Alcoholism is one of the most subtle forms of drug addiction since most regions have lax laws defining how one can engage in drinking. However, addiction of any kind is highly dependent on the intervention mechanism applied. There are two common intervention mechanisms dictating the approach to addiction: the medical model of addiction and the harm reduction approach. Of the two approaches to addiction, the harm reduction model is the most effective as indicated in Nicholas Sheff’s Case. super essay
The disease model of addiction explains that the addiction such as alcoholism is not a habit but a disease with underlying biological, genetic, and environmental causes. According to the traditional perspective on what constitutes a disease, the presence of an abnormal condition creates distress or dysfunction of the body functions of the people who are affected by the condition. Alcoholism fits the definition of a medical condition since it affects the mesolimbic pathway in the brain, which results in the dysfunction of normal body operations. The medical model also investigates the possibility of other biological and psychological factors that may affect how individuals interact with alcohol and other substances. Sociological factors as causes of addiction are also incorporated in the disease model of addiction since the individual could be exposed to triggering factors for substance abuse.
The disease model communicates the idea that there are biomolecular mechanisms that manifest in all forms of addiction. It advocates the development of the interventions that address biomolecular mechanisms of the addiction. However, the above model has been criticized for its stigmatization of addicts. Since the model defines any alcoholism as a disease, alcoholics develop excuses for their habits while reducing their input in the recovery process. Alcoholics can be stigmatized when this model is used in the explanation because it emphasizes the genetic and lifelong aspect of addiction. A certain family could be associated with the addiction, affecting how the rest of the society interacts with the family or the individual.
If the disease model of addiction had been applied in the case of Nicholas Sheff, the intervention could have been based on the symptoms whereby the treatment could have focused on their alleviation and the successful inclusion of Nic in the society. Instead of addressing the underlying causes of the condition, the intervention could have weaned him off the drugs while providing him with the medicines that would have reduced the chances of relapse. The risk factors could have been identified. Consequently, in each instance of relapse, he would have been treated as another patient who had been suffering from a common ailment in more than one instance.
On the other hand, the harm reduction model entails policies and practices that reduce the effects of using psychoactive drugs in people who are unwilling or incapable of stopping. Consequently, the focus of the model is on the prevention of detrimental effects as opposed to the prevention of the drug use. Additionally, it focuses on people who are continuing with interventions. The harm reduction approach can be used alongside any other intervention. The foundation of the intervention is that many people all over the world are incapable of stopping the consumption of alcohol despite numerous attempts or they simply do not have the willpower to continue the treatment. Another important consideration in the harm reduction model is that some alcoholics seek treatment but they are barred from access owing to high costs, as well as the lack of facilities that provide care.
Additionally, the significant number of people who use alcohol may not require drug treatment. Consequently, the harm reduction method provides them with options that may reduce the impact of their continued drug use on themselves and other people. Consequently, the focus is on the sustenance of the environment of safety and health. The harm reduction method was developed mainly due to the increased contraction of HIV from intravenous drug users. The mantra of the harm reduction method is the effective reduction in deaths of addicts that arise from preventable causes. Individuals also tend to prefer informal and non-medical interventions as far as the drug reduction is concerned. The harm reduction approach is based on evidence and cost effectiveness.
The harm reduction model is feasible because it is based on the research and relevant findings. It enables individuals seeking help to find the best intervention even if they do not have the finances to handle the normal cost of drug rehabilitation. Moreover, this approach emphasizes the incremental gain. Instead of coercing alcoholics into changing their drug habits, it acknowledges simple gains made in the reduction endeavor and, consequently, creates the desired cumulative impact. Incremental interventions focus on individual needs and they are configured to the situation of the individual. The small gains aspect makes the harm reduction model more effective compared to the medical model of addiction.
The harm reduction model emphasizes sustaining dignity and compassion, universality, creating challenging policies, and sustaining transparency. The sustenance of dignity and compassion is important since the harm reduction model accepts each individual without imposing any judgment on people. The universality principle seeks to apply the same human rights to all people. It also seeks to challenge policies that may increase harm among the people. Finally, counselors working within the framework of the harm reduction model have to ensure transparency when defining the objectives of the intervention program.
The main difference between the medical model of addiction and the harm reduction model is the sustained drug use in the latter case. The medical model is assessed based on the alcohol abuse cessation. The harm reduction model is also more focused on the reduction of the impact on the user and the community. The medical model of addiction is set on a finite timeline whereby the patient has to recover in the given time. The harm reduction method is a continued process with the ultimate result being the invalidation of the impact of drugs and alcohol on the individual.
Regardless of the method of treatment adopted, the six stages of change are applied. Pre-contemplation calls for the understanding of the impacts of addiction. The second stage is the contemplation stage whereby people are aware of the effects of their addictive behavior. The third stage is the preparation stage that calls for the identification of the course of action that they have to take in order for them to change their habits effectively. Action stage covers the eventual implementation of the plan. The maintenance stage includes the attempts made towards the sustenance of the action plan. The final stage focuses on the conclusion of the intervention after the goals have been attained or after the intervention has been deemed ineffective.
The two models of addiction help in the understanding of the road to recovery undertaken by Nic. For instance, the medical model was applied in the different commitment that the family had placed him. Numerous attempts to make him clean and sober through the admission to different rehabs were futile. The addiction was serious and he was unwilling to try the rehab way. The rehabs had provided him with the option of reducing his drug intake per day as opposed to pumping him with medicines intended to clean him.
The above interventions had been largely ineffective mainly due to the inability of the rehabs to configure their treatment paths to suit the needs of the patient. It is also indicative of ineffectiveness in the medical sector when it comes to the treatment of addicts. Instead of considering the needs of the patient, the rehabs focused on cleaning him. since this is one of the measures of how effective the medical facility is. Therefore, due to the focus on cleaning him, they were incapable of meeting the harm reduction approach. Eventually, he would end up on the streets. The family members were more concerned about Nic’s safety since even if he was still taking the crystal meth at home, he would be assured of better health and increased safety as opposed to when he was on the street. The family failed to accept him as an addict and did not effectively apply the harm reduction approach.
The inability to accommodate Nic also increased the harm caused to the family since the father recounts how he would keep walking in the park and the city with the hope of seeing his son. Additionally, the lack of understanding that the medical model of addiction could be applied also affected the interaction. Instead of treating the addiction as a condition traced to biological factors, the family took his affliction as a choice. Therefore, they did not offer him the system needed. The harm reduction method could have led to a quicker and more cost-effective treatment intervention compared to the medical interventions that the family had previously sought. Acceptance of the possibility of an alternative intervention could have reduced the harm that he faced while on the street.
In conclusion, the harm reduction model seems to be more effective for the recovery from any addiction because the medical model of addiction does not accommodate addicts who may be fluctuating between the commitment to recovery and relapse. On the contrary, the medical model seeks to create interventions that will eradicate the addiction while there are other factors that may affect how the patient recovers. The above conclusion is manifested in Nicholas Sheff’s case.