The self-medication theory of addiction is based on the idea that people use substances, such as alcohol and drugs, or the effects of other addictive behaviors, such as eating or gambling, not to seek euphoria, but to relieve dysphoria or change an uncomfortable emotional state. The self-medication theory usually refers to substance use disorders, but it can also be applied to non-substance or behavioral addictions.
The Self-Medication Hypothesis
The self-medication hypothesis began appearing in medical journals in the 1980s as clinicians noticed that people who were addicted to heroin were using the drug to cope with different types of underlying distress such as rage and loneliness.
The theory goes that, for some conditions, such as chronic pain, prescribed medications may be insufficient or problematic. As a result, people who use marijuana and who suffer from chronic pain are simply self-medicating. This has lead to increased interest and availability of medical marijuana for the treatment of certain conditions.
The self-medication theory suggests that use develops as a way of coping with specific types of emotional pain in the absence of adequate solutions and meaningful social relationships.
Responses
The self-medication theory is increasingly popular among people with addictions and professionals who treat them. However, there are some who take a hard line on addictions and believe the self-medication theory is an excuse for irresponsible behavior.
Many in the medical profession find it useful to transition people from substances and behaviors that they are addicted to and are causing the problems to prescription medications that more safely address the underlying problem directly. Depression, for example, can often be successfully treated with antidepressants and lifestyle modifications such as exercise, potentially freeing the individual from seeking emotional comfort from their mood symptoms in their addiction.
The self-medication theory also helpfully informs the therapeutic process. It can provide a model that unites medical, psychiatric, and addiction professionals with the shared goal of addressing the underlying distress that is fueling the addiction.
The theory is compassionate to people with addictions, particularly people who use illicit drugs. It suggests that drug use is often an attempt to change painful internal states that are often not addressed by medical options.
However, some argue that the theory may absolve illicit drug users of some of the responsibility for their problems. Another stance taken against the self-medication theory is that by arguing that people with addictions are self-medicating, the theory legitimizes drug use, and medication generally, as a way of solving emotional problems. Many people who have been through the process of becoming abstinent feel that any drug use, including medications, allows people to avoid dealing with psychological issues and reinforces denial.
In tandem with this, the self-medication theory reinforces the disease model of addiction. It runs the risk of simplifying the complex issue of addiction, which involves many psychological and social factors, to pure physiology.
The Future of the Self-Medication Theory
More and more people are going public with their addictions. Addiction and its treatment are no longer swept under the carpet, and these issues have even become the subject of reality shows, such as “Intervention.” Many celebrities and even politicians have admitted to past drug use.
With greater social change and openness about drug use and addictions, society is becoming more compassionate towards those with addictions. The drug legalization movement and the medical marijuana movement, both of which have become increasingly mainstream, support the self-medication theory. The theory will likely play an important role in current and future concepts of addiction.
