This theory hypothesizes that substance or alcohol addiction is a conscious choice made by the addict. Whitaker calls this theory the “cruelest of all” (152), since she thinks addicts tend to slowly develop dependencies rather than choosing to struggle with addiction. By rejecting this theory, the author tries to persuade the reader that addictions tend to develop slowly and unintentionally over time, rather than through conscious and informed choices.

The Disease Model of alcohol addiction argues that certain people are born significantly predisposed to developing addictions. This model contends that alcoholics have different brains from non-alcoholics, and that this population will always struggle with their more “addictive” personalities. This theory began in the 1960s with E.M. Jellinek’s book The Disease Concept of Alcoholism, and it remains popular with Alcoholics Anonymous and the National Institute of Alcohol Abuse and Alcoholism.

Whitaker largely refutes this interpretation of alcohol addiction, calling it simplistic and suggesting that there is nothing significantly different about so-called “alcoholics” and the rest of the population. However, she does acknowledge that there is some evidence that people with drug and alcohol dependencies tend to be less sensitive to stimulation than others, and therefore need more stimulation to generate dopamine, which could contribute to misuse and addiction.

This model, developed by Canadian psychologist Bruce K. Alexander, frames addiction as a response to feeling “disconnected” from meaningful parts of life, such as community, purposeful work, and nature. Whitaker acknowledges that this theory may help to explain why some people become dependent on alcohol and other substances while others do not. By discussing the role that social connections play in dependency and recovery, the author integrates the dislocation model into her work and acknowledges the importance of a healthy community in overcoming addiction.

The Learning Model is a theory from scientist Marc Lewis that maintains that addiction is a normal, adaptive response to people using substances or alcohol. This theory emphasizes the brain’s changeability and teaches that people can “unlearn” addiction because of the brain’s ability to adapt and create new habits. Whitaker acknowledges that the Learning Model offers valuable insight into understanding addiction, and she largely agrees with Lewis’s idea by discussing addictions as powerful habits, or learned behavior, which can be overcome with new habits.

Whitaker refers to private rehabilitation centers as the “Rehab Industrial Complex” and claims that these centers often exploit people struggling with addiction. The author emphasizes how these private businesses make a profit off of their clients by marketing treatments and programs, with the industry generating $35 billion a year. She claims that the Rehab Industrial Complex “mostly lines the pockets of people who exploit desperation” (478). Whitaker’s negative description of rehab centers contributes to her argument that people, especially women, should carefully consider all of their recovery options.

The Self-Medicating Theory posits that addicts use drugs and alcohol to “self-medicate,” or relieve their physical or emotional pain, and continue to use for the short-term relief that these substances provide. Whitaker suggests that there is some truth to this theory, but she considers it simplistic on its own.