Compare and Contrast two Models to Explain Substance Use, Abuse and Addiction.
Use, as the term infers is any use of a drug. The majority of people use a form of drug in one way or another, ranging from the use of prescribed medication over the counter, to alcohol, tobacco, caffeine or illicit drugs such as cannabis, or amphetamines. In reference to use, abuse and addiction two models will be addressed as a way to explain this epidemic. Exploring the disease model, from the 1930’s post-Prohibition it was a common perception that alcoholism was a moral failure. Medical and professional standards of the time treated it as a condition that was expected to be incurable and lethal. Moreover use, abuse and addiction will be explored through a psychological perspective where a psychodynamic modality will be discussed as a way to explain substance abuse.
The Australian Drug Foundation (2010) notes, there is no safe level of drug use. The use of any drug always carries some risk even medications can produce unwanted side effects, thus it is important to be careful when there is a level of any drug use.
Abuse, the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV, 2000) outlines substance abuse as a ‘maladaptive pattern of use leading to clinically significant impairment or distress.’
Dependence and addiction, the definitions of these two terms are somewhat debatable. There is also some debate over the use of these terms to describe how people use drugs. This is because the language used can affect perspectives on treatments, outcomes, motives and behaviors of those who use them. For an example; some people do not like the term addiction as it implies that the person is powerless over their use of the drug, however others argue that this powerlessness is the foundation of diagnosis and treatment. Furthermore, others argue that substance use and dependency are not psychiatric disorders, as the DSM IV classification suggests.
The DSM IV limits it classification of substance related disorders to dependence, it does not include a classification for addiction.
“In 1964 the World health organization recommended using the term ‘dependence’ in place of terms ‘addiction’ and ‘alcoholism’ (World Health Organization Technical Report series: No. 273, 1964). In 1981, ‘dependence’ as a socio-psycho-biological syndrome manifested by a behavioral pattern in which the use of a given psychoactive drug (or class of drugs) is given a sharply higher priority over other behaviors which once had significantly greater value (for example drug use comes to have a grater relative value).” (Edwards et al., 1980, p.240).
The two terms dependence and addiction are very closely intertwined as it is argued that the tolerance and withdrawal associated with dependence are what exactly defines addictions. However, the DSM IV classification more so describes what is known as a physical dependence, and does not take account of psychological dependence. Moreover, psychological dependence is when the person believes that they need to use the drug in order to feel emotionally stable or function efficiently. According to the Centre for Addiction and Mental Health (2011), addiction is:
“A primary, chronic, neurobiological disease with genetic, psychosocial and environmental factors that influence its development and manifestations. It is characterized by behaviors that include one or more of the following: loss of control over drug use, continued use despite harm, compulsive use and craving.”
Use, Abuse and addiction and the disease model:
In the 1930’s post-Prohibition it was a common perception that alcoholism was a moral failure. Medical and professional standards of the time treated it as a condition that was expected to be incurable and lethal.
In the same year Alcoholics Anonymous was founded by Bill Wilson and Dr. Robert Smith, Alcoholics Anonymous or (AA) holds the...
References: The Australian Drug Foundation – DrugInfo. (2010) Drugs – the facts, Melbourne. Available:
Clark, D. 2006. The disease Model of addiction. London: www.drinkanddrugs.net/backgroundinformation.breifings/sep2506/background_breifing.pdf
Edwards, & Griffith (2002) “Alcoholics Anonymous”. Alcohol: the worlds favorite drug. Thomas Dunne Books.
Chappel. J. (1999) Twelve step and mutual help programs for addictive disorders. Psychiatric clinics of North America
Stanton Peele, Ph.D., and Archie Brodsky with Mary Arnold (1992), The Truth About Addiction and Recovery
Woody, G.E.; McLellan, A.T.; Luborsky, L.; and O 'Brien, C.P. (1995), Psychotherapy in community methadone programs: A validation study. American Journal of Psychiatry.
Woody, G.E.; McLellan, A.T.; Luborsky, L.; and O 'Brien, C.P. (1998), Psychotherapy with opioid-dependent patients. Psychiatric Times.
Luborsky, l., Diguer, L, Seligman, D.A., Rosenthal, R.,. Krause, E.D., Johnson, S., Halperin, G., Bishop, M., Berman, J.S., Schweizer, E. (1999). The researcher’s own therapy allegiances: A “wild card” incomparisons of treatment efficacy.
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