Skip to main content

Switching to a Social Approach to Addiction: Implications for Theory and Practice

Abstract

The concept of addiction is complex and shaped by a range of understandings including how the recipient of an addiction is interpreted. This paper examines how concepts of self and concepts of addiction interact. Two fundamentally different understandings of self are considered: one which focuses on the self as a bio-psychological individual, the ‘particle’ self, and another that focuses on the self as a nexus of relationships, the ‘social’ self. The effect these have on understandings of addiction is examined along with implications for service interventions. Particle-informed understandings of addiction are seen as dominating services and leading to intervention responses that focus on the individual and de-emphasize the role of family, community and culture. The absence of social understandings limits both the range and quality of services offered. Particle and social approaches to addiction could operate side-by-side in offering a broader range of effective service responses to addiction.

This is a preview of subscription content, access via your institution.

References

  1. Adams, P. J. (2008). Fragmented intimacy: Addiction in a social world. New York: Springer.

    Book  Google Scholar 

  2. Alexander, B. K. (2012). Addiction: the urgent need for a paradigm shift. Substance Use & Misuse, 47(13–14), 1475–1482.

    Article  Google Scholar 

  3. Blume, A. W. (2005). Treating drug problems. New Jersey: Wiley.

    Google Scholar 

  4. Boisvert, R. A., Martin, L. M., Grosek, M., & Clarie, A. J. (2008). Effectiveness of a peer-support community in addiction recovery: participation as intervention. Occupational Therapy International, 16(4), 205–220.

    Article  Google Scholar 

  5. Brady, M. (2000). Alcohol policy issues for indigenous people in the United States, Canada, Australia and New Zealand. Contemporary Drug Problems, 435(Fall), 435–461.

    Google Scholar 

  6. Buchman, D. Z., Illes, J., & Reiner, P. B. (2011). The paradox of addiction neuroscience. Neuroethics, 4(2), 65–77.

    Article  Google Scholar 

  7. Carroll, K. M., & Onken, L. S. (2005). Behavioral therapies for drug abuse. American Journal of Psychiatry, 162(8), 1452–1460.

    PubMed  PubMed Central  Article  Google Scholar 

  8. Coletti, M. (2010). Making family a part of the treatment. In J. Barlow (Ed.), Substance misuse: The implications of research, policy and practice (pp. 138–145). London: Jessica Kingsley.

    Google Scholar 

  9. Copello, A. G., & Orford, J. (2002). Editorial: addiction and the family: is it time for services to take notice of the evidence. Addiction, 97, 1361–1363.

    PubMed  Article  Google Scholar 

  10. Copello, A. G., Velleman, R. D. B., & Templeton, L. J. (2005). Family interventions in the treatment of alcohol and drug problems. Drug and Alcohol Review, 24, 369–385.

    PubMed  Article  Google Scholar 

  11. Copello, A., Williamson, E., Orford, J., & Day, E. (2006). Implementing and evaluating Social Behaviour and Network Therapy in drug treatment practice in the UK: a feasibility study. Addictive Behaviors, 31(5), 802–810.

    PubMed  Article  Google Scholar 

  12. Courtwright, D. T. (2009). Forces of habit: Drugs and the making of the modern world. Cambridge: Harvard University Press.

    Google Scholar 

  13. Cunningham, J. A., & McCambridge, J. (2012). Is alcohol dependence best viewed as a chronic relapsing disorder? Addiction, 107(1), 6–12.

    PubMed  PubMed Central  Article  Google Scholar 

  14. Curzio, O., Tilli, A., Mezzasalma, L., Scalese, M., Fortunato, L., Potente, R., … Molinaro, S. (2012). Alcoholics in treatment in Italy: a national survey. Alcohol & Alcoholism, 47(3), 317–321.

  15. Davies, J. B. (1992). The myth of addiction: An application of the psychological theory of attribution to illicit drug use. Chur: Harwood Academic.

    Google Scholar 

  16. Depelteau, F. (2008). Relational thinking: a critique of co-deterministic theories of structure and agency. Sociological Theory, 26(1), 51–73.

    Article  Google Scholar 

  17. DiClemente, C. C. (2005). Addiction and change: How addictions develop and addicted people recover. New York: Guilford Press.

    Google Scholar 

  18. Dobkin, P. L., Civita, M. D., Paraherakis, A., & Gill, K. (2002). The role of functional social support in treatment retention and outcomes among outpatient adult substance abusers. Addiction, 97(3), 347–356.

    PubMed  Article  Google Scholar 

  19. Durie, M. (2001). Mauri Ora: The dynamics of Maori health. Melbourne: Oxford University Press.

    Google Scholar 

  20. Einstein, S. (Ed.). (1980). The community’s response to drug use. New York: Pergamon Press.

    Google Scholar 

  21. Elster, J., & Skog, O.-J. (Eds.). (1999). Getting hooked: Rationality and addiction. Cambridge: Cambridge University Press.

