get well
Apart from that, one of the obligations for the people to enter sick role is the sick
person must try to get well. The sick people have to find the alternatives to be healthy
so they will be able to carry out their daily routines and responsibilities. The alternatives
include seeking the medical advices as well as cooperate with the healthcare
professionals. The sick person is expected to comply with the healthcare personnels
instructions. According to Talcott Parson, one of the major concerns of sick role theory is
to change the persons behaviors from compliance to concordance. In compliance, the
decision-making about illness and its treatment is allocated within the health
professionals domain and only leaving little scope for patient involvement. Whereas,
concordance involves a negotiation between healthcare professionals and patients in
the consultations to reach therapeutic alliance between them. The movement from
compliance and concordance will help the sick person to participate actively in the
decision-making process regarding their desired therapeutic goals during the
consultation process with the healthcare professionals. This will enhance their

understanding about their diseases and increase their compliances towards the
medications prescribed.
In case of drug addicts, majority of them do not try to get well. Once they are
addicted to the drugs, they will always rely and depend on it. As a result, they will not
putting an effort to be healthy. In addition, drug addicts will spend almost all their money
to purchase the drugs. Hence, they will not afford to get the healthcare professionals
services as there is no money allocated for their own treatments. This clearly proves
that drug addicts do not try to get well. Naturally, the society will have the bad and
negative perceptions towards the drug addicts. This type of perception might cause the
drug addicts to have low self-confidence and thereby, do not have motivations to
receive an appropriate medical treatments. Therefore, drug addicts cannot enter sick
role due to their reluctance and unwillingness to get well.
d. Sick person are require to seek and co-operate with the physician to have
appropriate treatment.
Lastly, in sick role theory, a person having a disease should seek medical
practitioner to help him get well and also advise him on his health. A sick person should
have the desire to get well on his own and must find a way for curing his disease. Illness
behaviour, as shown in the use of medical services, is far greater in women. Many
studies have linked illness-behaviour variation to ethnicity, education, family structure,
and social networks. Illness behaviour is also shown to be related to health care
coverage and insurance. Most importantly, illness behaviour is highly related to
socioeconomic status. Classic studies done in the 1950s powerfully demonstrated that
socioeconomic class influenced how symptoms were acted on, with lower-class
individuals (lower in socioeconomic status) most likely to delay seeking professional
health care even when presented with severe symptoms.
While much of the early work on illness behaviour was seen in the context of
understanding patient help-seeking behaviour, the large research literature on illness
behaviour has gone well beyond this more narrow medicalized view. Many studies have
considered the different perspectives of illness behaviour held by individuals and health
care practitioners. The differing worldviews of patients and practitioners are now seen

as highly relevant to illness behaviour. The medical practitioner and the individual
experiencing symptoms go through very different appraisals of the meaning of the
symptoms. Increasingly in the literature there is the recognition of the strong relationship
between the physical and mental experience of symptoms and the meaning of that
experience for illness behaviour. David Mechanic, a pioneer in the study of illness
behaviour, best summarizes the current perspective on illness behaviour: "Illness
behaviours arise from complex causes, including biological predispositions, the nature
of symptomatology, learned patterns of response, attributional predispositions,
situational influences, and the organization and incentives characteristic of the health
care system that affect access, responsiveness and the availability of secondary
benefits" (Mechanic, 1995).
Therefore, in this case of drug addiction, sick role theory is not applicable because
the drug addict person does not seek medical practitioner and he does not have the will
to heal.

CONCLUSION

As a conclusion this drug addiction is not suitable and applicable with the sick
role theory. We know that, within the context of sick role, society allows two explicit
behavioural exemptions for the sick person but also enforces two explicit behavioural
requirements. The exemptions include that the sick person is temporarily excused from
normal social roles. Second, the sick person is not held responsible for the
illness. However, in order to be granted these role exemptions, the patient must be
willing to accept the following two obligations. The obligations or responsibilities are the
sick person must want to get well and the sick person is expected to seek medical
advice and cooperate with medical experts. Importantly, the sick role is applicable in
describing patient experience with acute illness only and is less appropriate is
describing persons with chronic illnesses who may not have easily recognizable
symptoms. This shows that, sick role is not relevant for the drug addicts. Obviously, like
we mentioned before in the sick role, the sick person should not be blamed for their
illness as they are not responsible for their condition. But in case of the drug addiction, it
is the persons own decision and fault. They chose to be abused by the drugs. So, they
should be hold responsibilities for what they have done to themselves. Furthermore,
majority of them do not try to get well and improve their condition. We know that, once
they are addicted to the drugs, they will always rely and depend on it. Thus, we all
agreed that based on all of these evidences been discussed, it is clear that this drug
addiction problems is not applicable for sick role.

REFERENCES