Theories of substance use Flashcards
When was the moral model introduced?
During the 18-19th centuries when addiction was viewed as a sin
What is the moral model?
- “morally weak” and addiction was seen as a fault of one’s character
- Users are characterised as ‘misfits’, ‘no-hopers’, or as objects of pity; dealers are routinely described as ‘scum’, ‘vermin’ or ‘an evil menace’.
What occured under the influence of the moral model?
- users were punished with whippings, public beatings, stocks, fines, and public ridicule
- Spiritual direction was also a common treatment.
- Jail sentences: mental hospitals as the jails became full.
What does the Disease Model believe?
- Addiction does not exist on a continuum: it is either present or it isn’t.
- Addicted people cannot control their intake. Once they consume some of the substance (eg one drink) they are powerless to stop themselves/overtaken by almost irresistible cravings when they cannot have it.
- The disease of addiction is irreversible. It cannot be cured and can only be treated by lifelong abstinence.
What is believed by the 12 step model?
- Alcoholism is “all or nothing”. Problem or no problem.
- Alcoholics are powerless over alcohol and experiences.
- Alcoholism cannot be “cured”, only managed.
- Disease is progressive and deterioration in condition is inevitable if drinking continues.
- Support through attending groups, peer support, submitting to a higher power.
What are the advantages of the 12 step model?
- drug use becomes a health issue and not just a legal issue
- allows ‘addicted’ people to understand their behaviour
- offers a treatment approach (abstinence) that works for some
- removes some of the shame often felt by people affected by addiction.
What are the disadvantages of the 12 step model?
- removes responsibility from the user
- offers only one course of treatment (abstinence) which is not suitable for all people, particularly young people
- not supported by a large amount of evidence.
What are the 12 steps in the 12 step program?
1 - Admission 2 - Recognition 3 - Submission 4 - Understanding 5 - Confession 6 - Readiness 7 - Humility 8 - Reparation 9 - Apology 10 - Integrity 11 - Mediation 12 - Awakening
Who did the psychodynamic model originate from?
Sigmund feud
What is the psychodynamic model?
- we can link problems to our childhood and how we cope as adults
- substance use may be an unconscious response to difficulties experienced in childhood
What are the psychodynamic model’s assumptions on drug use and addiction?
- Drug use is a symptom of an underlying psychological disorder
- Indicates severe psychopathology
- Psychological problems are the cause of substance abuse, not recognised as a consequence of use
- Addiction is considered a uniform disorder
What is the Freudian theory of the unconscious processes that govern the id, ego and superego and AOD use?
○ Fixated at the “oral” stage
○ Id – drive reduction theory.
○ Ego – “self medication”
What is the personality theory?
- Group of distinct personality characteristics that distinguish alcoholics/drug users from other individuals
- Predisposing factor (‘addictive personality’)
- Independent (personality trait and dependence)
What are personality predictors of drug use?
- Behavioural disinhibition (impulsivity)
- Emotional negativity (negative mood, depressive PD)
- Other personality features (e.g., narcissism)
- Used to enhance sensation and avoid pain
How does current psychodynamic research interpret addiction?
As a self-regulation disorder
- inability to regulate feelings,
- inability to establish sense of self/self-esteem, comforting relationships and control/regulation of behaviour and self-care
What do neuroscientific/biological theories focus on?
- Genetic characteristics
- Reward systems
- Neuro-adaption
