Sober living

A Comprehensive Approach to Understanding Substance Use Disorder and Recovery: Former Patients Experiences and Reflections on the Recovery Process Four Years After Discharge from SUD Treatment PMC

Engel’s concept-shifting maneuvers thus create a discursive space in which there appear to be few checks on the causal claims one can make about disease and illness. As McLaren has argued (1998), for the BPSM to be a genuinely scientific model, it would have to go beyond merely positing that illness involves biological, psychological, and social factors. It would have to provide an integrating theory that explained exactly how these factors interact to cause illness in practice. The model could do this by, for example, defining its three domains clearly and explaining how social factors of type X cause biological events of type Y, which in turn produce symptoms of type Z, and so on. Engel hoped that general systems theory could be used to build this kind of scientific version of the BPSM (Engel 1977). Yet he never built such a model, and nor has anyone else—although work on this project remains ongoing (Bolton and Gillett 2019; Edwards et al. 2016; Kelly et al. 2014; McLaren 1998, 2021).

a biopsychosocial approach to substance abuse

Even within such organizations, though, there is some cultural diversity; regional differences exist, for example, in meeting-related rituals or attitudes toward certain issues (e.g., use of prescribed psychotropic medication, approaches to spirituality). Here we see how wayward discourse can produce constructs that set research on an unstable path. Because it is unclear what constitutes a “biopsychosocial disease” or the “complex disease” of TMD in the first place, it is not clear what observed heterogeneity and comorbidity mean for the TMD construct. Their meaning is, as Ohrbach (2021, 90) puts it, “within the eyes of the beholder” in TMD research. But if key empirical observations have no clear theoretical significance because one’s framework and core concepts are vague, then the viability of one’s research program is open to question. In sum, we can see the question-begging variety of wayward BPSM discourse—and its power—at work in the TMD literature.


The mental health indicators were severe psychological distress and suicidality. A severe psychological distress indicator within the past year was based on responses from past-month Kessler-6 (K6) items and the worst month in the past-year K6 items. K6 items are from a screening instrument for nonspecific psychological distress developed by Furukawa, Kessler, Slade, and Andrews, [42] and Kessler et al. [43] Suicidality was assessed if at any time in the past year a participant had seriously thought about trying to commit suicide. Both social norms and laws influence attitudes, perceptions, and beliefs of the effects of substances and considerably affect consumption rates (Babor, Caetano, Casswell et al. 2003; Hawkins, Catalano, and Miller 1992). Proponents of a ‘war on drugs’, for example, believe that laws and policies that are lenient towards substance use are linked with greater prevalence of use and criminal activity. In one study comparing cannabis use in San Francisco (where cannabis is criminalized) and Amsterdam (de facto decriminalization), there was no evidence to support claims that criminalization laws reduce use or that decriminalization increases use.

  • Deterioration of cognitive health has a wide variety of negative effects on the lives of substance abusers, which is why at Soba Recovery Center we understand that it is important to treat each individual’s specific needs.
  • This approach assumes that psychological and biological factors are in constant interplay with relational, social, economic, cultural and political elements in the development and maintenance of SUD and that each person’s pathway to developing SUD is unique [10, 11, 37].
  • Although substance use disorder is a primary diagnosis, it does not occur in isolation.
  • They can likewise find a sense of purpose they otherwise lack in the daily need to seek out and acquire drugs.
  • In the best case, staff members will have a plan for creating a culture of recovery within their treatment population.
  • However, large international mutual-help organizations like Alcoholics Anonymous (AA) do represent the culture of recovery for many individuals.

Routine physical activity is known to promote positive mental wellness, while inadequate or excessive physical activity can contribute to different types of mental health struggles. Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. This course presents a model that integrates over forty years of scientific research on addiction into a practical and easy to understand model that can improve assessment, recovery education, and treatment planning. Women with substance use disorder have greater susceptibility to as well as earlier onset of serious medical problems and disorders.

