Addiction Morality: GateHouse Treatment Explores the Arguments from All Sides

Addiction morality: Is addiction simply an issue of lagging morality? When someone has no personal experience battling alcoholism or drug addiction, it can be challenging to see them as diseases rather than moral issues. Conversely, when you see others repeatedly fall short right before your eyes, regardless of how motivated they are to improve their circumstances, the belief that their morality is lacking becomes an infirm foundation upon which to make a judgment. The team at GateHouse Treatment has seen this struggle up close, with many having had the experience themselves, which is why we wanted to weigh in on the debate.

An open-access article from the “Journal of Addiction Research & Therapy” identifies the basis of each argument. It mentions, “Scholars have long attempted to explain the factors that lead to alcoholism. Indeed, various attempts to characterize alcoholism have been made using various models, including the moral model, the public health model, the temperance model, the disease model, the harm reduction model, the social education model, and the neurobiological model.” 

GateHouse Treatment wants to be your resource for the facts, so we’re going to break down the core of these models for a better idea of what the community used to think to be accurate and what the thinking is now.

Addiction Morality: The Moral Model (Morality) vs. the Disease Model (Addiction)

When you simplify their list of models, all the additional types are subsects of the primary two: the moral model and the disease model. This reduction means, almost immediately, we return to “Choice vs. Disease,” creating a circular argument. The social education and temperance models fall under the moral model. The disease model is the parent of public health, neurobiological, and harm reduction models. The article goes into great depth into the history and distinguishment but may have left room for common ground.

The moral model implies that a person addicted to alcohol or drugs has a character flaw. It “classifies a drunkard as morally weak.” Under the auspices of this model, the root of alcoholism is sin, and anyone who chronically consumes alcohol does so by choice and can stop drinking at any time. The moral model depicts alcoholism as a defect of the morally corrupt.

Skip ahead to 2016, when the sitting Surgeon General held a conference that took a stance and backed a different model. “US Surgeon General Vivek Murthy wants Americans to see addiction as a brain disorder instead of a moral failing.” This declaration was just the icing on the cake of the medical, psychological, and psychiatric communities, which all took the same position. “But one important change is Murthy’s explicit statement that addiction should be seen as a medical condition.”

Addiction Morality: Alcoholism as a Disease – The Early Years

During the early 1960s, Dr. Emil Jellinek introduced the disease concept of addiction. At that point, alcoholism began transitioning from being perceived solely as a moral problem to one related to physical and psychological health. With this insight into etiology and psychology, the scientific community began to embrace the idea that alcoholism has the pathology of a disease.

Like many other diseases, the impact is unique to each person, which made the acceptance of this declaration slow for many in the general public. When “Person A” can drink alcohol or ingest narcotics seemingly without repercussions, why can’t “Person B?” Or anecdotal stories like, “My cousin had a problem, but she prayed on it and never had another drink in her life!” Even with no concrete evidence or scientific backing, such stories make people more comfortable than the thought that it could be a generational issue with a DNA component. It was more difficult to believe that the enemy could be from within.

Addiction Morality: Which Model Is Widely Accepted?

While Jellinek’s disease model has been embraced overwhelmingly in the therapeutic community, the notion of individuals having a character defect continues to show traction in the public’s perception of addiction. With the paradigm shift from a moral framework to a treatment modality comes the misconception that the disease model minimizes personal responsibility for people’s drinking habits. However, the disease model aims to identify the pathology of alcoholism and establish treatment practices. Therefore, it is essential to explore the non-academic sources that contribute to the moral judgments attached to alcoholism.

Addiction Morality: What is the Moral Attraction to Choice Over Disease?

When arguing a position as to which model seems frivolous, we have to recognize that if doctors, scientists, psychologists, and psychiatrists are not convincing enough, then logic isn’t going to work. So why not meet in the middle and try wisdom? 

An excerpt from the above article presents a door: “With the paradigm shift from a moral framework to a treatment modality comes the misconception that the disease model minimizes personal responsibility for people’s drinking habits.” Defining this thinking as a “misconception,” admits that what addicts do while under the influence can often be immoral and highly harmful. The disease model does not denounce this. And those who say “choice” likely understand it as well. We do not want to get lost in the behavior’s genesis as opposed to the results of the actions themselves.

Addressing it not from the standpoint of “is it right or wrong?” but more, “it just is,” turns the attention to how addiction is best treated. There is a difference between fault and responsibility. The disease model shifts from faulting the addict to placing the responsibility in their hands to change. If the “disease model” side validated the point that their argument is about “cause” rather than “effect,” and the “choice side” compassionately conceded to the intense realism that “it just is,” we would have a starting point devoid of judgment and the need to be right sharing a common goal: Change.

GateHouse Treatment is Here to Help Institute that Change

We understand the difficulty surrounding and overcoming addiction. Many of our counselors and case managers have been there themselves. But rather than shifting our attention to what causes it, it is better to focus on what our clients can do to improve. Our goal is not to demean someone for having become an addict. We aim to help them chart a course for better habits and outcomes.

If you have any questions or concerns, contact us today at (855) 448-3588. We are available to you 24 hours a day/7 days a week!

GateHouse Treatment Editorial Staff
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