1 Creating the Context Substance Abuse Treatment: Addressing the Specific Needs of Women NCBI Bookshelf

To be diagnosed with IBS, a patient must report bowel troubles and also show no signs of “organic disease” (Camilleri and Choi 1997, 3, 8, 9, 11). Yet Camilleri and Choi classify IBS itself as “a disease.” In fact, they call it “the most common disease diagnosed by gastroenterologists” and say that “it” “affects about 20% of all people at any one time” and “has a large economic impact” (Camilleri and Choi 1997, 3). National Institutes of Health (NIH) funded a major TMD study known as “OPPERA.” The OPPERA study has been highly significant in the field of TMD research. It is referenced frequently in the literature, and has provided the data underlying many claims made about TMD and its causes. In several descriptions of the OPPERA project offered by field leaders, we find additional question-begging transformations of TMD. In the end, then, Engel’s arguments about the nature of disease and putative benefits of the BPSM seem uncompelling.

a biopsychosocial approach to substance abuse

They are essentially labels that identify pools of unexplained symptoms for further study. Although redefinitions of CFS and TMD have been proposed, both constructs have for decades remained relatively unchanged, in the face of little evidence for their validity (Institute of Medicine 2015; Ohrbach 2021; Ohrbach and Dworkin 2016; Schiffman et al. 2014). Adopting this strong position on the BPSM’s capabilities tends to place the researcher in an implicit bind. It creates an expectation that one can and will learn new things about disease by putting the BPSM to work; yet the BPSM itself offers no tools for generating new knowledge. I argue that, in practice, researchers have often bridged this gap between capacities and expectations with specious arguments that seem to deliver new insights about disease. I refer to these specious arguments, which follow certain common patterns, as “wayward” BPSM discourse.

Intrapersonal Contributors to Drug Use

Strengthening cultural identity can be a positive action for the client; in some cases, the client’s family or cultural peers can serve as a replacement for involvement in the drug culture. This option is particularly helpful when the client’s connection to a drug culture is relatively weak and his or her traditional culture is relatively strong. However, when this option is unavailable or insufficient, clinicians must focus on replacing the client’s ties with the drug culture (or the culture of addiction) with new ties to a culture of recovery.

Current ethical and legal debates in addiction draw upon new knowledge about the biological and neurological modification of the brain (Ashcroft, Campbell, and Capps 2007). It is crucial that treatment does not place emphasis solely on the drug of choice but on the entire process of the addiction at hand. At Soba Recovery our comprehensive addiction treatment program addresses all aspects of addiction. At Soba Recovery, we also incorporate the medical management of addiction into our clients’ treatment plans.


Through involvement in the drug culture, he was able to gain a measure of self-esteem, change his family dynamic, explore his sexuality, develop lasting friendships, and find a career path (albeit a criminal one). For this individual, who had so much of his life invested in the drug culture, it was as difficult to conceive of leaving that culture as it was to conceive of stopping his substance use. The relationship between the drug and mainstream cultures is not unidirectional. Since the beginning of a definable drug culture, that culture has had an effect on mainstream cultural institutions, particularly through music, art, and literature. These connections can add significantly to the attraction a drug culture holds for some individuals (especially the young and those who pride themselves on being nonconformists) and create a greater risk for substance use escalating to abuse and relapse.

Upon completing this Home Study Course, participants will have a solid understanding of risk factors, the biopsychosocial symptoms of both substance abuse and addiction, and will be able to describe the progressive stages of addiction and the biopsychosocial symptoms in each stage. A strengths-based approach builds on the woman’s strengths and uses available resources to develop and enhance resiliency and recovery skills, deepen a sense of competency, and improve the quality of her life. These strengths may include personality traits, abilities, knowledge, cultural values, spirituality, and other assets; while resources may involve supportive relationships, environments, and professional support.

Temporomandibular disorder(s)

The social does not necessarily include macrosocial circumstances, such as governmental social policies, drug policy or drug ‘strategy’ that has a direct effect on substance use rates and patterns. In this light, the addition of systems to the prototype biopsychosocial model allows for the inclusion of macrosocial systems as well as smaller components, such as cells and genes. 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). An individual living with an addiction is in-the-world-with-others and thus acts as a being-among-others, such that the individual’s decisions and complex engagement with the world may not be as automatic as the neurophilosophical model may suggest (Gillett 2008a, 2008b, 2009).

White (1996) notes that as a person progresses from experimentation to abuse and/or dependence, he or she develops a more intense need to “seek for supports to sustain the drug relationship” (p. 9). In addition to gaining social sanction for their substance use, participants in the drug culture learn many skills that can help them avoid the pitfalls of the substance-abusing lifestyle and thus continue their use. They learn how to avoid arrest, how to get money to support their habit, and how to find a new supplier when necessary. When people who abuse substances are marginalized, they tend not to seek access to mainstream institutions that typically provide sociocultural support (Myers et al. 2009). A marginalized person’s behavior is seen as abnormal even if he or she attempts to act differently, thus further reducing the chances of any attempt to change behavior (Cohen 1992). The drug culture enables its members to view substance use disorders as normal or even as status symbols.

Introductory Aspects and Main Concepts

This can extend to legal substances such as alcohol or tobacco (including, in recent years, the increased prohibition against cigarette smoking in public spaces and its growing social unacceptability in private spaces). As a result, mainstream culture does not—for the most part—have an accepted role for most types of substance use, unlike many older cultures, which may accept use, for example, as part of specific religious rituals. Thus, people who experiment with drugs in the United States usually do so in highly marginalized social settings, which can contribute to the development of substance use disorders (Wilcox 1998).

  • Additionally, many neurotransmitters are involved in the experience of reward (dopamine, opioids, GABA, serotonin, endocannabinoids, and glutamate; Blum et al., 2020).
  • It highlights the multiple contexts of women’s lives and treatment issues, provides gender responsive principles of treatment, and presents the unique biopsychosocial needs that characterize the issues women face in treatment.
  • I refer to these specious arguments, which follow certain common patterns, as “wayward” BPSM discourse.
  • I was lucky to negotiate a debt settlement, and in two years, I had no more debt.
  • They needed support and treatment thereafter—some for short periods and others potentially for the rest of their lives.
  • There is now a large body of research indicating that psychosocial factors often play important roles in shaping health outcomes (Bolton and Gillett 2019; Edwards et al. 2016; Gatchel et al. 2014; Vogele 2015).

We performed descriptive analyses to detail the characteristics of NSDUH sample participants. We checked the data for normality of the residuals, homoscedasticity, multicollinearity, outliers and influence. After the data were found to be adequate for the logistic regression model, four weighted multivariate models were built using Stata survey procedure. All models were weighted 7 Ways Creativity Supports Addiction Recovery and accounted for clustering and stratification of the complex survey design. All findings are reported in odds ratios (ORs) or adjusted odds ratios (AORs) using a 95% confidence interval (CI) and p-value for significance criteria. The biological basis of addiction helps to explain why people need much more than good intentions or willpower to break their addictions.

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