Dr. Jessica Katzman
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Harm Reduction, Part Three: Substance Use as a Biopsychosocial Phenomenon

2/11/2016

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Greetings again to you all! I've recently been occupied by the project of moving into my own office (news about that to follow soon), but have been wanting to return to this topic.
In today's installment, I'm going to discuss substance use as a biopsychosocial phenomenon. This means that all substance use patterns are the net result of a complex interaction between a combination of biological, psychological, social, and spiritual determinants. ​
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Because the origins and progression of these use patterns are complex and variable, it then follows that a single-cause, one-size-fits-all approach to treatment can not possibly be sufficient for everyone.
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​Before moving on to further discuss treatment, I'd like to mention an important point that's related to the biopsychosocial model: people use substances for reasons.

These reasons can be viewed as pathological, or entirely normative within one’s culture and time.

Here are some examples:
  • Because they (especially initially) feel GOOD! Every living organism is organized around the hedonistic pursuit of pleasure and avoidance of pain
  • For religious ritual or shamanistic traditions (e.g. vision quests)
  • To aid in self-exploration and growth
  • To increase stamina during heavy work
  • To escape reality 
  • For sensory enhancement and sensual pleasure
  • To aid social bonding with other humans
  • To create or maintain an identity
  • To treat disease (i.e. self-medication)
  • To escape boredom and psychological despair
  • Pressure from one’s peers, or in the service of fitting into a social group
  • To stimulate artistic creativity
  • For celebratory purposes
  • To aid sexual connection and performance, or to enhance intimacy

(This is hardly an exhaustive list--can you think of any other ones to add?)

As we will see in future installments, exploring these reasons will heavily inform the direction treatment will take, and aid us in creating a compassionate frame for intervention.
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That's all for now! I hope to have another installment for you coming up soon. Thanks for reading!
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    Jessica Katzman, Psy.D.

    I'm a psychologist with a private practice in San Francisco's Castro District. I'm interested in harm reduction, LGBTQQIAAP issues, psychedelic integration, social justice conversations, size acceptance, and any intersections of the above. I welcome your comments!

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    Photo credit: Tristan Crane Photography.

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