Disease Model of Alcohol & Drug Abuse

The disease model of addiction is the most commonly used method of treatment for people with alcohol and drug problems. It's the central concept within the vast Alcoholics and Narcotics Anonymous community, and it's also one of the preferred methods of legal authorities in rehabilitating people who commit criminal acts.

Chemical Dependency as a Disease

• The disease model for drug and alcohol abuse is most commonly associated with 12-step programs and Alcoholics Anonymous. It asserts that people who become addicted to drugs or alcohol develop a progressive and potentially terminal condition that requires life-long abstinence as a means of treatment.

  One of the diseases some experts say is most comparable to drug and alcohol addiction is Type II diabetes. Like Diabetes, drug and alcohol addiction can develop over time through poor consumption practices, and like a diabetic who consumes sugar, the addict who consumes a drug can set in motion a life-threatening process.

The Beginnings

• The concept of addiction as a disease has been around for a long time, but E.M. Jellinek is credited with introducing the model in 1960 when he presented a model for alcoholism. Even before the disease model for addiction was introduced, however, the World Health Organization had acknowledged alcoholism as a serious medical problem and it's been a long-standing concept in the A.A. community. The concept expanded to include drug addiction shortly thereafter.

The Controversy

• Among the most notable detractors of the disease model for drug and alcohol addiction is author Stanton Peele, who dismissed the disease model as contrary to common sense and its widespread acceptance as "cultural psychosis" in a recent interview. "Everybody knows that alcoholism is not the same as cancer and tuberculosis. Everybody knows that the cure for alcoholism is to change your drinking habits, to change your behavior. You don't remit from cancer if you change your behavior," Peele said.

  Peele is not alone in his assertions. There have long been detractors of the disease model. From before the 20th century when alcohol abusers were often seen simply as sinners to modern times where many people see addiction as a social or psychological condition that can be cured, the disease model is by no means accepted worldwide.

Other Methods

• There have been many competing treatment methods that run counter to the disease model for drug and alcohol addiction over the years. Some alternatives rely heavily on faith-based counseling. Many others treat addiction as a psychological condition that requires individual counseling or analysis. There are also a few centers that run parallel to the disease model with in-patient treatment centers but without the 12-step program and without acknowledging addiction as a disease.

Advantages and Disadvantages of the Disease Model

• First and foremost the disease model for drug and alcohol addiction is the most readily available treatment for the general public. It gives those who don't have the means help that they wouldn't have otherwise. From AA/NA meetings that are available for free in nearly every city to the insurance coverage for treatment that is available because addiction is regarded as a disease, the advantages are widespread. Some say looking at addiction as a disease also allows addicts to deal with the guilt that often accompanies a lifetime of chemically induced missteps.
  People who disagree with the disease model cite a cadre of disadvantages to its use. One of the most prevalent disadvantages pertains to the statement cited by Peele, in that it defies common sense and is therefore dishonest. Those that subscribe to that concept often believe that the disease model actually renders addicts helpless rather than empowering them to change.