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Bio-Psycho-Social Issues Foundations of Addiction Studies

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. These factors are not inherent in the composition of the social structure, are neither stable nor persistent, but are governed by the social values and norms of that social system or group (Bunge 2003). Furthermore, some communities are targeted more heavily with alcohol and tobacco advertisements and have more availability of drugs of abuse than others, particularly impoverished communities (Primack et al., 2007; Rose et al., 2019).

Addiction tends to run in families, and certain types of genes have been linked to different forms of addiction. “As with heart disease or diabetes, there’s no one gene that makes you vulnerable,” Koob says. A healthy brain rewards healthy behaviors—like exercising, eating, or bonding with loved ones. It does this by switching on brain circuits that make you feel wonderful, which then motivates you to repeat those behaviors.

Psycho-Social Systems

This integral approach examines substance abuse etiology and treatment from a four-quadrant perspective adapted from the work of Ken Wilber, and incorporates concepts from integrative medicine and transpersonal psychology/psychiatry. Women are more likely Sober Living Program in Kerrville Texas than men to seek out physical and mental health treatment, including substance abuse treatment. They are also more likely to make use of a variety of healthcare options including primary care and psychological counseling (Cherry and Woodwell 2002).

a biopsychosocial approach to substance abuse

But when you’re becoming addicted to a substance, that normal hardwiring of helpful brain processes can begin to work against you. Drugs or alcohol can hijack the pleasure/reward circuits in your brain and hook you into wanting more and more. Addiction can also send your emotional danger-sensing circuits into overdrive, making you feel anxious and stressed when you’re not using drugs or alcohol. At this stage, people often use drugs or alcohol to keep from feeling bad rather than for their pleasurable effects. This section argues that the rise of wayward BPSM discourse has had significant negative consequences for medicine and society. In particular, wayward discourse has created certain disease construct dysfunctions that may have helped undermine certain lines of medical research.

Addiction can occur regardless of a person’s character, virtue, or moral fiber.

Most of them started using substances at age 12–15, and heroin or amphetamines were their main substances, combined with cannabis, prescription drugs and alcohol. Projections indicate that if current prevention and intervention strategies do not change by 2025, the rate of misuse and overdose death will rise by 61% [5]. In response to the epidemic, multiple federal, state, and local agencies have implemented various strategies to address the opioid crisis. Increasing the availability of naloxone—a medication that reverses the effects of an overdose—is projected to reduce opioid-related deaths by approximately 4% according to the most recent projections [6]. Other interventions like reduced prescribing for pain patients and excess opioid management can increase life years and quality-adjusted life years, but overdose deaths would increase among those with opioid dependence due to a move from prescription opioids to heroin [6]. Overall, supply-side prevention strategies are estimated to have minimal impact, preventing only 3.0 to 5.3% of overdose deaths [6].

  • It is important to note that the wayward BPSM argument on gun violence has been set forth in the leading health policy journal Health Affairs (Grossman and Choucair 2019).
  • In this TIP, chapter 2 addresses initiation, risk factors, and patterns of substance use and substance use disorders among women across the lifespan.
  • Thus it is the limited option for choice that is one prevailing variable, not only the reduced ability to choose alternatively.
  • At a population-level analysis, we must acknowledge that results of a variable-centered approach such as this work only represent findings based on a population average.
  • Social services or volunteers organised the activities, and some participants had ordinary paid jobs.

As important, women with co-occurring serious mental illness and substance use disorders were less likely to be employed full-time than women with only a substance use disorder (SAMHSA 2003). Many female clients need assistance with transportation; affordable, safe housing; and onsite child care and other services for their children. To obtain more specific information on obstacles pertinent to women in treatment, refer to chapter 5. By and large, women with substance use disorders must find a way to support themselves and their children, often with little experience or education and few job skills.

Understanding Own Substance Use

A woman might have experienced sexual or physical abuse or witnessed violence as a child. She may be experiencing domestic violence such as battering by a partner or rape as an adult (Finkelstein 1994; Young and Gardner 1997). 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. We can see a relatively transparent attempt to harness this power of wayward discourse in the violence-as-a-disease literature.

  • These dimensions can be broken down to match the three parts of the BPS framework.
  • This includes intoxication, amnesia, short-term memory loss, neurological malfunctions, and a vast deterioration of the person’s ability to concentrate.
  • It does this by switching on brain circuits that make you feel wonderful, which then motivates you to repeat those behaviors.
  • Gillett criticizes theories of decision-making that conceptualize choice as autonomous phenomenon only if inner mental states or networks cause it.

In contrast, when you’re in danger, a healthy brain pushes your body to react quickly with fear or alarm, so you’ll get out of harm’s way. 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. Consider, for example, the cases of TMD and CFS (discussed in the Online Appendix).

Foundations of Addiction Studies

The NSDUH only targets noninstitutionalized US citizens, so active-duty military members and institutionalized groups (e.g., prisoners, hospital patients, treatment center patients, and nursing home members) are excluded. Thus, if substance use differs between US noninstitutionalized and institutionalized groups by more than 3%, data may be problematic for the total US population [44]. A particularly notable limitation of the NSDUH is that it does not include information regarding chronic pain. This omission necessarily narrowed our analysis and inhibited our ability to create a truly comprehensive model.

a biopsychosocial approach to substance abuse

Less evidence is available on gender differences regarding the effects and health consequences of other illicit drug use, but women also appear to have higher rates of health problems resulting from other substances (Sherman 2006). From moderate to heavy use, drugs and alcohol consumption increase specific health risks and physical disorders among women. Each ring represents a different system with the closest adjacent ring representing her most immediate relationships—the microsystem. The following ring, the mesosystem, represents the interrelationships between her immediate relationships and systems; e.g. the interaction between her family and school, the potential influence or conflict between her substance using peer group and her family. Next, the exosystem represents larger systems that directly influence the woman but where the woman has no direct active role; e.g., county funding for treatment or State and Federal laws pertaining to sentencing or child protective services.

One of the most significant contributions to the assessment and treatment of addictions is the bio-psycho-social (BPS) model. This holistic concept allows us to consider a range of factors that influence the development and maintenance of addictive behavior. I argue that TMD has become the subject of unjustified claims and that these claims are at least partly products of the question-begging strand of wayward BPSM discourse. To keep the detail presented to a minimum, I have provided a full version of the TMD case study in the online Appendix, and offered an abridged version here.

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