A lot of people wonder what “makes” a person get addicted to substances. Although there is no clear cut answer to this, psychologists have devised the biopsychosocial model, which explains why certain people are more or less likely to become addicted. The biopsychosocial model comprises of three specific factors, which are biological, psychological and social. It is the synergy and interplay between these three factors, which is unique for each individual, that make them more or less likely to become addicted.
The Biopsychosocial Model
The biopsychosocial model is actually very new and moves away from the more traditional models that try to explain addictive behavior. This model explains the complexity of the interactions that exist between a person’s biology, psychology and social life. Although a reasonably new theory, it is now widely accepted as being correct. This is mainly due to the fact that it explains very well that addiction is highly intricate and doesn’t present any clear cut answers. More and more often, however, treatment providers also include the term spirituality to this. For other treatment providers, however, spirituality comes under the social heading.
The model was first described in 1977 by George Engel. However, he didn’t develop this specifically for addiction, but rather for all aspects of medicine. In Engel’s day, medicine used a biomedical model. This meant that doctors were always trying to find a single source behind any illness. As a result, the illness would be treated looking only at that one source. This meant that various other factors were completely disregarded, when in actual effect the social behavior and psychological experiences of a patient were playing a very important role.
Some ten years later, Donovan and Wallace applied the biopsychosocial model specifically on addictive behavior. In their thinking, they acknowledged that alcoholic behavior in particular is highly multidimensional and cannot be reduced to a single cause. Donovan was responsible for pushing through a full and comprehensive assessment, through which practitioners were able to look at the biological, psychological and social elements in the life of an individual patient. This then allowed them to determine which multitude of factors would contribute specifically to addiction. Donovan’s hypothesis was that this information would facilitate quicker diagnostic, as well as ensuring appropriate treatment would be found and offered.
Since the late 1980s, the model has gone through various changes. Different professionals adapt it to their own theories and practices. All, however, focus on the fact addiction has a number of pathways. Genetic predisposition is one, but so is the need for self-medication, learned behaviors and how a family impacts on the behavior as a whole. It is safe to say that the biopsychosocial model has been a real breakthrough. Let’s explore the individual elements in a bit more detail.
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The Biological Element
The biological element means that there may be a biological or genetic predisposition to becoming an addict. This doesn’t mean that there is such a thing as an “addiction gene”, but a person can be genetically predisposed to seek thrills or engage in risky behavior. The genetic theory is perhaps the most important within the biological element. However, addiction specialists also look at neurbiological and neurobehavioral theories, which are incredibly important but often slightly harder to grasp.
The Psychological Element
The psychological element all has to do with how the person’s brain works, but also how they deal with certain stresses. For instance, one person is able to deal very well with stress and anxiety, others self-medicate through chemical substances. Psychology, as most people know, is a very broad and wide field of practice. As such, within addiction treatment, the psychological element is huge as well. It looks at various psychological theories, including psychoanalytic theory. It also works hard on the personality theory, which queries whether people simply have an addictive personality, a term that is used very regularly within addiction treatment. Then, it looks at classical conditioning and finally at social learning. Social learning could perhaps be placed in the social element of the biopsychosocial model, but as it is a psychological theory and one that speaks of the effects on the mind, it has been placed within the psychological element.
The Social Element
The social element relates to how the addict lives, what sort of social circles they operate in, whether they belong to religious groups, what job they have and so on. Some of these jobs condone drug use, where as others condemn it. There are various different theories within the social element. Firstly, there is the systems theory, which is about enabling and the role of the family. Then, there is the availability theory, which depends on factors such as geographical location and the availability of substances within that, but also whether other members of the household use or abuse substances. The anthropological theory also fits into the social element, which is a hugely complex theory. Lastly, there is the economic theory, which is all about whether or not people have the financial ability to afford a substance and, if they are not, where they would get the finances from.
What matters is how these three elements mix and interact with each other. Unfortunately, with some people, this makes them more likely to become addicted. Many practitioners have noticed that therapeutic programs still rarely use the biopsychosocial model. This is a shame, because we understand how important the model is in terms of determining why someone became addicted, meaning it stands to reason that making changes in the different elements of the model would provide the patient with the treatment they need. Some practitioners have complained that it is very difficult to assess according to the model, which makes treatment almost impossible too. However, other experts disagree. Standardized tests are starting to emerge, but the reality is that because the biopsychosocial model is about interaction and synergy, no real standardized model can be created. It is about practitioners understanding the model as a whole and learning how to talk to their patients to fit them on this model.