NCJ Number
60992
Journal
Contemporary Drug Problems Volume: 6 Issue: 4 Dated: (1977) Pages: 553-568
Date Published
1977
Length
16 pages
Annotation
AN EVALUATION OF CONCEPTUAL MODELS OF ALCOHOL ABUSE, INCLUDING THE DISEASE MODEL, CHALLENGES ASSUMPTIONS AND COULD LEAD TO CHANGES IN SELF-IMAGE, AND IN PUBLIC POLICY.
Abstract
THE TRADITIONAL APPROACH TO ALCOHOL ABUSE HAS BEEN TO TREAT IT AS A DISEASE, STRESSING ITS PROGRESSIVE NATURE, AND REACHING TO THE PERSON WHEN HE IS 'BOTTOMED OUT.' SELF-REFERRAL BEFORE THE NADIR IS AS UNLIKELY, BECAUSE OF THE STIGMA ATTACHED TO THE ALCOHOLIC. SUCH ABNORMAL BEHAVIOR MAY ALSO BE EXPLAINED BY A SOCIAL LEARNING MODEL, THAT THE DRINKER IN THIS CASE HAS NEVER LEARNED TO DRINK MODERATELY. PRECURSORS OF THE HABIT ARE NOTED, SUCH AS THE LIKELIHOOD OF BIOLOGICAL PREDISPOSITION, CULTURAL EXPECTATIONS, AND OTHER SOCIAL SKILLS. THE ROLE OF ALCOHOL AS POSITIVE REINFORCEMENT IS ALSO EXPLAINED. TREATMENT GOALS UNDER SUCH A MODEL ARE DIFFERENT THAN THOSE UNDER A MODEL WHICH SEES DISEASE AS A CAUSE AND ABSTINENCE AS THE ONLY CURE. SCIENTIFIC EVIDENCE IN THE SOCIAL LEARNING MODEL SHOWS THAT MODERATION IN DRINKING CAN BE TAUGHT. THE APPROACH TO TEACHING THIS MODERATION IS EXPLAINED, INCLUDING VIDEOTAPE FEEDBACK, DISCRIMINATION TRAINING TO MORE READILY IDENTIFY BODILY SIGNALS, AND DEVELOPMENT OF ALTERNATIVES TO DRINKING. A TWELVE MONTHS' FOLLOWUP OF THE TWO PROCEDURES SHOWED SIGNIFICANT DIFFERENCE IN FAVOR OF THE SOCIAL LEARNING MODEL'S METHODS. THE POLICY IMPLICATIONS ARE IN: (1) EDUCATION WHICH SHOULD OFFER GUIDELINES TO NORMAL DRINKING, AND COPING SKILLS THAT ALLOW USE OF ALCOHOL WITHOUT DEPENDENCE; (2) MEDIA, WHICH NOW PRESENTS MISUSE OF ALCOHOL IN AN INAPPROPRIATE WAY, COULD BE USED TO PRESENT MORE POSITIVE MODELS; (3) LAW CAN LIMIT THE USE OF, AND ACCESS TO ALCOHOL; (4) TREATMENT WORKS BEST WITH EARLY INTERVENTION. THE SOCIAL LEARNING MODEL OF ALCOHOL ABUSE YIELDS BETTER PREVENTION AND EARLY TREATMENT OF THE PROBLEM, WITH A SCIENTIFIC BASIS FOR TREATMENT. (RFC)