Addiction through a Biopsychosocial lens

This week we have been tasked with researching various multi-sphered or multi-layered models of health. In reflecting over the past few months and our ongoing discussions of ‘what is health?’, it became clear that it is not easily defined. Health is dynamic and multi layered. It means many things to many people, and in turn defining it is difficult. I have chosen to focus on Engel’s Biopsychosocial (BPS) model of care, and how it can apply to substance use.

Firstly, I would like to give a brief description of Engel’s theory of the BPS model. Initially this model of care was created to contradict the traditional biomedical approach and its limitations (Tramonti et al., 2021). The purpose of this model was to highlight how important social and psychological aspects are in defining and understanding health (2021). I chose to apply this model of health to substance use as I find both theory and subject to be multi-sphered. I enjoyed learning this theory in nursing school as it simplified many complexities when learning about mental illness and substance use.

Substance use is something I work with on a daily basis. At its core, it can be identified as a disease however, there are so many factors that lead to addiction.

On a biological level, many people are predisposed to addiction. Gender, ethnicity, physical and mental illness can increase a person’s risk of becoming a substance user. Many people are also at a higher risk of addiction based on a number of neurochemical deficiencies (Giordano, 2021).

When we speak of the psychological factors that contribute to substance use and misuse, we can consider many mental health concerns like depression and anxiety (2021.) Psychological aspects can also include people’s experiences, trauma and emotional responses to both. Often in my practice, it becomes apparent that many people who struggle with substance use also struggle with impulse control and poor coping mechanisms.

The final factor in the BPS model is the social aspect. This factor encompasses many elements that could contribute to substance use such as social relationships, social status and the physical environment. Social supports such as friends, family or scarcity of both, can heavily influence one’s chances of using substances and becoming addicted. The physical environment plays a large role in the accessibility and availability of substance use (2021).

The BPS model illustrates how one’s social and psychological spheres are tightly interconnected with one’s genetic predisposition to addiction. This multi-level model of health is highly applicable to the substance use population, and when considered, has the potential of resulting in better comprehension of the illness.

References

Giordano, A. (2021, July 10). What Exactly Is the Biopsychosocial Model of Addiction? | Psychology Today Canada. Psychology Today. https://www.psychologytoday.com/ca/blog/understanding-addiction/202107/what-exactly-is-the-biopsychosocial-model-addiction

Tramonti, F., Giorgi, F., & Fanali, A. (2021). Systems thinking and the biopsychosocial approach: A multilevel framework for patient‐centred care.

Systems Research & Behavioral Science, 38(2), 215–230.

https://doi.org/10.1002/sres.2725