Cocaine Treatment: Models of Cocaine Addiction

In the addiction field there are many models from which the treatment community view AOD (alcohol and other drug) problems. This is important, as these are the ways that people think of drug and alcohol abuse (AODA). The perspective of the potential client and that of the family tend to indicate which approach will benefit the person long term. A less categorical approach is currently favored, in which the problem is viewed from many perspectives, and at this time is the trend in AODA treatment.

Below are some of the major categorical classifications of Alcohol and other Drug Abuse perspectives in a developmental context and will familiarize you with some of the mose common and prominent philosophies in AODA. Each section will discuss causal factors, or the theory that states the cause of AODA; suggested courses of treatment, or what is recommended in the intervention of AODA; and treatment specialists, or who specializes in each model.

Moral Model

This is perhaps the longest standing view of AODA, it's suggested course of treatment and sources of it's causal factors. From the viewpoint of the Moral Perspective AOD abuse is seen as an infringement of societal rules by the abuser. Proponents feel it is a punishable crime and the individual is responsible for his or her choices. Many in the religous community take this viewpoint and criticize AOD use as a sinful act and a crime by the laws of society.

1. Spiritual Defecit
2. Concious Choice

1. Clergy Intervention (Spiritual Guidance)
2. Moral Persuasion
3. Imprisonment/Social Consequences

1. Clergy
2. Law Enforcement

Temperance Model

The temperance model has habitually been confused with moral approaches. This perspective began with a prohibition movement in the late 19th century. The movement emphasized the idea of moderation as primary to the shortcomings of treatment. The conviction was that moderation was an impractical task. Abstinence was asserted as the only alternative. The core assumption of the temperance movement was that the addictive and destructive power of the drug is strong and that it is the drug itself that is the problem.

1. The actual drug in itself

1. Abstinence
2. Prohibition

1. Abstainers
2. Legislators

Disease Model

After the successful repeal of Prohibition in the United States, a new viewpoint from which to view AODA was needed. In 1935, the same year Alcoholics Anonymous was founded by Bill W. and Dr. Bob, the American Disease perspective was developed primarily from the assertion that AODA is a unique, irreversible, and progressive disease. The belief of those who support this model is that while alcoholism and addiction cannot be cured, however, such conditions can be arrested by abstaining from the substance the individual is addicted to.

1. Abnormal traits inherint in the individual
2. Constitutional disease or disorder

1. Identification and confrontation of the condition
2. Lifelong abstinence

1. Other Recovering Individuals
2. Peer Support Groups (Alcoholics Anonymous, Narcotics Anonymous)

Psychological or Characterological Model

The characterological approach to AODA views chemical dependency as rooted in abnormalities of personality or character. The proponents of this model follow that an "addictive personality" exists in such individuals and is inherint with a degree of deficit in personal and psychological boundaries. Traits associated with the "addictive personality" are poor impulse control; low self-esteem; an inability to cope with stressors; egocentricity; manipulative traits; and a need for control and power, while feeling impotent and powerless. The belief in treating AODA from this viewpoint is that a complete restructuring of the individuals personality is key.

1. Personality or disposition ("addictive personality")
2. Low Self-Esteem
3. Poor Impulse Control

1. Psychotherapy
2. Identification and modification of self-esteem, interpersonal skills, impulse control, improved boundary setting

1. Psychotherapists
2. Social Workers with training in advanced practice

Social Education Model

The Social Education Model represents an integrative approach that borrows principles from the school of classical and operant conditioning, wherein AODA is seen as a learned behavior stemming from cognitive processes, modeling influences and behavioral as well as genetic influences. Although, not all proponents of this model agree wholeheartedly, a cohesive philosophy retains that AODA is maintained by precursory causes (classical conditioning or expectancies) and further reinforcement of that behavior through operant conditioning ("I do A-action and get B-effect, B-effect reduces stressors, therefore A-action reduces stressors").

Unlike aversive conditioning and some earlier models related to the Social Education Model, the Social Education theorists extend their thinking to place an emphasis on human-environment interactions as key to shaping AODA behaviors. They stress, in particular, socialization processes, imitation of observable behavior, as well as the influence of modeling (role models) in both the forming of an AODA behavior, but also in the successful treatment thereof.

1. Poor Socialization
2. Poor Modeling
3. Poor Coping Mechanisms and Skill Deficits

1. Correct estimation and realistic goal setting
2. Appropriate Modeling
3. Cognitive Exercises and Reconditioning
4. Skill Training
5. Impulse-Control Training

1. Appropriate peer modeling
2. Cognitive / Behavioral counseling

Summary

While most contemporary addiction professionals and treatment centers do not fit precicely with any one of the above models, each can be termed as such, by talking about their general philosophy and your background. Determining which modality of treatment is best is best left to the family and the individual needed treatment. We have qualified addictions counselors who can help you decide what is best for you or your loved ones, and offer referrals to many centers across the country.