What Exactly Is the Biopsychosocial Model of Addiction?

Some individuals may be more affected by the rewarding effects of drugs of abuse because they are trying their best to regulate painful emotions. When we see substance use disorders/addictions in a binary fashion, we are choosing one lens or another, which does not give us a clear picture of the person. You can further explore poverty, race, gender, and other examples of intersectionality that may play a role in a person’s substance use/addiction as you are working with them, ensuring your work is cultural, spiritual, gender-sensitive and trauma-informed. This chapter aims to explain that people who use drugs participate in a drug culture, and further, that they value this participation.

Themes related to Therapeutic Alliance were the most prevalent and suggest pathways to retention. Individualizing care through flexible appointment scheduling was strongly valued, while inflexible scheduling fostered fear of not getting medication. Some participants indicated they were less likely to remain in care when providers did not include them in decisions about medication type, dose, or formulation. Teens are especially vulnerable to possible addiction because their brains are not yet fully developed—particularly the frontal regions that help with impulse control and assessing risk. Pleasure circuits in adolescent brains also operate in overdrive, making drug and alcohol use even more rewarding and enticing.

Interactions between Psychological, Social, and Biological Factors

Others highlight personality traits like impulsivity, a desire for excitement, or mental health issues stemming from past traumas. Still, others focus on how social and economic factors like solid family bonds, good friends, and opportunities for education and work can influence your choices. In addition to helping initiate drug use, drug cultures serve as sustaining forces. They support continued https://yourhealthmagazine.net/article/addiction/sober-houses-rules-that-you-should-follow/ use and reinforce denial that a problem with alcohol or drugs exists.

Mainstream culture in the United States has historically frowned on most substance use and certainly substance abuse (Corrigan et al. 2009; White 1979,  1998). This can extend to legal substances such as alcohol or tobacco (including, in recent years, the increased prohibition against cigarette smoking in public spaces and its growing social unacceptability in private spaces). As a result, mainstream culture does not—for the most part—have an accepted role for most types of substance use, unlike many older cultures, which may accept use, for example, as part of specific religious rituals. Thus, people who experiment with drugs in the United States usually do so in highly marginalized social settings, which can contribute to the development of substance use disorders (Wilcox 1998). Further, using a BPS approach to substance use disorders allows us to identify the context in which problematic drug use occurs (Buchmann, Skinner, & Illies, 2011).

Biopsychosocial Model of Addiction Example

White (1996) gives an example of a person who was initially attracted in youth to a drug culture because of a desire for social acceptance and then grew up within that culture. Through involvement in the drug culture, he was able to gain a measure of self-esteem, change his family dynamic, explore his sexuality, develop lasting friendships, and find a career path (albeit a criminal one). For this individual, who had so much of his life invested in the drug culture, it was as difficult to conceive of leaving that culture as it was to conceive of stopping his substance use. The drug culture has an appeal all its own that promotes initiation into drug use. Stephens (1991) uses examples from a number of ethnographic studies to show how people can be as taken by the excitement of the drug culture as they are by the drug itself.

The Intricate Dance: Interactions Between Biological, Psychological, and Social Factors

The complex behaviour contributes both positive and negative feedback, and thus affects how the complex behaviour emerges. Systems theory, therefore, balances reductionism and the intrinsic heterogeneity within systems. Given the spectrum nature of substance use problems, decision-making capacity is therefore neither completely present nor absent, but may be, at some times in certain contexts, weakened.

Finding Meaning in Life: An Exploration of Existential Psychology

This intense pleasure surge creates an influential memory association between the addictive substance or behavior and the feeling of reward. Addiction is a complex disease that disrupts the brain’s reward system, motivation, memory, and learning. It can lead to uncontrollable use of substances or behaviors despite adverse consequences. It’s important to note that these psychological factors don’t cause addiction on their own. However, they can create a vulnerability that, combined with biological and social aspects, can increase the risk of addiction. Genetics play a significant role, with family history increasing a person’s vulnerability.

Personality theories in addiction explore the connection between personality traits and a person’s vulnerability to addiction. These theories propose that specific personality characteristics can make someone more likely to develop or struggle with addiction. The deontological principle of respect for persons is a characteristic feature of harm reduction efforts such as HAT. This ethical principle is justified and framed as a matter of human rights, which maintains that injection drug users, for example, have the right, like other less stigmatized members of society, to access medical and social services. This claim coincides with a recent emergence of a global advocacy movement that seeks to construct the use of drugs as a human right (Elliott, Csete, Wood, and Kerr 2005; Lines and Elliott 2007).

