PDF The Biopsychosocial Model of Addiction BIOPSYCHOSOCIAL VS BIOMEDICAL MODELS OF ADDICTION

Biology includes genetics and brain chemistry, while psychology examines an individual’s thoughts, emotions, and coping mechanisms. Social factors include influences like family, friends, and socioeconomic status. The factors that increase an individual’s risk for addiction are numerous, yet they all find their place in the biopsychosocial model of addiction (Marlatt & Baer, 1988). Taken together, this model provides a holistic conceptualization of addiction that acknowledges the complexity of the disorder and provides guidance toward a solution, which must necessarily be multifaceted and holistic as well.

Trauma and Life Stressors

It’s like a garden – the right environment can help a person flourish, but a toxic one can stunt growth and foster disease. For example, researchers have found a robust association between trauma and addiction (Dube et al., 2002, 2003; Giordano et al., 2016). Indeed, in the original Adverse Childhood Experiences (ACEs) study, Felitti et al. (1998) found that more ACEs increased the odds of subsequent drug and alcohol use.

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Such new iterations of systems theory concentrate on the cognitive and social processes wherein the construction of subjective knowledge occurs. The dynamic within these relationships can contribute to or inhibit the emergence of a complex behaviour such as problematic substance use, while regulating both inputs and outputs from changing internal and external environments. 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. Guiding an individual’s behaviour are brain processes, somatic mechanisms, the ethical rules and norms that govern society, and the nature of the interaction. The complex combination of biological, psycho-social and systemic factors may explain why it is so difficult for some individuals to refuse drugs in the face of increasingly negative consequences.

Addiction can occur regardless of a person’s character, virtue, or moral fiber.

It is important to note that one person’s reaction to the reward experience may be quite different from another’s. This realization should help us cultivate empathy for those with addiction—it is very likely that others truly do not know how drugs make them feel. Genetics and biology are a part of the picture—albeit not the entire picture. Although there is no “addiction gene” to definitively identify a person as being at risk for addiction, it is evident through twin studies, adoption studies, family studies, and more recently, epigenetic studies that addiction has a genetic component. Individuals who are genetically predisposed for addiction enter the world with a greater risk of becoming addicted at some point in their lives. Think back to the beginning days of the COVID-19 pandemic and how many people were negatively impacted by the social gathering restrictions.

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Recent research has suggested that enriched environments produce long-term neural modifications that decrease neural sensitivity to morphine-induced reward (Xu, Hou, Gao, He, and Zhang 2007). Accordingly, the social environment can increase the frequency of cravings, which may contribute to increased drug consumption, and thus increase the Sober House Rules: A Comprehensive Overview probability that affected individuals will participate in a series of habituated behaviours that facilitate using (Levy 2007b). Biological factors can profoundly influence psychological and social aspects. For instance, the genetic predisposition to addiction can shape personality traits and influence social behaviors. It’s like a domino effect, with one factor setting off a chain reaction that ripples through all aspects of a person’s life. The importance of this model in addiction treatment and research cannot be overstated.

Cultural Dimension

• The research indicates yes; remembering it is one risk factor and does not mean it WILL lead to a substance use disorder.
• 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).
• Individuals experiencing withdrawal may suffer severe symptoms that include sweating, nausea, vomiting, abdominal pain and irritability (Koob and Le Moal 2005).
• Notions of a pathologized self, deeply enmeshed with personal identity, may lead an individual to internally negotiate a relationship between the self and the brain (Dumit 2003).
• The latter may compromise an individual’s sense and experience of free will, being-in-the-world, perceptions of personal responsibility, and view abnormalities in dopamine pathways as fatalistic.
• This results in several unpleasant symptoms, such as anxiety, restlessness, and irritability.

Factors such as socioeconomic status, availability of substances, and exposure to peer groups that normalize substance use can increase vulnerability (Onyenwe & Odilibe, 2024). Adolescents and young adults, in particular, are highly susceptible to peer influence. Being surrounded by friends or family members who engage in substance use can increase the likelihood of initiating and maintaining addictive behaviors. Advances in addiction research are increasingly being applied to gain deeper knowledge about the impact of drug use on brain structure and functioning, capacity, autonomy, free choice and decision-making, behaviour, treatment, and symptom reduction.

This results in several unpleasant symptoms, such as anxiety, restlessness, and irritability. These withdrawal symptoms can be very intense and drive the person to use the substance or engage in the behavior again to relieve the discomfort. Neuropsychology plays a crucial role in understanding and treating addiction. It bridges the gap between the brain and behavior, specifically focusing on how substance use affects brain function and how those changes contribute to addiction. The Sociocultural Model of Addiction examines how societal norms, cultural attitudes towards substance use, and environmental stressors can all contribute to addiction. A supportive family can be a powerful force for recovery, but dysfunctional family relationships can contribute to the development and maintenance of addiction.

Yet many other elements are idiosyncratic, such as the intensity of the experience of reward and the functioning of the individual’s mesolimbic dopaminergic pathway in the brain. The biopsychosocial model provides a means of considering the myriad of factors that can contribute to the risk of addiction. All these theories separately create a narrower view of substance use and influence how we treat substance use disorders. As our understanding of substance use and substance use disorders continues to evolve, using a perspective which includes an intersectional approach may help us to address some of the societal inequities that put people and communities at risk of substance use disorders. We must be cautious to acknowledge there is no panacea, nor any magic bullet. Research consistently shows that genetics play a significant role in the development of addictive behaviors (Deak & Johnson, 2021).

Despite widespread efforts to “talk it up,” Engel’s “biopsychosocial model” has failed to have any lasting impact on psychiatry. The logical flaws in Engel’s original concept are explored, and some consequences noted. Furthermore, some communities are targeted more heavily with alcohol and tobacco advertisements and have more availability of drugs of abuse than others, particularly impoverished communities (Primack et al., 2007; Rose et al., 2019). Therefore, the social environment in which one exists contributes to their risk of addiction.

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It is important not to look at the biological dimension as neurobiology alone. It also takes into consideration aspects of health functioning such as addictive behaviour, diet, exercise, self-care, nutrition, sleep and genetics. We look at all aspects of health, whether it is positive, neutral or challenging. Understanding the impact this information has on the person as well as the additive behaviour gives us a clearer picture for positive changes and for the person to actively participate in their recovery and treatment plan. The Biopsychosocial Plus Model reflects a dimensional understanding of addiction. The Biopsychosocial Plus Model recognizes the complex interactions between the biological, psychological, social, cultural, and spiritual aspects of addiction.

Some folks are simply more prone to addiction than others, thanks to their DNA. It’s not a guarantee, mind you – having these genes doesn’t mean you’re destined for addiction any more than having genes for musical talent means you’ll be the next Mozart.