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People debate all the time about the disease model and addiction. Whether or not addiction is a disease, it nevertheless remains 100% treatable for those who seek help. One huge drawback to the disease model theory is that when addicts or alcoholics are told that they suffer from an incurable disease, they immediately are able to put the blame elsewhere and lose the accountability needed to change.
One of the most important elements in moving alcoholics or addicts to sobriety is their accepting responsibility for the addiction and associated behaviors. However, because addicts and alcoholics are all about shirking responsibility, the disease model concept can be counter-productive to them getting well. We do not believe in encouraging people to believe they suffer from a lifelong disease for which there is no known cure, as some groups want you to believe. Some of the most successful forms of treatment are ones that do not focus on the disease model and make addicts and alcoholics accountable for their behaviors and actions.
The Birth of the Disease Model and Addiction
In the original book for Alcoholics Anonymous, there is no reference to alcoholism as a disease. Prior to 1960, AA groups had a success rate of between 75-80%. Now, the success rate has declined to about 5%. What happened to cause such a drastic change? In 1956, the American Medical Association classified addiction as a disease, enabling doctors to treat addiction and bill insurance companies for it. Soon afterwards, the American Psychologists Association followed suit. As a result of the medical community and insurance companies getting involved, the overall success rates at treatment centers decreased dramatically because now everyone entering treatment was just given medication by a doctor or psychiatrist and asked to leave in 28 days or less, which is the limit imposed by insurance companies.
The path to successful treatment of alcoholics is to make them accountable and responsible for their problems, to have them work with others with similar problems, and to gain knowledge about the underlying issues as to why they abused substances in the first place. Today, solid one-on-one therapy and professional counseling have been replaced by doctors, psychiatrists, large doses of medication, dual diagnosis theories, and mental illness labels.
Although there are times when medications are helpful, such as when mental illness is present, the goal of our intervention group and the treatment centers we work with is to help people get well. This is achieved by not just treating their symptoms with medications and labeling them with a disorder shortly after arriving for treatment. After all, isn’t that what they were doing in the first place—medicating their own symptoms with alcohol or street medications?