Governing Images and Self‐Control: A Comment on Drew's “Beyond the Disease Concept of Addiction”

Critical reconsiderations of the policy implications of the disease concept of addictions have been produced over the last twenty‐five years. One widely adopted approach, drawing on psychiatric traditions, has been that of the alcohol dependence syndrome. Other approaches have substituted new governing images, such as Drew's ‘way of life leading to predicaments’ model, which gives primacy to individual free will. This model is morally based and consistent with much current treatment practice, which is based on the premise that the addict is responsible for his behaviour. By retaining faith in the usefulness of treatment, the model presents a potential contradiction, namely that self control can be learnt by external control. Policy implications and broader cultural considerations of the model need to be canvassed.