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Textbook of Addiction Treatment: International Perspectives pp 87–105Cite as

Social Aspects of Addiction and Environmental Strategies

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Abstract

Social-environmental factors serve two functions in addiction care, i.e., (Bean, Zinberg (eds) (1981) Dynamic approaches to the understanding and treatment of alcoholism. New York, The Free Press) for diagnosis, assessing the social-environmental nature and severity of the addiction and (Berne (1964) Games people play – the basic handbook of transactional analysis. New York, Ballantine Books) for treatment, identifying social-environmental obstacles and resources to recovery. In clinical settings, addicted persons may try to maintain addiction by eliciting rescuing or enabling behavior from clinicians and other parental figures; the antidote consists of adult-adult transactions aimed at recovery. Depending on the clinical context and phase of recovery, clinicians can choose a variety of roles vis-à-vis the addicted patient, i.e., impersonal or mechanistic I-it for early detoxification, formal I-You for diagnosis and treatment planning, and personal I-thou during later recovery. Ultimately, the recovering addict must achieve trust within himself/herself and regain the trust of others, through acquiring personal and social integrity. Two available social entities consist of mutual-help groups (e.g., Alcoholics Anonymous, Narcotics Anonymous) and the family. These two resources can gird the addicts in re-creating a supportive, functional intimate social network (ISN) – a core foundation for happy and healthy living. Clinicians’ understanding of the ISN structures and functions provide a potent means for coaching addicts in recovery. In addition to clinicians, families, and mutual-help groups, communities, governments, and society at large can design environments that facilitate relapse or favor recovery. Social-environmental obstacles include a high prevalence of addiction and local profiteer-enablers who prey upon addicts. Social-environmental resources include clear norms regarding substance use, availability of timely treatment, and implementing prevention strategies. Coordinated international action can bolster local social-environmental initiatives.

This article reflects the opinions of the author only and not those of the Minneapolis VE Health Care Center or the University of Minnesota.

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Authors and Affiliations

  1. Staff Psychiatrist, Minneapolis VA Health Care Center, University of Minnesota, Minneapolis, MN, USA

    Joseph Westermeyer

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  1. Joseph Westermeyer
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Correspondence to Joseph Westermeyer .

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Editors and Affiliations

  1. Department of Psychiatry, Alberta Gambling Research Institute University of Calgary, Calgary, Alberta, Canada

    Nady el-Guebaly

  2. Faculty of Brain Sciences UCL Division of Psychiatry, University College London, London, United Kingdom

    Giuseppe Carrà

  3. Division of Alcoholism & Drug Abuse, New York University School of Medicine, New York, New York, USA

    Marc Galanter

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Westermeyer, J. (2015). Social Aspects of Addiction and Environmental Strategies. In: el-Guebaly, N., Carrà, G., Galanter, M. (eds) Textbook of Addiction Treatment: International Perspectives. Springer, Milano. https://doi.org/10.1007/978-88-470-5322-9_5

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  • DOI: https://doi.org/10.1007/978-88-470-5322-9_5

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  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5321-2

  • Online ISBN: 978-88-470-5322-9

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