What is a theory or model?

A theory is an idea about how things work, what causes something to happen, or an attempt to explain something in our world that we don't fully understand.

To illustrate, imagine that you are many years back in time.  You are living in a cave with a group of neanderthals.  Thunderstorms would be very frightening.  You have observed lightning and know that sometimes it kills people or starts a fire.  Your group would want to know why thunderstorms happened so you could predict what would happen during a storm and maybe do something to control or prevent them.  Unfortunately, you do not have any science to help you do this.

In an effort to understand thunderstorms, you share ideas about what causes them to happen.  You might conclude that the Gods are angry.  This is a theory.

A model is a more detailed description of why something happens and how it happens, and is based on theory.  In this case, you develop "The Gods are Angry" model of thunderstorms.

A model also suggests what course of action we can take to control or prevent what is happening.  Under "The Gods are Angry" model of thunderstorms, you might conclude that to control or stop thunderstorms you need to pacify the Gods, and you might decide to throw a virgin into the volcano as a sacrifice to the Gods.

A scientific theory is one that can be tested through experimentation or study.  For example, if I know nothing about cars, I might develop my own theory about how my car works.  I might theorize that there is a big wheel under my hood with several hamsters running around inside, transferring power to the wheels and generating electricity.  I admit it's a silly theory, but it could be considered a scientific theory because it can be tested.  How can I test it?  I just have to lift the hood of my car, and my theory would be tested and proven wrong.

There have been several theories and models of addiction, and it is important to understand them because each suggests a different treatment or approach to helping people who have problems because of drugs or alcohol.

Moral Model

Moral theories and models are based on beliefs or judgments of what is right or wrong, acceptable or unacceptable.  These judgments imply that people who use drugs or alcohol are bad or sinful people.  There is something morally wrong with people who use drugs or alcohol heavily.  This model contributes little to our understanding of why people use drugs and alcohol heavily and offers no real help to those who have problems in their lives because of alcohol or drugs.

Treatment:  The suggested treatment under this model would be punishment.  Bad people should be punished.  Punishment could range from social disapproval to locking users up in jail.

Biological Models

Biological models of addiction assume that people addicted to drugs or alcohol have a biological abnormality that causes them to become addicted.  Like the moral model, there is something wrong with these people.  However, what is wrong is assumed to be something physical that is beyond the control of the individual.  These people are not sinful or bad, but they are sick.  These models are sometimes referred to as Disease Models.

There is some evidence that in some, but not all, addicted people there is an inherited predisposition to become alcoholic or addicted.  This means that they could become more easily or quickly addicted than other people.  It does not mean that all with this predisposition will go on to develop alcoholism or addiction.  This explanation does not explain addiction or alcoholism in all cases; there are many alcoholics and addicts who have no family history of addiction.

These models suggest that a biological abnormality causes an alcoholic's desire for another drink to increase after taking one drink, and that long-term drinking or drug use leads to damage of brain centres responsible for willpower and judgment.  According to these models, alcoholism and addiction are incurable diseases and the best that can be hoped for is to achieve remission.  

Treatment:  The assumption here is that there is no cure, and one will be an addict or alcoholic for the rest of his or her life.  Through abstinence, one can achieve remission.  Another assumption is that the alcoholic or addict has no willpower, poor judgment, and one drink leads to an increased desire for another.  Moderate drinking is not viewed as an option and abstinence is viewed as the only acceptable treatment goal.  There are many programs based on these models such as Alcoholics Anonymous, 12 step programs, and Brentwood Recovery.  Many people have been helped through these programs.

Sociological Models

It has been suggested that societies that produce higher levels of inner tension such as guilt, stress, suppressed aggression, conflict and sexual tensions have higher rates of heavy drinking and drug use.  This idea suggests that the primary role of alcohol and drug use is to reduce anxiety.  Another idea under this model is that societies that are permissive of and/or encourage drug or alcohol use have higher rates of problem drinking and drug use.  This model also examines the influence of those who stand to make a profit, such a the makers of alcohol.  Consider the many beer commercials on television, or the promotion of sporting events by tobacco manufacturers.  

Treatment:  Under this model treatment would involve changing our society.  While such efforts can have an impact, sociological change is slow.  For an individual who has problems in his or her life due to alcohol or drug use, changing the world is too slow a process to be of immediate help.

Psychological Models

Psychological models view heavy alcohol and drug use as problem behaviors.  An individual drinks or uses to enjoy the effects of alcohol or drugs.  Under these models a user or drinker is not bad or deficient in any way.  Anyone can become addicted to drugs or alcohol because of the way our bodies and minds work, and because of how alcohol and drugs affect our bodies and minds.

Treatment:  There are many different psychological theories that have been applied to help an individual with drug or alcohol problems including transactional analysis, pscyhoanalytic theories, and personality theories, each suggesting different courses of treatment.  Most of the newer programs for drug and alcohol treatment are based on Social Learning Theory, detailed in the next section.

Social Learning Model

This is a psychological model of understanding problematic drug and alcohol use.  It is based on results of scientific experimentation and study.  It proposes that drug or alcohol use is learned and continues because the user gets some desired outcome from it.  We also learn to drink or use in response to certain stimuli--people, places, things, events, thoughts and feelings.  Under this model, users are not bad or defective people with some abnormality.  Anyone can become addicted to drugs or alcohol because of the way that alcohol and drugs affect our minds and bodies.

Treatment:  Under this model the individual works to unlearn drug and alcohol use behavior, and to learn new behaviors to replace them in order to get the benefits he or she received from alcohol or drugs.

My Personal Approach

My training has been based on the Social Learning Model, and it is this model that is used in the construction of the website.  

In my opinion, moral and sociological models offer no or little real help for a person who wants to change his or her drinking or drug use behavior.  The  biological model has spawned research into the long term effects of alcohol and drugs and how intoxicants have their effect on us.  This research has been important in terms of our understanding of physical dependence, tolerance, and withdrawal.

Alcoholics Anonymous, Brentwood Recovery, 12 Step Programs, and several other programs based on the biological model have helped many people overcome problems related to drug and alcohol use and represented a great improvement over the moral model.  

However, the biological model has not been of help to everyone.  Many do not want to accept a label as an alcoholic or addict.  Many reject the idea that addiction and alcoholism are incurable diseases.  Some do not believe that abstinence is the only option and wish to work towards a moderation goal, or they want to abstain but reject the other assumptions of the biological model.  For these people, the Social Learning Model offers another alternative treatment.

If you believe that abstinence is the only way for you, you are most likely right.  You know you best, and I don't want to change your mind.

I like to think of my approach as the "Shopping Cart" approach.  Take what is useful from this site, "off the shelf" and put it in your shopping cart like you would in a supermarket.  If the idea of moderate drinking is threatening to you, ignore it, leave it on the shelf and don't put it in your shopping cart.  

If you do believe you have problems in your life because of your alcohol or drug use, I strongly urge you to seek professional counseling, individually or in a treatment group.

I hope that the information on this site will help you to choose the kind of treatment that will be the most helpful to you.  You could print out information on this site to discuss with your counselor or therapist.  It is also my hope that this site will help those struggling against slips or relapse to stay focused and motivated.

The Drug Lady

  Bankhead Web Services