Drug Models

Below is a brief description of the most commonly referred to models and frameworks of drug use. These provide different ways of viewing, understanding, planning and reviewing interventions. Other models (such as moral, pharmacological, developmental, behavioural, psychodynamic, etc) can also be used to explain drug use but are not mentioned further here.

Further information can be accessed by clicking on the links which will take you to downloadable PowerPoint presentations (identified by 'pp' after the link - best with Internet Explorer 4.0 or above & PowerPoint 95 or above ). For more information about the PowerPoint features click on PowerPoint Index.

Contents

Models of Drug Use

Social Learning Model
Disease Model

Useful Frameworks

Interaction Framework (DIE)
Shafer's Patterns of Use
Thorley's Framework (Inotx, Reg Use, Dep)
Liver Lover Livelihood Law
Stages of Change
Harm Reduction
Solution Focused Brief Therapy

Models of Drug Use

General Models

Social Learning Model

		Drug use is functional with positive and negative consequences
		Drug use is learned (and can be 'unlearned')
		Social setting important

Controlled use is possible

Disease Model

		Genetic predisposition to addiction
		Biochemical reaction to alcohol or other drugs

		Abstinence required
		Use of 12 step programs

Useful Frameworks

Interaction Framework (DIE) pp

Three main domains interact to resulting in the drug experience:

Drug (dose, strength, purity, etc)

Individual (age, size, psychology, etc)

Environment (family, culture, socio-economic factors, etc)

Shafer's patterns of drug use

Five grouping reflect different styles of drug use. Majority of users fit within the first three categories. However, clinical samples may be over-represented by last two groups. One stage doesn't necessarily lead to another.

Experimental: Initial, possibly single or short-term use

Social/Recreational: controlled use in a social setting (largest group)

Situational: used for specific reason (eg to study, to calm down before an important interview)

Intensive: binge use (tends to be intermettent - eg adolescent weekend binge drinking)

Compulsive: daily use with signs of dependence - see below.

Thorley's Framework pp

Three, overlapping areas of drug-related problems (beyond simply consumption):

Intoxication: short-term (accidents, overdose, hep C & HIV, domestic violence, etc)

Regular Use: drip, drip, smoke, smoke (organ damage, financial problems)

Dependence: Stuckness & exclusiveness of use (withdrawal, obsession, psychological distress)

Four Ls pp

Four categories of drug-related problems useful as assessment checklist:

Liver (physical and psychological health)

Lover (relationships: family, friends, peers)

Livelihood (employment, recreation, financial, lifestyle)

Law (legal, statutory issues)

Stages of Change pp

Five stages described as person moves through change process (process attached to each stage also described)

Pre-contemplation (not thinking about change - either happy user or learned helplessness)

Contemplation (thinking about change)

Preparation (decision and early action plans made)

Action (initial action taken, not yet consolidated)

Maintenance (change over time, changed behaviour replaced by alternatives)

Relapse (not a stage, but a common move back to any former stage)

Harm Reduction

Focus on reducing harms associated with drug use rather than reducing drug use per se.

Use Thorley & 4 Ls to identify harms.

Should not promote drug use.

Can be useful at all stages of change.

Harm Reduction Steps (Problem Solving Approach) Harm Reduction Steps (Problem Solving Approach)

Identify drug-related problem(s)

Prioritise

Brainstorm solutions/options

Choose best solution/s

Try it/them out

Evaluate

Re-plan as necessary

Solution Focused Brief Therapy (SFBT)pp

Acknowledge distress but focus on success. Looks for what's working rather than what's broken. Seeks identification of change if problem was not there. Works on 'exceptions to the problem' generated by client's own experience - ie the client has the answers. Key points:

		Acknowledge distress but focus on success
		If it' working do it more, if it's not do something different
		If it aint broken, don't fix it

Some techniques include:

Scaling questions

'Miracle Question'

Exceptions to the problem

Click here for the QIK (The Quick Interview for Kids)

Click here for more SFBT links