Exploring Critical Issues in Addiction Field

Exploring Critical Issues in Addiction Field and the Impact on Counseling Practice


A critical issue in the addiction field, which is still bubbling and brewing, is the role of recovering counselors and recovery philosophies. Critically discuss and evaluate these two statements and their relationship to one another: Well- known addictions researcher Rudolf Moos, writing in the journal Psychology of Addictive Behaviors, asked: . . . “does a 12-step philosophy provide a more coherent and sustainable belief system, and thus more goal congruence and clarity, than does a cognitive behavioral orientation, which is based more on scientific evidence and technical expertise? Is it true that an ideology based only on empirical support cannot sustain service providers?” (Moos 2003, p. 6)

Jimmy K., perhaps the best-known founder and leader of Narcotics Anonymous, in a speech made in 1973 to the twentieth anniversary World Conference of NA:

There are people all over this world dying of our disease. And believe it or not, we are truly the only people who can really help them. Let’s never forget that you and I have been given, through illness, through suffering, and through disease, a talent for helping other human beings like ourselves. (Jimmy K., quoted in The NA Way Magazine, July 2003)


Brainstorm a list of synonyms for getting drunk. Next, brainstorm to think of synonyms for a drunkard.

Write down your responses.

What did you notice about the list of words? Usually the words about getting drunk— smashed, bombed, stoned, and so on— seem violent but exciting. The words associated with a drunk— a bum, a no- good, a lush, and so on— are usually derogatory. What messages do the media give about alcohol, tobacco, and over- the- counter drugs? What messages do the media give about alcoholics and drug addicts?


What are some issues that a mental health professional needs to be wary of in his or her practice?


Describe two presumptive fallacies-those that make you think they address the facts-and two classification fallacies. Give an example of each and discuss how these fallacies can impact your addiction work.


Read the following description of the fictitious people and rank them from 1 to 10 on the basis of how strongly you feel about their negative characteristics. Number 1 would represent the character you feel has the most negative characteristics and number 10 would have the fewest negative characteristics. For example, one might rank a person who deliberately gives a child an apple in which she has hidden razor blades as number 1 and a person who cheats on his diet by having a candy bar as number 10.

  • Rita is a mother who uses diet pills, tranquilizers, and booze, but gets upset when her kids use drugs.
  • Mrs. Elling, a school counselor, tells the parents of a student who has confided in her about his involvement with drugs.
  • Stan is a good provider, but he gets drunk occasionally and beats his wife.
  • Jackson sells a mixture of Nestlé’s Quik and saccharine as mescaline for $ 3 a hit.
  • Mariah obtains a large supply of “reds” (barbiturates) and passes them around at school.
  • Mohammed, a 22- year- old man, has been drinking heavily at a party and decides to drive his buddies’ home in his parents’ car.
  • Police Officer Gaudette knows of a 9th- grade drinking party and decides not to investigate because “kids will be kids.”
  • Lee, a 17- year- old, turns his 12- year- old brother on to drugs.
  • Eldon constantly argues with his wife and causes family problems because he drinks and cannot hold a job.
  • Janice is addicted to heroin and steals to support her habit.

After you have ranked all the people in the list, think about criteria you used to decide ranking. Discuss the values and attitudes that went into the ranking. How could these values and attitudes affect your future counseling work? Describe how attitudes can affect a mental health professional’s interaction with clients.

Sample Solution

Exploring Critical Issues in Addiction Field and the Impact on Counseling Practice

Question One

Various treatment methods are available for individuals with substance abuse disorder, but determining the most effective approach is crucial for optimal recovery outcomes. Rudolf Moos raises thought-provoking questions in his article published in Psychology of Addictive Behaviors. He questions whether a 12-step philosophy offers a more coherent and sustainable belief system, providing greater goal congruence and clarity compared to a cognitive-behavioral orientation, which relies more on scientific evidence and technical expertise. Moos also explores the notion that an ideology solely based on empirical support may not be sufficient to sustain service providers in the field (Moos, 2003).

The 12-step program and cognitive-behavioral therapy are two commonly used treatment methods for substance use disorders. The 12-step program offers patients a sustainable belief system, providing a framework to acknowledge their addiction, understand its consequences, and identify pathways to recovery (National Alliance on Mental Illness, 2020). This approach fosters ongoing participation in the recovery process by establishing a support network within the community.

