Models of Addiction - Alcohol Moderation & Substance Abuse Treatment
Models of Addiction
Arnold M. Washton, Ph.D.
Disease Model Assumptions
X Addiction is a biologically-based syndrome with psychological and social components affecting its expression
X "Brain allergy" to psychoactive substances X Predisposition is invisible (can be inherited) X Once the addiction "switch" in the brain is turned
on, it can't be turned off X Addiction remains dormant (in remission) until
reactivated by alcohol/drug use
Disease Model
Assumptions
X Inevitably if left unchecked, the disease becomes progressively worse leading ultimately to disability and death
X The disease is generic to all psychoactive substances, irrespective the particular substances the person happens to choose
Disease Model
Treatment Implications
X Lifelong total abstinence from all psychoactive substances is the only acceptable treatment goal
X Confrontational and coercive tactics are seen as necessary to break through "denial"
X Successful recovery requires true acceptance of the disease, powerlessness, and surrender to a higher power
X Recovering addicts are in the best position to help other addicts recover
Disease Model Treatment Implications
The more severe the addiction, the more accurately the disease model describes the problem-
X People with chronic, persistent, relapsing addiction X People with multiple or substitute addictions X People who suffer severe life-damaging
consequences, but continue to use
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