The biopsychosocial model proposes that there are physiological, behavioural and social factors that coalesce to increase the risk of developing problematic substance use. Incorporating some of the factors described in the medical and disease models, certain biological factors are seen to be influential, including genetic predisposition to the effects of certain substances and the potential of these substances to cause physical dependency. Similarly, encompassing the theories of social learning and cognitive-behavioural approaches, the biopsychosocial model identifies that many problematic substance users often use or over-use substances in response to psychological factors such as depression, anxiety, low self-esteem and other life-stressors. Again, within this model, ‘stress and coping theory’ can be applied to explain substance use as a response to stress, distress, interpersonal conflict and alienation.
The biopsychosocial model also recognises the social components that can contribute to the development and perpetuation of problematic substance use. These include: peer and social, family, and community factors including poverty, conflict and discrimination; exposure to positive attitudes towards substance use such as parental or sibling substance use; poor social, material and emotional support; high crime rates; and lack of academic achievement or employment.
It has been suggested that cognitive-behavioural approaches in isolation do not take enough account of the physiological dependency effects that problematic substance use can entail. Conversely, it has long been acknowledged that pharmacological treatments on their own are less effective than when they are combined with a psychosocial element . As such, the biopsychosocial approach is often seen as bridging these gaps with its combination of psychosocial and clinical or prescribing elements.