How do you spell “addiction”?
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"Addiction" may not be what most people think it is at first glance. Most of us "know" what addiction is "when we see it," but too often this recognition is of the disorder in its latter stages.

Can someone be addicted when not using a drug? Can someone be physically dependent on a substance, but not be addicted to it? Is there one all encompassing definition that would address the beliefs of all who wish to describe an addiction or more importantly, diagnose an addicted individual? These are questions that have not been answered with anything approaching a consensus in the “helping professions” so I do not expect that we will reach a consensus this semester where the fields of medicine, psychology, biology, sociology, and numerous other disciplines have failed to accomplish such to date.

This post attempts to expand on what you have hopefully begun to recognize as the foundation for your approach to “understanding addiction,” namely, a personal consideration of the etiology or “origins” of an addictive disorder. This is of the utmost importance for the counselor providing counseling services to the addicted client and her/his family.

If a counselor is unable to explain the diagnosis to the diagnosed individual’s satisfaction (understanding), it will be difficult if not impossible to engage that individual in the recommended course of treatment. If you tell me, assuming I’m your client, that after having conducted an assessment, it is your opinion that my presenting problem involves the abuse of or dependence on substance “X,” but you are unable to help me understand what that means other than the judgmental meaning ascribed by "the public," I am not very likely to embrace the treatment suggestions that you might make. And if you can explain an addictive disorder, but that explanation is steeped in hearsay rather than documented fact, then your efforts to “get the horse to drink” once you have led it to the water is rather slim.

In this post you are invited to consider some of the major models that have been used to explain the etiology or “origins” of an addictive disorder. Reviewing these models and determining which has the greatest utility in effectively treating an individual's addiction, is a crucial piece in engaging that person in treatment. If your he or she hears you calling him a bum or her a tramp when you suggest that s/he is an “alcoholic” or an “addict,” then that client will resist your treatment efforts if not refuse to work with you altogether. Remember: just as you and I have formulated an opinion of what an addiction is and what an addicted person is like from our “observations on life,” so have our clients. Many “hear” addict/alcoholic/etc and think “failure,” "loser," "degenerate," etc.

As you read the assigned material this week (http://wings.buffalo.edu/aru/ARUreport04.html), I would like you to identify which outlined model most closely captures your understanding of the etiology of an addictive disorder. Consider posting your comments on this topic/reading, be prepared to explain: 1) what is attractive about the model you most strongly related to; and/or 2) what argument might you mount if you were to use this model in order to explain it to a client you have diagnosed as having an addiction. NOTE: In responding to your positions, I may pretend to be your client, listening to your explanation of my addiction in the context of your model. I will then “give you feedback” as I would anticipate a resistant client might do in response to your explanation :)

Later in this series of posts we will talk about “premature” treatment, that is, suggesting action oriented treatment before the client has made a commitment to change. For now, however, we will assume that the client is at least willing to consider changing in order to improve—although that does not mean this change will automatically include a willingness to abstain from “X” simply because you have suggested it.

If you have the time, you may enjoy this review of various models that are used to explain addictive disorders - http://www.indiana.edu/~engs/cbook/chap1.html