The Dilemma of Understanding Addiction


We explore the dilemma of understanding addiction

If there’s something about social media that we can all agree upon, it’s that it provides a forum where people can voice their opinions and where people are heavily challenged by their opinions. How does the topic of understanding addiction fit into this? The ongoing debate that is prevalent circles back to the idea of addiction being a disease rather than a choice. The stories that flood social media of overdoses or stories of substance use that people feel are “newsworthy” fuel a platform for debate.

What does all this mean? What is the answer?

Understanding the Moral Model of Addiction

Well, for some, the moral model of addiction is heavily weighted in the reasoning behind why someone uses substances. The moral model followers believe addiction is a defect of character. This model ascribes addiction to one’s own choice, a personality flaw, or something wrong with their moral compass. If it’s hard to wrap your head around what would constitute someone’s ideas of addiction being under the moral model, here are a few examples of the language used in social media posts:

  • “Another junkie, just don’t do drugs in the first place”
  • “Ummm, just say no, it’s really not that hard”.

These types of responses turn into debate that fuel the fire for those in recovery, those actively struggling with their own addiction, substance abuse professional or anyone who follows the disease model of addiction. According to the Butler Center for Research,

“Many people assume that addiction is not a disease but a weakness of character. This misconception contributes to the stigma of addiction and unfairly minimizes the challenge of overcoming chemical dependence.”

Understanding the Disease Model of Addiction

So, what is the disease model and how does it differ from the moral model? We often have parents come in for coaching sessions or intake sessions that feel their child or loved one should just stop using as if it’s as easy as turning off a light switch. The disease model is much more complex. The option to just stop isn’t that easy. The Butler Center for Research suggests that the disease model considers both genetic and environmental factors to cause physical changes to the brain. Furthermore, researchers believe that hereditary traits can cause individuals to develop physical dependencies after exposure to a rewarding stimulus, and if the stimulus is repeated, then those individuals may be subjected to a greater dependence based on the brain being unable to self-regulate effectively.

In the clinical world, it is common knowledge that dopamine plays a role in addiction. Recent research indicates that specific dopamine receptors known as “D2 receptors” may hold the key to understanding those who are more vulnerable to addiction. Those who have fewer D2 receptors may be more impulsive and susceptible to seeking short-term rewards than those who are genetically predisposed to a higher frequency of D2 receptors. In short, those with fewer D2 receptors may be more at risk to addiction.

Although the moral model of addiction has been around for many years, the disease model of addiction is more scientifically proven and is becoming more widely accepted. No matter which model you follow, the most important thing to remember is to support those who need help and encourage them to seek treatment.

By: Courtney Bushnell, LCSW

Excerpts taken from “Advances in Neuroscience Have Evolved the Understanding of Addiction,” Butler Center for Research, March 1, 2016. Hazeldon Betty Ford Foundation. January 14, 2018.