A revitalized biopsychosocial model: core theory, research paradigms, and clinical implications PMC

Psycho-social systems are concrete entities or groups whose members act in relation to each other, such as families, religious organizations, and political parties (Bunge 2004). Social processes in addiction are investigated by examining social categories such as networks, groups, organizations and subcultures that alone cannot be explained by neurobiology. Addiction consists of interacting biological and psychosocial mechanisms because the mechanism (e.g., the behaviour) contributing to addiction involves action within a social system. The larger societal structure either restricts or enhances interactions between agents in a social system (Bunge 1997). 14Slade et al.’s arguments may also indicate that the vagueness of the BPSM and “complex disorder” idea effectively grant researchers wide discretion in deciding what observations would be validating of a construct like TMD.

Drugs, Health, Addictions & Behaviour – 1st Canadian Edition

biopsychosocial model of addiction

Francisco A. Montiel Ishino and Faustine Williams, and Ms. Bonita Salmeron was supported by the Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily reflect the views of the National Institutes of Health. Use of these data does https://thebostondigest.com/top-5-advantages-of-staying-in-a-sober-living-house/ not imply the National Institutes of Health agrees or disagrees with any presentations, analyses, interpretations, or conclusions herein, nor was it involved in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. Finally, we argue that progress would come from integration of these scientific perspectives and traditions.

Substance Use Disorders in Children and Adolescents

Using this model, four fundamental questions that are central to the phenomenology of addiction can be addressed. Whether his affinity for alcohol influenced his philosophy of behavior is not known, but it is worth noting that some of earliest contributors to Western philosophical traditions were familiar with substance-induced intoxication and other phenomena related to addiction. In his dialogues, Socrates argued that when faced with a choice between two alternatives, it is our nature to choose the alternative that is most right, most good, and most virtuous (Plato, as translated by Jowett, 2011).

  • The biopsychosocial model was not so much a paradigm shift—in the sense of a crisis of the scientific method in medicine or the elaboration of new scientific laws—as it was an expanded (but nonetheless parsimonious) application of existing knowledge to the needs of each patient.
  • In some ways, this model contradicts the prevailing characteristic of addiction as a “chronically relapsing brain disease” (Leshner, 1997) in that it is neither relapsing nor limited to the brain.
  • In closed meetings, these factors are shared with others – not as an exercise in vulnerability – but to draw attention to the personal factors that contribute to addiction across individuals.
  • This factor is as broad as it sounds and includes personality traits (like sensation-seeking and impulsivity), mental health concerns (like anxiety and depression), psychological constructs (like self-esteem and self-worth), and the psychological impact of an individual’s life experiences (such as trauma).

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Reflecting on these concerns, the authors stated “we [had] to be clear in our ethics applications and in our informed consent process with participants that HAT will not be available outside the context of the study” (p. 267). Although a full discussion is warranted pertaining to these challenges, these ethical concerns raised by Oviedo-Joekes et al. (2009) resonate with our present discussion. Additionally, many neurotransmitters are involved in the experience of reward (dopamine, opioids, GABA, serotonin, endocannabinoids, and glutamate; Blum et al., 2020).

  • The BPSM simply posits that when people fall ill, it is because some subset of all possible causal factors somehow interacted to make them ill.
  • Overall self-reported health was categorized as (1) excellent, (2) very good, (3) good, and (4) fair/poor.
  • Accordingly, the matrix of a person’s socio-historical context, life narrative, genetics, and relationships with others influence intention, decision, and action, and thus shape the brain.
  • Unhealthy and maladaptive moods, thoughts, and behaviors can all be symptoms of mental health conditions, and in turn can contribute to our overall health.

Of most importance, however, is the social environment, which acts to either encourage or discourage drug use. Indeed, one of the strongest prognosticators of drug use is the drug-use behavior of peers (Bahr et al., 2005; Walden et al., 2004), and numerous epidemiological studies have identified functional relationships between the behavior of peers and an individual’s drug use (Bot et al., 2005; Kelly et al., 2013). Drug use may be transmitted socially by a number of mechanisms (Strickland and Smith, 2014; 2015), and several of these mechanisms Top 5 Advantages of Staying in a Sober Living House have received empirical support. The impact that other people have on an individual’s drug use is directly related to their physical proximity – with intimate partners, family members, and close friends having the largest impact on drug use (Salvy et al., 2014; Kendler et al., 2013; Kuperman et al., 2013). All support groups guided by the 12-step principles address the functional relationships that determine drug use. Going forward, these same principles can be used to guide the development of metacontingency-based interventions to aid recovery.

  • We conclude with a discussion of the model and its implications for drug policy, research, addiction health care systems and delivery, and treatment of substance use problems.
  • What brings us together is a passionate commitment to improving the lives of people with substance use problems through science and science-based treatments, with empirical evidence as the guiding principle.
  • However, large international mutual-help organizations like Alcoholics Anonymous (AA) do represent the culture of recovery for many individuals.
  • Just as people who are actively using or abusing substances bond over that common experience to create a drug culture that supports their continued substance use, people in recovery can participate in activities with others who are having similar experiences to build a culture of recovery.
  • These data are subject to the individual participant’s bias, truthfulness, recollection, and knowledge.
  • It is not quantal in the sense that the person is or is not currently in relapse, but it is graded in the sense that the probability of drug use is always at a moment-to-moment value based on the total of direct and indirect factors that are determining its occurrence.
  • Other individuals are arguably unique, in that they reside in their own network of reciprocal determinism.

It is worth noting that the wayward BPSM discourse on gun violence is almost transparently political rather than scientific. The literature in this area does not provide a meaningful definition of “biopsychosocial disease” and then demonstrate that gun violence qualifies. The articles on the topic consistently argue that gun violence “can” and “should” be “framed as a biopsychosocial disease” to expand medical jurisdiction over the problem (Barron et al. 2021, 1; Grossman and Choucair 2019, 1640; Hargarten et al. 2018, 1024–26; Kohlbeck and Nelson 2020). “Without this framing,” Hargarten et al. warn, “we limit progress… [and] will be limited to education of our patients” (2018, 1025). Despite its almost conspicuously contrived nature, “gun violence disease” is treated as though it were a disease like any other.

Whole Person Healthcare The Biopsychosocial Spiritual Model of Medicine. By Doodle Med.(

Why do individuals choose the pathological choice of using drugs at the expense of taking care of oneself and loved ones, of sacrificing personal relationships, of destroying one’s social environment. According to Socrates, the answer is troubling – one must have bad judgement, bad priorities, or even worse – both (see excellent lay discussion by de Kenessey, 2018). To understand what an individual gains from participating in a drug culture, it is important first to examine some of the factors involved in substance use and the development of substance use disorders.


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