Return to Dr. Samenow's Homepage There is a predisposition in some families toward substance abuse. And people do develop a physiological dependence. However, in working with people who are antisocial, there are real problems in using a disease model. First, people choose what to put into their bodies. Drug use is a choice! People also make a series of choices as to whether to persist with drug use or stop. Some go "cold turkey". In other words, the individual has a role in whether he has the "disease" unlike most diseases. For the antisocial person, the disease is one more excuse. One murderer said, "I didn't do the crime. My disease did." Who chose to use drugs against all warnings? Who chose to assume the risks? The aspect of the disease model that may be useful is the idea of "relapse" -- one sip of the alcoholic punch can open the door to going all the way.