The understanding and etiological theories related to substance abuse and addiction have changed drastically over time. This is due to a range of factors, from the rise in awareness of the harms associated with drug use, to increased research into its causes. In particular, there has been an evolution in how society views substance abuse as well as changes in terms of which approaches are used for treatment and prevention (Raistrick & Heather, 2003). Such shifts have occurred on both a scientific level and within communities worldwide.
In the past, individuals suffering from addiction were largely seen as immoral or degenerate people whose behavior was willfully chosen despite knowing it would bring about dire consequences (Deacon et al., 2018). Substance abuse was largely viewed as a moral issue that could only be addressed through strict enforcement of laws prohibiting its use. As such, individuals who abused drugs were often locked up rather than given access to help or resources. Further, governments across the world typically focused their efforts on criminalizing drug users rather than looking at ways to minimize harm caused by drug use (Werb et al., 2011).
Examine how the etiological theories and issues related to substance abuse and addiction have changed over time.
This view shifted somewhat during the late 20th century when many countries began acknowledging that substance misuse could result from social or environmental problems present in one’s life such as poverty or exposure to trauma (Loffredo et al., 2017). This idea has since become widely accepted among medical professionals and researchers alike who believe that pre-existing issues can contribute heavily towards an individual’s risk for developing addiction (Brecht & Magura, 2009). Thus today we understand that while ‘just say no’ campaigns may have some merit they are not nearly enough when it comes dealing with addiction due its complex nature (Miller & Hester 2006).
Similarly there has been considerable change in terms of how experts approach treating those suffering from substance misuse disorders. Historically treatments often included hospitalization where patients received abstinence-based care consisting primarily of behavioral therapies along with occasional pharmaceutical interventions if needed. The goal here was ultimately total abstinence although this alone did not provide long term success rates for many patients (Cotto & Sommers 2008) . Recently however much more focus is being placed on harm reduction strategies instead which involve minimizing harmful effects without necessarily requiring complete abstinence beforehand (Vanderplasschen 2012) . For instance needle exchanges programs allow intravenous drug user access clean needles which has proven effective at reducing HIV infection rates among these populations significantly(Strathdee et al., 2005).
Overall then there have been drastic changes in our understanding regarding causality , prevention ,and treatment currently surrounding substances misuse disorders; moving away from stigma-based policies towards more evidence based ones geared towards helping people find healthier lifestyles instead.(Whitehead 2019 ) While there is still much work left to do we now recognize that addressing problems related to addictions require comprehensive multi-faceted approach involving policy makers health providers , family members ,and other stakeholders working together(Fisher 2017 ).