Addictions research using heroin-assisted treatment (HAT) trials such as the North American Opiate Medication Initiative (NAOMI) and similar HAT studies and programs in Europe are a striking, if not controversial example of an effort to embody a biopsychosocial systems approach. 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. Guiding an individual’s behaviour are brain processes, somatic mechanisms, the ethical rules and norms that govern society, and the nature of the interaction. The complex combination of biological, psycho-social and systemic factors may explain why it is so difficult for some individuals to refuse drugs in the face of increasingly negative consequences.
Eating Behavior
This work may end up being conducted under the emerging field of “nutritional psychiatry” (222, 223). To date, gut-based nutrition interventions for OUD have not been investigated in humans but do appear to be timely. 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).
Chronic drug use can disrupt these systems, leading to intense cravings and difficulty resisting them. Biological factors that increase an individual’s risk of developing an addiction include their genetic makeup, brain chemistry, brain development, and health status. 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. Furthermore, some communities are targeted more heavily with alcohol and tobacco advertisements and have sober house more availability of drugs of abuse than others, particularly impoverished communities (Primack et al., 2007; Rose et al., 2019). Therefore, the social environment in which one exists contributes to their risk of addiction.
Affect Dysregulation Model
These Models of Addiction provided valuable insights but failed to capture the full picture. It’s like trying to describe an elephant by touching only its trunk or its tail. Since 1997, the Bio-Psycho-Social Model, proposed by George Engel, attracted the interest of clinical researchers as well epistemologists and was recognized as a turning point in the culture and praxis of medical diagnosis and treatments. According to Engel, biological, psychological as well as social events are mutually interconnected and reciprocally influenced; a paradigmatic shift in the approach to the mind-body problem. Lately, this model has received persuasive criticism that has caused a fading of its scientific reliability. This concise review focuses the core feature of Engel ” s position as well as the scientific controversy that followed during these forty years.
Psychosocial Factors
- Then, by calling the random function method, the people who were the subjects of the study were randomly selected, and finally, the paper questionnaires were distributed to the participants under the on-site guidance of professional investigators.
- With such strong evidence of overlapping pathways between drugs of abuse and food (220), it is surprising that food has not been investigated as a long-term modulator of reward pathways in humans.
- It is unknown how a nutrition intervention might modify reward pathways over extended periods of time (i.e., years).
- The way we think about ourselves, our substance use, and the world around us can either fuel addiction or help us overcome it.
Our work has shown educational and culinary interventions can be effective despite operational challenges (199). Nutritional protocols for OUD have been described elsewhere (200) and specific group education topics for SUD treatment have also been recommended (201). When we see substance use disorders/addictions in a binary fashion, we are choosing one lens or another, which does not give us a clear picture of the person.
Addiction Treatment and Cognitive Control
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. However, unlike models in mainstream science, the original model has not been developed or expanded. Despite widespread efforts to “talk it up,” Engel’s “biopsychosocial model” has failed to have any lasting impact on psychiatry. The logical flaws in Engel’s original concept are explored, and some consequences noted.
These theories propose that specific personality characteristics can make someone more likely to develop or struggle with addiction. Self-acceptance Questionnaire (SAQ), Drug use Stereotype Threat Scale(DSTS) and Center for Epidemiologic Studies Depression Scale(CES-D) were used to conduct a questionnaire survey in January 2024 on 1068 drug addicts in two compulsory isolation drug rehabilitation centers in Sichuan Province. It is important to allow them the journey of peer support, mutual aid, culture, nature, and spirituality to find their own spiritual dimension and it’s important to them. Culture is very personal and we need to allow it to be whatever the person identifies it as. It may have been lost, not yet experienced, which leaves a person feeling like there are missing pieces. Sometimes it is by choice, or experience, a negative representation of what they believed culture meant.
