Addiction is different for everyone. For some people, there was a catastrophic emotional event that forced them to turn to drugs and alcohol. For others, a love of partying in their 20’s never went away and spiraled into dependence over the course of several years. Some people have a family history of addiction, while others see themselves as the “black sheep.” You hear stories of individuals who quit for a while on their own, got their lives on track and were then able to drink moderately, but other people enter expensive treatment programs, only to have repeated severe relapses. Addiction seems to take myriad forms and have many different remedies, and experts believe it’s because there are different models of addiction: Disease, choice and self-medication.
Defining addiction as a disease is the most common and popular way people in the addiction community choose to approach it – and with good reason. According to this model, prolonged use of a substance causes the brain to stop producing as much dopamine as it should, causing withdrawals and cravings for more. Over time, the brain essentially reorganizes itself so that obtaining more alcohol or drugs becomes one’s top priority. Sadly, what this means is that someone has completely lost control over his or her decision-making and it’s the substance that’s in the driver’s seat – at this point, the person has a disease. Of course, studies have shown time and time again that some people’s brains are genetically pre-disposed to abnormalities that lead to the disease of addiction. Exactly how this works is still unclear, but it can explain why some people’s brains rewire themselves into the disease model of addiction, while others can more easily overcome substance abuse.
We’ve all had the experience of thinking, “I need a drink!” after a rough day of work or emotionally exhausting experience. But some people take this too far and reach out to alcohol or drugs as a means of feeling better during a trying time – this is especially prevalent among people suffering from mental illness. Under this addiction theory, people use drugs, alcohol, food or something else as a way to “feel better” and compensate for issues that aren’t being treated, like stress, anxiety, loneliness or PTSD. People who begin abusing substances under the self-medicating model usually end up breaking off into two directions: Those who overcome their addiction once the underlying issue is treated through therapy and those who continue down a dangerous path and eventually become physically addicted.
The most controversial model in the addiction community, the choice model essentially revolves around the idea that people who have developed addictions are able to overcome them, but make conscious, rational choices to “jump the gap” from sobriety to substances. Recently, the New York Times profiled a researcher named Carl Hunt who sought to prove just that by bringing crack addicts into his lab. The addicts had to stay put for several weeks and, over that time, were offered crack or money. He found that, the majority of times, the addicts chose money – and because they weren’t allowed to leave the facility, they weren’t choosing money simply to score drugs. In these cases, he argued, people had another positive element to choose and he believes that many people succumb to addiction because they don’t really have anything else going for them.
Although each of these models is different, they are interwoven and it’s easy for anyone with a history of substance abuse to slip from one to the other. It is important for someone who is suffering from addiction to seek professional help to identify which model fits him or her best – knowing this is critical to receiving proper addiction treatment.
