Moving Beyond the Moral Model of Addiction
As human beings, we strive to make sense of the world and our place in it—it is a part of human nature. We do this individually in our everyday lives, and we do it on a larger scale in fields such as psychology and medicine. Explaining and classifying situations, behaviors, and other people can certainly be beneficial—it helps to identify with other people, provides a framework for understanding problems like addiction, and often leads to remarkable insight into the world, the human body, and human nature.
But sometimes our classifications are too rigid and our explanations just aren’t right. In these instances, our need for explanation interferes with our ability to see and interact with the world and other people clearly and effectively. One such example is the moral model of addiction, a psycho-social explanation of addiction that led to stigma and intolerance, and kept many people from seeking help.
The Moral Model
There are a number of models that have been posed in an effort to understand and explain addiction, and the favored model has changed throughout the years. In recent years, as science has discovered more and more biological and genetic factors involved in conditions like alcoholism, models that stress these viewpoints have become more popular. But one of the first models for addiction, and one that set the tone for decades to come, was the moral model.
The moral model frames addiction as a result of human weakness—a defect in character. It doesn’t recognize biological or genetic components to addiction and offers little sympathy for those who display addictive behaviors. The implication is that addiction is the result of poor choices, which addicts make because of a lack of willpower or moral strength.
The Moral Model’s Impact on Alcoholics and Addicts
Unsurprisingly, viewing addiction as a moral failing led alcoholics and other addicts to be grouped with others who had demonstrated “moral failings.” In the 19th and early 20th century, alcoholism was associated with other socially undesirable situations and behaviors such as crime, poverty, sin, domestic violence, and laziness. Rather than proposing treatment methods for alcoholism, the moral model viewed punishment as a more appropriate response. Alcoholics were reluctant to publicly acknowledge their problem, as society had little sympathy for their struggle.
The temperance movement hit its stride in the United States during the mid-1800s, and alcohol became a thing to be feared. While the temperance movement placed the blame on alcohol rather than the user, it also propagated the idea that alcohol should be associated with evil and sin. In the years leading up to Prohibition, a number of states began passing laws that mandated the sterilization of those they considered “defectives”–the mentally ill, developmentally disabled, and alcoholics and addicts. During this time and throughout Prohibition (1920-1933), alcoholism was viewed primarily from a social—rather than medical—perspective. Alcoholics were relegated to drunk tanks in the city jail, asylums, and public hospitals, where they were not offered the help they needed.
Moving Beyond the Moral Model
With the repeal of Prohibition in the United States in 1933, the moral and temperance models fell out of favor. While the disease model of alcoholism was put forth as long ago as 1870, when the American Association for the Cure of Inebriety was founded under the principle that “Inebriety is a disease,” it didn’t rise in prominence until the founding of Alcoholics Anonymous in 1935. The World Health Organization and the U.S. government began studying alcoholism and the medical community, led by Dr. E.M. Jellinek, began to recognize the disease model of alcoholism and provide humane treatment, as opposed to imprisonment or social contempt.
Today, alcoholism and many other addictions are recognized as genuine medical problems, with genetic and biological components. This view of addiction as a disease or illness has encouraged scientists to put effort and money into studying alcoholism and other addictive behaviors, which has led to the development of more effective treatments. Social stigma toward those who struggle with addiction has decreased, and many more people are able to get the assistance they need.
However, the moral model of addiction has not been completely replaced by other models, and many people—even medical professionals—sometimes find it difficult to separate a person’s character and the negative consequences of their addictions. Although alcoholism has made great strides in moving beyond the moral model, alcoholics are not immune to social stigma, and other types of addiction have yet to be widely viewed as a disease rather than a choice. But as we move further away from the idea that addiction is the result of moral failure, we move closer to providing effective treatment and support for all those who suffer.