2.3. Mood Disorders and Addiction

These traits might lead them to experiment with addictive substances or behaviors more readily. The objective of these trials is to investigate the benefits and risks of administering medically supervised, pharmaceutical-grade injectable heroin to chronic opiate users where other treatment options, such as methadone maintenance therapy, have failed. Both social norms and laws influence attitudes, perceptions, and beliefs of the effects of substances and considerably affect consumption rates (Babor, Caetano, Casswell et al. 2003; Hawkins, Catalano, and Miller 1992).

• The Vermont Department of Health reported a 500% increase in drug overdose related deaths with at least 79% involving one or more opioids between 2010 and 2022.
• Fifteen semi-structured telephone interviews were conducted from August through November of 2021 regarding patient experiences receiving MOUD in 13 Vermont Hub and Spoke clinics.
• Social factors such as family dynamics, peer influence, cultural norms, and socioeconomic status can significantly contribute to the development and maintenance of addiction, particularly in individuals with underlying mental health disorders or mental health problems.
• One claim is based on the fact that decisional autonomy, or rationality, is not the most valuable human characteristic, and the individual-as-independent does not adequately characterize human beings (Russell 2009).
• The biopsychosocial model emphasizes the interaction of biological, psychological, and social factors.
• In the best case, staff members will have a plan for creating a culture of recovery within their treatment population.

Social factors include influences like family, friends, and socioeconomic status. Recent advances in neuroscience provide compelling evidence to support a medical perspective of problematic substance use and addiction (Dackis and O’Brien 2005). Despite these developments, the science is still in its early stages, and theories about how addiction emerges are neither universally accepted nor completely understood. Current ethical and legal debates in addiction draw upon new knowledge about the biological and neurological modification of the brain (Ashcroft, Campbell, and Capps 2007). The relationship between Shared Decision-Making and continuing engagement in MOUD at a given clinic was expressed by some participants who shared that they were less likely to continue care when they do not have input into medication and treatment decisions.

“You can walk in at one point you have a UA and unfortunately for me I had trouble going to the bathroom when people were staring at me. I wasn’t used to it and it took me years to get through Sober Houses Rules That You Should Follow it… And that’s just one night without medication, because you know you’re going to be sick” (P3, -). “She made an exception, and we could do a one-on-one group instead of doing the new person’s group because I have my children. I thought that was really awesome that they’re willing to work with me…I really appreciated that because they could’ve just said, ‘Well you have to figure it out’” (P9; +).

This impairment makes it difficult for individuals to stop using substances or engaging in addictive behaviors, even when they recognize the negative consequences. The social burden of illicit drug addiction is estimated at billions of dollars per year (Fisher, Oviedo-Joekes, Blanken, et al. 2007). Research that involves providing drugs to individuals living with an addiction must negotiate between science, ethics, politics, law, and evidence-based medicine.

Moreover, the model does not solve the problem of free choice, as the model still, even at the systems (macro) level, has causally sufficient preceding conditions. A tangled web of biology, psychology, and social influences lies at the heart of addiction, a complex and multifaceted disorder that has long perplexed scientists and devastated countless lives. This intricate interplay of factors forms the foundation of the biopsychosocial model of addiction, a comprehensive framework that seeks to unravel the mysteries of substance use disorders and pave the way for more effective treatments. Insufficient access to culturally relevant and appropriate SUD treatment including care provided in a patient’s native language has been identified as a treatment barrier 49.

In 2022, it was reported that 91% of those deaths involved at least one opioid 8. Additionally, from 2017 to 2019 the number of deaths related to heroin and fentanyl decreased in three urban counties, and increased in almost all rural counties 9, 10. Moreover, there are 16 states where the urban and rural rates were increasingly similar, highlighting the need to address substance use in these rural areas. With such high prevalence rates, building a system of care for OUD has been a challenge nationwide, particularly in rural settings. Patient-centered MOUD care was important to participants and encouraged engagement in care. Prioritizing alliance with patients, adapting care to patient needs and preferences particularly when scheduling, including patients in medication decisions, and biopsychosocial attention to patients are congruent with patient perception of desirable MOUD care.