The threats are based on emotional and moral attitudes towards the existence of the SIS and drug addicts generally, as opposed to empirical evidence (Des Jarlais, Arasteh, and Hagan 2008). The biopsychosocial systems model is grounded in systems theory in which knowledge occurs at the intersection of the subjective and the objective, and not as an independent reality. This is a radical departure from the traditional positivist epistemology, which relies on empirical study and material proof (Bunge 1979; Heylighen, Cilliers, and Gerschenson 2007). Such new iterations of systems theory concentrate on the cognitive and social processes wherein the construction of subjective knowledge occurs.
- 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.
- Biological factors that increase an individual’s risk of developing an addiction include their genetic makeup, brain chemistry, brain development, and health status.
- 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.
- Addiction is often described as a brain disease because it alters the brain’s structure and function (Koob et al., 2023).
- The Moral Model emphasizes the role of free will and personal agency in the development and maintenance of addiction.
The Biopsychosocial Model of Addiction
Many subcultures are neither harmful nor antisocial, but their focus is on the substance(s) of abuse, not on the people who participate in the culture or their well-being. By acknowledging addiction as a medical condition rather than a moral failing, this https://www.inkl.com/news/sober-house-rules-a-comprehensive-overview model has paved the way for more effective and evidence-based treatment options that address the biological, psychological, and social aspects of the disorder. They encompass a person’s mental health, emotional state, and thought patterns, all of which can influence their vulnerability to addiction and how they use substances. 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. While research of this kind raises important issues about identity, and notions of health and illness, the outcomes have implications for drug policy, health care systems and delivery, and treatment for substance use problems. The multifaceted disorder needs a multifaceted conceptualization, and we find that in the biopsychosocial model of addiction (Marlatt & Baer, 1988).
Cultural Dimension
This means that the person needs more and more of the addictive substance or behavior to experience the same level of pleasure. Wolfram Schultz et al., in their 2000 study titled ‘Dopamine reward prediction error signal in primate dopamine neurons, ’ show that our brains release dopamine when humans engage in pleasurable activities. Dopamine signals to the brain that something good is happening, motivating us to repeat the behavior. Addictive substances and behaviors hijack this reward system, causing the brain to release dopamine in much more significant amounts than usual.
Factors such as drug availability within the environment can increase craving and consequently the vulnerability for relapse (Weiss 2005). 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). 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). Thus, numerous psychological factors and experiences can increase the risk of changing how one feels (or regulating emotions) via drugs of abuse. They support continued use and reinforce denial that a problem with alcohol or drugs exists. The importance of the drug culture to the person using drugs often increases with time as the person’s association with it deepens (Moshier et al. 2012).
A BPS model provides a foundation for understanding both the causes of addictive disorders and the best treatments for them. The degrees in which self-control is exerted, free choice is realized and desired outcomes achieved are dependent on these complex interacting biopsychosocial systems. Many post-modern theorists such as Christman (2004) have challenged the original Kantian privileging and definition of autonomy. 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).
However, they can create a vulnerability that, combined with biological and social aspects, can increase the risk of addiction. Personality theories suggest certain personality traits, like impulsivity or risk-taking, can make someone more prone to addiction. These traits might lead them to experiment with addictive substances or behaviors more readily. Heroin is lipid soluble, which leads to fast penetration of the blood-brain barrier and high abuse potential (Julien 2001). The reinforcing and euphoric properties of opiates arise from increased amounts of extracellular dopamine in the ventral tegmental area and nucleus accumbens.
Whole Person Healthcare The Biopsychosocial Spiritual Model of Medicine. By Doodle Med.(
Using theories may help you understand the complexity of substance use and why one theory is generally not enough. “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. Its role and effectiveness is entangled with the ancillary services available, drug policies, and treatment philosophy” (p.262). Hunt (2004) takes the rights-based notion further and identifies and characterizes two ethics of harm reduction.
Trauma and Life Stressors
The goal of these treatments is to address the multiple dimensions of addiction and provide a comprehensive and personalized approach to care. Given the emphasis on mental health and cognitive processes within the Psychological Model, treatment approaches informed by this model often involve various forms of psychotherapy. The goal of these therapies is to address the underlying emotional and cognitive factors that contribute to addiction, as well as to develop healthier coping strategies and more adaptive beliefs and thought patterns. As you have come to understand, to look at substance use disorders in a binary fashion, choosing one lens or another is not effective. You can further explore poverty, race, gender, and other examples of intersectionality that may play a role in a person’s substance use as you are working with them, ensuring your work is culturally and gender sensitive. Understanding the various models of addiction is crucial in order to comprehensively address the complex and multifaceted nature of this disorder.
