The causes and roots of addiction are of great interest as addiction affects people from all demographics and areas of life. The reasons and triggers that lead people to resort to substance abuse are diverse, however two main models of addiction have been proposed:
The Disease Model
Looks at addiction as a set of causal relationships that suggest people follow a logical process whereby they first become susceptible to addiction, addicted, and then self destructive. Their individual susceptibility is attributed to a genetic predisposition and/or psychological damage from childhood.
When a susceptible individual is then exposed to either drugs or environmental stress, drug addiction or alcoholism is likely to result due to their predisposition. This typically leads to an array of other issues such as self hate, depression, and dependence.
The Adaptive Model
This model also looks at a series of causal relationships for addiction, but beginning with a combination of faulty upbringing, inadequate environmental support, and genetic unfitness such as a disability. These issues, in addition to how the individual understands them, results in failure to achieve some of the basic expectations of society- competence, social integration, acceptance, and self reliance.
The failure to meet integration is a causal problem itself; often resulting in social ostracism, despair, and creation of an urgent need to search out and utilize substitute ways of providing meaning and social support. Various ‘substitute adaptations’ may be considered for this purpose including substance abuse. Drug addictions are ‘adaptive’ because alternatives to it are worse- despair, mental disintegration, and suicide.
A Critical Comparison
- The disease model assumes people who are addicts are sick and that this is causal to their addiction. The adaptive model instead assumes that addicted people are adapting to the situation they have found themselves in given the abilities they possess.
- Drug addiction is seen as causal of an array of associated problems in the disease model, while the adaptive model states that drug addiction is in fact the result of the problems an individual faces.
- The adaptive model takes on a more critical view of the environment the addict may find themselves than the disease model.
- The disease model hinges on a susceptibility of the addict to becoming a dug abuser based on a predisposition or sickness. Contrastingly, the adaptive model focuses on the idea of ‘search and choice’ where actions are viewed as more deliberate.
Source: Alexander, Bruce K. The Disease and Adaptive Models of Addiction: A Framework Evaluation.
The recognition of addiction models is especially critical to policy makers and treatment personnel. Drug policy and addiction treatment may need to differ considerably depending on whether addicts are viewed as suffering from a disease imparting them a susceptibility for substance abuse, or viewed as failing to properly integrate into society and substituting their need for adaptation with substance abuse.
Empirical evidence does not favor one model over the other. Perhaps this is a reason why there are differing beliefs and attitudes surrounding the causes of addiction, drug policy that emerges, and treatment options that are available for addicts.
