在官方成瘾认识理论未曾确立之前,美国社会对于成瘾的认识可谓是五花八门、应有尽有。这些纷纭复杂的成瘾认识理论,一方面反映了美国社会对于成瘾现象本身在认识上所存在着的偏差与不同,另一方面也说明成瘾认识上的曾经困难之处。的确,麻醉品成瘾是至今尚未完全把握的一种麻醉品依赖症状。虽然在20世纪20年代之后崛起的以劳伦斯·科尔博为代表的“精神病学说”确立了对于麻醉品成瘾的美国官方见解,但是,这种解释并不意味着成瘾治疗在其实践过程中的卓有成效以及从此一劳永逸。事实上,在经历了乐观治疗成瘾的时期之后,美国社会上下对于治疗成瘾基本上已不抱太大的希望,而随着成瘾治疗的束手无策,以及医学界对于成瘾主流理念逐渐转向成瘾并非一般疾病的认识,美国成瘾治疗或者说美国社会对于成瘾者的治理也进入了一个特殊的时期。既然成瘾非病,或许说即使是一种疾病,也是一种非正常的精神疾病,那么,在成瘾治疗乐观时期形成的自由无拘的个人治疗成瘾的方式,尤其是那些维持成瘾的行医方式遭受摒弃也就成为理所当然之势。
需要强调的是,与这些成瘾认识以及治疗理念的变化并行不悖的是,因联邦执法机构对待成瘾的态度变化与医学界对于成瘾认识的变化而导致的医疗模式的方向性转变。很显然,既然成瘾并非疾病,而成瘾治疗也已无法解决成瘾问题,那么,以法律惩戒对麻醉品及其成瘾现象予以禁止,毫无疑问地也就成为当时美国社会解决成瘾问题的首要选择。这也是成瘾治疗在此后的相当一段时间里只能以一种附属方式依附于法律惩戒模式的缘由所在。
注释
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