SHAMAN THREE
Monday, February 28, 2005
ADDICTION: AN ECLECTIC APPROACH
When does drug usage become substance abuse? Addiction, the
physical and psychological substance dependency or habituation,
is an often misrepresented entanglement.
As the public intellect or social consciousness about human behaviors
has evolved, addiction has been viewed through each of these myopic
windows of perspective. Each "one true light" doctrine was defended
as the key to unlocking this gateway to understanding. Each doctrine
reflects disagreements and uncertainty regarding the nature and
etiology of addiction problems.
Each has a defendable basis for its approach to intervention. What we
can learn from these doctrines are the undeniably relevant aspects that
comprise the STILL UNSOLVED MYSTERY. The presentation of these
conceptual models should be considered in their historical context to
fully appreciate each group's quest for the solution.
------------------------------------------------------------
------------------------------------------------------------
A DEVELOPMENTAL HISTORY OF MODELS OF ADDICTIVE BEHAVIOR
AND THEIR IMPLICATIONS OF INTERVENTION
= = = = = = = = = = = = = = = = = = = =
M O D E L # 1
Moral
DOCTRINE EXAMPLES
Abuse as Sin
EMPHASIZED CAUSAL FACTORS
Lack of Spirituality & Personal Irresponsibility
Demons
IMPLIED APPROPRIATE INTERVENTIONS
Condemnation, Spiritual Sanctions, & Prayer
INTERVENTION AGENT
Clergy Direction, Exclusion from Church
= = = = = = = = = = = = = = = = = = = =
M O D E L # 2
Temperance
DOCTRINE EXAMPLES
Prohibition & Woman's Christian Temperance Union
EMPHASIZED CAUSAL FACTORS
Drug's Evil Nature, Satan
IMPLIED APPROPRIATE INTERVENTIONS
Exhortation & Incarceration
INTERVENTION AGENT
Legislators & Law Enforcement
= = = = = = = = = = = = = = = = = = = =
M O D E L # 3
American Disease
[Note: 3% recovery rate, yet most pervasive in the USA]
[Many courts only recognize AA/NA meetings instead of jail]
DOCTRINE EXAMPLES
Alcoholics Anonymous
Narcotics Anonymous
Al-Anon
EMPHASIZED CAUSAL FACTORS
Irreversible Abnormality of Individual
IMPLIED APPROPRIATE INTERVENTIONS
Identification and Confrontation
INTERVENTION AGENT
Peer Group
= = = = = = = = = = = = = = = = = = = =
M O D E L # 4
Education
DOCTRINE EXAMPLES
Drug Abuse Resistance Education (DARE)
EMPHASIZED CAUSAL FACTORS
Lack of Knowledge or Motivation
IMPLIED APPROPRIATE INTERVENTIONS
Lecturing & Affective Dramatization
INTERVENTION AGENT
Teaching by Law Officers
= = = = = = = = = = = = = = = = = = = =
M O D E L # 5
Characterological
DOCTRINE EXAMPLES
Psychoanalysis
EMPHASIZED CAUSAL FACTORS
Personality Traits
Defense Mechanisms
Dispositions
IMPLIED APPROPRIATE INTERVENTIONS
Psychotherapy & Self-image Modification
INTERVENTION AGENT
Psychotherapist
= = = = = = = = = = = = = = = = = = = =
M O D E L # 6
Conditioning
DOCTRINE EXAMPLES
Classical & Operant Conditioning
EMPHASIZED CAUSAL FACTORS
Conditioned Response
Reinforcement
IMPLIED APPROPRIATE INTERVENTIONS
Counterconditioning & Relearning
INTERVENTION AGENT
Behavior therapist
= = = = = = = = = = = = = = = = = = = =
M O D E L # 7
Biomedical
DOCTRINE EXAMPLES
Physiological
EMPHASIZED CAUSAL FACTORS
Heredity & Genetic Brain Chemistry
IMPLIED APPROPRIATE INTERVENTIONS
Risk Identification
Medical Treatment
INTERVENTION AGENT
Diagnostician & Physician
= = = = = = = = = = = = = = = = = = = =
M O D E L # 8
Social Learning
DOCTRINE EXAMPLES
Cognitive Modeling & Appropriate Behavior
