Beyond Addiction: Accepting Sobriety in Life

Comprehending Addiction: Integrating Social Learning Theories with Social Scientific Models

Studying Social Learning Models in the Context of Addiction

Theory of social learning

According to Albert Bandura’s 1977 social learning theory, people pick up addictive behaviors by watching and copying role models in their social surroundings. The reinforcement and punishment experienced by an individual from others can impact their propensity to engage in and maintain similar addictive behaviors. According to the reciprocal determinism concept, behavioral, environmental, and personal factors function in concert to determine addictive behavior. Consequently, every dynamic aspect of the biopsychosocial illness is the focus of effective treatment.

Model of transtheory (stages of transition)

According to the transtheoretical model of transformation, beating an addiction is a multi-stage, step-by-step process.

Precontemplation: People go through this preliminary phase before they think about changing their behavior. They may not understand the need for change because they are unaware of or in denial about their addiction.

The stage of contemplation is when people start to recognize the issues their addiction is causing them and are thinking about making a change. Even if they might not give it their all, they consider the advantages and disadvantages of changing.

People in this stage are preparing for a shift in circumstances. They may have started modestly with commitments or information gathering as a prelude to changing their behavior.

In order to address addictive behavior, action entails actively changing behavior through the implementation of precise, noticeable adjustments. The action stage calls for a large investment of time and energy.

Maintenance: Following a successful change’s implementation, people go on to the maintenance stage, where they strive to maintain the new behavior and avoid relapsing. Consolidation of gains and continuous effort are characteristics of this stage.

Termination/relapse prevention: This stage focuses on identifying and resolving variables that may lead to a return to previous behaviors, acknowledging that relapse is a common aspect of the change process. With the ultimate goal of totally eradicating or ceasing the targeted habit, relapse is seen as a chance for learning and approach modification.

The transtheoretical approach can aid in the development of customized behavioral interventions that can encourage long-term transformation. As people transition between stages, progress through them may not necessarily happen in a straight line. It is acknowledged that resistance to change is a normal element of the process.

Both individuals and society at large suffer from the “astoundingly high financial and human toll” that addiction causes. The aggregate economic burden on society in the United States is higher than the entire cost of all forms of diabetes and all cancers put together. These expenses result from long-term consequences (such as lung cancer from tobacco products, liver cirrhosis and dementia from chronic alcohol consumption, and meth mouth from methamphetamine use), the direct negative effects of drugs and related healthcare costs (such as emergency medical services and outpatient and inpatient care), the loss of productivity and related welfare costs, fatal and non-fatal accidents (such as traffic collisions), suicides, homicides, and incarceration, among other things.

According to data from the US National Institute on Drug Abuse, the number of overdose deaths in the US between 2002 and 2017 nearly tripled for both males and females; 72,306 overdose deaths were recorded in the US in 2017. With 81,000 overdose deaths over a 12-month period, 2020 broke the record set in 2017 and became the year with the highest number of overdose deaths.

learn about case book work’s social science models of addiction

Biopsychosocial, Cultural, and Religious

Addiction is a complex condition involving components of biology, psychology, society, culture, and spirituality (biopsychosocial–cultural–spiritual), while being classified medically as a neuropsychological problem. A biopsychosocial, cultural, and spiritual approach encourages interdisciplinary thinking and holistic perspectives on addiction. For instance, a biopsychosocial–cultural–spiritual approach takes into account the ways in which physical environments impact experiences, routines, and addictive tendencies.

Understandings of addiction that are biopsychosocial, cultural, and spiritual have been shaped by ethnographic engagements and advances in knowledge domains. One such example is the work of Philippe Bourgois, whose observations of street-level drug dealers in East Harlem highlight the connections between drug use and structural oppression in the US. The following earlier models have influenced the current biopsychosocial–cultural–spiritual understanding of addiction:

Cultural paradigm

Dwight Heath created the cultural model, an anthropological explanation of how drug use and abuse started. Heath conducted fieldwork and anthropological study with the Bolivian Camba people from June 1956 to August 1957.

At least twice a month, Heath said, adults in the community drank “large quantities of rum and became intoxicated for several contiguous days.” This regular heavy drinking, which led to intoxication, was usually done in a social setting during festivals. Returned in 1989, Heath noted that although much had changed, ‘drinking parties’ continued as before and ‘there appear to be no detrimental effects to anyone’. Heath’s observations and conversations demonstrated that the Camba community respected and encouraged high alcohol consumption as a social behavior that strengthened social ties.

The Camba did not recognize alcoholism, a type of addiction, despite their regular intoxication—”even to the point of unconsciousness”—and there were no overt signs of addiction or alcohol-related social problems.