    Google Scholar 

  22. Engel, G. L. (1992). How much longer must medicine’s science be bound by a seventeenth century world view? Family Systems Medicine, 10(3), 333–346.

    Article  Google Scholar 

  23. Fergus, S., & Zimmerman, M. A. (2005). Adolescent resilience: a framework for understanding healthy development in the face of risk. Annual Review of Public Health, 26, 399–419.

    PubMed  Article  Google Scholar 

  24. Fernandez, A. C., Begley, E. A., & Marlatt, G. A. (2006). Family and peer interventions for adults: past approaches and future directions. Psychology of Addictive Behaviors, 20(2), 207–213.

    PubMed  Article  Google Scholar 

  25. Galea, S., & Vlahov, D. (2002). Social determinants and the health of drug users: socioeconomic status, homelessness, and incarceration. Public Health Reports, 117(Suppl 1), S135–S145.

    PubMed  PubMed Central  Google Scholar 

  26. Gergen, K. J. (2009). Relational being: Beyond self and community. Cary: Oxford University Press.

    Google Scholar 

  27. Graham, M. D., Young, R. A., Valach, L., & Wood, R. (2008). Addiction as a complex social process: an action theoretical perspective. Addiction Research & Theory, 16(2), 121–133.

    Article  Google Scholar 

  28. Granfield, R. (2004). Addiction and modernity: A comment on a global theory of addiction. In P. Rosenqvist, J. Blomqvist, A. Koski-Jannes, & L. Ojesjo (Eds.), Addiction and lifecourse. Helsingfors: NAD.

    Google Scholar 

  29. Heath, D. B. (2000). Drinking occasions: Comparative perspectives on alcohol and culture. Philadelphia: Brunner/Mazel.

    Google Scholar 

  30. Heather, N. (1998). A conceptual framework for explaining drug addiction. Journal of Psychopharmacology, 12(1), 3–7.

    PubMed  CAS  Article  Google Scholar 

  31. Hudolin, V., Gosparini, P., Guidoni, G., Kohl, N., Kolstad, H., Marcomini, F., … Sforzina, M. (Eds.). (2001). Club of treated alcoholics: A guide for the work in the clubs of treated alcoholics (social-ecological approach). Trieste: European School of Alcohology and Ecological Psychiatry.

  32. Huriwai, T. (2002). Re-enculturation; culturally congruent interventions for Mäori with alcohol and drug-use-associated problems in New Zealand. Substance Use and Misuse, 37(8–10), 1259–1268.

    PubMed  Article  Google Scholar 

  33. Hyman, S. E. (2005). Addiction: a disease of learning and memory. American Journal of Psychiatry, 162(8), 1414–1422.

    PubMed  Article  Google Scholar 

  34. Kalant, H. (2010). What neurobiology cannot tell us about addiction. Addiction, 105(5), 780–789.

    PubMed  Article  Google Scholar 

  35. Keane, H. (2002). What’s wrong with addiction. Melbourne: Melbourne University Press.

    Google Scholar 

  36. Klostermann, K., & O'Farrell, T. J. (2013). Treating substance abuse: partner and family approaches. Social Work in Public Health, 28(3–4), 234–247.

    PubMed  Article  Google Scholar 

  37. Larkin, M., Wood, R. T. A., & Griffiths, M. D. (2006). Towards addiction as relationship. Addiction Research & Theory, 14(3), 207–215.

    Article  Google Scholar 

  38. Lavallee, L. F., & Poole, J. M. (2010). Beyond recovery: colonization, health and healing for indigenous people in Canada. International Journal of Mental Health and Addiction, 8(2), 271–281.

    Article  Google Scholar 

  39. Lee, C. E., Christie, M. M., Copello, A., & Kellett, S. (2012). Barriers and enablers to implementation of family-based work in alcohol services: a qualitative study of alcohol worker perceptions. Drugs: Education, Prevention & Policy, 19(3), 244–252.

    Google Scholar 

  40. Leshner, A. I. (1997). Addiction is a brain disease, and it matters. Science, 278(5335), 45–47.

    PubMed  CAS  Article  Google Scholar 

  41. MacAndrew, C., & Edgerton, R. B. (1969). Drunken comportment: A social explanation. Chicago: Aldine Publishing.

    Google Scholar 

  42. Marlatt, G. A., & Donovan, D. M. (Eds.). (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviours (2nd ed.). New York: Guilford Press.

    Google Scholar 

  43. Marlatt, G. A., & VandenBos, G. R. (Eds.). (1997). Addictive behaviours: Readings on etiology, prevention and treatment. Washington, DC: American Psychological Association.

