The disease model

The notion that there is a disease called addiction or alcoholism is contested. This idea can help explain people’s experiences and behaviours and even be empowering for people with a substance use problem (see addict; see addiction; see alcoholic; see alcoholism). Describing experiences as disease symptoms may help people integrate apparently unconnected, difficult and troubling experiences into a whole and allow people to understand and explain their personal experiences and even move on from them.

However not all evidence leads to a conclusion that people who have a substance dependency have a chronic relapsing condition. In fact there is long-standing evidence that this is not the case – or certainly not the whole story. This evidence suggests that problem substance use occurs where there are substances available and few other opportunities or resource (see Rat Park) and where substance use helps deal with trauma and there are not other supports available through family or others and through a supportive daily routine like, for example, a home and regular work (see drug set and setting; see Vietnam veteran studies).

The disease model is often challenged as disempowering for people who have a substance use problem and unnecessarily burdening them with a diagnosis for something that actually may otherwise come to have little or no significance in their future lives.

The disease model is sometimes challenged by people who want to diminish or eliminate the role of medical professionals in treatment. Confusingly, often the same people who make this challenge describe themselves or others as ‘addicts’ – which is a medical term – for someone with the ‘disease’ of ‘addiction’ (see addict and addiction).