Substance Use in Young Swiss Men: The Interplay of Perceived Social Support and Dispositional Characteristics

The disorder becomes a source of pride, and people may celebrate their drug-related identity with other members of the culture (Pearson and Bourgois 1995; White 1996). Social stigma also aids in the formation of oppositional values and beliefs that can promote unity among members of the drug culture. It is worth noting that the wayward BPSM discourse on gun violence is almost transparently political rather than scientific. The literature in this area does not provide a meaningful definition of “biopsychosocial disease” and then demonstrate that gun violence qualifies. The articles on the topic consistently argue that gun violence “can” and “should” be “framed as a biopsychosocial disease” to expand medical jurisdiction over the problem (Barron et al. 2021, 1; Grossman and Choucair 2019, 1640; Hargarten et al. 2018, 1024–26; Kohlbeck and Nelson 2020).

  • This helped them stay sober and maintain contact with other people, making them feel normal and part of society.
  • Ghaemi is one of the few scholars to have given a sustained answer to these questions (Ghaemi 2010).
  • Evidence supports the havoc substances play on reproductive processes, such as the role of heavy alcohol use on infertility and drug use on menstrual cycles (Lynch et al. 2002; Reynolds and Bada 2003; Tolstrup et al. 2003).
  • Timely initiation of prenatal care remains a problem nationwide, and it is overrepresented among women with substance use disorders.
  • Such moves are, no doubt, enabled by the BPSM’s lack of scientific content, which makes it a poor tool for vetting knowledge claims.

Women’s sociocultural role as caregivers predisposes them to define themselves in terms of social relationships and obligations. Through this lens, women are more likely to view relationship building as an essential treatment ingredient. If attention is given to establishing and maintaining relationships across the continuum of care, women are more likely to initiate, engage, and successfully complete treatment. Women have identified several counselor characteristics that they believe contribute to treatment success—a projection of acceptance and care, trust and warmth, a non-authoritarian attitude, and a sense of confidence in their abilities (Fiorentine and Anglin 1997; Sun 2006). In this TIP, chapter 7 covers the main factors that influence retention; particular attention is given to women’s treatment expectations surrounding environment, theoretical approach, therapeutic alliance, and counselor characteristics.

How the Biopsychosocial Model Impacts Mental Health

In terms of other health professions (i.e., nurses, social workers, counselors, occupational therapists, and professional psychologists), the BPS model is the basic framework for understanding health and illness. Within psychology, some have argued that the biopsychosocial framework provides the central pathway to unify the field of professional psychology. Women often take different paths in accessing treatment for substance use disorders. Women who abuse substances have specific health issues and medical needs related to gynecology. Acknowledge the importance and role of socioeconomic issues and differences among women. Biological, cognitive–behavioral, and psychological dimensions of women’s substance use and abuse should be framed in their socioeconomic contexts including, but not limited to, employment, educational status, transportation, housing, literacy levels, and income.

a biopsychosocial approach to substance abuse

Social relationships benefit a person’s health via social control that others exercise over that person. Strong, positive social relationships often discourage behaviors that damage the person’s health, such as drug and alcohol use and abuse. These positive social relationships can result in the user’s increased accessibility to others that are also struggling with addiction, and resources that support a healthy lifestyle. At Soba Recovery our clients’ social and emotional health is nursed back to life during the treatment process. Aftercare and referrals are provided by Soba Recovery because we know that having a strong, positive social support system, even after the completion of treatment, ensures a long-lasting recovery. The primary audience for this TIP is substance abuse treatment clinicians and counselors who work with women.

Gender and addiction from a professional’s perspective

The resort to fallacious arguments in wayward discourse is almost certainly unintentional—a result of misunderstanding or carelessness, mixed with excitement about the BPSM’s perceived potential. Second, the BPSM itself does not provide intellectual tools for establishing 7 Ways Creativity Supports Addiction Recovery causality. Unlike, say, the Henle-Koch postulates or Evans’ criteria for causality (Evans 1976), the BPSM does not articulate epistemic principles that would allow researchers to distinguish true cause-effect relationships from spurious correlations.

The model includes the way in which macro factors inform and shape micro systems and brings biological, psychological and social levels into active interaction with one another. The contemporary model, adapted for addiction, reflects an interactive dynamic for understanding substance use problems specifically and addressing the complexity of addiction-related issues. The empirical foundation of this model is thus interdisciplinary, and both descriptive and applied. Women are more likely to be introduced to and initiate alcohol and drug use through significant relationships including boyfriends, spouses, partners, and family members. This influence does not stop with initiation; it extends to greater use and higher incidence of substance use disorders when they have partners who abuse substances (Klein et al. 2003).

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