The larger societal structure either restricts or enhances interactions between agents in a social system (Bunge 1997). 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. The importance of multiple theoretical perspectives in understanding addiction cannot be overstated. It’s this diversity of viewpoints that allows us to approach the problem from different angles, much like a team of specialists collaborating on a complex medical case. Adult-onset addiction, often triggered by life transitions or stressors, reminds us that vulnerability to substance abuse can emerge at any age.

Impulsivity Models

This might involve medication to address biological aspects, therapy for psychological issues, and social support interventions. 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) https://yourhealthmagazine.net/article/addiction/sober-houses-rules-that-you-should-follow/ study, Felitti et al. (1998) found that more ACEs increased the odds of subsequent drug and alcohol use. One explanation for this trend is that the toxic stress from trauma leads to a dysregulated stress response. An individual’s stress hormones (cortisol and adrenaline) are chronically elevated (Burke Harris, 2018; van der Kolk, 2014). Additionally, many neurotransmitters are involved in the experience of reward (dopamine, opioids, GABA, serotonin, endocannabinoids, and glutamate; Blum et al., 2020).

Stigma, Heroin Assisted Treatment, and the Biopsychosocial Systems Model

Addiction, in its simplest terms, is a compulsive engagement in rewarding stimuli despite adverse consequences. But this definition barely scratches the surface of the intricate mechanisms at play. Throughout history, our understanding of addiction has evolved dramatically, from viewing it as a moral failing to recognizing it as a complex interplay of genetic, neurological, psychological, and environmental factors. Ultimately, our understanding of addiction must be as dynamic and multifaceted as the individuals it affects.

The Biopsychosocial Model

Dual process models of addiction are like trying to drive a car with two steering wheels – one controlled by our rational, deliberative system, and the other by our impulsive, automatic system. These models suggest that addiction involves an imbalance between these two systems, with the impulsive system often taking the wheel when it comes to drug-seeking behaviors. The cognitive model of addiction is like a pair of glasses that allows us to see the world through the eyes of someone struggling with substance abuse. At its heart, this model posits that addiction is maintained by maladaptive thought patterns and beliefs. It’s as if the addict’s mind is running a faulty software program, constantly spitting out thoughts that justify and perpetuate drug use.

By drawing out these similarities, medical and psychiatric scholars can revitalize the biopsychosocial model, and they can open medicine and psychiatry to a rich philosophic heritage and a flourishing interdisciplinary tradition. 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. 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. An individual living with an addiction is in-the-world-with-others and thus acts as a being-among-others, such that the individual’s decisions and complex engagement with the world may not be as automatic as the neurophilosophical model may suggest (Gillett 2008a, 2008b, 2009).

What are the Biological Causes of Addiction?

• These interventions aim to help individuals learn new, healthier ways of interacting and coping, essentially “reprogramming” their social learning.
• Others highlight personality traits like impulsivity, a desire for excitement, or mental health issues stemming from past traumas.
• This single cohesive framework considers the interdependency of the entire system, drawing its conceptual roots from socio-ecological models (188, 189) including Ecosocial Theory (23).
• A person might use a drug for the first time and enjoy the feelings it creates, which is a positive reinforcement for the behavior.

Such findings may be called a scientific-explanatory reduction to biological processes. This type of ‘reduction’ is different from theory-reduction of, for example, biology to physics and chemistry. Both types of ‘reduction’ are relevant to the relation between the BMM and the BPSM and both are in play in Engel’s 1977 paper. The BMM would predict scientific-explanatory reduction to primary biological causes only across the whole of health, like the biomedical models of infectious diseases (or of effects of lesions or of genes of major effect). While the biopsychosocial model has its place in the healthcare and mental healthcare systems, individuals might also implement tenants of this model in their own lives. This means being aware of how environmental factors impact their mental and physical health, as well as how their genetics and medical history in turn influence behaviors, thoughts, and emotions.

What Exactly Is the Biopsychosocial Model of Addiction?

