Journey to Acceptance: Treating the Severe Disabilities of Alcohol Use Disorder and Substance Use Disorders

Alcohol use disorder and substance use disorders are complex brain disorders. They both contribute significantly to the global burden of disease and disability not only in terms of suboptimal physical and mental health, but also lost productivity. The negative impact on quality of life, family life, and relationships is significant. Crimes related to antisocial behavior, substance use disorder, and illegal drug trafficking, along with the economic costs of implementing policies to manage these issues, represent significant public health challenges. This chapter highlights the importance of considering current knowledge of the neurobiological mechanism underlying addiction, as well as contributing factors, to develop comprehensive treatment measures. The evolution of addiction models is described, starting from the moralistic “deviance” model to the contemporary disease-based medical model. It highlights the need for further progress towards a more enlightened approach within the social context of disability—one that is less punitive, improves access to treatment and support, reduces stigma, and promotes inclusion. As well as the journey to acceptance required by society and policy makers for the need for this more compassionate, holistic approach, there is the personal journey to acceptance required by individuals with substance use disorders undergoing treatment. Therapeutic techniques such as journaling and integrating the stages of grief model to assist in navigating the complex and emotional transition to a meaningful life after substance cessation are discussed.