- The Social Model of addiction emphasizes the influence of social, cultural, and environmental factors on the development and maintenance of addiction.
- The Social Model posits that individuals are more likely to develop addiction when they are exposed to environments that promote substance use or addictive behaviors.
- This results in several unpleasant symptoms, such as anxiety, restlessness, and irritability.
- However, it is important to consider the Disease Model in conjunction with other models of addiction, as a comprehensive understanding of addiction requires the integration of biological, psychological, and social factors.
- 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.
What are the Models of Addiction?
Addiction is a complex and multifaceted condition that impacts individuals and their families on multiple levels. While the stereotypical image of addiction might involve a person misusing substances like alcohol or drugs, addictive behaviours extend beyond substances and include activities such as gambling, internet use, and even food consumption. Understanding addiction requires a comprehensive approach that considers biological, psychological, and social factors—known collectively as the biopsychosocial model (Masiak, 2013).
Substances and addictive behaviors often serve as maladaptive coping mechanisms, providing temporary relief from emotional pain, anxiety, or depression (Mack, 2023). For example, alcohol may be used to numb feelings of sadness, while compulsive internet use may serve as a distraction from feelings of loneliness or inadequacy. You will hear about the importance of spirituality to people, whether it is religious or non-religious. It is very important to be respectful around all spiritual dimensions as it is very important to people. Think of it as the therapeutic imagination of what spirituality means to the individual and show respect to each person, so that they can have the freedom to find, explore, revisit or discover their own beliefs.
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. Once an intention has been formed for example, to use substances one is aware of the intention, though intention itself does not sufficiently cause the individual to seek out or use drugs. From a neuroscience perspective, it is difficult to see such actions as completely free, particularly when explanations of natural phenomena are understood as causally ordered. The notion of free choice becomes particularly troublesome due to the conscious experience of acting freely. As Searle (2004) argues, “there is a striking difference between the passive character of perceptual consciousness and the active character of what we might call ‘volitional consciousness’“ (41). Every learned action, whether pro-social or anti-social, may be prompted by social conditions such as a lack of resources, conflict, social norms, peer pressure, an underlying drive (e.g., hunger, sex, craving), or a combination of these factors (Bunge 1997).
One area in particular in which these neuroethics notions of addiction may have significant impact is in the clinical setting. 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). Proponents of a ‘war on drugs’, for example, believe that laws and policies that are lenient towards substance use are linked with greater prevalence of use and criminal activity. In one study comparing cannabis use in San Francisco (where cannabis is criminalized) and Amsterdam (de facto decriminalization), there was no evidence to support claims that criminalization laws reduce use or that decriminalization increases use. In fact, San Francisco reported a higher cannabis use rate than Amsterdam (Reinarman, Cohen and Kaal 2004). Since the beginning of a definable drug culture, that culture has had an effect on mainstream cultural institutions, particularly through music, art, and literature.
Negotiating the Relationship Between Addiction, Ethics, and Brain Science
White (1996) notes that as a person progresses from experimentation to abuse and/or dependence, he or she develops a more intense need to “seek for supports to sustain the drug relationship” (p. 9). 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. They learn how to avoid arrest, how to get money to support their habit, and how to sober house find a new supplier when necessary. In terms of cognitive processes, research has shown that individuals with addiction often exhibit distorted thinking patterns, such as denial, rationalization, and minimization of their substance use or addictive behaviors. These cognitive distortions can serve to maintain addiction by justifying continued substance use or impeding the individual’s ability to recognize the negative consequences of their behavior.
These connections can add significantly to the attraction a drug culture holds for some individuals (especially the young and those who pride themselves on being nonconformists) and create a greater risk for substance use escalating to abuse and relapse. Substance users, loved ones, and treatment providers need to realize that significant lifestyle changes are frequently required to replace the culture of addiction with a culture of recovery. In the following passage, the Substance Abuse and Mental Health Services Administration (SAMHSA) shares its insights into the role of drug cultures.
Leave a Reply