Comparisons

Several models for understanding and intervening in drug use have been developed. While all of these have their strengths and weaknesses, clinicians should have some appreciation of the differences in these views. The table below briefly outlines broad differences between the general thrust of 'traditional' approach with 'contemporary' approaches. All approaches have value in the drug field. The aim of this comparison is to broaden options. Click on to models and frameworks of drug use for a summary table and dot point information. See also Project MATCH (USA) for ordering details of free Manuals on Twelve Step Facilitation Therapy, Motivational Enhancement Therapy and Cognitive-Behavioural Coping Skills Therapy as well as other material such as improving compliance.
Traditional and Contemporary Approaches
Traditional Approach	Contemporary Approach
Drugs are bad	Drugs are functional with positive and negative consequences
Assess if an individual is an addict/alcoholic	Assess for problems such as: Intoxication, Regular Use & Dependence; Liver, Lover, Livelihood, Law
Treatment = Abstinence	Controlled use possible Decrease problems & risks of problems Harm Reduction Improve lifestyle May also include abstinence
Progressive disease & must hit rock bottom for treatment to work	Primarily a learned behaviour (initially from drug using adults) Early intervention stressed
Clients are in denial. Confrontation required to break through denial.	Clients at different stage of change Skills to enhance motivation Generic counselling skills are most useful
Specialist area	General area for intervention including non-drug specialists Principles are same for many other behavioural processes
Individual focus	Drug, Individual & Environment (environment = politics, laws, socio-economic issues, policies, agency, etc.)
Focus on Illegal Drugs	Focus on all psychoactive drugs. Alcohol and Tobacco often referred to because high levels of harm associated with their use.
One drink = one drunk, One 'hit' = one addict	Drug use can be controlled A 'lapse' can be prevented from becoming a full relapse. Relapse is normal