Understanding Why Addicts Are Not All Alike: Recognizing the Types and How Their Differences Affect Intervention and Treatment

186 Pages·2011·0.88 MB·English

by  Gary L. Fisher

Understanding Why
Addicts Are Not All Alike

Understanding Why
Addicts Are Not All Alike
Recognizing the Types and How Their
Differences Affect Intervention
and Treatment
Gary L. Fisher
Copyright2011byGaryL.Fisher
Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrieval
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LibraryofCongressCataloging-in-PublicationData
Fisher,GaryL.
Understandingwhyaddictsarenotallalike:recognizingthetypesandhowtheirdifferences
affectinterventionandtreatment/GaryL.Fisher.
p.;cm.
Includesbibliographicalreferencesandindex.
ISBN978–0–313–38707–4(hardcopy:alk.paper)—ISBN978–0–313–38708–1(ebook)
1. Substanceabuse—Patients—Classification.2. Substanceabuse—Patients—Rehabilitation.
I.Title.
[DNLM:1. Substance-RelatedDisorders—psychology.2. Substance-RelatedDisorders—
therapy.3. Behavior,Addictive—classification.4. Behavior,Addictive—psychology.5. Models,
Psychological.6. TreatmentOutcome. WM270]
RC564.F574 2011
362.29—dc22 2011009439
ISBN:978–0–313–38707–4
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Toalladdicts, thoseinrecovery andthosestill searching

Contents
Preface ix
ONE: Addicts: WhoTheyAre, What TheyDo 1
TWO: The DiseaseModelofAddiction 19
THREE: Antisocial PersonalityDisorder(ASPD) 51
FOUR:FunctionalAddicts 79
FIVE: Implicationsfor Interventionand Treatment 111
Appendix 1:ClassificationofDrugs 129
Appendix 2:TreatmentApproachesand Strategies 143
Appendix 3:Resources 151
Notes 155
Index 163

Preface
As an academic discipline, the field of alcohol and other drug addiction
treatment is relatively young. The first treatment program that had some
resemblance to the treatment programs we see today was developed by
the Hazeldon Foundation in the 1940s and 1950s. There was not much
ofaresearchbaseforthedevelopmentofthisprogramanditwasdesigned
foralcoholicsonly.DuringtheVietnamWar,therewasaconcernamong
the military and government administration officials about the number of
returningsoldiersaddictedtoheroin.AphysicianfromChicago,Dr.Jerry
Jaffee, became involved in treating these veterans, primarily through
methadone maintenance. Dr. Jaffee attracted residents who were inter-
ested in treating drug addicts and a specialty in addiction medicine
occurred. As with most medical specialties, this also spurred academic
research, in this case, in addiction. Dr. Jaffee became the nation’s first
drug czar during the Nixon Administration. In 1993, he was an adminis-
trator in the federal Center for Substance Abuse Treatment (part of the
Health and Human Services’ Substance Abuse and Mental Health Serv-
icesAdministration).Bythen,Jaffeehadrealizedthattheaddictiontreat-
mentfieldwouldneverapplytheresearchfindingscomingoutofcolleges
and universities unless the education and trainingfor treatment providers
was upgraded. Up to that time, nearly all drug and alcohol counselors
wererecovering individuals,and statesrequired verylittle,if any,educa-
tion and training. Because of a federal grant initiative (still going on
today)thatJaffeestarted,trainingprogramsforaddiction-treatmentprov-
iders were started in colleges and universities across the country, at both