The etiology of addiction presupposes studying and understanding its roots and origins that tend to influence the course of its development (NIAAA, 2006). What is more, etiology studies determine the possible treatment strategy (DiClemente, 2006)? Throughout the history of addiction research, many various models and theories have been suggested, but there are general patterns to their development that are going to be demonstrated in the present paper.
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Personal Responsibility Models
Personal responsibility models link the etiology of addiction to the addicted people and their flaws. This idea is among the oldest in the history of the scientific study of addiction etiology (Miller, 2013, p. 271). It appeared before the scientific study of the issue itself, which is reflected in the religious texts, for example, of Abrahamic religions. In the case of this model, the prevention is connected to the educative and legislative measures; treatment presupposes social sanctions and repentance. An example of such a model is the 12-step approach that appeared in 1935 and emphasized the necessity of the “spiritual awakening” of the addicts (Miller, Forcehimes, & Zweben, 2011, p. 24).
Agent models blame the addictive substance, and the various “dry laws” (for example, the US Prohibition) and prohibitions of drugs stem from this theory. In this case, to prevent addiction, society attempts to get rid of the drug, and the relevant measures are legislative.
Dispositional models claim that an addict has a predisposition to addiction, which they cannot control. As a result, unlike personal responsibility models, dispositional ones do not blame the addicted person. An example is the disease model, in which the addicts are considered to be “constitutionally different from others” (Miller et al., 2011, p. 25). Dispositional theories contributed to the scientific understanding of addiction etiology significantly. Namely, they emphasized the genetic risk factors and the changes that constant substance abuse cause for the brain. Most importantly, these models introduced a humane approach to treatment.
With the accumulation of scientific evidence, a more comprehensive view on the etiology of addiction was being introduced (Miller et al., 2011, p. 26). The influence of society was admitted by social learning models that linked addiction to the experience of a person. It included the reaction to the social environment and the following of the observed models. For example, it has been proved that a higher level of family cohesion coupled with social control decreases the risks of developing an addiction while the lack of parental attention and negative models increase it (Jadidi & Nakhaee, 2014). The prevention and treatment suggestions, in this case, include social support with particular attention to high-risk cases, interacting with the family as well as cognitive-behavioral coping skills (Miller et al., 2011, p. 26).
A more comprehensive approach is termed the sociocultural model; it combines the previously mentioned social factors with cultural ones since the two tend to interact (Jadidi & Nakhaee, 2014, p. 4). The culture of substance use is considered to be a part of certain groups, for example, college fraternities. Apart from that, this culture can be supported, for instance, by the media (Miller et al., 2011). This model returns once again to the necessity of introducing substance use policies that are supported legally.
Public Health Perspective
Given the tendency to broaden the scope of the supposed etiological factors, it is not surprising that an all-encompassing model was proposed: the public health perspective. This approach presupposes the analysis of all the mentioned factors that were termed as the host, the agent, and the environment. Apart from that, the models take into account the interactions of the factors (Miller et al., 2011, p. 26). The various properties of drugs include, for example, addiction potential or toxic side effects. Host factors, such as family history or psychological self-regulation are similarly significant. The environment includes the legal, economic, and normative aspects, all of which can have various effects on addiction development as it has been demonstrated above.
Multiple combinations of the mentioned factors tend to produce varied effects; for example, a youngster in touch with drug abuse culture can be protected by sufficient parental control and understanding (Jadidi & Nakhaee, 2014, p. 5). Therefore, when relevant measures are aimed at any of the three aspects, the general public health is expected to improve. An example of such a model development is the harm reduction strategy that describes the elimination of addiction as something impossible and is aimed at mitigating its harmful consequences (Horvath, Misra, Epner, Cooper, & Zupanick, 2015, para. 3). The goal can be achieved, for instance, by prohibiting intoxicated drivers from driving.
The Role of Heredity
Pedigree, twin, and adoption studies have demonstrated the fact that heredity and genetics do play a role in the development of addiction, for example, to the alcohol (NIAAA, 2006). Apart from that, various aspects of the person’s temperament are also believed to be inherited and can affect the predisposition to addiction (Miller et al., 2011, p. 27). At the same time, the genetic predisposition does not guarantee the development of addiction; it is the interaction of host and environment factors that enable addiction heredity. In other words, the role of heredity is significant, but it is the interaction of the factors that leads to the development of addiction.
In my personal opinion, the comprehensive model is the most attractive one since it does not disregard any of the mentioned factors. As the examples above demonstrate, it is not exactly the factors that enable addiction development, but their interaction. Factors can both enhance and mitigate the effects of each other, and this is the main reason for the necessity of a comprehensive approach.
DiClemente, C. (2006). Addiction and change. New York, NY: Guilford Press.
Horvath, A. T., Misra, K., Epner, A. K., Cooper, G. M., & Zupanick, C. E. (2015). Public Health Model of Addiction and Recovery Implications. Web.
Jadidi, N., & Nakhaee, N. (2014). Etiology of Drug Abuse: A Narrative Analysis. Journal of Addiction, 2014, 1-6. Web.
Miller, P. (2013). Principles of addiction. Amsterdam: Elsevier Science.
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Miller, W., Forcehimes, A., & Zweben, A. (2011). Treating addiction. New York, NY: Guilford Press.
NIAAA. (2006). Etiology and Natural History of Alcoholism. Web.