Understanding Addiction

Competency 1

Understand a variety of models and theories of addiction and other problems related to substance use.


  • Terms and concepts related to theory, etiology, research, and practice.
  • Scientific and theoretical basis of model from medicine, psychology, sociology, religious studies, and other disciplines.
  • Criteria and methods for evaluating models and theories.
  • Appropriate applications of models.
  • How to access addiction-related literature from multiple disciplines.


  • Openness to information that may differ from personally held views.
  • Appreciation of the complexity inherent in understanding addiction.
  • Valuing of diverse concepts, models, and theories.
  • Willingness to form personal concepts through critical thinking.

Competency 2

Recognize the social, political, economic, and cultural context within which addiction and substance abuse exist, including risk and resiliency factors that characterize individuals and groups and their living environments.


  • Basic concepts of social, political, economic, and cultural systems and their impact on drug-taking activity.
  • The history of licit and illicit drug use.
  • Research reports and other literature identifying risk and resiliency factors for substance use.
  • Statistical information regarding the incidence and prevalence of substance use disorders in the general population and major demographic groups.


  • Recognition of the importance of contextual variables.
  • Appreciation for differences between and within cultures.

Competency 3

Describe the behavioral, psychological, physical health, and social effects of psychoactive substances on the person using and significant others.


  • Fundamental concepts of pharmacological properties and effects of all psychoactive substances.
  • The continuum of drug use, such as initiation, intoxication, harmful use,
  • abuse, dependence, withdrawal, craving, relapse, and recovery.
  • Behavioral, psychological, social, and health effects of psychoactive substances.
  • The effects of chronic substance use on clients, significant others, and communities within a social, political, cultural, and economic context.
  • The varying courses of addiction.
  • The relationship between infectious diseases and substance use.


  • Sensitivity to multiple influences in the developmental course of addiction.
  • Interest in scientific research findings.

Competency 4

Recognize the potential for substance use disorders to mimic a variety of medical and mental health conditions and the potential for medical and mental health conditions to coexist with addiction and substance abuse.


  • Normal human growth and development.
  • Symptoms of substance use disorders that are similar to those of other medical and/ or mental health conditions and how these disorders interact.
  • The medical and mental health conditions that most commonly exist with addiction and substance use disorders.
  • Methods for differentiating substance use disorders from other medical or mental health conditions.


  • Willingness to reserve judgment until completion of a thorough clinical evaluation.
  • Willingness to work with people who might display and/or have mental health conditions.
  • Willingness to refer for treating conditions outside one’s expertise.
  • Appreciation of the contribution of multiple disciplines to the evaluation process.


Members of the National ATTC Curriculum Committee reviewed the bibliography from the first printing of The Competencies. Following previously established guidelines, the Committee reviewed and linked each reference with a specific transdisciplinary foundation. Primarily textbooks are referenced in this section; however, such texts are not mutually exclusive of the practice dimensions.

  • Akers, R.L. (1992). Drugs, Alcohol, and Society: Social Structure, Process, and Policy. Monterey, CA: Brooks/Cole.
  • Baer, J.S., Marlatt, G.A., & McMahon, R.J. (Eds.) (1993). Addictive Behaviors Across the Life Span. Newbury Park, CA: Sage Publications.
  • Bennett, L.A., Reiss, D., et al. (1987). The Alcoholic Family. New York: Basic Books.
  • Blevins, G.A., Dana, R.Q., & Lewis, J.A. (1994). Substance Abuse Counseling: An Individual Approach (2nd ed.). Pacific Grove, CA: Brooks/Cole.
  • Cohen, W.E., Holstein, M.E., & Inaba, D.S. (1997). Uppers, Downers, All Arounders: Physical and Mental Effects of Psychoactive Drugs (3rd ed.). Ashland, OR: CNS Publications.
  • Collins, R.L., Leonard, K.E., & Searles, J.S. (Eds.) (1990). Alcohol and the Family: Research and Clinical Perspectives. New York: Guilford Press.
  • Curtis, O. (1998). Chemical Dependency: A Family Affair. Pacific Grove, CA: Brooks/Cole.
  • Epstein, E.E., & McCrady, B.S. (Eds.) (1999). Addictions: A Comprehensive Guidebook. New York: Oxford University Press.
  • Fisher, G.L., & Harrison, T.C. (2004). Substance Abuse: Information for School Counselors, Social Workers, Therapists, and Counselors. Boston: Allyn & Bacon.
  • Gullotta, T.P., Adams, G.R., & Montemayor, R. (Eds.) (1994). Substance Misuse in Adolescence.
  • Thousand Oaks, CA: Sage Publications.
  • Jaffe, J. (Ed.) (1995). Encyclopedia of Drugs and Alcohol. New York: Macmillan.
  • Jonnes, J. (1999). Hep-Cats, Narcs, and Pipe Dreams: A History of America’s Romance With Illegal Drugs. Baltimore: Johns Hopkins University Press.
  • Kinney, J. (2003). Loosening the Grip: A Handbook of Alcohol Information (7th ed.). New York: McGraw-Hill.
  • Lawson, A.W., Lawson, G.W., & Rivers, P.C. (1996). Essentials of Chemical Dependency Counseling (2nd ed.). Gaithersburg, MD: Aspen Publishers.
  • Lawson, G.W., & Lawson, A.W. (1992). Adolescent Substance Abuse: Etiology, Treatment, and Prevention. Gaithersburg, MD: Aspen Publishers.
  • Lewis, J.A., Dana, R.Q., & Blevins, G.A. (2001). Substance Abuse Counseling (3rd ed.). Pacific Grove, CA: Brooks/Cole.
  • Lowinson, J.H., Ruiz, P., et al. (Eds.) (1997). Substance Abuse: A Comprehensive Textbook (3rd ed.). Baltimore: Lippincott Williams & Wilkins.
  • McKim, W.A. (2002). Drugs and Behavior: An Introduction to Behavioral Pharmacology (5th ed.). Upper Saddle River, NJ: Prentice Hall.
  • Miller, G. (2004). Learning the Language of Addiction Counseling (2nd ed.). Hoboken, NJ: John Wiley & Sons.
  • Musto, D.F. (1999). The American Disease: Origins of Narcotic Control (3rd ed.). New York: Oxford University Press.
  • Nathan, P.E., & Gorman, J.M. (Eds.) (2002). A Guide to Treatments That Work (2nd ed.). New York: Oxford University Press.
  • Pita, D.D. (2004). Addictions Counseling: A Practical and Comprehensive Guide to Counseling People With Addictions. New York: Crossroad Publishing.
  • Rutzky, J. (1998). Coyote Speaks: Creative Strategies for Psychotherapists Treating Alcoholics and Addicts. Northvale, NJ: Jason Aronson.
  • Thombs, D.L. (1999). Introduction to Addictive Behaviors (2nd ed.). New York: Guilford Press. Venturelli, P. (Ed.) (1994). Drug Use in America: Social, Cultural, and Political Perspectives. Boston: Jones and Bartlett Publishers.
  • Wallen, J. (1993). Addiction in Human Development: Developmental Perspectives on Addiction and Recovery. New York: Haworth Press.
  • White, W.L. (1998). Slaying the Dragon: The History of Addiction Treatment and Recovery in America. Bloomington, IL: Chestnut Health Systems.

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