SW24D Drugs

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SW24D Drugs Society

• Etiology of drug abuse/addiction

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Aim of the session

• Explore the theories that attempt to explain the
  phenomenon of substance abuse

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Etiology of addiction/drug abuse

• Cause or sum of knowledge regarding its cause
• There are many explanatory theories as there are
  reasons for addiction but it is important to have
  a conceptual framework

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Etiology of addiction/drug abuse

• Reason for knowing cause
• For a general understanding of the condition
• Selection and implementation of appropriate
  treatment

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Etiology of addiction/drug abuse

• 3. Prediction of possible outcomes of treatment
• Construction of appropriate research
• 5. Prevention of condition

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Traditional theories

• Moral theory
• Disease theory

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Moral theory

• Ascribes the genesis of alcohol problems to
  weakness in character and personal choice

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Moral theory (Contd)

• Mid 19th century alcohol consumption was actively
  promoted
• But people were expected to hold their liquor
• Drunkenness and dependence on alcohol was
  considered sinful and a shameful example of lack
  of will power

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Moral theory (Contd)

• Drunkenness was seen as an individual weakness
  and a threat to society
• Church and conservative groups of the community
  made it clear that such moral degradation was
  inexcusable.
• Imbibing of alcohol was considered sinful and the
  imbiber morally corrupt

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Moral theory (Contd)

• The assumption was that Alcoholism was under
  ones control and that willpower and desire alone
  could prevent overindulgence.
• 1919 saw the 18th amendment to the Constitution
  of US prohibiting the sale manufacture and
  transportation of intoxicating liquor
  bootlegging developed

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Moral theory (Contd)

• 1935 saw a shift away from the moral model and
  replaced by a self help organization AA
• Retained some elements of moral model except that
  individual was not held responsible for having
  the disease of alcoholism but for seeking help to
  overcome it

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Disease model

• Deficiencies or abnormalities in a persons
  physical or psychological makeup

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Disease theory

• Work of Jellinek, 1950
• Addiction particularly alcoholism is seen from a
  medical point of view reason for vulnerability
  is caused by a physiological deficit in an
  individual that makes that person unable to
  tolerate alcohol.

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Disease theory (Contd)

• Based on premise the only treatment for the
  disease is abstinence
• Jellinek suggests that there are distinct signs
  and symptoms of alcoholism an important criterion
  if it is to be termed a disease

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Strengths of Disease theory

• Acceptance of an addictive disorder as a disease
  means that the substance abuser does not live as
  an outcast. Employers and family members are
  empowered to support treatment and rehabilitation
  efforts.

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Strengths of disease theory

• Relieving the guilt and shame felt by addicts
  for having the disease may make them more
  amenable to treatment
• Viewing addiction as a disease opens it to
  research on its etiology, symptomology,
  progression and treatment

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Limitations of disease theory

• Claiming to have a disease, some addicts may deny
  responsibility for change, especially since
  denial is a main symptom of substance abuse.
• Alcoholism and other substance abuses are treated
  in the same way without recognition of the
  complex factors accompanying polydrug use.

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Limitations (contd)

• 3. Using recovering alcoholics and addicts to
  work as paraprofessionals staff members in
  treatment and education programs may use only
  their experience to substantiate abuse as a
  disease rather than referring to scientific
  evidence

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Contemporary/Current perspectives

• Genetic
• Systems
• Behavioral
• Sociocultural
• Biopsychosocial theories

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Text used

• Substance Abuse Counselling Theory and practice
  by Patricia Stevens-Smith and Robert L Smith
• Chemical Dependency A systems approach by C.
  Aaron McNeece and Diana M DiNitto