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Addiction Treatment: Medical (Disease) Model, or Something Else?

I recently spoke to a graduate of an in-patient addiction treatment facility in Tennessee. He said he was cured of his alcohol addiction. I didn’t know how to respond. My training as a therapist has taught me that being diagnosed with an addiction to drugs or alcohol is a life sentence. AA groups all over the country are helping people cope daily with addiction. They teach that the person has an incurable disease. They must fight this disease every day. We encourage people to get into groups and to get a sponsor because these programs are helping people.

But…

Problems With the Life Sentence

I have always had a problem with the diagnosis as a lifelong disease with no cure. There are too many variables like life choices, family of origin issues, easy access to drugs and alcohol and simple behaviorism 101. The medical model treats addiction as the main issue and disregards any attempt to find a cause or triggering event or series of events. Some treatments even include using drugs like methadone as a substitute for heroin.

Logic brain wakes up, opens the door, stretches and says, “Wait. Did I just hear that we are treating people with chemical dependency issues with more chemicals?” We answer, “ YES. It is science, accepted by the AMA so you can go back to sleep now.” Logic brain yawns, goes back to sleep.

Denial is Powerful

We all have clients who make excuses and deny the problem.

  • “Drinking helps me relax, helps me forget, numbs the pain, etc.”
  • “All my friends drink”
  • “I just want to have a good time”
  • “Everybody in my family drinks and they don’t have problems”
  • “I only use heroin on the weekends, it doesn’t affect my job/family/finances”
  • “My doctor prescribes me pain pills for my back pain….It isn’t enough, so I have to make copies and go to several other pharmacies…”

So what I hear as a therapist are cognitive and behavioral problems. I don’t hear “disease.” I hear:

  • “My mother was a narcissist”
  • “My father abandoned us”
  • “My sense of self worth is very low”
  • “I am unlovable”
  • “The chemicals I use help me cope with life”
  • “My father beat the hell out of me for 12 years”
  • “I don’t think I have a problem”

Our clients are ready to admit the problem but accept the disease model because it lets them off the hook.

“It isn’t my fault, it is a disease. I inherited the disease from my parents/uncles/ancestors. Look, I am Irish okay.”

So we send them to AA. Or some in-patient program which will graduate them, and send them to AA. It works.

Solutions

I was excited to hear about a program that actually gave hope to clients that their addiction isn’t a life sentence. That program is S2L Recovery, a Christian rehab center in middle Tennessee.

The treatment program is heavy on Bible, so it won’t be a good fit for everyone. But it may be a good referral source for some of our clients.

My friend and his family are doing very well. His wife reports that he is like a new person. He has refused to accept a label, or identity that says he is an alcoholic. Instead, he says, he used alcohol to cope with his issues, but he has learned that he doesn’t need that anymore. His alcohol use was a symptom of a problem. He identified that problem and solved it. Now he doesn’t need alcohol anymore. That is the whole point.

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