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 https://northiowatoday.com/2025/01/27/sober-house-rules-what-you-should-know-before-moving-in/ system. The larger societal structure either restricts or enhances interactions between agents in a social system (Bunge 1997). Understanding this is crucial to providing treatment plans and interventions representative of the individual and their needs.
Psychological Factors: The Mind’s Influence on Addiction
White (1996) draws attention to a set of individuals whom he calls “acultural addicts.” These people initiate and sustain their substance use in relative isolation from other people who use drugs. Examples of acultural addicts include the medical professional who does not have to use illegal drug networks to abuse prescription medication, or the older, middle-class individual who “pill shops” from multiple doctors and procures drugs for misuse from pharmacies. Although drug cultures typically play a greater role in the lives of people who use illicit drugs, people who use legal substances—such as alcohol—are also likely to participate in such a culture (Gordon et al. 2012). In this chapter, drug culture refers to cultures that evolve from drug and alcohol use. Addiction is not a one-dimensional problem but a complex interplay of biological, psychological, and social factors.
When dopamine release is triggered by a substance or behavior, it creates feelings of pleasure and reward, reinforcing the likelihood of repeating the behavior. Hunt (2004) takes the rights-based notion further and identifies and characterizes two ethics of harm reduction. First, he describes a “weak” rights ethic, wherein individuals have the right to access good healthcare. Second, Hunt identifies a “strong” rights account that acknowledges a basic right to use drugs.
2.7. Self-Harm and Suicide Risk in People with SUD
While support for Holistic Care emerged less prominently than other PCC domains in the data, the Holistic Care themes that did emerge support the importance of biopsychosocial care. Additionally, participants highlighted positive experiences and appreciation when they had parental support from the clinic staff, particularly when they felt that the support given went above and beyond standard care. Examples of this include assistance with housing, employment, non-substance related mental health needs, clothing, and child custody advocacy. Support regarding other substance use goals, such as alcohol, were also appreciated by patients. When holistic care was present for individuals in their treatment, they were supported in several facets of their life, all of which had an impact on their substance use treatment experience.
- This project utilized a convenience sample of individuals receiving care at a Vermont Hub or Spoke, aged 18 years and older, English speaking, and had received their most recent dose of MOUD within the last 45 days.
- As a rule, mental health workers are familiar with an integrative understanding of addiction, and would not recommend a treatment intervention based on biological information alone.
- Two interviewers independently reviewed and de-identified transcripts and used directed content analysis 26, 27 based on the interview questions to code patterns and divergent perspectives surrounding patient experiences of rural MOUD care.
- As Hyman (2007) has written, “neuroscience does not obviate the need for social and psychological level explanations intervening between the levels of cells, synapses, and circuits and that of ethical judgments” (p.8).
- Despite having differing theories about the root causes of substance use disorders, most researchers would agree that substance abuse is, to some extent, a learned behavior.
1. Complex Entanglement: Substance Use Disorder; Personality; and Psychopathology
Advances in neuroscience are changing how mental health issues such as addiction are understood and addressed as a brain disease. Although a brain disease model legitimizes addiction as a medical condition, it promotes neuro-essentialist thinking, categorical ideas of responsibility and free choice, and undermines the complexity involved in its emergence. We propose a ‘biopsychosocial systems’ model where psycho-social factors complement and interact with neurogenetics. A systems approach addresses the complexity of addiction and approaches free choice and moral responsibility within the biological, lived experience and socio-historical context of the individual.
Biopsychosocial Model of Addiction Example
Based on this definition, we believe that HAT falls into both camps HAT seeks to promote the right to access good health care, and the basic right as an individual asserting sovereignty over his or her body to inject heroin. 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. Individuals experiencing withdrawal may suffer severe symptoms that include sweating, nausea, vomiting, abdominal pain and irritability (Koob and Le Moal 2005).
Finding Meaning in Life: An Exploration of Existential Psychology
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. Instead of focusing entirely on causal, reductive neurobiology and difficulties in sober house decision-making, the biopsychosocial systems model places the individual in his or her social environment and integrates his or her life narrative. The model contextualizes the responsibility placed on the individual and further allows for individual members of society to reflect on their own contributions in facilitating substance misuse (Levy 2007b). The model, therefore, allows for diverse and multidimensional aspects of knowledge to be drawn upon depending on the concern to be addressed, and the tools available to address them (Cochrane 2007). Action, subjective experience of action, and consequently responsibility for action is mediated by many factors, including psychological phenomenon such as an individual’s emotional processes. As a point of illustration, Damasio’s (1994) somatic marker hypothesis (SMH) provides a helpful perspective on integrating the neuropsychological domain of decision-making and human interaction with the social environment.
Causes of Addiction: Biopsychosocial Model, Personality Theories and Neuropsychology
- 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).
- If you’re tempted by something questionable—like eating ice cream before dinner or buying things you can’t afford—the front regions of your brain can help you decide if the consequences are worth the actions.
- As the effects of the addictive substance or behavior wear off, the brain goes into a state of withdrawal.
- There are also practical matters involved in using substances (e.g., how much to take, how to ingest the substance for strongest effect) that people new to drug use may not know when they first begin to experiment with drugs.
Future research should explore patient-centered perspectives at different stages of recovery, different durations in treatment, a culturally and linguistically diverse patient population, and include both housed and unhoused patients. Research consistently shows that genetics play a significant role in the development of addictive behaviors (Deak & Johnson, 2021). Individuals with a family history of addiction are at higher risk of developing similar problems. Studies suggest that genetic factors can account for a substantial portion of a person’s vulnerability to addiction (Koob et al., 2023). These inherited traits can influence how the brain responds to substances or addictive activities, making some individuals more susceptible.
Fifteen semi-structured telephone interviews were conducted from August through November of 2021 regarding patient experiences receiving MOUD in 13 Vermont Hub and Spoke clinics. Emergent themes were deductively mapped to PCC domains of Therapeutic Alliance, Individualized Care, Shared Decision-Making, and Holistic Care. Four decades after the publication of the concept of Engel’s “biopsychosocial model” for medicine and its subsequent enthusiastic embrace by psychiatry, it is widely accepted as a valid alternative to the reductionism of biological psychiatry.