The modern approach to treating alcohol or substance dependency is now formulated and understood through science and observations of human behaviour. This has allowed the understanding of dependency to move away from the older models of addiction which believed that dependency was due to an inherent illness and the alcoholic or drug user was something of a lost case, who could look forward to a life of abstinence and complete helpessness in the face of their poison of choice. This idea has become the standardised way in which the general public now view addiction as an intractable life long condition. The problem with this theory is that it does not account for the many people who everyday learn how to give up and live better quality lives with more control and self understanding to their vulnerabilities and limitations. The 'addiction as illness' is the standard Alcoholic Anonymous (AA) approach. However, it is not the only way or approach available....

 

Since dependency treatment has evolved, understanding has moved on beyond a social support system to become a multi modal and comprehensive approach to human wellbeing encompassing biological, psychological and sociological components. This modern scientifically informed 'bio-psycho-social approach' examines all contributory factors to human behaviour and health. It considers that when there is 'unhealth' or imbalance in a system, often human beings will attempt to rebalance this by other external factors. 

 

A bio-psycho-social approach also understands that human behaviour is learnt, which equally applies to learning to adopt and use drugs or alcohol. As the human brain exhibits plasticity (ability to change), we then also know that new behaviours can be learnt and old ones rejected with the correct type of modelling and reinforcement. For this to be maximised the neuronal systems of the brain linked to addictive behaviour (dopamine pathways) need to be included in this incentive (reward) based focusing approach. This is achieved through challenging old ways of thinking/behaving and replacing them with more rewarding new models of being that are more attractive and replace a possible sense of loss. 

 

This formulation also includes personal history, contributary factors like trauma, underlying mental health and mood disorders like anxiety, stress and depression and present day concerns like employment, relationships, and other social factors. Observation of addictive/dependency conditions are seen to link to underlying personal issues and substances are often used to mask these. By treating such disorders in this manner a unique profile approach is taken and a clear pattern of usage can be seen to emerge upon assessing lifestyle and historical factors. 

 

Such an analysis starts to create the realisation that the substance misuse is more of a symptom of contributory factors rather than the causal factor alone. Treatment then focuses on resolution of contributory factors via the appropriate therapeutic approach coupled with psycho education around moving forward and increasing self awareness and well being. 

 

Lying at the heart of treatment is a thorough assessment to begin the process of building a picture of what has been happening in a persons life and how they have ended up looking for support to get better. From there and with the information gathered an appropriate way forward can be mapped. 

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Read a case example here.