It would arguably fall within the purview of all the physical and social sciences, including biology, chemistry, psychology, sociology, economics, and so on. Disease and illness (and human experience, syndrome,11 etc.) are not the same thing. The fact that it cannot explain all aspects of illness proves nothing in particular. 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.

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

The BPSM is also increasingly taught in medical schools and healthcare trainings (Barron et al. 2021; Bolton and Gillett 2019). When people with substance use disorders experience discrimination, they are likely to delay entering treatment and can have less positive treatment outcomes (Fortney et al. 2004; Link et al. 1997; Semple et al. 2005). Discrimination can also increase denial and step up the individual’s attempts to hide substance use (Mateu-Gelabert et al. 2005). The immorality that mainstream society attaches to substance use and abuse can unintentionally serve to strengthen individuals’ ties with the drug culture and decrease the likelihood that they will seek treatment. This book presents the main concepts and tools for the adoption of a biopsychosocial approach to psychotropic substances use and abuse management, prevention and treatment.

Assessment tools for screening and clinical evaluation of psychosocial aspects in addictive disorders

  • “HAT is not simply a pharmacotherapy; it is a treatment approach that is situated within a context involving neighborhood factors, the local drug scene, housing, policing, medical care, and other treatment services.
  • These changes have great importance for those who provide care to this age group.
  • 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).
  • However purely reductive, neurobiological explanations of addiction occlude a comprehensive understanding of the added influence of psychological, social, political, and other factors.
  • Thus, Kohlbeck and Nelson would have health professionals working to restructure society and manipulate the parameters of public debate as forms of disease control and prevention.
  • Second, the authors claim that the OPPERA findings support the proposition that TMD is a “complex disorder.” However, as discussed, this argument only works if we read the proposition into the empirical findings.

We performed descriptive analyses to detail the characteristics of NSDUH sample participants. We checked the data for normality of the residuals, homoscedasticity, multicollinearity, outliers and influence. After the data were found to be adequate for the logistic regression model, four weighted multivariate models were built using Stata survey procedure. All models were weighted and accounted for clustering and stratification of the complex survey design.

  • In addition to gaining social sanction for their substance use, participants in the drug culture learn many skills that can help them avoid the pitfalls of the substance-abusing lifestyle and thus continue their use.
  • Moreover, heroin is a less commonly used opioid and there are issues in accounting for the true prevalence of this substance use [70, 71].
  • This study provides the most recent and comprehensive risk assessment of possible biopsychosocial characteristics indicative of opioid misuse.
  • There is no single drug culture; likewise, there is no single culture of recovery.
  • The model avoids a forced choice between brain disease and condition of a weak will, and thus provides a useful framework for overcoming a neuro-essentialist trap.

Tools to assess neuropsychological functioning in those with SUDs

“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. Medical and health professionals are said to have a right and a responsibility to “prevent and manage gun violence, just as they… prevent and treat other diseases,” like HIV infection and tuberculosis (Barron et al. 2021, 2; Hargarten et al. 2018). (These arguments, it is important to note, also rely on the appeal-to-authority maneuver described above).

  • These points suggests that “gun violence disease” is not necessarily a fringe argument, and that its potential to shape medical and political practices should be taken seriously.
  • Addiction tends to run in families, and certain types of genes have been linked to different forms of addiction.
  • To add to that, repeated use of drugs can damage the essential decision-making center at the front of the brain.
  • Consequently, the findings reported can be viewed with confidence and are likely to generalise to the TCs within Australia and beyond.
  • 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.

Five informants had received inpatient treatment for substance use and mental health problems or detox several times since they left Tyrili. The informants who had periods of severe use of substances all talked about demanding situations relating to work, troubled relationships, mental health problems, or loneliness. These struggles concerned being caught up by adverse childhood experiences, situations that arose during severe substance use, or life challenges during the years after they left treatment. These individuals may experience constant hyperarousal, hypervigilance, anxiety, and abuse drugs may be an effective way to regulate these emotional experiences (Felitti et al., 1998).

Sociodemographic variables and factors

Additionally, many neurotransmitters are involved in the experience of reward (dopamine, opioids, GABA, serotonin, endocannabinoids, and glutamate; Blum et al., 2020). Thus deficiencies in any combination of these neurochemicals may contribute to a predisposition to addiction. 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. Consider, for example, the cases of TMD and CFS (discussed in the Online Appendix). They are essentially labels that identify pools of unexplained symptoms for further study.

a biopsychosocial approach to substance abuse

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. Rates of substance use and dependence vary across, and even within, cultural and social groups (Wallace 1999; Wallace, Bachman, O’Malley et al. 2002). Factors such as availability and peer modeling account for the inter- and intra-group disparities (Thomas 2007). These factors may indicate a certain level of group risk for problematic substance use, but cannot verify either the likelihood of substance use occurring within the group or which individuals within the group are more likely to be affected.

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. 1The DSM-IV-TR differentiates between Substance Dependence and Substance Abuse. In this paper we use the term “substance use disorder” or “addiction” to refer to both the complex nature of severe substance dependence and substance abuse. While making a decision is itself a mental act, a mental act or event does not cause behaviour alone, but is one part of the complex process between neuronal firing and action.