As noted in the preceding section "Disease Concept".The dual diagnosis theory conflicts with the disease model in that it presumes that addictive behavior is a symptom of an under lying psychological disorder. This is perhaps the most accepted view, particularly by those outside the addiction field. It emphasizes that the problematic use of alcohol and other drugs is secondary to some other psychological problem or condition; the primary psychological problem causes emotional pain, and alcohol and other drugs serve to temporarily relieve this pain. An example of this would be a woman who was sexually molested as a child by a relative. She does not tell anyone and she does not receive any assistance. The woman experiences anger, guilt, embarrassment and anxiety as a result of the experience, she does not possess the abilities to deal with this on her own and she finds that alcohol and other drugs to relieve these uncomfortable feelings. Another example would be the person who suffers from depression and self-medicates with stimulants to relieve the constant symptoms of depression.

Related to the view that alcohol and other drug problems are secondary to other psychological problems is the question about whether an alcoholic or addictive personality exists. Clearly, there are alcoholics and drug addicts who seem to be free of any identified psychological problems prior to their problematic use patterns. Proponents of psychological explanations of addiction believe that there may be an "addictive personality" that could be identified and that would explain why individuals with addictions often have problems with non-drug addictive behavior (e.g., gambling, food, work, sex) following successful recovery from their drug of choice. However, this effort to identify the "addictive personality" has largely been unsuccessful. It has been noted that alcoholics appear to be as variable in personality as are non-alcoholics. (20)

In this particular approach it is quite common for medications to be prescribed to help deal with the underlying disorder. The practice of medicating does cause concern for some "based on extensive clinical experience, use of any psychoactive drug will usually lead back to use of the primary drug or addiction to the secondary drug (drug switching) the only safe path to follow is complete abstinence from all psychoactive drugs." (21)

It would therefore dictate that caution be used when medications are necessary, and the individual would be monitored or at least closely watched for signs of returning addictive behavior which may serve as a warning to relapse. Also it would be advantageous if the medicated period were of minimum necessary duration.

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