New perspectives on the similarities and differences of alcoholism and drug abuse.

Abstract

This article reviews the similarities and differences of alcoholism and drug abuse from a biopsychosocial perspective. Special emphasis is given to newer developments. In biology, the role of endorphins and isoquinolines is considered against the more traditionally recognized clinical differences between alcohol and drug disorders. Consideration is given to psychological themes such as the utility of the addictive personality concept, the impact of more sophisticated prevention strategies, and the combined treatment of alcoholics and drug abusers. Reports from social fields include a cross-cultural view of chemical dependence and an appraisal of legal and political trends which influence chemical use and the civil rights of chemical users. Recent developments in the biologic, psychologic and social sciences have solidified the impression that the chemical dependencies, for all their differences, share a number of important characteristics. The etiology of alcoholism and drug abuse has been attributed to biopsychosocial causes, currently a widely accepted hypothesis. From one perspective, this theory could be seen as a grab bag approach, since no specific universal cause has been discovered while many have been postulated. From another aspect, the hypothesis is a rational synthesis of present knowledge which finds no one etiological factor to be either preeminent or ubiquitous. This article presents in succession an overview of the biology, psychology and sociology of chemical dependence with emphasis on integrating newer developments with familiar knowledge.