HISTORICAL UNDERSTANDING OF ADDICTION



Episodic intoxication in traditional societies
•Substance use known throughout time and cultures •Limited access – psychoactive substances are
rather rare and expensive •Heavy societal control for who, when and where can have access to. E.g.:
•heavy drinking during festivals and important social situations
•altered states of mind during religious rituals
•use for medical purposes (e.g. pain relief)

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Epidemic spread of drugs
•16th century
•New discoveries and globalisation of trade
•Cheap and slave labour
•Advancement in agricultural technology
•Intensification of substances – more potent, cheaper, easily transportable, available worldwide
• 1) introduction of tobacco in Europe and Asia, 2) export of cheap alcohol to Europe, 3) export of
opium to far east Asia and Europe
•First attempts to solve the problem: taxation and market limitation

https://upload.wikimedia.org/wikipedia/commons/thumb/b/b6/Opium_imports_into_China_1650-1880_EN.svg
/1280px-Opium_imports_into_China_1650-1880_EN.svg.png


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Addiction as immoral/criminal conduct
•The first model of addiction (appeared in 16th century) and still living today
•Substance use is not seen as a disease but as a personal moral failure, sinful and criminal act
•Excessive substance use is considered as a behaviour of choice and not as loss of control and thus
subject of legal action and punishment
•Understanding still preferred right-wing political ideology. E.g. war on drugs
•It is simple, clear and straightforward
•BUT it is oversimplification and in contradiction to current knowledge (e.g. genetic
predisposition). And leading to even bigger problems  - escalation of violence, organized crime
networks, prisons overload
•

http://s1.ibtimes.com/sites/www.ibtimes.com/files/styles/embed/public/2016/07/13/philippines.jpg



‘They Are Slaughtering Us Like Animals’ - The New York Times - Mozilla Firefox
http://www.nytimes.com/interactive/2016/12/07/world/asia/rodrigo-duterte-philippines-drugs-killings
.html?_r=0

‘They Are Slaughtering Us Like Animals’ - The New York Times - Mozilla Firefox



Russia: The silent HIV epidemic | Focus on Europe - Spotlight on People | DW | 29.11.2018 - Mozilla
Firefox Stigma means Russia risks HIV epidemic as cases rise | World news | The Guardian - Mozilla
Firefox Russia’s HIV/AIDS epidemic is getting worse, not better | Science | AAAS - Mozilla Firefox
Russia’s HIV/AIDS epidemic is getting worse, not better | Science | AAAS - Mozilla Firefox Stigma
means Russia risks HIV epidemic as cases rise | World news | The Guardian - Mozilla Firefox

Addiction as immoral conduct
•Believe in just world (just world hypothesis)
•
•Consequences are result of one's actions (you reap what you sow)
•Often used as blaming of the victims of crimes, poverty etc. (raped woman was too seductive; poor
people are too lazy,…)
•Connected to believe in destiny and higher order - often found in right-wing and religious
ideology
•Guilt reduction, discomfort reduction (discomfort caused by empathy with victims), anxiety
reduction (anxiety caused by uncertainty and unpredictable world)
•
•The poor homosexuals — they have declared war upon nature, and now nature is exacting an awful
retribution (Pat Buchanan, 1983) – summary of why not doing anything with spreading HIV epidemic in
US during Reagan‘s administration
•
•

Temperance model of addiction
•In the most primitive form – preternatural model – the substances are demonic and can take
possession over human mind  (demon alcohol)
•Addict does not have ability to control him/herself
•Addiction is a form of involuntary mental condition
•It is the substance to be blamed
•It is reasonable to abstain from the use completely
•Sympathize with addicts but rejects mild users
•

Temperance model of addiction
https://upload.wikimedia.org/wikipedia/commons/thumb/7/7d/Benjamin_Rush_Painting_by_Peale.jpg/220px
-Benjamin_Rush_Painting_by_Peale.jpg
•Benjamin Rush (1745-1813)
•Founding fathers of the United States
•Founding father of American Psychiatric Association •Alcohol use is behind poverty, health issues,
violence, crime, family disruptions •Addiction is also a disease – addicts should be treated
•Taste not, handle not, and touch not!
•

National Council of IOGT - USA - Mozilla Firefox
International Organization of Good Templars


https://images.vice.com/noisey/content-images/contentimage/23665/straight-edge.jpg
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http://pre11.deviantart.net/19d2/th/pre/f/2015/341/e/f/i_m_19_years_old_and_i_m_straight_edge__by_h
adiali-d9jdzz5.png

Illness & personality disorder models of addiction
•Evolved in 1800s in USA – asylums in rural areas that supported people with food and shelter. No
access to the substance
•People in such treatment where in miserable conditions and had to accept themselves as ill. Often
moral semi-religious treatment
•
•
•Addict has a personality disorder – excessive substance user often shows array of antisocial and
maladaptive behaviours.
•The person is untreatable and unrepairable
•Rise of self-help communities

12 step program – Alcoholics Anonymous
•1939 - Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from
Alcoholism
•
•self-help group
•admitting that one cannot control one's alcoholism, addiction or compulsion;
•recognizing a higher power that can give strength;
•examining past errors with the help of a sponsor (experienced member);
•learning to live a new life with a new code of behavior;
•helping others who suffer from the same alcoholism, addictions or compulsions.
•
•newcomers to becoming aware of their lack of ability to control their behaviour (steps 1 through 3
)
•to expand self-examination and incorporate the outcomes of self-reflection into actions (steps 4
through 9 )
•focus on maintaining positive changes in behaviour and the recovery process. The recovery process
includes attending meetings, listening to other members at different recovery stages and working
with a sponsor, who is an experienced member who is encouraged to complete all of the steps (steps
10 through 12 )

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List of twelve-step groups - Wikipedia - Mozilla Firefox (Anonymní prohlížení)