The Clinic

Although many theories regarding addiction’s origins exist, most experts define it as a complex interaction of biological, psychological, and social factors. The biological model defines addiction as a medical issue: Repeated substance use alters dopamine pathways, reducing the ability to regulate behavior. As a result, treatment in this model focuses on rebuilding those pathways and finding new ways to regulate the body. The cognitive model suggests that addiction is the result of unresolved emotional pain and that people turn to substance use because they believe it will help them manage stress and negative emotions. Treatment in this model focuses on the emotional roots of addiction and often involves therapy. The behavioral model views addiction as a learned behavior reinforced by social factors like the availability of substances and the presence or absence of supportive relationships. In this model, treatment focuses on relationship-building and changes in environment to remove negative influence. In most cases, recovery experts draw on multiple models, tailoring treatment to the specific needs of each patient, depending on their circumstances. 

The Clinic’s approach to addiction and recovery closely follows the cognitive model. Meg comes to believe that her addiction to oxycodone and alcohol is her way of coping with her extensive childhood trauma. In Meg’s therapy sessions, Max argues that her “unprocessed memories trigger physical emotions” that she cannot handle and that she turns to drugs to temper these emotions (127). As a result, his recovery plan involves extensive therapy and other treatments to help Meg work through her traumatic memories. Although the conclusion of the novel complicates Max’s status as an objective professional, Meg’s sobriety and embrace of therapy validate this aspect of his approach.