Merrill Singer pointed out that Heath’s findings cast doubt on the idea that alcohol is socially “inherently disruptive” when paired with later cross-cultural encounters. Heath’s ‘cultural model’ was introduced after this fieldwork, implying that ‘issues’ related to binge drinking, such alcoholism (a recognized kind of addiction), were cultural in nature. In other words, alcoholism is influenced by cultural ideas and differs between cultures. The idea that “continuous use (alcohol) is inexorably addictive and detrimental to the consumer’s health” was refuted by Heath’s research.

Sociologist Robin Room, among others, did criticize the cultural model, arguing that anthropologists could “downgrade the severity of the problem”. Merrill Singer observed that ethnographers operating within the framework of the cultural model belonged to the ‘wet generation,’ which was’socialized to view alcohol consumption as normal’ despite being aware of the ‘disruptive, dysfunctional and debilitating effects of alcohol consumption’.

Model of subculture

In the past, the etic approach on addiction has defined addicts by the pathology of their illness. The cultural model was applied in anthropological studies investigating drug subculture activities in the West as drug use reports rose quickly.

The methodology changed from the ethnographic investigation into the lived realities and subjectivities of drug subcultures in the 1960s and 1970s. Edward Preble and John J. Casey’s groundbreaking book “Taking care of business” provided a unique window into the vibrant social environments and activities that surrounded the drug use of New York street-based intravenous heroin users by documenting their everyday lives in great detail.

These studies conceptualize substance misuse as a social phenomena, challenging common conceptions of immorality and deviance. Drug use behaviors can be influenced more by the dominant culture than by the physiological and psychological effects of the drug.

Drug subcultures can offer marginalized people a social network, symbolic value, and a socially manufactured purpose that they may not feel is possible to achieve through traditional channels. The subcultural model highlights the necessity for an integrated strategy by illuminating the complexity of addiction. It argues that in order to comprehend addiction holistically, a biosocial approach is necessary.

Model of Critical Medical Anthropology

The critical medical anthropology concept emerged in the early 1980s and, according to Merrill Singer, ‘was applied immediately to the examination of drug use’. The critical medical anthropology model, which took into consideration drug use and addiction within the context of larger political systems, economic disparities, and institutional power over social processes, revealed the body politic, whereas the cultural model of the 1950s looked at the social body.

The three concerns highlighted in the model, which are extremely pertinent to addiction, are:

• Taking drugs by yourself
• The creation of misery in society
• Political economy (drugs, illicit and otherwise)

These three main ideas show how the politics of the legal and illegal drug markets are intertwined with the psychological trauma that results from socio-political injustice and inequality. Anthropologists employ social suffering—defined as “the misery among those on the weaker end of power relations in terms of physical health, mental health, and lived experience”—to examine how people’s personal issues may be influenced by their access to political and financial power. From the standpoint of critical medical anthropology, these larger-scale imbalances in power lead to heavy drug use and addiction.

The three models that are proposed here—the Critical Medical Anthropology Model, the Cultural Model, and the Subcultural Model—show that addiction is not a condition that should simply be viewed from a biological perspective. A holistic and thorough understanding of addiction can be developed by taking into account the biological, psychological, social, cultural, and spiritual (biopsychosocial–spiritual) factors that impact its experience.

Final Thoughts | Addiction in Case Book Work

To sum up, studying addiction through case studies provides priceless insights into the nuances of drug use problems in authentic settings. By analyzing specific cases, we are able to reveal the complex interactions between social dynamics, personal experiences, and institutional elements that lead to addiction. In addition to illuminating the various forms of addiction, these case studies emphasize the value of comprehensive evaluations and tailored interventions in meeting the needs of those who are abusing substances.

In addition, case book work is a driving force behind the improvement of clinical procedures, treatment methodologies, and the formulation of addiction-related policies. Through methodical documentation and analysis of cases, practitioners are able to discern patterns, evaluate treatment outcomes, and customize interventions to suit the distinct requirements of every client. Moreover, the incorporation of heterogeneous viewpoints from case studies facilitates a more profound comprehension of addiction in numerous settings, opening doors for multidisciplinary cooperation and inventive approaches to addiction treatment.

Addiction in case book work essentially emphasizes the value of customized, research-based methods in the field of addiction recovery and therapy. We can increase our combined efforts to combat addiction, promote recovery, and assist people on their journey towards health and well-being by utilizing the rich insights gained from case studies.

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Tirachard Kumtanom, Wouter de Jong ,subbu noir ,Karolina Grabowska, Min An.