VALUES AND BELIEFS: EXISTENTIAL MODELS OF ADDICTION

Existential models of addiction focus on beliefs, attitudes, and values of the drug users. For example, psychologists have found that problem drinkers and alcoholics anticipate greater benefits and more powerful effects from drinking than do other drinkers. These beliefs precede actual drinking experiences (Miller, Smith, & Goldman, 1990).

Beliefs about oneself and about the role of drugs or alcohol in one's life are sometimes called existential models (Greaves, 1980). Khantzian (1985) has proposed that addicts use drugs to offset or address specific problems they believe they have, such as a lack of confidence in social-sexual dealings, a view sometimes referred to as the adaptive model of addiction. According to Peele (1985), the individual becomes addicted to a substance because it fulfills essential intrapsychic, interpersonal, and environmental needs.

Views about oneself in regard to a substance-abuse problem are crucial for dealing with this problem. If the client and treatment personnel see the problem differently, in viewing it as a disease or not, for example, treatment will generally not succeed.

CULTURAL BELIEFS IN ADDICTION

Cultural differences are among the most powerful determinants of the patterns of substance use and the proclivity to addiction (Heath, 1982). For example, moderate drinking is inculcated as an early and firm cultural style among Mediterranean ethnic groups, the Jews and the Chinese. Such cultural socialization incorporates beliefs about the power of Alcohol and the nature of those who overindulge or misbehave when drinking. Groups such as the Irish, which invest alcohol with the power to control and corrupt their behavior, have high levels of Alcoholism (Vaillant, 1983). In contrast, Jews, Italians, and Chinese believe that those who overdrink are displaying poor self-control and/or psychological dependence, rather than responding to the power of the alcohol itself (Glassner & Berg, 1984). Similar cultural variations occur in views toward drugs such as Marijuana, Narcotics, Psychedelics, and Cocaine.

Cultural recipes for moderate consumption of alcohol and other drugs have been developed, although systematic cross-cultural empirical support for these models is weak. One cross-cultural survey of addictive (loss-of-control) behavior is MacAndrew and Edgerton's (1969) Drunken Comportment, which describes cultural beliefs that encourage overconsumption and drunken excesses. Yet cultural attitudes about alcohol and other drugs in relation to their misuse are generally regarded as cultural oddities, rather than scientifically meaningful factors in models of addiction.

VALUES

If individual and cultural beliefs have been given short shrift in addiction theories, then values have been considered in such models primarily as illustrations of moralistic prejudice.

Whereas a layperson might condemn the values of a mother who uses drugs or drinks excessively during pregnancy or of a person who assaults others when drunk or using drugs, some pharmacologically based theorists instead emphasize the potency of the drug and the irrevocable need of the person to obtain the drug at the cost of any other consideration whatsoever.

Peele (1987) turned this model on its head—claiming that people become addicted due to a failure of other values that maintain ordinary life involvements. In Peele's view, personal values influence whether people use drugs, whether they use them regularly, whether they become addicted, and whether they remain addicted. These values included prosocial behavior (including achievement, concern for others, and community involvement), self-awareness and intellectual activity, moderation and healthfulness, and self-respect. Evidence for the role of values in addiction are the explicit values people cite as reasons for giving up addictions to cocaine, alcohol, and nicotine (Reinarman, Waldorf, & Murphy, 1991).

(See also: Addiction: Concepts and Definitions ; Adjunctive Drug Taking ; Asia, Drug Use in ; Causes of Substance Abuse ; Expectancies ; Religion and Drug Use )

BIBLIOGRAPHY

Glassner, B., & Berg, B. (1984). Social locations and interpretations: How Jews define alcoholism. Journal of Studies on Alcohol, 45, 16-25.

Greaves, G. B. (1980). An existential theory of drug dependence. In D. J. Lettieri, M. Sayers, & H. W. Pearson (Eds.), Theories on drug abuse (pp. 24-28). Washington, DC: U.S. Government Printing Office (DHHS Pub. No. ADM 80-967).

Heath, D. B. (1982). Sociocultural variants in alcoholism. In E. M. Pattison & E. Kaufman (Eds.), Encyclopedic handbook of alcoholism (pp. 426-440). New York: Gardner Press.

Khantzian, E. J. (1985). The self-medication hypothesis of addictive disorders: Focus on heroin and cocaine dependence. American Journal of Psychiatry, 142, 1259-1264.

MacAndrew, C., & Edgerton, B. (1969). Drunken comportment: A social explanation. Chicago: Aldine.

Miller, P. M., Smith, G.T., &Goldman, M. S. (1990). Emergence of alcohol expectancies in childhood. Journal of Studies on Alcohol, 51, 343-349.

Peele, S. (1987). A moral vision of addiction: How people's values determine whether they become and remain addicts. In S. Peele (Ed.), Visions of addiction (pp. 201-233). Lexington, MA: Lexington Books/Heath.

Peele, S. (1985). The meaning of addiction: Compulsive experience and its interpretation. Lexington, MA: Lexington Books/Heath.

Reinarman, C., Waldorf, D., &Murphy, S. (1991). Cocaine changes: The experience of using and quitting. Philadelphia: Temple University Press.

Vaillant, G. E. (1983). The natural history of alcoholism. Cambridge: Harvard University Press.

Stanton Peele