Theories and models of addiction and substance abuse

Psychology

Theories and Models of Addiction/Substance Abuse

A lot of people do not know why or how people become addicted to drugs. It is sometimes implicit that drug abusers lack moral principles or willpower and that they could stop utilizing drugs merely by choosing to alter their behavior. Some people believe that drug addiction is a multifaceted illness, and quitting takes more than good objectives. These people believe that drugs alter the brain in manners that promote compulsive drug abuse, and quitting is difficult, even for those who are ready to do so. Because of scientific advances, more is known about how drugs work in the brain than ever before. It is also known that drug addiction can be effectively treated to help people to stop abusing drugs and lead industrious lives (NIDA InfoFacts: Understanding Drug Abuse and Addiction, 2011).

"Addiction is a relentless, frequently relapsing brain disease that causes compulsive drug seeking and use, despite the harmful consequences to the addicted patient and to those around them" (NIDA InfoFacts: Understanding Drug Abuse and Addiction, 2011). Even though the initial decision to take drugs is controlled for most people, the brain alters that occurrence over time to confront a person's self-control and capability to oppose intense desires urging them to take drugs. Fortunately, treatments are obtainable to help people counter addiction's influential disruptive effects. Research shows that uniting addiction treatment medications with behavioral therapy is the best way to make sure accomplishment for most people. Treatment advances that are modified to each patient's drug abuse patterns and any co-occurring medical, psychiatric, and social troubles can lead to continued recovery and a life devoid of drug abuse. Comparable to other chronic, relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be administered productively. And as with other chronic diseases, it is not infrequent for a person to relapse and begin abusing drugs again. Relapse, on the other hand, does not indicate treatment breakdown, rather, it designates that treatment should be restored, attuned, or that a substitute treatment is desired to help the person reclaim control and get well (NIDA InfoFacts: Understanding Drug Abuse and Addiction, 2011).

Research over the past several years has attempted to decide how drug abuse starts and how it advances. A lot of factors can add to a person's risk for drug abuse. Risk factors can augment a person's odds for drug abuse, while defensive factors can decrease the risk. Most people who are at risk for drug abuse do not start utilizing drugs or become addicted. In addition, a risk factor for one person may not be the same for another. Risk and protective factors can affect kids at different stages of their lives. At each stage, risks take place that can be altered through prevention intervention. Early youth risks, such as violent behavior, can be altered or barred with family, school, and community interventions that center on helping kids develop suitable, positive behaviors. If not dealt with, pessimistic behaviors can lead to more risks, such as school failure and social troubles, which put kids at additional risk for later drug abuse (Preventing Drug Abuse among Children and Adolescents, n.d.).

No one thing can forecast whether a person will become addicted to drugs. Risk for addiction is influenced by a mixture of things that comprise a person's biology, social background, and age or phase of development. The more risk factors a person has, the greater the possibility that taking drugs can lead to addiction. For instance:

Biology - the genes that people are born with, in association with environmental influences, account for about half of their addiction vulnerability. In addition, gender, ethnicity, and the incidence of other mental disorders may influence risk for drug abuse and addiction.

Environment - a person's environment comprises a lot of different influences, from family and friends to socioeconomic status and overall quality of life. Factors such as peer pressure, physical and sexual abuse, stress, and excellence of parenting can significantly influence the incidence of drug abuse and the increase to addiction in a person's life.

Development - genetic and environmental factors interrelate with critical developmental phases in a person's life to influence addiction vulnerability. Even though taking drugs at any age can lead to addiction, the earlier that drug use starts, the more likely it will advance to more serious abuse, which creates a special test to adolescents. "Because their brains are still developing in the areas that administer decision making, judgment, and self-control, young people may be predominantly prone to daring behaviors, including trying drugs" (NIDA InfoFacts: Understanding Drug Abuse and Addiction, 2011).

Research has shown that the main risk stages for drug abuse are throughout chief stages in children's lives. The first big stage for kids is when they leave the safety of the family and enter school. Later, when they move forward from elementary school to middle school, they frequently experience new academic and social circumstances, such as learning to get along with a wider group of peers. It is at this phase, early adolescence that kids are liable to come across drugs for the first time. When they enter high school, young people face supplementary social, emotional, and educational tests. At the same time, they may be exposed to better accessibility of drugs, drug abusers, and social behaviors involving drugs. These tests can augment the risk that they will abuse alcohol, tobacco, and other substances. When young adults leave home for college or work and are on their own for the first time, their risk for drug and alcohol abuse is very elevated (Preventing Drug Abuse among Children and Adolescents, n.d.).