On the other hand, cognitive-behavioral therapy is an evidence-based and structured treatment approach. However, it may not be suitable for individuals with complex substance use disorders as it primarily focuses on addressing existing problems without adequately addressing underlying issues (National Alliance on Mental Illness, 2020). The application of evidence-based ideologies can be challenging for service providers since it limits their practice to public research findings. Given the increasing complexity of substance use disorders, mental disorders, and other related conditions, ideologies solely based on empirical support may not fully support service providers in their work.

In a speech delivered at the 20th Anniversary World Conference in 1973, Jimmy K., a prominent figure in Narcotics Anonymous, emphasized the importance of community support in helping individuals with substance abuse disorders. He highlighted the role of individuals who have experienced similar struggles in providing genuine assistance to those in need. Substance abuse disorders often lead to isolation due to perceived stigma, resulting in silence and shame (Myers & Salt, 2013). Both Jimmy K. and Moos recognize the potential of the community to aid individuals in their recovery journey by fostering social connections among people who have faced similar challenges.

The statements made by Rudolf Moos and Jimmy K. underscore the positive relationship between community support and long-term recovery from substance abuse. These insights highlight the significance of incorporating community networks, acknowledging the multifaceted nature of addiction, and considering individual needs and experiences throughout the treatment process.

Question Two

The media, including television, social media, and movies, plays a significant role in the increasing prevalence of drug abuse, especially among young people. Through the messages they convey, the media exposes youth and adolescents to dangerous opportunities related to drug abuse. They use exciting names to refer to substances like tobacco, alcohol, and over-the-counter drugs, and often depict images and videos of people drinking or smoking, thereby normalizing drug abuse (Taylor, Buchanan, & Ayres, 2016). This normalization leads individuals to believe that using tobacco and alcohol is acceptable. Furthermore, the media promotes alcohol and tobacco abuse through advertisements, which desensitizes people to the risks associated with drug abuse. Studies indicate a significant increase in alcohol and tobacco abuse among adolescents due to this media desensitization (Taylor, Buchanan, & Ayres, 2016).

Although the media may occasionally present positive messages about alcohol and drugs, they typically portray alcoholics and drug users in a negative light by associating them with risky behaviors such as crime and violence (Taylor, Buchanan, & Ayres, 2016). Consequently, individuals struggling with drug addiction or alcoholism are often reluctant to seek help from healthcare facilities. Additionally, the media’s use of offensive terms to describe drug addicts significantly impacts their self-esteem. Moreover, the media has played a significant role in establishing a connection between substance abuse and criminality.


Mental health professionals face various complex challenges in their line of work. One significant issue they need to be mindful of is the unpredictable behavior displayed by their patients. Many individuals with mental illness exhibit violent or aggressive tendencies, posing a safety risk to mental healthcare providers. Therefore, mental health practitioners should be cautious about identifying and addressing any erratic changes in their patients’ attitudes.

Another important concern is the negative perception some patients have towards their own mental health. They may deny their condition and develop a pessimistic attitude towards the treatment process. Mental healthcare providers must be aware of this issue and work on establishing a positive therapeutic relationship to help patients acknowledge their illness and understand the importance of medication. Furthermore, professionals should also be prepared for situations where patients may refuse to take prescribed medications, requiring additional strategies to address this challenge effectively.


Hansson, L., Jormfeldt, H., Svedberg, P., & Svensson, B. (2011). Mental health professionals’
attitudes towards people with mental illness: Do they differ from attitudes held by people
with mental illness? International Journal of Social Psychiatry, 59(1), 48-54.

Myers, P. L., & Salt, N. R. (2013). Becoming an addictions counselor: A comprehensive text.
Burlington, MA: Jones & Bartlett Learning.

National Alliance on Mental Illness. (2020). Substance Use Disorders. Retrieved October 01,
2020, from https://www.nami.org/About-Mental-Illness/Common-with-Mental-

Satel, S., & Lilienfeld, S. O. (2014). Addiction and the brain-disease fallacy. Frontiers in
psychiatry, 4, 141. doi: 10.3389/fpsyt.2013.00141

Taylor, S., Buchanan, J., & Ayres, T. (2016). Prohibition, privilege and the drug apartheid: The
failure of drug policy reform to address the underlying fallacies of drug prohibition.
Criminology & Criminal Justice, 16(4), 452-469. doi:10.1177/1748895816633274

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