Saturday, February 18, 2017

Alternative Views on Addiction

There is much more to the addictions than the disease model might suggest. This model tends to devolve dialog into "it's in the brain" or "it's in the genes" syllogisms. End of discussion.

But other aspects of behavior influence the development of substance abuse problems. We look art two interesting set of behaviors below. These two may interact with each other in interesting ways, but that remains to be established.

In the first view, typical deficits in many adolescents are seen to lead to impulse control problems, which in turn is related to substance abuse. The review author notes that "Drug use in adolescence is often linked to later substance-abuse problems. The new study finds that key risk factors include a combination of weak working memory and cognitive processing. These deficits lead to poor impulse control." It is suggested that programs which help adolescents improve on their impulse control skills may represent the best methods to reduce future substance abuse problems.

In another view, it is hypothesized that the addictions are at their heart an inability to connect with others. Here, it is posited "...that addiction is not about the pleasurable effects of substances, it’s about the user’s inability to connect in healthy ways with other human beings. In other words, addiction is not a substance disorder, it’s a social disorder." In this way substance abuse is a vehicle of escape from social realities which have become aversive to the user. Of course this may lead to isolation which will not likely improve the situation.

When we take into consideration that alcohol abuse may be both a cause and consequence of child maltreatment, it is not difficult to surmise that such victims, who sooner or later will likely exhibit impulse control issues, are also motivated to reduce human contact and may find substances appealing for this reason. Not to mention the role that anger may have in their lives.

This view is infinitely richer, and suggestive of more complex interventions, than the disease model of addiction. Anything that is more complex is more difficult to implement and fund, and that may be the real moral of this story. But successful approaches are worth this effort.