Negotiating the Relationship Between Addiction, Ethics, and Brain Science PMC

Consequently, absent or traumatically ruptured attachments are expected to impact the development of personal identity and affect regulation (Berner, Carlos, & Whipple, 2010; Fonagy et al., 2004; Speranza et al., 2017). Addiction can be understood from multiple perspectives and here we have focused on addiction through the lens of neurobiology and psychoanalysis. The neurobiological perspective provides a considerably structured and empirically-based approach, acknowledging that substance use leads to a series of neurochemical reactions in the brain that have structural and functional neuroadaptations.

Understanding Own Substance Use

  • Although there is no “addiction gene” to definitively identify a person as being at risk for addiction, it is evident through twin studies, adoption studies, family studies, and more recently, epigenetic studies that addiction has a genetic component.
  • First, he describes a “weak” rights ethic, wherein individuals have the right to access good healthcare.
  • This task is monumental but not impossible, and social learning theory points to a possible solution.
  • It is possible that a specific health condition at a particular stage may turn out to be primarily caused by only one kind of factor – biological, psychological, or social – and of course biomedical models of infectious diseases have had stunning successes in exactly this way.

To solve the problem of addiction, reciprocal determinism demands metacontingencies, interlocking sets of contingencies between two or more individuals that produce an outcome greater than (or at least more efficiently than) that which can be obtained by any one individual (Glenn, 1988). In a metacontingency, the behavior established and maintained by one individual determines the contingencies for others. These interdependent contingencies thus control the behavior of both individuals and the broader social network. The term, metacontingency, was not used by either Skinner or Bandura, but it places operant contingencies squarely in the middle of a social context.

  • These social connections that are critical for our development as babies, toddlers, youth and into adulthood play a role in what we do, how we act, and how we live.
  • A systems approach strives to achieve a unification of disciplines neuroscience, biology, psychology, sociology, philosophy, economics, politics and law by examining interacting and emerging patterns from each discipline, rather than focusing on common material components (Heylighen et al. 2007).
  • As such, holistic treatment alternatives targeting these factors in both the child and the mother have been recommended (Neger & Prinz, 2015; Suchman, Mayes, Conti, Slade & Rounsaville, 2004).
  • These practices borrowed from 12-step programs are just a few of the turn-key strategies that can be employed when developing new metacontingency- and network-based interventions for drug addiction.

Mind the dad–A review on the biopsychosocial influences of drug abuse on father-infant interaction

The models of relationship that have tended to appear in the medical literature, with a few notable exceptions,19 have perhaps focused too much on an analysis of power and too little on the underlying emotional climate of the clinical relationship. For this reason, we suggest a reformulation of some of the basic principles of the biopsychosocial model according to the emotional tone that engraves the relationship with such characteristics as caring, trustworthiness, and openness.49,50 Some principles of biopsychosocial-oriented clinical practice are outlined below. Engel’s perspective is contrasted with a so-called monistic or reductionistic view, in which all phenomena could be reduced to smaller parts and understood as molecular interactions. Nor did he endorse a holistic-energetic view, many of whose adherents espouse a biopsychosocial philosophy; these views hold that all physical phenomena are ephemeral and controllable by the manipulation of healing energies.

  • At the same time, there was another major anomaly for the BMM, the emerging findings of social epidemiology, noted in the previous section, that social status affects a wide range of physical health and mental health outcomes, in the Whitehall Studies by Michael Marmot and colleagues (Marmot, Rose, Shipley, & Hamilton, 1978; Marmot et al., 1991).
  • The clearest clinical implications of the BPSM, in contrast as always with the narrower BMM, is accommodation of psychological and social factors as well as biological factors relevant to clinical management and treatment.
  • In this first demonstration of Palovian conditioning (also known as “classical” or “respondent” conditioning), Pavlov showed that a previously neutral stimulus could come to elicit a biologically relevant response if it was paired with a biologically relevant stimulus (Pavlov, 1927).
  • For instance, an abundance of data indicate that modeling and imitation play a strong role in both the amount and pattern of drug use (Koordeman et al., 2011; Larsen et al., 2009; 2010), and there is some evidence that social reinforcement can maintain and escalate drug use (Fazzino et al., 2018; Lochbihler et al., 2014).

A ‘components’ model of addiction within a biopsychosocial framework

Going forward, these same principles can be used to guide the development of metacontingency-based interventions to aid recovery. The sponsor/coach/guide with a vested interest in sobriety is a critical component of any treatment intervention involving addiction. Indeed, this person is absolutely necessary for the establishment of a metacontingency in which the behavior of one individual determines the contingencies for another. A sponsor with a history of addiction (i.e., a peer) but also a history of long-term abstinence controls the contingencies that control the drug use of the individual just beginning recovery – this person models and reinforces abstinent-related behaviors while redirecting drug-centric behaviors to those that are conducive to recovery. Because both individuals are in long-term recovery – these behaviors both feedback and feed forward to maintain the abstinence of both individuals.

biopsychosocial theory of addiction

  • The biopsychosocial systems model is grounded in systems theory in which knowledge occurs at the intersection of the subjective and the objective, and not as an independent reality.
  • By the time of Darwin’s death, we had the building blocks for a new science of behavior – a science based on sensory experience, a science based on learning associations, and a science based on the notion that learning associations between relevant events in our environment is necessary for our survival.
  • Aristotle, unlike his predecessors, was an empiricist, insisting that it was our interactions with the external environment that are responsible for our knowledge of the world.
  • A systems approach allows for the inclusion of psycho-social and socially systemic explanations of addiction, which extend well beyond neurobiology while still interacting with it (Bunge 1991).
  • Third, the same kind of theoretical apparatus used in biology (function, organization, regulation and dysregulation, information, production, and distribution) is also used in the psychological and social sciences – as reviewed below.


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