Stress environment over morality to treat addiction: clinic chief

The treatment director at a Thai-based rehabilitation clinic popular with Westerners has stressed the need to view addiction as an ecological problem, as opposed to a moral dilemma, in an as yet unpublished paper about gambling addiction.

Dr Phil Townshend is a clinical psychologist at Drug and Alcohol Rehab Asia (DARA) Thailand, a treatment clinic specialising in alcoholism, other substance abuse and problem gambling. He said a non-judgemental approach built around removing the client from familiar and relapse-susceptible environs is a crucial element of treatment.

“The predominant community view is that addiction is a moral issue caused by character flaws in an individual,” Townshend said. “However, researchers are pointing to environmental stimuli that rapidly alter an ecological situation, and where the speed of environmental change does not match the speed with which humans can adapt genetically, or behaviourally, to that change.”

“Understanding and removing the environmental trap, together with standard treatment options, is likely to lead to more successful outcomes than current practice,” Townshend said. “Addiction is currently defined as a primary, chronic disease of brain reward, motivation memory and related mental processes; modern treatments, such as counselling, behavioural therapy and psychological education alone, are limited in an ecological trap scenario.

“If we can help people change their personal environment, reduce access to their addictive agent or behaviour, and make ecological intervention an equal priority to other therapeutic options, we may see heightened success with treatment programs.”

Treatment at one of DARA Thailand’s two facilities starts at just under US$5000 for a four-week course. There are also 8- and 12-week programs available.

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