The disease model of addiction can be defined as viewing addiction as a primary, non-accompanying ailment that is not caused by the conditions from another disease. Meaning that addicts may become deeply addicted to a drug or substance due to overlying emotional and social circumstances, but the addiction is not a consequence of said circumstances. In fact, the circumstances can often worsen while the addiction is intensifying within a person. The disease model and concept of addiction began to rise in prominence after the World Health Organization decided to classify alcoholism as a health problem in 1951 (Chapter 3, n.d., p. 39). Later on in the same decade, The American Medical Association decided to declare that alcoholism was a treatable condition later in that same decade.
Jellinek outlined the progressive stages as the early stage and the middle stage. In the early stage of addiction, the addict often increases their tolerance to the drug of their choice. Along with increasing their tolerance of a certain drug, addicts also adapt to blackouts, sneaking around to do their drug, and any feelings of guilt that may manifest within themselves while they are gaining ground in their addictions (Chapter 3, n.d., p. 40). The middle stage is characterized by the loss of control of an addict’s drug use and the addict may also experience a loss of relationships with friends and family, employment with their jobs, and some negative personality changes (Chapter 3, n.d., p. 40).
Evidence that supports the disease model of addiction is often based upon the similarity of alcohol and drug addictions and other chronic diseases. Mainly being the effect that these ailments have on how the brain functions. Chapter 3 (n.d.) states that literature that was reviewed as it pertains to certain chronic diseases and the details that were presented were compared to details about addiction. It was found that genetics, and inheriting said genetics, had a lot of similarities when it came to who had a higher chance of gaining a chronic disease or addiction. It was also found that ignoring signs of addiction caused the addiction to become worse, much like when a chronic disease is left untreated (Chapter 3, n.d., p. 42).
While the disease concept is used by many mental health professionals in the present day, there are criticisms to the disease model of addiction. One criticism is that Jellinek’s data was not complete as some of the questionnaires that he used during his research were thrown away and none of his questionnaires were offered to women (Chapter 3, n.d., p. 43). One other criticism of the disease model of addiction is that the model has been used for so much great profit and political success, that other self-destructive behaviors such as overeating, child abuse, and excessive shopping are being viewed as diseases as well (Chapter 3, n.d., p. 43). This can cause a problem over time because it may cause those who are carrying out these negative behaviors to use the disease model of addiction as a crutch. Therefore not holding themselves accountable for the things that they can control.
The advantages of the disease concept is that the study of addiction of all types and forms can be medically and scientifically researched. Often, addicts and their addictions are viewed as being mentally and morally weak and impaired. These are solely the opinions of others who may have their own conditions to be concerned about and not scientific fact. Viewing addiction as a disease allows resources and funding to be given to the top researches, doctors, and mental health professionals so that cures and advancements in treating addictions can be discovered.
A disadvantage to the disease concept is that not all people will view the addiction model as being legitimate. While this is a very general statement, this can lead to public officials who have decision making power refusing to grant said resources and funding to researchers so that cures to addiction can be found. Some detractors to this model may have a bootstrap mentality and will never view addiction as a medical condition.
Some similarities between the moral, disease, and biopsychosocial models of addiction is that the addicts surrounding environment still plays a large role in how the addiction progresses. For example, if an addict is being morally shamed for overdrinking, that may cause them to drop into a state of shame and loneliness. This will cause the addict to look for a stimulant or depressant that will make them feel better almost immediately. Once their brain feels better, the disease of alcoholism immediately gets worse than before because the addict now associates overdrinking with security and comfort from the pressures of the outside world. While scenarios like this can link these three concepts together, there are also situations that break the concepts apart. For example, if an alcoholic has a disease, then they will never truly be rid of it. No matter how long they abstain from drinking, they will always have the urge to relapse. Someone who subscribes to the moral model of addiction, however, will say that this is false. Mainly due to the belief that the addict needs to realize that what they are doing is morally wrong and that the addict needs to stop making excuses and become a better person. The biopsychosocial subscribers will say that a reconditioning program should be used to help the addict and more beneficial stimulants and aids should be used to replace the alcohol.