At one point in time people with troubles connected with alcohol or other drugs were regarded as sinners or criminals, and any help they might be given came by way of the courts or the church. "Towards the end of the 19th century the medical profession began to use the word addiction as both a cause for, and diagnosis of, excessive drug use. This idea was formalized in the 1950's when the World Health Organization (WHO) and American Medical Association (AMA) classified alcoholism as a disease. One consequence of this change in viewpoint is the idea that the addict is not in control of their behavior, that they require treatment rather than reprimand" (Drug Addiction, 2006).

According to the disease model of addiction, routine use of alcohol or drugs can be distinguished as an illness. Studies show that permanent alterations take place in those who use substances repetitively. When people become addicted to alcohol or drugs, those alterations make being a normal drinker or social drug user not possible. The harsher the loss of control is while using or drinking, the truer this is. Substance abuse becomes a fixation of the mind, in which the only thing that matters is drinking or using (Drug and Alcohol Information - Disease Model of Addiction-, 2011). One issue with the disease model is that it not apparent how one gets this disease. The presence of withdrawal symptoms led to the thought that the averting of withdrawal symptoms was the basis for people continuing to self-administer drugs. This is the essence of the physical dependency model (Drug Addiction, 2006).

After recurring exposure to certain drugs, withdrawal symptoms emerge if the drug is stopped. Withdrawal symptoms are compensatory responses that go up against the primary effects of the drug. Consequently they are the opposite of the effects of the drug. Withdrawal effects are unpleasant and decrease in these effects would thus comprise negative reinforcement. Negative reinforcement is the reinforcement of actions that ends an aversive stimulus. Negative reinforcement could explain why addicts persist to take the drug. On the other hand some addicts will undergo withdrawal indications in order to reduce their tolerance so that they can resume drug intake at a lesser dose which costs less to buy. Decrease in withdrawal indications does not clarify why people take drugs in the first place. Negative reinforcement may account for initial drug taking in some instances. However the most likely motive for drug taking entails positive reinforcement (Drug Addiction, 2006).

Supporters of the choice model of addiction contend that the use of drugs or alcohol is a choice, and that just as people can decide to take drugs or alcohol, they can decide not to. Under the choice model of addiction, people addicted to drugs or alcohols are thought to be weak, with poor resolve or other moral flaws (Understanding Addiction: The Disease Model vs. The Choice Model, 2009). Poor decisions certainly figure into the beginning of addiction, and decisions aren't normally measured to be part of a disease course. Furthermore, poor choices can certainly result from what might be called personal flaws, for instance a genetic vulnerability to addiction related to a particular kind of dopamine receptor, or a fondness for risk-taking, whether learned, innate, or both. What is meant by personal flaws and bad choices is that the addict should have risen above their flaw. They should have decided otherwise at the time addiction took hold. There's an understood supposition of opposing causal agency at work. No matter what pressures and factors came to bear, the addict could have done something else, but simply decided not to (Choice and Free Will: Beyond the Disease Model of Addiction, 2010).

A more behavioral approach to understanding addiction is the social learning model, which suggests that people learn how to behave by watching others in their environment and by duplicating actions that create affirmative consequences. One learns to take drugs or alcohol through ones connections with family, friends, or even popular media. And through personal experimentation with drugs or alcohol, one learns that they like the way drugs make them feel. Whether it is the elation of a high, the augmented confidence they feel while intoxicated, or a reduced sense of social nervousness, intoxication can be a positively reinforcing state of being.

As one discovers how much they like certain facets of drug or alcohol use, the positive reinforcement of that use leads to even greater use. By the time extreme drug or alcohol use creates considerably pessimistic consequences, one has yielded to a physical or psychological addiction to the substance (Understanding Addiction: The Disease Model vs. The Choice Model, 2009).

In essence, Social Learning Theory (SLT) explains the effect of cognitive processes on goal aimed behavior. It reflects on the human capability for learning inside a social environment by way of watching and communication. Supporters of SLT portray the role of maintenance, cognitive expectancies, modeling, coping and self-worth in influencing substance use and abuse. Reinforcement is a central idea of SLT. The learning element of SLT is the straightforward operant response, where a person will duplicate any behavior that leads to a reward. SLT also distinguishes that dissimilar kinds of drugs put forth different effects and the effects will differ between people and their wishes, depending on things like past history, personality and present life conditions. When a person takes a drug or drinks alcohol, they shape an expectancy of what they will feel like when they take the substance again (Social Learning and Coping Models of Addiction, 2011).