• The field of Social Services is working to move beyond a moral model of substance use disorders.
• Enter the integrative models, which attempt to weave together various strands of addiction theory into a more comprehensive tapestry.
• The social burden of illicit drug addiction is estimated at billions of dollars per year (Fisher, Oviedo-Joekes, Blanken, et al. 2007).
• The biopsychosocial model of addiction (Figure 1) posits that intersecting biological, psycho-social and systemic properties are fundamental features of health and illness.
• Biopsychosocial approaches to future nutrition research will hopefully renegotiate the boundaries between physical and mental health by targeting the gut-brain axis and examining novel outcomes.
• It suggests that many individuals turn to substances as a way of coping with the psychological and physiological effects of traumatic experiences.

For example, the sociocultural model might highlight how economic stress can increase vulnerability to substance use, or how cultural norms around alcohol consumption can influence drinking patterns. It also draws attention to how social policies, such as drug laws and healthcare access, can impact addiction rates and treatment outcomes. Another key component of the biological model is the neurotransmitter imbalance theory. This perspective focuses on how drugs of abuse hijack the brain’s natural reward system, leading to imbalances in neurotransmitters like dopamine, serotonin, and norepinephrine. These chemical messengers play crucial roles in mood regulation, pleasure, and motivation, and their disruption can contribute to the compulsive drug-seeking behavior characteristic of addiction.

Medication for Weed Addiction: Effective Treatment Options and Support

This perspective, while groundbreaking for its time, was just the beginning of a long and winding road of theoretical development. The biopsychosocial model is not just one of many competing possibilities – another intelligently constructed explanation of health. The biopsychosocial model’s emergence in psychiatry was influenced by the credibility problem in psychiatry as a medical specialism that arose during wartime conditions. A lot more is going on in clinical care than decisions as to what treatments to recommend, including personal, interpersonal, and institutional processes. Engel says a lot of interesting things about all these things in his 1997 paper and others around that time (Engel, 1980, 1982), and they can be considered as part of what is covered by the BPSM. This overview of BPSM research paradigms with examples of major research programs has to briefly mention that the two life sciences that have accelerated the most in recent decades – genetics and neuroscience – are suited to a biopsychosocial theoretical framework.

What Are the Three Aspects of the Biopsychosocial Model?

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.

At a minimum, nutrition interventions may improve the body’s resilience in response to stress and negative affect throughout the recovery process, but this is unproven. The environment in which one resides is a known predictor of consumption behavior (39), thus behavioral economics is a conceptual system to understand how one’s access and exposure will predict demand and subsequent intake (40–43). Eventually it became clear that the quest to “maximize utility” could not capture human preference (44) nor would it apply to disorders such as addiction. Behavioral economics is a scientific discipline at the intersection of economics and psychology as it pertains to health-related behavior (45). It has been used to study decision making in the context of substance use disorders (SUD) (46–48) including alcohol (49) and other health behaviors such as food and drink consumption (40, 50).

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. Enter Cognitive-Behavioral Therapy (CBT), the superhero of addiction treatment approaches. CBT aims to identify and challenge these distorted thoughts, replacing them with more realistic and helpful ones. Therapists using CBT might help clients recognize their triggers, develop coping strategies, and practice new ways of sober house thinking about themselves and their addiction.

As we unravel these theories, we begin to see the multifaceted nature of addiction and the profound impact it has on individuals, families, and communities. In conclusion, while the multitude of addiction models might seem overwhelming, this diversity reflects the complex nature of substance use disorders. By embracing this complexity and drawing from multiple perspectives, we can develop more comprehensive, compassionate, and effective approaches to preventing and treating addiction. As we continue to unravel the intricate web of factors that contribute to addiction, we move closer to a future where effective support and recovery are accessible to all who need it. Future directions in addiction research and model development are likely to focus on further integrating these diverse perspectives.

Genetic research has identified polymorphisms in dopaminergic genes and other neurotransmitter variants which may put individuals at an increased risk of impulsive behavior and addiction (94). The heritability of impulsivity has been linked to a range of genes known as DAT, MAOA, and COMT (101) suggesting that no single gene can predict impulsivity in humans. More recent data points to loci within the HTR2A gene (encodes a serotonin receptor), casting some doubt on the previously identified candidate loci for impulsive personality traits (102). Importantly, with elevated stress levels there appears to be a cumulative effect on vulnerability to OUD (103). The concept of reward deficiency syndrome (RDS), introduced by Blum et al. (104), identified the dopamine D2 receptor (assessed by A1 allele) as the primary site for substance-seeking behavior. Interestingly, DAD2 dysfunction has also shown associations with increased risk of PTSD (105).