Addiction is basically defined as uncontrollable dependence on a substance or behavior. Others view it as dependence for abuse of substances. Some researchers have classified addiction into two main groups for instance substance addictions which mainly involve dependence on alcohol and drugs. The other form of addition is what is referred to as process addiction; in this case a person is addicted to processes like shopping and sexual activity among many others. Researchers have come to a realization that many poly drug abusers are usually not addicted to one substance alone. In the United States addiction is very costly public health problem because in absence of treatment people’s conditions tend to progress severely. One of the most common characteristic of substance abuse is relapse.
There are many addiction models which are used for designing treatment for substance and process addiction. Besides that there a number of models which are employed for alcohol and drug abuse interventions. Families and addicts usually settle for an intervention which is more likely to bring improvement. Below are some of the addiction models which are used in case of substance addition. The widest standing opinion of Alcohol and Drug Abuse (AODA) is the moral model. Through this model abuse is viewed as violation of the societal laws by the addict. People in support of this model feels that the offender should be punished therefore the victim is supposed to be responsible of his behavior and wrong choices.
Moral addiction model is strongly supported by Christians because they feel that abuse of alcohol and substance is sinful and it should therefore the abuser should be punished by the law. Some of the factors which are thought to cause this situation are conscious choice and spiritual deficiency. For this reason some of the suggested treatment courses include spiritual intervention, imprisonment and moral persuasion. Specialists who can offer the treatment include clergies and law enforcers. Temperance model has been confused for a long time with moral approaches to addiction. This model was initiated in the late 19th century with a prohibition movement. Its proponents greatly emphasized that moderation was a hindrance to addiction treatment and therefore impractical. Temperance model assumes that dangerous effects of the drug on the user are more powerful and strong and therefore the drug is the main issue in the whole scenario. For this reason the causal factor is the drug. The model suggests that prohibition and abstinence are the suitable treatment courses.
Disease model is another type of addiction model. Its proponents believe that addiction and alcoholism is beyond cure. Therefore the best way to deal with this situation is totally abstinence from drug or substance that one is addicted to. Factors that are thought to cause addiction in this model include abnormal innate traits in the victim and constitutional disorder or disease. This model proposes two forms of treatment which include lifelong abstinence and identification of the exact situation followed by its confrontation. Treatment specialists who are recommended in this model include peer support groups and other recovering individuals. Characterological or psychological model views addiction as character or personality abnormality. Proponents explain that addicts usually possess addictive personality which is inherent. This addictive personality leads to deficit in psychological and personal boundaries. Major indication of addictive personality is low self esteem, manipulative traits, poor impulsive control, inability to cope with stressors, powerlessness, impotent feelings and need for power and control.
Psychological model recommends complete restructuring of a person’s personality as the best treatment. The causal factors in this model include poor impulse control, low self esteem and addictive personality. Suggested treatment courses include self esteem and interpersonal skills modification as well as psychotherapy. Specialists who can administer treatment using this model include psychotherapists. Finally there is a social educational model; this model employs an integrative approach where principles are obtained from operant and classical conditioning schools. This model view addiction as a learned behavior that develops from cognitive process. This behavior is acquired from influential process and it may also be genetically impacted. Proponents of this model greatly emphasize on the impacts of environmental human interactions in character modeling and acquisition of behavior. Socialization interactive process greatly contributes to this problem as well as imitation of observed behavior. The people who are looked at as role models greatly influence the lives of addicts. Causal factors in this model include poor modeling, poor socializing, skill deficits and poor coping mechanisms (Thombs, 2006: 191).
Social education model treatment interventions include realistic goal setting, correct estimation, impulse control training, reconditioning, appropriate modeling, skill training and cognitive exercise. Recommended treatment specialists include behavioral or cognitive counselor and suitable peer modeling. It is important to realize that the interventions in the above models do not always fit with most addiction professional. The addict and his family are always left to decide for themselves the suitable model for treatment or the preferred model. There are cognitive and social learning models which were mainly derived from the social learning theory. Social learning aspects which are greatly emphasized in this theory include environmental stimuli or situational factors, self efficacy, coping skills and social modeling. Addictive models which heavily rely on the social learning theory include the model of relapse process. This model shows that availability of high risk situation is the main cause of addiction. This situation of high risk is said to be the cause of the increased risks of relapse as well as the weakened sense of control.
An individual can only avoid the underlying risks of the situation by exercising behavioral coping mechanisms. The activated cognitive coping response in turn produces the needed self efficacy. In case the coping response is not initiated the person encounters a reduced self efficacy which draws them to abuse of the relevant substance. The person is forced to use the substance because of the formed cravings. Therefore initial use of the substance occurs because of the cravings which are formed after one fails to activate the increased production of self efficacy. The first time the substance is used is what is referred to as the lapse. Cognitive dissonance occurs because of this lapse.
The initial consumption of the substance makes a person to feel much guilty and sense of failure and weakness because their self esteem is usually lowered. These mixed reactions and sense of guilt drives a person to additional use of the substance which makes them to start developing special likelihood for the drug or alcohol. The initial dosage makes one to develop the desire for continual use of the drug. The resulting response makes one to eagerly want to use the substance. One important event that occurs at the initial stage of addiction is the physiological activation and the expectation of positive results. The individual’s self efficacy is threatened at this initial stage due to reduced behavioral and cognitive coping. The resulting low self efficacy further leads to numerous risks of relapse and lapse. The model of alcohol abuse and dependence also explains what happens when one is addicted to either drugs or alcohol (Maurer and Smith, 2005: 576).
Alcohol abuse and dependence model explains that people drink because they want to overcome the overwhelming stress and other negative daily issues or impacts. Drinking is used as a way of coping with stress though it’s a poor intervention and as result it is unreasonable for one to expect positive outcomes. This strategy shows how people evade confronting the underlying situations and issues. The moods which are enhanced after consumption of alcohol usually don’t help in solving any issues that one was having or experiencing. The social learning theory has been effectively used in developing addiction models. Some other models includes Goldman’s expectancy model. In this model expectancies have been given an upper hand. Goldman explains that expectancies are instrumental components of memory which plays a key role of organizing contributions made to the central nervous system. This process is very important in guiding human behavior.
Goldman further explains that these expectancies and conceptualization plays a very fundamental role because they serve as mediators and regulators of other causal factors of drug addiction. Expectancies are therefore thought to be the last common pathway which is followed by cultural information, genetic predisposition and social aspects in abuse of drugs. For example drug related expectancies are basically referred to as risk factors for drug abuse. It is important to realize that expectancy is the initial stage before usage of a drug. Therefore the initial experience occurs because of the expectations which had been formed. Developed positive expectation is a clear indication that a person will start using the drug any moment when their self efficacy diminishes. Developed positive expectations usually influence the outcome in a negative way. These principles both apply to addiction to alcohol as well as drugs. Drug use influence expectations the same way expectations influence the initial usage of the drug (Maurer and Smith, 2005: 578).