Activity 3: What are addictions? Why are they so difficult to treat?

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Topic Progress:

Introduction

Continuing with the theme of self-awareness, we now move to your self-awareness of evidence-based practice. We begin by thinking about how you conceptualize the reasons that people use substances and why some people develop substance use disorders while others do not. A wealth of information is available about the nature, cause, and maintenance of substance use; and the misuse and development of substance use disorders. Similarly, a plethora of research reports on effective treatments also are available. However, a gap remains between what the empirical research identifies as effective and what the substance use workforce practices. Why is this the case?

Substance use disorders continue to be a major social problem despite the serious negative individual and societal, social, health, and economic consequences. In part, this problem continues because of the complex, chronic, and relapsing nature of the disorder—it does not have a simple causation. In Chapter 2 of your textbook, Bickel and Potenza (2006) propose a view of addiction as a complex self-organizing system. This activity asks you to consider your perspective on the etiology of addictions and whether your treatment approaches are consistent with your attitudes and values related to the causes of substance use/problems.

Instructions

  1. Read the following:
    • Carroll, K., & Miller, W. (2006). Defining and addressing the problem. In W. Miller & K. Carroll (Eds.), Rethinking substance abuse: What the science shows, and what we should do about it (pp. 3–7). New York, NY: Guildford Press.
    • Bickel, W., & Potenza, M. (2006). The forest and the trees: Addiction as a complex self-organizing system. In W. Miller & K. Carroll (Eds.), Rethinking substance abuse: What the science shows, and what we should do about it (pp. 8–24). New York, NY: Guildford Press.
  2. Consider the following questions:
    • How would you describe the etiology (cause) of addictions to a friend/client/supervisor?
    • What do you think are the individual factors associated with the development of substance use problems?
    • What do you think are the societal factors associated with the development of substance use problems?
    • How do you explain that despite a strong research base, substance use disorders are so difficult to treat?
    • Are your treatment approaches consistent with your perspectives on the etiology of substance use?
    • How could society respond differently to reduce the onset and maintenance of the socio-economic harms caused by substance use disorders?