Choice is Still the Popular Understanding
Addiction to drugs and alcohol, in the past, has been referred to as a choice and, hence, a lack of willpower. As most have come to see (unfortunately, not everyone), this is not accurate. In both Canada and the United States we’ve come to see addiction is not a choice. We learned that punishing people for using substances or alcohol or having an addiction isn’t helpful, and it most cases more harmful, because it isn’t a choice. Rather, it’s a symptom of a collection of social, psychological, and physical issues plus much more.
However, just because addiction to drugs, alcohol, or other behaviors is not a choice, doesn’t mean it’s a disease* (or that it can be reduced to a disease). The disease model is one of the most popular theories on addictions in Canada, but it doesn’t reflect the whole condition of addiction and has resulted in some negative effects in practice and society.
*Disclaimer! While we don’t subscribe to the disease model at SCHC, our meaning-centered approach also does not ignore that addiction does have a role in brain chemistry and neuroplasticity.
Theories of Drug & Alcohol Addiction
There are a lot of theories on addiction throughout North America, both Canada and the United States. Our program director, Geoff Thompson, at our Powell River, BC, drug rehab and alcohol treatment centre, can summarize around 60 theories personally. The funny (and sometimes frustrating) part is that even though there are so many theories on addiction available, researchers are all playing poker around a table together and refusing to collaborate.
Regardless of where addiction stems from (which, as we can see, may be many different places based on the many theories out there), getting better is a choice. The struggle with the disease model is that it tends to allow people to remain in a “helplessness” and “victim” narrative. Because the disease is happening to them, they are forever burdened with it regardless of whether they’re actively in addiction or have been in recovery for days, months, or years.
Improving Recovery Rates from Drugs and Alcohol in Canada
For some, this narrative isn’t a problem. There are many people in AA who are living well in recovery even though AA maintains the idea that addiction is with you forever and ready to take advantage of you at a moment’s notice if you let your guard down (e.g. relapse).
For others, in fact many, this idea is a significant barrier to an improved quality of life. If addiction is with them forever, then what’s the point? Many people can’t make sense of getting better through this understanding of addiction. Another consequence is that many people feel defective, damaged, and incompetent under the disease model. So, while the disease model has been effective systemically in making governments and authorities acknowledge that addiction is an issue that deserves healthcare attention, it has been harmful to individual identities.
Focus on the Future to Combat Drug and Alcohol Dependency
To avoid having our loved ones fall into despair around being forever afflicted with addiction, perhaps we should focus on the present (while also keeping an eye on the future). To do that, we mustn’t limit our thinking to addiction as a disease. Let’s focus on helping our loved ones with addictions figure out what they can do and what they’d like to do in terms of their life and health. If we do that, then we’re acknowledging recovery is their choice. Getting better is their choice.
If you or your loved one are struggling with drugs, alcohol, or other types of addictions in Vancouver, Edmonton, Calgary, and other Canadian cities, reach out to us for a consultation or help in finding the right treatment for you.
Note: The author acknowledges that addiction systemically is also a symptom of larger systemic inequalities and processes at work such as poverty, classism, racism, capitalism, and MUCH more. Unfortunately, there’s not enough room or reader attention span to explore it all on one blog. Check back regularly on the SCHC blog for future blogs on those topics.