EMPHASIZED CAUSAL FACTORS
Expectancies
Skill Deficits
IMPLIED APPROPRIATE INTERVENTIONS
Models/Goals Therapy, Self-control Training,
& Relapse Prevention
INTERVENTION AGENT
Cognitive-Behavior Therapists
= = = = = = = = = = = = = = = = = = = =
M O D E L # 9
General Systems
DOCTRINE EXAMPLES
Transactional Analysis
ACOA (Adult Children of Alcoholics)
EMPHASIZED CAUSAL FACTORS
Family Dysfunction
IMPLIED APPROPRIATE INTERVENTIONS
Family Therapy, Recognition, & Peer Support
INTERVENTION AGENT
Family Therapist Support Groups
= = = = = = = = = = = = = = = = = = = =
M O D E L # 10
Sociocultural
DOCTRINE EXAMPLES
Control of Consumption
EMPHASIZED CAUSAL FACTORS
Environment
Cultural Norms
IMPLIED APPROPRIATE INTERVENTIONS
Social Policy Intervention
INTERVENTION AGENT
Legislators, Lobbyists, & Supplier
= = = = = = = = = = = = = = = = = = = =
M O D E L # 11
Public Health
[Note: Recovery rates as high as 95%. Ignored by courts.]
DOCTRINE EXAMPLES
World Health Organization
National Academy of Sciences
EMPHASIZED CAUSAL FACTORS
Interactions of Host, Agent, & Environment
IMPLIED APPROPRIATE INTERVENTIONS
Multifaceted & Comprehensive
INTERVENTION AGENT
Interdisciplinary
= = = = = = = = = = = = = = = = = = = =
Source credit for this evolutionary model is:
"The Handbook of Alcohol Treatment Approaches"
Permagen Press; Edited by R K Hester & Wm R Miller.
= = = = = = = = = = = = = = = = = = = =
----------------------------------------------------------
CEREBRAL AROUSAL CONSIDERATIONS
The undisciplined eclectic roams from one trend to
another, reaching into a bulging bag of tricks and
drawing out whatever is in hand or intuitively meets the
immediate moment. Trial and error reigns!
These perspectives reflect three different myths about
addiction treatment:
1. Nothing works.
2. There is one particular approach which is superior
to all others.
3. All treatment approaches work about equally well.
----------------------------------------------------------
Central Assumptions of an Informed Eclectic:
1. There is no single superior approach to treatment
for all individuals.
2. Different types of individuals respond best to
different treatment approaches.
3. It is possible to match individuals to optimal
treatments, thereby increasing treatment
effectiveness and efficiency.
----------------------------------------------------------
WHY ISN'T EVERYONE AN ADDICT?
IS THERE AN ADDICTIVE PERSONALITY?
Consider the interaction of these factors:
The Drug - A fast big bang. A painful crash.
The Body - An addict in the family. Chronic
pain. Drug sensitivities.
The Mind - Lacks self control. Lacks values.
Low self esteem. Depression.
The Setting - Barren environment. Lack support
group. Drug availability. Social
guidelines.
----------------------------------------------------------
A RANKING DRUGS BY ADDICTIVENESS:
(a scale of 1 to 100 with Nicotine at 100)
100 Nicotine
99 Ice, Glass (Methamphetamine smoked)
98 Crack
92 Crystal Meth (Methamphetamine)
85 Valium, Diazepam
82 Quaalude, Methaqualone
80 Seconal, secobarbital
80 Alcohol
79 Heroin
78 Crank (amphetamine taken nasally)
72 Cocaine
70 Caffeine
60 PCP, Phencyclidine
20 Marijuana
19 Ecstasy (MDMA)
17 Psilocybin Mushrooms
17 LSD
17 Mescaline
Research on Substance Addiction Propensity
by John Hastings
----------------------------------------------------------
physical and psychological substance dependency or habituation,
is an often misrepresented entanglement.
