Welcome back, I would like to do a quick recap of my last blog, we started off with whether Addiction is a Disease or a Choice? We left off with the important result of the controversy is that there are treatments and that happens to be where the evidence resides to find closure to this controversy! Let’s start with a little history, people have been doing drugs for as far back as humankind can date! So, with that being said, over the years the different models or paradigm of addiction and treatment have evolved! If you pay attention you will see a pattern and be able to connect the dots as to how to solve the “Disease or Choice” controversy for yourself. There are several examples of the cause and effects of Addiction and Treatment. The moral/legal model, the disease/medical model, the learning/social model, and the public health/harm-reduction model. I’ll go into these a little bit and then narrow them down to the most current models!
The Moral/Legal model would be the famous “it’s a choice” theory. It’s explained in short as those who suffer from addiction have a moral failing and the ways to treat that was to lock them up or convictions of legal consequences for their actions. Come to find out jails and probation weren’t treating the problem, so legal consequences have morphed into being sentenced to evidence-based treatment centers. The Disease/Medical model involves the theory that the brain chemistry changes with drug use and needs medical attention. Addiction is progressive and chronic and doesn’t have a cure which happens to be the medical definition of a disease. This model believes that one must remain abstinent for treatment to get better by continuing with a 12-step program. Most people need rehab to begin abstinence and that’s where they start to get better. Then when they get out, most people relapse. This is where I’m going to introduce the learning/social model. This model classifies addiction as a learned behavior through one’s environment. Changing environments, finding healthy activities to stimulate the chemical of dopamine in one’s brain, and the reinforcement of good behavior would be the treatment plan. There is also the psychological/mental health model which in short is driven by psychological stress. In this theory people use drugs as a coping skill to mental illness. The treatment would involve a psychologist and mental health medications along with dual diagnosis programs. All the paradigms use some sort of cognitive behavioral therapy, finding a spiritual program, and psychologist. The Newest Model is the public safety/harm reduction model this alone gets a lot of kick back because the most popular treatment strategy is maintenance drug prescriptions. The reality to this model is all about reducing risk factors for the public due to the risky-behaviors people participate in. The most logical idea is when they aren’t ready to stop using or have tried everything else and still can’t manage to stop, we can still help keep them alive and the public healthy.
Addiction is very broad and there’s several other models out there, keep in mind the least effective was the moral/legal model or the choice model. The pattern here is each of these models has some form of medical treatment. If the more effective answers to our problem consists of some type of medical solution is addiction a choice or a disease?
From experience implementing each treatment theory every day helps me maintain abstinence and in turn I’m able to work through the reasons I started using in the first place! It’s not about being a disease and it’s not about being a choice it’s about addiction being a complex issue and there are tons of ways to attempt to solve addiction! Now I want to touch on the fact that this controversy, labeling, shaming, and criticizing is just adding to the stigma. One reason why it’s so hard for someone to ask for help and get treatment is due to the stigma of addiction. This doesn’t just fall on those who don’t suffer from addiction, it also falls on those who do suffer. Addiction is complex, just as, treatment is complex, and people too are complex. Everyone is different, what works for one may not work for another, but those that keep trying to find what will work for them are the bravest of the brave in my eyes!