alcohol and substance misuse - The Addiction Problem
“I don't like you but I love you
Seems I'm always thinking of you
Though you treat me badly
I love you madly.
You really got a hold on me.”
Smokey Robinson
What is “Addiction” or Chemical Dependency?
There are a number of psychological and biological models of chemical dependency and alcoholism, including the moral model, developmental theory and social learning theory. Chemical dependency and alcoholism are most usefully viewed and treated as diseases.
It is the only disease that tells you you haven't got it; where the patient has a secret desire to get worse.
This disease also includes non-substance addictive practices such as compulsive gambling. Both substance dependence and compulsive gambling are addictive practices; the former just happens to also involve the ingestion of addictive substances.
Although the exact nature of the illness is not yet fully understood, there are many who strongly believe it has genetic components. This would infer that individuals are born with a pre-disposition to the disease, and cannot drink or drug themselves into alcoholism or drug addiction; however, chemical dependency represents a group of very complex behavioural disorders, and the possibility of a genetic pre-disposition is just one factor. Addiction is not an ordinary biological disease. Roger Vailant in his book The Natural History of Alcoholism says that “A person stands as much chance of inheriting alcoholism as of inheriting the skill of being a good basketball player.”
The disease model maintains that the chemically dependent person is the victim of an illness. The afflicted individual is neither morally corrupt nor irresponsible, but suffering. This means that the substance abuse is not freely chosen; rather the excessive drinking or drugging is seen to be beyond the control of the sufferer. This is the condition called Powerlessness .
“One is too many and a thousand never enough.”
Conceptualising chemical dependency as a disease makes it much less painful to bear and reduces the shame and guilt engendered by a chaotic and often destructive past. It allows the sufferer to break the cycle of shame and self-destructive behaviours that are an attempt to contain and manage the shame.
It makes sense to treat the alcoholic or addict with the same care and compassion as one would treat an individual suffering from any other painful disease, whilst holding them responsible for the problem and empowering them to own the solution.
The disease model takes addiction out of the moral realm. It has clearly helped hundreds of thousands of alcoholics to return to healthful living. The addict or alcoholic is not merely bad or weak; they are in the grip of a profoundly painful condition and in need of expert help.
Alcoholism and chemical dependency are the most widespread and costly addictions in our society. The impact of this disease on individuals, children, families, industry and society as a whole is a cause for grave concern.