As the public intellect or social consciousness about human behaviors
has evolved, addiction has been viewed through each of these myopic
windows of perspective. Each "one true light" doctrine was defended
as the key to unlocking this gateway to understanding. Each doctrine
reflects disagreements and uncertainty regarding the nature and
etiology of addiction problems.
Each has a defendable basis for its approach to intervention. What we
can learn from these doctrines are the undeniably relevant aspects that
comprise the STILL UNSOLVED MYSTERY. The presentation of these
conceptual models should be considered in their historical context to
fully appreciate each group's quest for the solution.
------------------------------------------------------------
------------------------------------------------------------
A DEVELOPMENTAL HISTORY OF MODELS OF ADDICTIVE BEHAVIOR
AND THEIR IMPLICATIONS OF INTERVENTION
= = = = = = = = = = = = = = = = = = = =
M O D E L # 1
Moral
DOCTRINE EXAMPLES
Abuse as Sin
EMPHASIZED CAUSAL FACTORS
Lack of Spirituality & Personal Irresponsibility
Demons
IMPLIED APPROPRIATE INTERVENTIONS
Condemnation, Spiritual Sanctions, & Prayer
INTERVENTION AGENT
Clergy Direction, Exclusion from Church
= = = = = = = = = = = = = = = = = = = =
M O D E L # 2
Temperance
DOCTRINE EXAMPLES
Prohibition & Woman's Christian Temperance Union
EMPHASIZED CAUSAL FACTORS
Drug's Evil Nature, Satan
IMPLIED APPROPRIATE INTERVENTIONS
Exhortation & Incarceration
INTERVENTION AGENT
Legislators & Law Enforcement
= = = = = = = = = = = = = = = = = = = =
M O D E L # 3
American Disease
[Note: 3% recovery rate, yet most pervasive in the USA]
[Many courts only recognize AA/NA meetings instead of jail]
DOCTRINE EXAMPLES
Alcoholics Anonymous
Narcotics Anonymous
Al-Anon
EMPHASIZED CAUSAL FACTORS
Irreversible Abnormality of Individual
IMPLIED APPROPRIATE INTERVENTIONS
Identification and Confrontation
INTERVENTION AGENT
Peer Group
= = = = = = = = = = = = = = = = = = = =
M O D E L # 4
Education
DOCTRINE EXAMPLES
Drug Abuse Resistance Education (DARE)
EMPHASIZED CAUSAL FACTORS
Lack of Knowledge or Motivation
IMPLIED APPROPRIATE INTERVENTIONS
Lecturing & Affective Dramatization
INTERVENTION AGENT
Teaching by Law Officers
= = = = = = = = = = = = = = = = = = = =
M O D E L # 5
Characterological
DOCTRINE EXAMPLES
Psychoanalysis
EMPHASIZED CAUSAL FACTORS
Personality Traits
Defense Mechanisms
Dispositions
IMPLIED APPROPRIATE INTERVENTIONS
Psychotherapy & Self-image Modification
INTERVENTION AGENT
Psychotherapist
= = = = = = = = = = = = = = = = = = = =
M O D E L # 6
Conditioning
DOCTRINE EXAMPLES
Classical & Operant Conditioning
EMPHASIZED CAUSAL FACTORS
Conditioned Response
Reinforcement
IMPLIED APPROPRIATE INTERVENTIONS
Counterconditioning & Relearning
INTERVENTION AGENT
Behavior therapist
= = = = = = = = = = = = = = = = = = = =
M O D E L # 7
Biomedical
DOCTRINE EXAMPLES
Physiological
EMPHASIZED CAUSAL FACTORS
Heredity & Genetic Brain Chemistry
IMPLIED APPROPRIATE INTERVENTIONS
Risk Identification
Medical Treatment
INTERVENTION AGENT
Diagnostician & Physician
= = = = = = = = = = = = = = = = = = = =
M O D E L # 8
Social Learning
DOCTRINE EXAMPLES
Cognitive Modeling & Appropriate Behavior
EMPHASIZED CAUSAL FACTORS
Expectancies
Skill Deficits
IMPLIED APPROPRIATE INTERVENTIONS
