The legal model is based on trying to prevent addiction and the damage it can cause by a combination of legislation, education, control, deterrence and the use of the criminal justice system. Some substances such as alcohol and prescription drugs are controlled; others are illegal. While this model disrupts the production and supply of drugs to addicts it has proved ineffective in preventing access to drugs or their continued misuse. Criminalising the use of these drugs has natural consequences which may, or may not, help in dealing with those who are addicted.
The medical model assumes that the addict has a clinical problem that can be addressed by the application of appropriate treatment and medication. This assumes that addicts first recognise their problem and want to be cured. While this can be effective, in most cases what results is seldom a cure but more often a regime that allows the addict to cope with their addiction through alternative medication or other coping mechanisms such as avoidance (eg avoidance “once an alcoholic always an alcoholic.”).
The social model treats the addiction in the contextual environment of the addict. Here the addiction is treated alongside addressing those wider circumstances eg housing, mental illness, criminality and family relationships rather than simply the addictive behaviour. The various problems in an addict’s life often have multiple causes and effects and can only be properly addressed holistically. Addicts often need considerable support if they are to be helped to change their environment to one where the temptation to turn back to their addiction is minimised.
Stephen Morse, Professor of Psychology and Law in Psychiatry at the University of Pennsylvania presents a very clear description of the three models in his paper entitled Hooked on Hype: addiction and responsibility.
All three models have their part to play in overcoming addiction. For many the move to seek help comes first from the individual addict recognising their problem; others require the intervention of another agency, most often, the justice system.
All people are individuals and thus require different approaches. Thus whatever strategies, policies, initiatives and interventions are used must be person centred and provide holistic care for the individual. We recognise that poverty makes a considerable contribution to the difficulties in overcoming addiction. In the end, however, we remain in no doubt that positive and supportive relationships are what carry people through and enable the most effective recovery.
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