    Google Scholar 

  44. Marshall, M. (Ed.). (1979). Beliefs, behaviours and alcoholic beverages in cross cultural survey. Anne Arbor: University of Michigan Press.

    Google Scholar 

  45. McCrady, B. S., & Epstein, E. (1995). Marital therapy in the treatment of alcohol problems. In N. S. Jacobson & A. S. Gurman (Eds.), Clinical handbook of couple therapy. New York: Guilford Press.

    Google Scholar 

  46. McCrady, B. S., Zucker, R. A., Molina, B. S., Ammon, L., Ames, G. M., & Longabaugh, R. (2006). Social environmental influences on the development and resolution of alcohol problems. Alcoholism: Clinical and Experimental Research, 30(4), 688–699.

    Article  Google Scholar 

  47. Midanik, L. T. (2006). Biomedicalization of alcohol studies: Ideological shifts and institutional challenges. New Jersey: Transaction Publishers.

    Google Scholar 

  48. Midanik, L. T. (2010). The name game. Addiction, 105(12), 2053–2054.

    PubMed  Article  Google Scholar 

  49. Miller, W. R., & Wilbourne, P. L. (2002). Review: Mesa Grande: a methodological analysis of clinical trials of treatments for alcohol use disorders. Addiction, 97, 265–277.

    PubMed  Article  Google Scholar 

  50. Orford, J. (2013). Power, powerlessness and addiction. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  51. Robins, L. N. (1993). Vietnam veterans’ rapid recovery from heroin addiction: a fluke or normal expectation? Addiction, 88(8), 1041–1054.

    PubMed  CAS  Article  Google Scholar 

  52. Robinson, T. E., & Berridge, K. C. (2002). The psychology and neurobiology of addiction: an incentive–sensitization view. Addiction, 95(8s2), 91–117.

    Article  Google Scholar 

  53. Rubak, S., Sandbæk, A., Lauritzen, T., & Christensen, B. (2005). Motivational interviewing: a systematic review and meta-analysis. British Journal of General Practice, April, 305–312.

  54. Selbekk, A. S., Sagvaag, H., & Fauske, H. (2014). Addiction, families and treatment: a critical realist search for theories that can improve practice. Addiction Research and Theory, Early Online.

  55. Simmons, J. (2006). The interplay between interpersonal dynamics, treatment barriers, and larger social forces: an exploratory study of drug-using couples in Hartford, CT. Substance Abuse Treatment, Prevention, and Policy, 1(12), 1–12.

    Google Scholar 

  56. Valverde, M. (1998). Diseases of the will: Alcohol and the dilemmas of freedom. Cambridge: Cambridge University Press.

    Google Scholar 

  57. Weiner, B. (1986). An attributional theory of motivation and emotion. New York: Springer.

    Book  Google Scholar 

  58. White, W. L., Kelly, J. F., & Roth, J. D. (2012). New addiction-recovery support institutions: mobilizing support beyond professional addiction treatment and recovery mutual aid. Journal of Groups in Addiction & Recovery, 7(2–4), 297–317.

    Article  Google Scholar 

  59. Wilkes, E., Gray, D., Saggers, S., Casey, W., & Stearne, A. (2010). Substance misuse and mental health among aboriginal Australians. In N. Purdie, P. Dudgeon, & R. Walker (Eds.), Working together: Aboriginal and Torres strait islander mental health and wellbeing principles and practice (pp. 117–134). Canberra: Commonwealth of Australia.

    Google Scholar 

  60. Wilkinson, R. G., & Marmot, M. G. (2003). Social determinants of health: The solid facts. Geneva: World Health Organisation.

    Google Scholar 

  61. Wilson, R. A. (1997). Cartesian psychology and physical minds: Individualism and the science of the mind. Cambridge: Cambridge University Press.

    Google Scholar 

  62. Zinberg, N. E. (1984). Drug, set, and setting: The basis for controlled intoxicant use. New Haven: Yale University Press.

    Google Scholar 

Download references

Acknowledgments

I am grateful to Anne Schanche Selbekk for her feedback on this article.

Funding

The author did not receive funding support for this work and, to his knowledge, has no relationship to any other activity that benefits directly from alcohol, gambling and other dangerous consumption industries. The author has participated in research teams funded by a government administered levy on gambling.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Peter J. Adams.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Adams, P.J. Switching to a Social Approach to Addiction: Implications for Theory and Practice. Int J Ment Health Addiction 14, 86–94 (2016). https://doi.org/10.1007/s11469-015-9588-4

Download citation

Keywords

  • Family inclusion
  • Social approach
  • Bio-medical approach
  • Community engagement
  • Treatment interventions