The Moral Model of Addiction: What Is This Persistent Viewpoint?
Addictions are hard to understand. We need an explanation for why people do the things that addicted people do. That’s what the moral model of addiction does for us. It explains things.
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. We also 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. This is true of the moral model of addiction, a psycho-social explanation of addiction. Unfortunately, it has led to stigma and intolerance and kept many people from seeking help.
What Is the Moral Model of Addiction?
By model, we simply mean a way of viewing of something. A globe is a model of the world. A flat-world model is also a model of the world; it’s just not accurate. You’d be better looking at the globe to understand our world.
A model of addiction isn’t a physical thing we can tough (like a globe), but it’s an idea that draws a mental picture of what addiction is. There are a number of models that have been posed in an effort to understand and explain addiction. Throughout history, the favored model has changed many times. 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, society associated alcoholism 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 of addiction 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 was evil and sinful (a moral view).
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), society and lawmakers viewed alcoholism from a social—rather than medical—perspective. Courts and families sent alcoholics to drunk tanks in the city jail, asylums and public hospitals. These institutions generally did not offer the help alcoholics needed.
The Disease Model of Addiction
With the repeal of Prohibition in the United States in 1933, the moral and temperance models fell out of favor. Technically the American Association for the Cure of Inebriety first put forth the disease model of addiction in 1870 with its founding principle, “Inebriety is a disease.” However, 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 the scientific community recognizes alcoholism and many other addictions 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. This, in turn, 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. 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. Other types of addiction face still more stigma. 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.
It’s time to drop the moral model of addiction.