Invitation to Psychology

Chapter 11 Psychological Disorders 403

How can we assess these two positions criti-

cally? Because alcoholism and other kinds of sub-

stance abuse occur for many reasons, neither model

offers the only solution. In the case of alcohol, many

problem drinkers may not be able to learn to drink

moderately because physiological changes in their

brains and bodies have turned them from heavy

drinkers into addicts. But many who go through a

period of alcohol abuse may indeed be able to learn

to drink moderately. They may benefit from pro-

grams such as Harm Reduction, which teach people

how to drink moderately and keep their drinking

under control (Witkiewitz & Marlatt, 2006).

So perhaps the question we should be asking

is “What are the factors that make it more or less

likely that someone can learn to control problem

drinking?” Problem drinkers who are most likely

to become moderate drinkers have a history of less

severe dependence on the drug. They lead more

stable lives and have jobs and families. In contrast,

those who are at greater risk of alcoholism (or

other drug abuse) have these risk factors: (1) They

have a genetic vulnerability to the drug or have

been using it long enough for it to have damaged

or changed their brains; (2) they believe that they

have no control over their drinking or other drug

use; (3) they live in a culture or a peer group that

promotes and rewards binge drinking or discour-

ages moderate drug use; and (4) they have come

to rely on the drug as a way of avoiding problems,

suppressing anger or fear, or coping with stress.

Debating the Causes

of Addiction LO 11.16

The biological and learning models both con-
tribute to our understanding of substance abuse
and addiction. Yet, among many researchers and
public health professionals, these views are quite
polarized, especially when it comes to thinking
about treatment. The result is either–or thinking
on a large scale: Either complete abstinence is the
solution, or it is the problem.
Those who advocate the biological model
say that alcoholics and problem drinkers must
abstain completely, and that young people should
not be permitted to drink, even at home with
their parents, until they are 21. Those who cham-
pion the learning model argue that most prob-
lem drinkers can learn to drink moderately if
they learn safe drinking skills, acquire construc-
tive ways of coping with stress, avoid situations
that evoke conditioned responses to using drugs,
and avoid friends
who pressure them
to drink excessively.
Besides, they ask,
how are young peo-
ple going to learn to
drink moderately if
they don’t first do so at home  or in other safe
environments? (Denning, Little, & Glickman,
2004; Rosenberg, 1993).

After five years in and

out of rehab and facing

more prison time, Robert

Downey, Jr., got serious

about getting help. He

was able to overcome his

addictions and resume a

successful acting career.

Here he’s shown at the

2012 world premiere of

The Avengers.

Recite & Review

Recite: Say aloud what you have learned about substance abuse, the biological model of addic-

tion, the learning model of addiction, and the arguments for and against abstinence-only solutions

to addiction.

Review: Next, if you are addicted to passing exams, reread this section.

Now take this Quick Quiz:

1. What is the most reasonable conclusion about the role of genes in alcoholism? (a) Without a
   key gene, a person cannot become alcoholic; (b) the presence of a key gene will almost al-
   ways cause a person to become alcoholic; (c) genes may increase a person’s vulnerability to
   some kinds of alcoholism.


2. Which cultural practice is associated with low rates of alcoholism? (a) a gradual introduction to
   social drinking in family settings, (b) infrequent binge drinking, (c) drinking as a rite of passage
   into adulthood, (d) policies of prohibition.


3. In a national survey, 52 percent of American college students said they drink to get drunk and
   42 percent said they usually binge when drinking. To reduce this problem, many schools have
   instituted zero-tolerance programs. According to the research described in this section, are
   these programs likely to work? Why or why not?
   Answers:

Study and Review at MyPsychLab

They are not likely to be successful because zero-tolerance programs do not address the reasons that students 3. a2. c1.

binge, do not affect the student culture that fosters binge drinking, and do not teach students how to drink moderately.

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