9 3 Biopsychosocial Plus Model Drugs, Health, Addictions & Behaviour 1st Canadian Edition

It also acknowledges the role of the individual’s behavior – including behaviors involved in the acquisition of drugs, the use of drugs, and ultimately, the abstinence from drugs. Most importantly, it recognizes the functional relationships and interdependence between these factors. It’s a model that also points an accusatory finger at the specialty scientists and clinicians (the present author included!) who are interested in only one aspect of the phenomenon. Addiction is bigger than the person who needs help and the person who offers it – organizing principles are needed to describe it and organized structures are needed to heal it.

biopsychosocial model of addiction

The importance of choice and agency in animal models of addiction

Gillett criticizes theories of decision-making that conceptualize choice as autonomous phenomenon only if inner mental states or networks cause it. Nothing in the relevant literature indicates this occurred (Bair et al. 2013; Slade et al. 2016). This section argues that the rise of wayward BPSM discourse has had significant negative consequences for medicine and society.

Neuroscience and genetics are biopsychosocial

Subsequently, between July 2016 and September 2017 deaths due to illicit opioid overdose increased by 30%, leading to an emergency declaration in 45 states [4]. It is not trivial to delineate the exact category of harmful substance use for which a label such as addiction is warranted (See Box 1). Throughout clinical medicine, diagnostic cut-offs are set by consensus, commonly based on an evolving understanding of thresholds above which people tend to benefit from available interventions. Because assessing benefits in large patient groups over time is difficult, diagnostic thresholds are always subject to debate and adjustments. It can be debated whether diagnostic thresholds “merely” capture the extreme of a single underlying population, or actually identify a subpopulation that is at some level distinct.

What Do We Know About Informal Caregiving in the Field of Addiction?: A Scoping Review

Metacontingencies represent an important approach to addiction because their behavior analytic origins emphasize the role of functional relationships that determine behavior. Unlike other approaches that consider personal factors as imbedded within and inseparable from the social context (e.g., relational autonomy), metacontingencies recognize the separateness yet interdependence of these factors. Bandura argued that social systems are not the products of immaculate conception – they are products of human activity that are designed to influence human development and human functioning (Bandura, 2008). In the collective agency described above, people pool their knowledge, skills and resources to shape their future.

Availability of data and materials

For Darwin, an animal’s interaction with its environment was entirely reflexive – each and every behavior was an automatic response elicited by a specific stimulus in the environment. But humans were different – they had a soul, which was metaphysical, given by God, and outside the realm of simple elicited reflexes (Descartes, as translated by Cress, 1993). Underlying the analysis of power in the clinical relationship is the issue of how the clinician handles the strong emotions that characterize everyday practice. On the one hand, there is a reactive clinical style, in which the clinician reacts swiftly to expressions of hostility or distrust with denial or suppression. The more an individual’s needs are met within a drug culture, the harder it will be to leave that culture behind.

  • An individual’s stress hormones (cortisol and adrenaline) are chronically elevated (Burke Harris, 2018; van der Kolk, 2014).
  • Descartes was interested in how organisms interact with their environment, believing that nonhuman animals were nothing more than biological machines.
  • Staff are present 24/7, and we have meals together and social contact with people in the same situation.
  • 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.
  • Wilson has argued more broadly for greater consilience [109], unity of knowledge, in science.
  • For instance, drugs with high addictive liability produce their effects by interacting with the central nervous system.


Wilson has argued more broadly for greater consilience [109], unity of knowledge, in science. A plurality of disciplines brings important and trenchant insights to bear on this condition; it is the exclusive remit of no single perspective or field. Moreover, those who suffer from addiction will benefit most from the application of the full armamentarium of scientific perspectives. Drawing on previous work (Bolton & Gillett, 2019), I will present a case that Engel’s main idea – that a BPSM was required to replace the BMM – was visionary but programmatic. It was visionary in anticipating radical changes in the ways that health and disease were becoming theorized and researched, but programmatic because the radical changes were in their early stages, still in progress and not yet widely implemented. However, I suggest, the position has changed by now, and theories that can underpin a broader BPSM are well-known and can be drawn upon to revitalize the model.

For the BPSM, shared themes and questions are straightforwardly specifiable about the causes and cures of illness. The substantial task for the BPSM is to explicate a unified theoretical perspective and integration across the three relevant sciences. It turns out, I will propose Top 5 Advantages of Staying in a Sober Living House in what follows, that the required shared theoretical perspectives is systems theoretic, as Engel anticipated, in which concepts such as regulation and control, information and communication, function and dysfunction, play critical roles across the whole biopsychosocial domain.

biopsychosocial model of addiction

Biological Dimension

Models in which regulation/dysregulation are prominent are now to be found not only in biomedicine, but also in clinical psychology and psychiatry (Kendler & Woodward, 2021; Liu, Chua, Chong, Subramaniam, & Mahendran, 2020). Two well-known illustrations of theorized biopsychosocial https://parliamentobserver.com/2024/05/27/top-5-advantages-of-staying-in-a-sober-living-house/ causal mechanisms are given below. However, proposals to roll the psychosocial up into the biological appear to be, in name, a kind of reductionism, so far by-passing the need to theorize the acknowledged causal role of psychosocial factors or biopsychosocial causal mechanisms.







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