Conceptualizing Drug Addiction and Chronic Pain through a Biopsychosocial Framework to Improve Therapeutic Strategies

A significant factor in the and maintenance of addictive behavior is the context in which the behavior occurs. Drug-using rituals are often an ingrained part of life for people with substance use disorders.

Many young men are taught to keep things to themselves rather than share their feelings and seek help from a mental health professional. So, they tend to misuse substances that make them feel better, even if only temporarily. To add to that, repeated use of drugs can damage the essential decision-making center at the front of the brain. This area, known as the prefrontal cortex, is the very region that should help you recognize the harms of using addictive substances. The first two dimensions, the biological categories, uncover how physiology influences drug use.

Biopsychosocial Model of Addiction

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. Mainstream culture in the United States has historically frowned on most substance use and certainly substance abuse (Corrigan et al. 2009;White 1979,1998). As a result, mainstream culture does not—for the most part—have an accepted role for most types of substance use, unlike many older cultures, which may accept use, for example, as part of specific religious rituals. Thus, people who experiment with drugs in the United States usually do so in highly marginalized social settings, which can contribute to the development of substance use disorders . 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.

Phelan J, Yang L, Cruz-Rojas R. Effects of attributing serious mental illnesses to genetic causes on orientations to treatment. Gilllett argues that the causal model is based on a faulty account of human autonomy and consciousness and is scientifically and conceptually questionable.

The Informants

Although substance use disorder is a primary diagnosis, it does not occur in isolation. A BPS model provides a foundation for understanding both the causes of addictive disorders and the best treatments for them. For many people, the process includes stable periods and periods characterised by emotional, relational, and social pain and trouble . Thus, recovery processes should be met with patience and adjusted and collaborative support.

What are the 5 Ps in the biopsychosocial model?

They conceptualized a way to look at clients and their problems, systematically and holistically taking into consideration the (1) Presenting problem, (2) Predisposing factors, (3) Precipitating factors, (4) Perpetuating factors, and (5) Protective factors.

The SMH proposes a mechanism where emotion guides or significantly influences, particularly decision-making. Somatic markers are acquired by experience and are under control of a neural “internal preference system is inherently biased to avoid pain, seek potential pleasure, and is probably pretuned for achieving these goals in social situations” . The brain responds to particular social cues that may provide instant pleasure, or regulate biological homeostasis, such as relief from withdrawal . Brain systems that moderate feeling, memory, cognition, and engage the individual with the world influence the decision to consume or not consume a drug, or participate in a specific behaviour or series of actions. Accordingly, this cybernetic brain-environment interaction may trigger strong somatic signals such as desire, urge and anticipation (Verdejo-Garcia and Bechara 2009).

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Then in the 1970s, George L. Engel proposed that there were more than biological factors to consider when treating mental illness. His approach included examining the psychological, environmental, and social components and how they influence one’s biological functioning related to mental health disorders. SUD and recovery should be understood using the same coherent approach—as an interplay between biological and psychological factors and social, political and cultural contexts. This study emphasised that inpatient treatment is necessary but inadequate for many people with SUD, and long-time access to various professional and social support systems is crucial in the recovery process. Receiving such support is not understood as a defeat, and each person’s resources and vulnerabilities should be recognized and acknowledged.

As Hyman 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). Along with genetics, another contributing factor to the risk of addiction is one’s psychological composition. This factor is as broad as it sounds and includes personality traits (like sensation-seeking and impulsivity), mental health concerns , psychological constructs (like self-esteem and self-worth), and the psychological impact of an individual’s life experiences . Some individuals may be more affected by the rewarding effects of drugs of abuse because they are trying their best to regulate painful emotions. Chronic pain and addiction are widespread, pervasive, and significant public health burdens that demonstrate a need for more effective management strategies. The known effectiveness of opioids for managing acute pain combined with the limited therapeutic alternatives for chronic pain, have led to an overreliance on opioids for long-term pain management and the current opioid crisis in the United States . In this chapter, the authors have discussed conceptualizing chronic pain and SUD using a similar biopsychosocial framework and suggest that both can be more effectively managed by including clinical mental health therapeutic techniques as opposed to a purely biomedical approach.

Biopsychosocial Model Of Addiction Essay

Conversely, recurring drug use can also promote the development of chronic pain, illustrating the logical fallacy in treating chronic pain with prescription opioids. As with other addictive drugs, repeated opioid administration can shift the balance between reward and antireward processes, affecting the ability to experience positive emotions from natural rewards over time . This shift in balance is accompanied by amplification of the antireward state, effectively establishing a reward deficit state, which drives further opioid use to compensate . When people who abuse substances are marginalized, they tend not to seek access to mainstream institutions that typically provide sociocultural support (Myers et al. 2009).

  • Applying a solution-focused mindset to other psychotherapies, including CBT and MBSR, has also led to positive outcomes in the treatment of SUD and depression .
  • These imbalances could cause a predisposition and increased risk of developing an addiction.
  • 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.
  • The findings indicated that recovery processes are hard work, and feelings of wellbeing and success vary over time.

However, when this option is unavailable or insufficient, clinicians must focus on replacing the client’s ties with the drug culture with new ties to a culture of recovery. Notions of a pathologized self, deeply enmeshed with personal identity, may lead an individual to internally negotiate a relationship between the self and the brain . It may further challenge understandings of “accepted” identities, such as health seeking and rational, as opposed to “contested” identities, such as addict, intoxicated, and at-risk . The latter may compromise an individual’s sense and experience of free will, being-in-the-world, perceptions of personal responsibility, and view abnormalities in dopamine pathways as fatalistic. 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).

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