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This paper examines the differences between the disease model and the harm reduction model based on “Beautiful Boy: A Father’s Journey Through His Son’s Addiction” by David Sheff and “Tweak: Growing Up on Methamphetamines” by his son Nick Sheff.
In order to understand the given topic deeper and broader, it seems appropriate to summarize memoirs presented in the books. Both books are memoirs of a father and his son while the first book is written by father David, and the latter one reveals the point of view of his son. The story begins with Nick’s early childhood when he was a lovely kid and was interested in the world. For a long time, Nick managed to hide his addiction from his parents.
They understood that their son is a drug addict when they find methamphetamine in his room (N. Sheff, 2008). David knew that the use of methamphetamine causes the strongest, often irreparable damage to human health. First and foremost, it heavily affects the human brain and the entire nervous system decreasing immunity, the liver and weakening the heart at the same time. He tried to talk to his son explaining that drugs do not lead to anything good, and did his best to bring his son back to normal life (D. Sheff, 2009). Books describe the pain, despair, and suffering experienced by the family of Nick, including himself.
He has rehabs and relapses. Books tell about the situation that could happen to every family, and how to handle it. Two different treatment models of disease model and the harm reduction model were used by Nick.
Harm Reduction Model
To begin with, the strategy of harm reduction initiating its physiological roots in pragmatism and combined with approaches used in public health, offers a practical alternative to the moral model, in other words, the harm reduction model. Proponents of it move the focus from the consequences of drug use to the results of such behavior. These results are evaluated in terms of harmfulness or usefulness for drug addicts and others.
The harm reduction model insists on the complete rejection of drugs as the only acceptable purpose of treatment. Most chemical dependency treatment programs refuse to accept patients who continue to use drugs. The fact that the patient should first stop using drugs before entering the treatment aimed at maintaining a complete renunciation of the drug says that this approach is an example of a “high threshold”, which is often a barrier for those seeking help. Those who hold the opinion that addiction is a disease, emphasize that the abstinence is the only acceptable purpose of addiction prevention and its treatment (Miller, 2015).
From this point of view, drug addiction is seen as a progressive disease that cannot be cured, but that might be “arrested” by a lifelong commitment to abstinence. All subsequent attempts to drug use are defined as the recurrence of the disease state, in particular, the inevitable result occurring due to biological factors that are not controlled by a person.
The harmful effects of the dangerous drug could be regarded as a continuum (continuous procedure). Abstinence is accepted as an ideal ultimate goal of the continuum, which could be extremely harmful or less dangerous. Considering the harmful consequences of drug use as a continuum of harm reduction, advocates of this model encourage any movement towards harm reduction as steps in the right direction.
Harm reduction strategy defines drug abuse and other behaviors associated with dangerous addictions like psychological maladjustment. As an approach based on acceptance and compassion, harm reduction has parallels with other concepts and schools of therapy. Harm reduction takes a human approach to human suffering, in other words, it takes the same position as well as humanistic psychology.
The second model applied by Nick is the disease model. It states that drug addiction is, primarily, psychiatric disorder and associated with the existence of social conditions in which the identity is formed, developed, and operated. It does not deny the role of heredity in the occurrence of disease, constitutional, and other factors.
This model has gained popularity among professionals and has received wide public recognition (for instance, in the “Twelve Steps” program). In accordance with the considered model, addiction is a disease that requires special care. The addict is partially exonerated from responsibility for the origin of his illness. For example, a diabetic cannot be responsible for his diabetes, and a drug addict should not be accountable for his dependence. Addicts are treated as individuals with the inherent predisposition to dependence on exogenous substances (Hall, Carter, & Forlini, 2015). Since the dependence is recognized intractable, a person suffering from it should resist the morbid attraction all his life. It is the thing he is personally responsible for.
The most important feelings of this model are depression and despair. If healthy people’s main sense is their awareness of that power, then drug addicts lost it. First of all, the disease is associated with a fragile life stereotype that has an ambiguous strength. The addict gets some advantages, now he can avoid making important decisions, and the responsibility for his decisions and actions he or she passes to others. The socio-psychological situation of «disease» compensates for the inferiority complex.
Addiction becomes a manifestation of maladjustment that is considered as the violation of human adaptation to life. Awareness of infringement of his or her freedom and dignity creates a nagging feeling of dissatisfaction, which resulted in plenty of various abuses in the organism of the addict. The first sign of revitalization of the model of disease is feeling depressed and feeling that life goes somewhere beyond it. In other words, one feels separated from life, and he does not want to interfere with it with friends or relatives.
In conclusion, it should be emphasized that the basic principles of the harm reduction model include the following strategy:
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- it is inevitable that drugs were used, used now, and will be used for non-medical purposes;
- drug users are part of society, even if society does not realize it;
- illicit drug use could lead to negative consequences both for addicts and for their loved ones, as well as for the communities in which they live;
- drug use causes personal and social damage in various ways; therefore, the program should have a set of tools for intervention.
In its turn, the disease model focuses on the following fundamentals:
- social conditions play an integral part in the addiction;
- the most considerable feeling is depression;
- an addict cannot control himself.
Thus, two different models associated with drug addiction were discussed, and their distinctive features were revealed.
Hall, W., Carter, A., & Forlini, C. (2015). The brain disease model of addiction: Is it supported by the evidence and has it delivered on its promises? The Lancet Psychiatry, 2(1), 105-110. Web.
Miller, G. A. (2015). Learning the language of addiction counseling (4th ed.). New York: Wiley. Web.
Sheff, D. (2009). Beautiful boy: A father’s journey through his son’s addiction. New York, NY: Mariner. Web.
Sheff, N. (2008). Tweak: growing up on methamphetamines. New York, NY: Atheneum Books. Web.