The bio-psycho-social model of addiction (BPS) is an attempt to explain how addiction occurs and is maintained. It is meant to give a framework of understanding so that treatment can be more effective. The main contrast with BPS is the disease model of addiction and that will be contrasted here.
The disease model of addiction proposes that biological factors (genetic and chemical changes from drug use) are the primary cause of addiction. The case revolves around what we know about the biochemistry and physiology of drug abuse. It gives us useful targets for treatment and testing and places addiction into a category where traditional medicine act. There is a great deal of research based on this model and some real strides have been made. Particularly, brain imaging and new drugs have shown that behaviors can and do change when brain chemistry is altered.
Criticism of a strict disease model comes from the addiction treatment community and addicts themselves. There is evidence that, while addiction does have elements of a disease, it can be prevented and treated if other aspects of an addict’s life are taken into account. They point out cases where addicts have successfully quit drugs on their own – with no medication at all. What kind of disease could it be if willpower and support are able to cure it?
The BPS model expands to include not only the physical causes of addiction (bio) but also the emotional (psycho) and the social parts as well. In other words, without addressing the environment the addict finds themselves in (both psychological and social), we won’t do very well at treating it.
The argument is that the disease model is too narrow and the BPS model better fits what’s actually happening. Family matters; poverty and crime matter; opportunity and friends have an influence; underlying mental illness matters (especially depression). BPS is more holistic.
Critics of the biopsychosocial model agree there is more to addiction than simply biological destiny, but they point out that BPS is too broad; it doesn’t really give us a clear target to attack. By mixing psychology and sociology with traditional medicine, treatment specialists are left wandering in the dark.
Practical addiction treatment is actually a blend of the two models. When medications (methadone, Suboxone, others) do some good, they are tried. Along with medications though, some effort should be made to alter the patients outside influences (family and friends). Simultaneously, a patient’s mental status needs to be evaluated – to catch when addiction is the result of self-treatment for depression or other condition.
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