Toward a Biopsychosocial Theory of Substance Abuse
Theoretical integration of the fast-accumulating literature in the substance abuse field has been sadly lacking. Most theories have been developed from a single perspective or level of analysis, and in many cases they were inconsistent with data from other approaches on the day the theory was published. For example, Peele (1981) reviewed several theoretical approaches that emphasized that a complete “answer” to substance abuse problems was to be found by analysis of genetic or biochemical factors alone. As Peele showed, these analyses completely ignored other data that clearly indicated the importance of environmental and psychosocial factors. Yet in the same paper, Peele proposed a theoretical approach that denied the importance of any biological factors! To illustrate the current lack of integration in the field, consider again the recent edited collection on drug abuse theory (Lettieri, Sayers, & Pearson, 1980) that included over 40 completely distinct theories. Particularly noteworthy in the Lettieri et al. collection was that most of the theories tended to incorporate only a narrow band of data, and their generalizability beyond a highly limited domain appeared poor. Clearly, there is a need for theoretical integration in the substance abuse field, and a careful inspection of the preceding chapters should convince the reader that such integration will require a model that incorporates factors from several disciplines: in short, a “biopsychosocial” model.
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