Issues with the moral model of addiction

The best known models for addiction currently are disease models, and yet currently we live in a world where addiction is seen as a moral failing.

Cultures all around the world treat addicts with hatred and disdain. Even our own governments have been known to paint us as drains on society, undeserving of support, and fully deserving of the mistreatment we face.

Scientist have known for a long time that the moral model of addiction fails to explain it as a phenomenon. It tends to be concentrated among groups exposed to high levels of trauma. Despite this, addiction can come for anyone.

Addiction knows no boundaries. Rich or poor, POC or white, educated or school drop-out. People don’t appreciate quite how easily it could be them, doing anything for that next fix. This is certainly a case of “check your privilege”.

As an autistic person, who has been through active addiction, there are a few things I have noticed.

Regardless of your social class, addiction is treated as a shameful secret. The main difference is that the rich have access to fancy and expensive rehabilitation services, while those with less money have to get by on state funded services.

Those state funded services are rarely suited to autistic people.

Another thing I gave noticed is that when you are a sober addict, everyone is quick to remind you that you have a disease, that it’s not your fault. When you are actively using, those same people are just as likely to treat you as if you choose to be addicted.

A final thing I have noticed is that even medical staff, who themselves push the disease model for treatment purposes, will sometimes treat your addiction as a nuisance at best, a moral failing at worst.

The moral model of addiction exists, in likelihood, because addicts cause a lot of harm and chaos when actively engaging with the object of their addiction. When people can’t see past their privilege as non-addicts, they seek to find blame for negative behaviour.

Addicts are labelled as challenging. But as many will tell you in the autistic community, calling somebody challenging falls short. There is always a valid underlying reason for behaviour.

I’m willing to bet that for most addicts, that reason is trauma.

That is why I talk so regularly about addiction amongst Autistics. Autistic people experience trauma at a much higher rate than the general population, increasing the risk of developing an addiction.

The moral model especially fails autistic addicts, who just by existing autistically, find themselves alienated from society. When the shame of addiction that the moral model dictates is added to the mix, it makes for a huge risk of isolation, and an increase in the risk of suicide.

I would speculate that the moral model of addiction is why so many autistic addicts go without formal diagnosis. Autistic people are regularly infantilised, treated as if we are filled with child-like innocence. This makes it less likely that an addict will be diagnosed as autistic.

If every autistic addict had a formal autism diagnosis, I suspect that the already alarming suicide rate for Autistics would be even higher.

For the sake of every person coping with an addiction, not just autistic addicts, we must defuse the moral model. I believe that if we want to move forward in our understanding of this phenomenon, we must used a trauma-informed model.

Maybe then, we can see that the war on drugs, is a war on traumatised people.

Published by David Gray-Hammond

David Gray-Hammond is an autistic mental health and addiction advocate living in the South East of England. He is in recovery from addiction and psychosis, as well as other complex mental health conditions. He was diagnosed as autistic seven months after achieving sobriety, and is resolved to share his experiences with the world in the hopes of being the person that he needed when he was younger.

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