Over the years, we have continued to research addiction in order to learn more about how it develops, the specific factors that make some individuals more susceptible to addiction than others, whether the various types of addiction work similarly or differently, and so on. The ultimate goal was to understand the disease better so that we can make treatments and the recovery process more efficient.
Along the way, we’ve come to understand that addiction can be more than uncontrollable substance abuse: There are countless individuals suffering from sex addiction, gambling addiction, exercise addiction, food addiction, and many more. Moreover, it’s been found that there’s even a certain personality type—appropriately referred to as the addictive personality—that makes an individual likely to become addicted to things that stir the reward and pleasure centers of the brain.
As such, some have tried to figure out a way to determine what, if anything, to which any given individual would be especially likely to become addicted. Enter: The PACE model of care.
The PACE Model of Care – Addiction Specificity
With the elevated rates of addiction that have been occurring worldwide, there’s a concerted effort among scholars and researchers to understand the factors that would put certain individuals at higher risk for addiction or becoming addicted to certain substances than others. Moreover, many have sought to understand why some individuals develop co-occurring or comorbid addictions when many individuals who suffer from addiction do not.
The PACE model was adapted from use as a means of measuring interpersonal intimacy to be used as a framework for understanding what’s referred to as addiction specificity, which is the behavioral phenomenon in which an individual who could have developed a number of possible addictions develops one over the others. Addiction specificity is essentially the opposite of comorbidity; whereas individuals with comorbid addictions are addicted to more than one substance, addiction specificity deals with what’s involved in an individual’s so-called selection of one addiction over another.
In short, the PACE model is intended to explain the patterns of addictive behavior, including the identification of variables that direct individuals to certain addictions over others, which also help to determine whether there are addictions that can serve the same functions—and, therefore, potentially replace—other addictions.
The PACE model of care consists of four variables—pragmatics, attractions, communication, and expectation—that form a chain of action or flow chart. Progressing through pragmatics and each of the successive variables, the individual proceeds closer and closer to the development of an addiction.
Pragmatics & Attraction
There are a number of factors that influence or determine the substances that are actual, physically available to an individual, which reduces the potential number of substances to which an individual can be attracted. The first two variables of the PACE model of care are pragmatics and attractions.
In short, pragmatics refers to the availability of a substance and whether the individual has access to the substances. This includes whether or not a substance is sold in the individual’s hometown, whether the individual has access to the substance through channels of introduction such as suppliers, having the means or money required to purchase the substance, and so on.
When there is only one substance that’s physically available to an individual, he or she either will or won’t become addicted to that substance; however, if there are multiple substances that are physically accessible to the individual, the next variable of the PACE model—attraction—comes into focus. The variable of attraction is as simple as determining to which of the available substances the individual feels most drawn, which includes preferences for certain effects over others, whether a drug feels more familiar or foreign, and so on.
Moreover, the attraction also considers the potential consequences of using a substance, which must be outweighed by the perceived benefits. If there is only one drug to which an individual is especially attracted, that is the substance to which he or she will develop an addiction. However, if there is more than one substance the subsequent PACE variables will come into play.
Communication & Expectation
In terms of communication, it’s been found that individuals with prior exposure to certain differential vocabularies tend to pursue the behaviors associated with those vocabularies later in life. For example, a child with an older sibling who experiments with marijuana might frequently hear words like “bong,” “lighter,” “weed,” “rolling papers,” and “high,” which has shown in research to make those children more likely to pursue the behaviors associated with those vocabularies, which would be experimentation with marijuana in the case of this example.
The reason is that people tend to select social and physical environments according to what they already know or have experienced previously, making even new experiences seem much more familiar and, therefore, more comfortable. The PACE model of care suggests that individuals will choose to abuse and potentially become addicted to the substance associated with the vocabulary—and behavior—that are most familiar to them based on prior exposure and experiences.
When individuals are determining whether or not they want to behave in a certain way, they first do a quick assessment of the potential outcomes. If they feel that the consequences of the event will be positive and provide relief to a certain experiential request, which often entails an outcome that offers some benefit or level of comfort in the immediate situation; in the case of substance abuse, this would entail a substance offering a lubricating effect in a social interaction, increasing self-esteem and confidence, and so on.
However, the benefits can also be more long-term as well, such as with individuals who feel that smoking cigarettes will help them with maintaining or losing weight. In many cases, individuals recall prior experiences in which they witnessed an individual expressing the benefit of partaking in a certain behavior, such as when an adult says they need a cocktail to cope with the day’s stresses. In essence, the expectation of the PACE model refers to an individual’s belief that imbibing a substance has benefits that outweigh any potential negative consequences.
The Bottom Line: Is PACE Accurate or Helpful?
The PACE model is unique because it explores an often overlooked aspect of addiction development, which is the selection of one addiction over others that are available. Moreover, the PACE model can offer preliminary explanations for the tendency of some individuals to substitute one addiction for another, which occurs only when the secondary addiction can help the individual achieve the same things as the first substance did. However, perhaps the greatest benefit of the PACE model of care is that it gets professionals thinking about how addictions develop in new ways.
For most individuals who develop an addiction, they chose one of the substances that were available to them rather than becoming addicted to the only substance they could obtain. Because of this, determining some of the factors involved in the selection of one substance over others would help professionals make treatments more effective. This is because they could isolate the more specific effects and perceived benefits that individuals experienced when they abused their substance or substances of choice, helping them to learn to substitute their substance abuse with healthier, more productive behaviors that can achieve some of the same effects.
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Addiction is a very dangerous, potentially deadly disease. However, recovery is both possible and attainable. If you or someone you love is suffering from chemical dependency and would like to learn more about recovery, Drug Treatment Center Finder is here to help. Call today at 855-619-8070 to speak with one of our recovery specialists who offers free consultations and assessments, matching individuals in need with the programming that can deliver them to lives of sobriety, happiness, and fulfillment.