The moral model frames addiction as a consequence of human failing, an imperfection in character. It doesn't distinguish biological or genetic workings to addiction and proposes little understanding for those who exhibit addictive actions. The inference is that addiction is the consequence of poor decisions, which addicts make because of a lack of willpower or moral power. Predictably, looking at addiction as a moral failing led alcoholics and other addicts to be clustered with others who had demonstrated moral failings. "In the 19th and early 20th century, alcoholism was connected with other socially undesirable situations and behaviors such as crime, poverty, sin, domestic violence, and laziness. Rather than recommending treatment methods for alcoholism, the moral model viewed punishment as a more appropriate response. Alcoholics were unresponsive to publicly admit their problem, as society had little compassion for their struggle" (Moving beyond the Moral Model of Addiction, 2011).

"The temperance movement hit its stride in the United States during the mid-1800s, and alcohol became a thing to be feared. While the temperance movement placed the blame on alcohol rather than the user, it also spread the idea that alcohol should be associated with evil and sin. In the years leading up to Prohibition, a quantity of states began passing laws that mandated the sterilization of those they considered defectives, like the mentally ill, developmentally disabled, and alcoholics and addicts. During this time and throughout Prohibition, alcoholism was seen primarily from a social, rather than medical perspective. Alcoholics were put into drunk tanks in the city jail, asylums, and public hospitals, where they were not offered the help they needed" (Moving beyond the Moral Model of Addiction, 2011).

The nature vs. nurture debate is a major foundation of argument between the different advances to understanding human behavior, including addiction. Theories that found their understanding of human behavior on nature center on characteristics that people are born with, like their genetic make-up, established personality traits, and physical tendencies. In contrast, theories that found their understanding of human behavior on nurture, stress those experiences that shape and alter people throughout their lives, such as how peoples parents raised them, what they were taught at school, and their culture (Hartney, 2010).

While most professionals agree that addiction entails a multifaceted interaction between innate characteristics and life experiences, the focal point of research tends to highlight one or the other. For instance, a study looking at the effects of neurotransmitters on the development of addiction leans towards the nature end of the discussion, while a study looking at peer pressure distinguishes that nurture is also significant in people's potential for addiction. There are risks in depending too greatly on either nature or nurture when explaining addiction. If one believes that addiction is a merely physical process, they can lose the belief in people's freedom to make decisions, and to conquer tendencies that might put them at risk. Yet if one believes that addiction is completely reliant on life experiences, they can lose sight of a lot of individual differences that can persuade people's vulnerabilities to addictions including the possibility that medications, like antidepressants, can help deal with mental health problems that may add to addiction (Hartney, 2010).

The nature vs. nurture issue has been around for ages, and researchers have still not figured out which of the two has a bigger effect on a person. Nature, referring to genetics, and the nurture, referring to ones surroundings, are two very rational reasons to why people are who they are. This discussion over whether nature or nurture has a bigger effect on people has been contested and supported very well for both sides. Each side highlights significant details and good explanations for why nature, or nurture, controls how people behave. Experimentation and research has been carried out on these two sides, and each is supported with good theories as to why nature or nurture is the significant influence on people (Guirguis, 2004).

Nature is thought to be what establishes ones personality, looks, and other things because it's all hereditarily passed down. Any matter regarding traits relies upon the notion of innate biology. A lot of parents believe that any bad trait that their child has gotten is because of bad parenting, but it may be more an issue of biology, and genes that run in the family. It has been determined that a newborn doesn't have an empty slate of personality, but does have a set of innate traits. "Tests have been done at the University of Wisconsin to show that dispositions of an infant are influenced more by biology than interactions with their siblings. In a way, an individual's nature is their genetic gift, which gives him or her physical traits such as hair color, eye color, and form of the body. It does also conclude the kinds of emotions and motivations one will experience, which can be never-ending. Any new emotion is not probable to experience unless there is change to ones genetic material. So in a way, genes give people certain traits or behavior characteristics; but it's all a matter of whether or not they carry out their certain inherited qualities" (Guirguis, 2004).