Drug and alcohol treatment providers’ views about the disease model of addiction and its impact on clinical practice: A systematic review

Abstract

The review suggests treatment providers may endorse disease and other models while strategically deploying the DMA for presumed therapeutic benefits. Varying DMA support across workforces indicated service users may experience multiple and potentially contradictory explanations of addiction. Future policy development will benefit by considering how treatment providers adopt disease concepts in practice.

One model to rule them all? Governing images in the shadow of the disease model of addiction

“…In light of these highly contested conceptions, I strongly oppose one alternative put forward in the review [3]: that policy makers should standardise treatment through 'implementing an overarching, universal addiction model'. The concept cannot become fixed in the foreseeable future.…”

Implications of treatment providers’ varying conceptions of the disease model of addiction: A response

“…As a result, people accessing AOD services may face multiple, even contradictory, explanations of their AOD issues [1]. They come from very different walks of life, with varying educational backgrounds, and bring vastly different experiences to the task of helping people overcome problems with drugs.…”

“…Unsurprisingly, they also have divergent views about the nature of AOD problems (whether viewing it as a disease, a moral or social problem). As a result, people accessing AOD services may face multiple, even contradictory, explanations of their AOD issues [1].…”

“…In their responses to our systematic review of treatment providers' views about the disease model of addiction [1], Savic and Lubman [2] and Storbjörk [3] make compelling cases against attempting to 'standardise' treatments to address contradictory explanations that treatment seekers may face. Savic and Lubman's argument against implementing an 'overarching, universal addiction model' is threefold.…”

A persistent contradiction in treatment providers’ views on addiction

“…While we may tolerate such contradictions in political views, we expect more logical consistency from the clinical and scientific enterprise. Yet Barnett et al's [2] systematic review shows that internationally, many addiction treatment providers adhere to contradictory views on the nature of addiction. Many treatment providers adhere to the disease model of addiction, which assumes that addicts are not responsible for their affliction, while simultaneously adhering to the moral model, which purports the opposite, that the addict is personally responsible for his or her problem.…”