The Bio-Psycho-Social Approach

shutterstock_243591430Addiction can no longer be rationalized as a social or moral problem.

Science has illustrated beyond reasonable doubt that addiction is in fact a brain disease. Like other illnesses, addiction has biologic, psychological, social, spiritual and nutritional elements. Unimodal treatment, or treatment that only addresses one aspect of the problem, is destined to be less effective than multimodal treatment. Every individual is different and requires a customized combination of biologic, psychological, social, spiritual and nutritional interventions to be as effective as possible.

Addressing the biology of substance dependence and pain is mandatory. Prolonged exposure to substances of abuse can cause undeniable and negative changes in the brain. The use of medications and exercise to re-stabilize and enhance biologic function and to minimize dysfunction is a crucial part of customized addiction treatment. Constantly striving to continue to evolve my expertise on opioids, gabaenrgic drugs (i.e. benzodiazepines and alcohol) and stimulants helps inform the medication choices I make for my patients. I strive to help my patients address other biological issues (i.e. psychiatric, endocrine, cardiovascular, orthopedic, etc) in collaboration with the most qualified and accessible physicians available.

Using drugs or alcohol to cope with a psychological or social problem, is like "using a shredder to deal with your credit card bill." The problem is momentarily "gone", but actual magnitude of the problem continues to grow. It is crucial that individuals learn to deal with historical negativity, trauma and pain as they strive to deal with new problems in real time to the greatest extent possible. Customized combinations of individual therapy, group support, cognitive behavioral techniques and other psychological interventions are necessary to give patients the best chance of sustained success.

“One can have the best doctor, the best medication and the best therapist, but if they still live and work in a crack house, it is extremely unlikely that they will be able to stop smoking crack.” Sometimes social changes are necessary for patients to recover. Getting away from truly negative influences can be an essential aspect of success. Understanding and addressing unmet educational, vocational, familial and peer issues can at times be life saving.

"The minimum faith requirement is faith in yourself to achieve your goals. You aren't going to hit the bull's eye looking at the floor and you are not going to finish the marathon repeating the mantra of "I can't, I can't, I can't." Whatever faith and world view patients have can be maximized to help them connect and control themselves. The use of mind body activities like prayer, meditation, yoga and tai chi buttress other faith based strategies to enhance outcomes."

We are what we eat. Learning to avoid toxic and unhealthy food choices is necessary for sustained success. High glycemic index and processed foods have psychoactive properties and effect the body and brain in intensely negative and long lasting ways. Learning to make healthy food choices when coupled with appropriate use of vitamins and nutraceuticals provides the necessary building blocks for individuals to truly heal themselves.

No matter what someone’s drug problem is like, in order to have the best possible chance for long term recovery from addictive disease, individuals need to address the biologic, psychological, social, spiritual and nutritional factors that affect their illness. Combining interventions in each of these 5 areas is essential to most effectively treat substance dependence. It can extremely challenging and it takes a lot longer than we wish that it did, but it can be done. More importantly, it can be done by YOU! Substance related disorders can take years to develop to the point that patients are motivated to seek treatment. Recovery from these issues can take as long or longer to completely resolve.