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Biopsychosocial Model Social Anxiety and Substance Use Revised Current Psychiatry Reports

For example, McWhinney’s Textbook of Family Medicine (McWhinney and Freeman 2009), which draws on the BPSM and similar frameworks, has helped practitioners develop a more holistic approach to medical care. However, they also encourage physicians and other practitioners to move beyond considerations of organic pathology by understanding each patient as a person whose being is fundamentally social and psychological, in addition to biological. Attending to these aspects of the patient can promote trust, bring to light additional information relevant to patient well-being, and expand opportunities for treatment (McWhinney and Freeman 2009).

This chapter aims to explain that people who use drugs participate in a drug culture, and further, that they value this participation. White (1996) draws attention to a set of individuals whom he calls “acultural addicts.” These people initiate and sustain their substance use in relative isolation from other people who use drugs. Examples of acultural addicts include the medical professional who does not have,_1988) to use illegal drug networks to abuse prescription medication, or the older, middle-class individual who “pill shops” from multiple doctors and procures drugs for misuse from pharmacies. Although drug cultures typically play a greater role in the lives of people who use illicit drugs, people who use legal substances—such as alcohol—are also likely to participate in such a culture (Gordon et al. 2012).

The Biopsychosocial Model of Addiction

Individuals involved in treatment could learn effective coping strategies, modify proximal environmental triggers, and achieve other social goals. As Hall and colleagues (2003a) remark, “A ‘disease’ that can be ‘seen’ in the many-hued splendor of a PET scan carries more conviction than one justified by the possibly exculpatory self-reports of individuals who claim to be unable to control their drug use” (p.1485). Some aspects are universal (e.g., the activation of the reward system by drugs of abuse).

This is an example of “ethnocentrism”, the pattern to feel that a provider’s own cultural development and personal beliefs are correct (Narayan 2010). Providers need to be mindful of that a patient’s pain response is influenced by a variety of social, ethnic, and cultural factors that the provider may recognize as ‘wrong’ or not appropriate when they are in fact just different (Narayan 2010). For example, HCPs working in international settings should note that perception of pain is influenced by societal norms as well. Within various African societies, barriers such as HIV-stigma itself may prevent certain cultures from acknowledging HIV disease related pain (Alexander et al. 2015).

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