The Addiction Dilemma: Gaps in Knowledge, Information-Dissemination, Service and Training

The "urge to classify" the drug user: a review of classifications by pattern of abuse

Attempts to classify drug abusers are divided into three main categories: psychiatric classifications, psychosocial classifications and classifications by pattern of abuse. The present article focuses on pattern of abuse classifications which are divided into two subcategories: by substance of abuse and by degree of involvement. The various groups of these classifications are reviewed and their potential uses are discussed. The review indicates that classifications by substance of abuse may be useful for administrative and theoretical purposes, while their clinical uses are limited to medical emergencies. On the other hand, classifications by degree of involvement are useful for initial treatment planning and for predicting treatment outcomes. The authors conclude that for a thorough treatment planning and for better understanding of the addiction process, psychosocial classifications may be the most useful approach.

A psychosocial typology of drug addicts and implications for treatment

The underlying assumption of the paper is that the poor state of our understanding in the field of addiction stems, in part, from our failure to differentiate among different personality structures to be found in addicted people. To test this assumption, a typology was developed based on personal and psychological data of 663 drug addicts. Cluster analysis of these data, which did not include variables pertaining to drug abuse, resulted in nine types of addicts with different sociocultural backgrounds and psychological makeups. Treatment recommendations, including goals, techniques, staff, settings, and prognosis are offered for five types. The paper concludes that drug addicts are not a homogeneous group, but that there are different types of addicts with differing motives for drug use and differing psychological needs, and therefore drug addiction treatment should be matched with the specific needs of each type.

The "urge to classify" the narcotic addict: a review of psychiatric classification. I

Attempts to classify drug addicts are divided into three main groups: (1) psychiatric classifications, (2) psychological classifications, and (3) classifications by pattern of abuse. An extensive literature review of the psychiatric classifications of narcotic addicts suggests that there is no one diagnosis that fits all narcotic addicts and that the importance of psychopathology in drug addiction has been exaggerated. It is concluded that theoretical psychiatric classifications of narcotic addicts have failed to stimulate empirical research and that empirical classifications have not demonstrated their utility for treatment and prognosis.

Are addicts' self-reports to be trusted?

A review of the literature and a report of an empirical inquiry both suggest that retrospective inquiry, based on addicts' self-reports, are, in very many cases, valid and reliable. The paper suggests that the relevant problem connected with addicts' self-reports is not whether they are to be trusted or not, but rather what types of questions and situations best lend themselves to be researched when using retrospective techniques.

The Classification of Drug Users

This paper outlines a possible approach for decreasing the harmful personal and social consequences of legal and illegal drug misuse and abuse. It is suggested that the role of rehabilitation and treatment should not be abstinence or even, necessarily, the reduction of drug use. It is argued that rehabilitation programs with drug users should be directed primarily toward eliminating the need for society to identify and deal with the drug user.