Concept of the Month -- November 2002

"Addiction" -- the disease concept in treating criminals

The debate goes on.  Is addiction a "disease" and, if so, in what sense?  Surely, one does not catch the "disease" as one does the flu or some other contagious illness.  The person chooses to empty the bottle, inject or ingest a particular substance, or smoke a "joint" of marijuana.  The role of personal choice is critical. A disease, in the medical sense, is something that one turns to a doctor for in order to be cured.  This model definitely has its limitations with criminals.  Over the years, I have heard many say, "I didn't do it; my disease did" speaking of a crime (including homicide).  Of course, drugs bring out only what already resides within the person.  Although I have found the disease model to have its limitations, the "relapse" concept is sound. If the user takes a sip of beer, he risks opening the door all the way. The need for sobriety is unequivocal.  Why would a person who has come close to ruining his own life and that of others  take the risk of drinking a beer if he truly was committed to significant and enduring change? If one is to subscribe to the disease model, and utilize it when working with offenders, take care that the criminal does not latch on to it and use it as yet another excuse.  And do make use of what is helpful from the model -- i.e., never putting oneself at risk through relapse. 

Stanton E. Samenow, Ph.D.

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