A Behavioral and Cognitive Look at Substance-Related Disorders

Drug use has been, and continues to be, a serious problem worldwide. Besides burdening the community and the legal system, drug use drags the user into a downward spiral that affects all areas of said user's life. For this latter issue, clinical theorists have formulated explanations as to why substance abuse often renders the user dependent. These theories are meant to aid in the rehabilitation of substance abusers and promote a better understanding of why drug use and abuse is such a massive problem in many countries around the world. One such theory aimed at explaining drug addiction and dependence is based on the behavioral and cognitive theories.

Psychology from a behavioral viewpoint deals greatly with learning through conditioning, the behavioral look at substance abuse takes a similar approach. Behaviorists assert that operant conditioning plays a key role in why an individual becomes dependent on drugs and/or alcohol. Operant conditioning is a term coined B.F. Skinner to explain the effects or consequences of a specific behavior on the occurrence of future behavior. Meaning, behavior which promotes positive effects for the individual is likely to be continued, whereas behavior which causes negative effects will be discontinued as it is not pleasurable for the individual. Similarly, behaviorists believe that drug/alcohol users continue to use drugs and/or alcohol because it produces pleasurable effects for the user. Unfortunately, behaviorists also note that the rewarding effects that drugs and alcohol tend to lead users to consume higher doses (Comer, 2005), which cause greater dependence and can be lethal. Cognitive theorists agree and assert that the pleasurable effects of drugs and alcohol cause the user to expect the same reward every time the drug is consumed. This in turn causes individuals to use drugs and alcohol when they're stressed, or otherwise in need of release or relief (Chassin, et al., 2001).

In essence, cognitive and behavioral theorists believe that self-medication is a huge reason why people turn to drugs and alcohol. In fact, Hasin, et al., 1985 notes that a study of 835 clinically depressed individuals yielded that over a fourth abused drugs during the times that they were depressed. Robert Comer (2005) notes that similar "higher than usual rates of drug abuse have been found among people with posttraumatic stress disorder, eating disorders, schizophrenia, antisocial personality disorder, histories of being abused, and other psychological problems.

Clearly the aforementioned research findings support the theory of self-medication and conditioning among drug and alcohol abusers. However, drug and alcohol abuse probably cannot solely be explained through conditioning and self-medication. For this reason, theorists tend to combine the behavioral and cognitive viewpoints with those of the biological, psychodynamic, and sociocultural in order to come to a more rounded and full explanation for substance abuse. Still, understanding the concepts of conditioning and self-medication can help one to understand why a person is driven to drink or use drugs when feeling down, tense, stressed, or pressured; an area that is often very misunderstood by non-drug and alcohol users. It is also important to remember the biological aspect behind this disposition for drugs and alcohol as well, as it plays a huge part in the desire for these addictive substances.

References:

Chassin, L., Collins, R., L., Ritter, J., Shirley, M., C. (2001). Vulnerability to Substance Use Disorders Across the Life Span. In R.E Ingram & J. M. Price (Eds.), Vulnerability to Psychopathology: Risk Across the Lifespan. New York: Guilford Press.

Comer, R., J. (2005) Fundamentals of Abnormal Psychology, 4^th Ed. New York. Worth Publishers.

Hasin, D., Endicott, J., Lewis, C. (1985). Alcohol and Drug Abuse in Patients with Affective Syndromes. Comprehen. Psychiat.