Some of the theories that attempt to explain how addiction occurs include:

• The disease model
• The choice model
• The social learning model

Regardless of the model used, drug or alcohol addiction is a condition characterized by drug or alcohol seeking, drug cravings, and the continued use of drugs or alcohol despite physical, mental, or emotional harm.

The Disease Model of Addiction

Under the disease model, addicts are born and not made. Genetic differences leave some people far more susceptible to the effects of drugs or alcohol and far more vulnerable to addiction. The disease of addiction has a set of recognizable symptoms and a progression of symptoms that if left unchecked, will lead ultimately to death.

Under the disease model, there are four stages of addiction:

1. Pre-Symptomatic Stage – The use of alcohol or drugs does not yet present any significant problems.
2. The Early or Prodromal Stage – A stage of increasing problems caused by substance use, including guilt over consumption, increasing use, and (for alcoholics) blackouts.
3. The Crucial Stage – During this stage the person tries to control their use as consumption escalates, and fails. As consumption increases, the social, physical, and mental consequences also increase.
4. The Chronic Stage – The end stage, which includes very heavy use and increasing mental and physical consequences from that use.

Under the disease model, people with an addiction to drugs or alcohol face:

• A condition that is chronic and for life, but one that can be treated. Alcoholics or drug addicts will never be capable of recreational or moderate consumption of drugs or alcohol.
• A disease that, if left untreated and allowed to run its course, is ultimately fatal.
• A disease that robs them of their ability to control their consumption, which often results in taking less personal responsibility for their actions while using drugs or alcohol.

The disease model is recognized by the American Medical Association and the World Health Organization. AA and NA also support the premises of the disease model, but the paradigm is less supported outside of the United States. Even the strongest proponents of the disease model will recognize some flaws in the scientific rigor of the paradigm, but counter that it still offers a "best-fit" for the understanding and treatment of the very complex bio-psycho-social phenomenon of addiction.

The Choice Model

Proponents of the choice model of addiction argue that the consumption of drugs or alcohol is a choice, and that just as people can choose to take drugs or alcohol, they can choose not to. Under the choice model of addiction, people addicted to drugs or alcohol are considered weak, with poor willpower or other moral failings.

The Social Learning Model

A more behavioral approach to understanding addiction is the social learning model, which proposes that you learn how to act by observing others in your environment and by repeating behaviors that produce positive consequences.

You learn to take drugs or alcohol through your interactions with family, friends, or even popular media. And through personal experimentation with drugs or alcohol, you learn that you like the way drugs make you feel. Whether it is the euphoria of a high, the increased confidence you feel while intoxicated, or a reduced sense of social anxiety, intoxication can be a positively reinforcing state of being.

As you discover how much you like certain aspects of drug or alcohol use, the positive reinforcement of that use prompts ever greater use. By the time excessive drug or alcohol consumption creates significantly negative consequences, you have succumbed to a physical or psychological addiction to the substance.

There Are No Clear Answers

There is no clearly and completely accepted paradigm for making sense of addiction, but no matter how someone gets addicted to drugs or alcohol, once they are, they face a difficult and sometimes deadly disease.

The debate between proponents of the different theories continues, with no clear end or winner in sight. The debate is significant, with the most accepted model of addiction influencing a great deal of governmental policy and research. Of course, nobody fighting an addiction today can afford to await the outcome of a scientific debate before getting lifesaving treatment.

Don't Look Back, Look Forward

Fortunately, there is a consensus that once you have an addiction to drugs or alcohol, you have a disease that needs treatment – and addiction treatment works. It doesn't really matter how you got addicted because getting the kind of treatment that's going to help you get better is far more important. Spending your time wondering how or why you got addicted won't solve your problems, but spending some time learning about (and ultimately taking) needed steps in the treatment of your disease just might.

According to the National Institute on Drug Abuse (NIDA), you need know the following facts about addiction treatment:

• Treatment works, but only if you commit enough time and energy to your treatment.
• Counseling and behavioral therapies are vital and effective components of addiction treatment.
• Medications are sometimes necessary and beneficial in the treatment of addiction, especially when these medications are combined with therapies and other treatments.
• Mental health issues must be treated in conjunction with addiction issues (also referred to as dual diagnosis).
• People don't have to want help or agree to treatment to benefit from it.
• Treatment must be a long-term process, and since addiction is a chronic, relapsing condition, multiple instances of treatment over the years are sometimes necessary.

Any questions you might have about addiction treatment can be answered by specialists at the National Resource Center at (877) 637-6237.