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.
Buy single article
Instant access to the full article PDF.
Price includes VAT (USA)
Tax calculation will be finalised during checkout.
Adams, P. J. (2008). Fragmented intimacy: Addiction in a social world. New York: Springer.
Alexander, B. K. (2012). Addiction: the urgent need for a paradigm shift. Substance Use & Misuse, 47(13–14), 1475–1482.
Blume, A. W. (2005). Treating drug problems. New Jersey: Wiley.
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.
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.
Buchman, D. Z., Illes, J., & Reiner, P. B. (2011). The paradox of addiction neuroscience. Neuroethics, 4(2), 65–77.
Carroll, K. M., & Onken, L. S. (2005). Behavioral therapies for drug abuse. American Journal of Psychiatry, 162(8), 1452–1460.
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.
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.
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.
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.
Courtwright, D. T. (2009). Forces of habit: Drugs and the making of the modern world. Cambridge: Harvard University Press.
Cunningham, J. A., & McCambridge, J. (2012). Is alcohol dependence best viewed as a chronic relapsing disorder? Addiction, 107(1), 6–12.
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.
Davies, J. B. (1992). The myth of addiction: An application of the psychological theory of attribution to illicit drug use. Chur: Harwood Academic.
Depelteau, F. (2008). Relational thinking: a critique of co-deterministic theories of structure and agency. Sociological Theory, 26(1), 51–73.
DiClemente, C. C. (2005). Addiction and change: How addictions develop and addicted people recover. New York: Guilford Press.
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.
Durie, M. (2001). Mauri Ora: The dynamics of Maori health. Melbourne: Oxford University Press.
Einstein, S. (Ed.). (1980). The community’s response to drug use. New York: Pergamon Press.
Elster, J., & Skog, O.-J. (Eds.). (1999). Getting hooked: Rationality and addiction. Cambridge: Cambridge University Press.
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.
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.
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.
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.
Gergen, K. J. (2009). Relational being: Beyond self and community. Cary: Oxford University Press.
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.
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.
Heath, D. B. (2000). Drinking occasions: Comparative perspectives on alcohol and culture. Philadelphia: Brunner/Mazel.
Heather, N. (1998). A conceptual framework for explaining drug addiction. Journal of Psychopharmacology, 12(1), 3–7.
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.
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.
Hyman, S. E. (2005). Addiction: a disease of learning and memory. American Journal of Psychiatry, 162(8), 1414–1422.
Kalant, H. (2010). What neurobiology cannot tell us about addiction. Addiction, 105(5), 780–789.
Keane, H. (2002). What’s wrong with addiction. Melbourne: Melbourne University Press.
Klostermann, K., & O'Farrell, T. J. (2013). Treating substance abuse: partner and family approaches. Social Work in Public Health, 28(3–4), 234–247.
Larkin, M., Wood, R. T. A., & Griffiths, M. D. (2006). Towards addiction as relationship. Addiction Research & Theory, 14(3), 207–215.
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.
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.
Leshner, A. I. (1997). Addiction is a brain disease, and it matters. Science, 278(5335), 45–47.
MacAndrew, C., & Edgerton, R. B. (1969). Drunken comportment: A social explanation. Chicago: Aldine Publishing.
Marlatt, G. A., & Donovan, D. M. (Eds.). (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviours (2nd ed.). New York: Guilford Press.
Marlatt, G. A., & VandenBos, G. R. (Eds.). (1997). Addictive behaviours: Readings on etiology, prevention and treatment. Washington, DC: American Psychological Association.
Marshall, M. (Ed.). (1979). Beliefs, behaviours and alcoholic beverages in cross cultural survey. Anne Arbor: University of Michigan Press.
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.
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.
Midanik, L. T. (2006). Biomedicalization of alcohol studies: Ideological shifts and institutional challenges. New Jersey: Transaction Publishers.
Midanik, L. T. (2010). The name game. Addiction, 105(12), 2053–2054.
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.
Orford, J. (2013). Power, powerlessness and addiction. Cambridge: Cambridge University Press.
Robins, L. N. (1993). Vietnam veterans’ rapid recovery from heroin addiction: a fluke or normal expectation? Addiction, 88(8), 1041–1054.
Robinson, T. E., & Berridge, K. C. (2002). The psychology and neurobiology of addiction: an incentive–sensitization view. Addiction, 95(8s2), 91–117.
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.
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.
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.
Valverde, M. (1998). Diseases of the will: Alcohol and the dilemmas of freedom. Cambridge: Cambridge University Press.
Weiner, B. (1986). An attributional theory of motivation and emotion. New York: Springer.
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.
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.
Wilkinson, R. G., & Marmot, M. G. (2003). Social determinants of health: The solid facts. Geneva: World Health Organisation.
Wilson, R. A. (1997). Cartesian psychology and physical minds: Individualism and the science of the mind. Cambridge: Cambridge University Press.
Zinberg, N. E. (1984). Drug, set, and setting: The basis for controlled intoxicant use. New Haven: Yale University Press.
I am grateful to Anne Schanche Selbekk for her feedback on this article.
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.
About this article
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
- Family inclusion
- Social approach
- Bio-medical approach
- Community engagement
- Treatment interventions