Group Therapy

Alternative Approaches to Treatment

The group model approach to drug use is predicated upon the belief that addiction underlies the user's decision to use illicit substances. Addiction is thought of as a compulsive need to use a certain substance or an irresistible need to engage in a particular behavior. Traditional methods of dealing with addiction, with their focus on punishment and prohibition, are deemed to be ineffective as a means of dealing with underlying problems. Over time an addict develops tolerance for the habit-forming substance, needing more of the drug to obtain the desired effect, and unpleasant symptoms arise when the addict is not able to use that substance.

[Page 338]Traditionally, the overuse of alcohol or other mind-altering substances was regarded as sinful or slothful, but beginning in the 1940s, medical experts began to examine addiction as a series of interrelated stages: patterns, habits, compulsions, impulse control disorders, and physical addiction. As such, addiction began to be approached as a disease rather than a moral shortcoming. Beginning in 1956, the American Medical Association adopted the disease model of responding to alcoholism, an approach that has since been adopted to narcotics and other mind-altering substances. The disease model has gradually gained adherents, and many have advocated its approach be used with those involved with illegal substances.

Others dispute the analogy between addiction and a physical disease. While some favor a more traditional response to users of illegal drugs, others believe an approach more in keeping with learning and behavior theories is more appropriate. This approach maintains that addictive behaviors are maladaptive habits that have been learned as a manner to deal with feelings such as anger, anxiety, depression, discomfort, fear, and shame. To deal with these feelings, users attempt to self-medicate and use mind-altering substances to ameliorate their painful emotions.

Such responses to negative feelings are learned behaviors. In order to effectively respond to such feelings, maladaptive habits must be unlearned and replaced with new more healthy responses. The tendency of an individual to respond to emotions by using mind-altering substances is largely determined by a combination of one's family history, environment, experiences, peer group, beliefs, and expectations. Treatment of these underlying issues that cause the response of using mind-altering substances is seen as necessary to break the cycle of substance abuse and addiction.

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