Models/Goals Therapy, Self-control Training,
& Relapse Prevention
INTERVENTION AGENT
Cognitive-Behavior Therapists
= = = = = = = = = = = = = = = = = = = =
M O D E L # 9
General Systems
DOCTRINE EXAMPLES
Transactional Analysis
ACOA (Adult Children of Alcoholics)
EMPHASIZED CAUSAL FACTORS
Family Dysfunction
IMPLIED APPROPRIATE INTERVENTIONS
Family Therapy, Recognition, & Peer Support
INTERVENTION AGENT
Family Therapist Support Groups
= = = = = = = = = = = = = = = = = = = =
M O D E L # 10
Sociocultural
DOCTRINE EXAMPLES
Control of Consumption
EMPHASIZED CAUSAL FACTORS
Environment
Cultural Norms
IMPLIED APPROPRIATE INTERVENTIONS
Social Policy Intervention
INTERVENTION AGENT
Legislators, Lobbyists, & Supplier
= = = = = = = = = = = = = = = = = = = =
M O D E L # 11
Public Health
[Note: Recovery rates as high as 95%. Ignored by courts.]
DOCTRINE EXAMPLES
World Health Organization
National Academy of Sciences
EMPHASIZED CAUSAL FACTORS
Interactions of Host, Agent, & Environment
IMPLIED APPROPRIATE INTERVENTIONS
Multifaceted & Comprehensive
INTERVENTION AGENT
Interdisciplinary
= = = = = = = = = = = = = = = = = = = =
Source credit for this evolutionary model is:
"The Handbook of Alcohol Treatment Approaches"
Permagen Press; Edited by R K Hester & Wm R Miller.
= = = = = = = = = = = = = = = = = = = =
----------------------------------------------------------
CEREBRAL AROUSAL CONSIDERATIONS
The undisciplined eclectic roams from one trend to
another, reaching into a bulging bag of tricks and
drawing out whatever is in hand or intuitively meets the
immediate moment. Trial and error reigns!
These perspectives reflect three different myths about
addiction treatment:
1. Nothing works.
2. There is one particular approach which is superior
to all others.
3. All treatment approaches work about equally well.
----------------------------------------------------------
Central Assumptions of an Informed Eclectic:
1. There is no single superior approach to treatment
for all individuals.
2. Different types of individuals respond best to
different treatment approaches.
3. It is possible to match individuals to optimal
treatments, thereby increasing treatment
effectiveness and efficiency.
----------------------------------------------------------
WHY ISN'T EVERYONE AN ADDICT?
IS THERE AN ADDICTIVE PERSONALITY?
Consider the interaction of these factors:
The Drug - A fast big bang. A painful crash.
The Body - An addict in the family. Chronic
pain. Drug sensitivities.
The Mind - Lacks self control. Lacks values.
Low self esteem. Depression.
The Setting - Barren environment. Lack support
group. Drug availability. Social
guidelines.
----------------------------------------------------------
A RANKING DRUGS BY ADDICTIVENESS:
(a scale of 1 to 100 with Nicotine at 100)
100 Nicotine
99 Ice, Glass (Methamphetamine smoked)
98 Crack
92 Crystal Meth (Methamphetamine)
85 Valium, Diazepam
82 Quaalude, Methaqualone
80 Seconal, secobarbital
80 Alcohol
79 Heroin
78 Crank (amphetamine taken nasally)
72 Cocaine
70 Caffeine
60 PCP, Phencyclidine
20 Marijuana
19 Ecstasy (MDMA)
17 Psilocybin Mushrooms
17 LSD
17 Mescaline
Research on Substance Addiction Propensity
by John Hastings
----------------------------------------------------------
posted by mag00 # 2/28/2005 04:20:00 AM 
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