A study was conducted in Ziyang Compulsory Drug Rehabilitation Center and Sichuan Women’s Compulsory Drug Rehabilitation Center in Sichuan Province. Based on the principle of stratified cluster sampling, group tests were conducted on drug addicts in the two compulsory drug rehabilitation centers. First, the number of drug addicts in each brigade of the two drug rehabilitation centers was ranked, and then the number of people from each brigade https://northiowatoday.com/2025/01/27/sober-house-rules-what-you-should-know-before-moving-in/ was determined by implementing an equal proportion sampling strategy. Then, by calling the random function method, the people who were the subjects of the study were randomly selected, and finally, the paper questionnaires were distributed to the participants under the on-site guidance of professional investigators. According to the experience of previous studies using LPA, the sample size based on reliability and validity should be 5–10 times or more than the number of items, therefore the number should be 230–460 or more 35. In order to ensure that participants can truly express their thoughts and feelings, this study adopted an anonymous survey and provided detailed instructions to participants 36.
Biological theory
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). For that reason, individuals who live with an addiction may not completely be enslaved or forced by their brain in the way in which, as Levy (2007a) has previously deferred to Aristotle (1999), “a wind or people have an agent in their control were to carry him off” (p.30). Given the spectrum nature of substance use problems, decision-making capacity is therefore neither completely present nor absent, but may be, at some times in certain contexts, weakened. One area in particular in which these neuroethics notions of addiction may have significant impact is in the clinical setting. 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.
Other authors believe that restricting the ability of physicians to write prescriptions is only a short-term fix (30). It is important to note substance use disorders do not often have one-specific cause. You may use a combination of theories to help your clients explore why they use substances and why they continue to use substances, are increasing substance use, or choosing to change their substance use, remembering you are not diagnosing. Using theories may help you understand the complexity of substance use and why one theory is generally not enough. The social burden of illicit drug addiction is estimated at billions of dollars per year (Fisher, Oviedo-Joekes, Blanken, et al. 2007).
- The specific contents of the general information questionnaire include drug types (including traditional drugs such as opium, cannabis, cocaine, ecstasy and new drugs such as nitrous oxide and etomidate), age, years of drug addiction, gender, HIV infection and education level.
- Accordingly, the matrix of a person’s socio-historical context, life narrative, genetics, and relationships with others influence intention, decision, and action, and thus shape the brain.
- Males had lower levels of self-acceptance than females, HIV-positive than negative, less educated than more educated, and drug addicts who were alienated.
- The samples of this study are all from Sichuan Province, it is difficult to fully represent the diversity and regional characteristics of this group.
- 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).
- Such new iterations of systems theory concentrate on the cognitive and social processes wherein the construction of subjective knowledge occurs.
The social dimension is considered to be vitally important, it is the immediate interpersonal domain that is most proximal to the person who develops an addictive disorder. Who is in the social dimension includes, family, friends, workplace, social, exercise, the community of choice, leisure companions and faith community. It also takes into consideration the socio-structural perspective of the individual as it relates strongly to the many decisions that are made around addictions. This also takes into consideration the social determinants of health, social factors, culture, age, gender and other stressful situations that were experienced. We will be exploring substance use disorders as a biopsychosocial phenomenon and unpack biological, psychological and social theories of substance abuse.
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. We examine heroin-assisted treatment as an applied case example within our framework. We conclude with a discussion of the model and its implications for drug policy, research, addiction health care systems and delivery, and treatment of substance use problems. The dimension of alienation plays an important role in the effect of drug use stereotype threat on the type of self-acceptance of drug addicts. Bandura’s theory suggests that individuals form perceptions of social groups based on others’ views, which may lead to simplified or biased information processing and prejudice.
Our addiction treatment centers in West Palm Beach, Florida offer comprehensive programs that address the physical, psychological, and social factors of addiction using the biopsychosocial model, personality theories and neuropsychology. By addressing cognitive deficits, addiction treatment can empower individuals to regain control of their thoughts, behaviors, and, ultimately, their recovery journey. By understanding the ways addiction disrupts these processes, treatment approaches can be tailored to strengthen cognitive skills and promote long-term success. It’s important to remember that social and environmental factors interact with biological vulnerabilities.