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the Disease Model of Addiction

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 Most addiction professionals are quite comfortable with the Disease Model of Addiction and consider addiction is the following:


  • A Primary Disease where the focus should be on accepting the disease, doing something about it, not analyzing how and why the client became addicted.
  • A Progressive Disease which will get worse if not intervened with. Thus clients and families should be embracing recovery sooner rather than later; they should not enable the disease to progress and to have the addicted person suffer longer.
  • A Feeling Disease where substances are used to numb feelings or produce a high.


Dr. Hanes-Stevens alerted us that some minority populations may have trouble with the Disease Model, and that sensitivity to their challenges is important in treatment. Here are awarenesses to consider:


  • Primary Disease - Some African-Americans may believe that legal, financial and social problems are the cause of the addiction, not the result of a Primary Disease. Rather than focus on the addicted person, some may challenge the emphasis on treatment, feeling that the causative legal, financial and social problems are not confronted and addressed. (This concern is at the heart of the debates Bill Cosby's statements have provoked, where he has been challenged for his rebuke of African-American parenting)
  • A Progressive Disease - Some populations have been taught to tolerate problems, be strong, be private about problems, to "tough it out".
  • A Feeling Disease - Minorities who have had to survive victimization by being strong, have learned which feelings are safe and OK to feel and which are not. Appreciating the central cultural messages will increase empathy for how to deal with feelings. It is hard to tell a person to surrender, be powerless and let go, when their minority position has necessitated that they be strong and embrace any power they can to survive.
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