A biopsychosocial overview of the opioid crisis: Considering nutrition and gastrointestinal health
By David A. Wiss
What happens in early life has profound consequences in adulthood, and what happens in one generation may hold significance for future generations. To combat the opioid epidemic, we cannot ignore either the social or the biological determinants of health. This paper adds to the voice of other authors that have called for a “biopsychosocial revolution” linking science and humanism. It is time to advocate for an integration of social and biological disciplines in order to better address the opioid tragedy. Collaborative efforts and partnerships across disciplines will be critical, and the field of public health nutrition appears ripe for leading the way.
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Abstract
The opioid crisis has reached epidemic proportions in the United States with rising overdose death rates. Identifying the underlying factors that contribute to addiction vulnerability may lead to more effective prevention strategies. Supply side environmental factors are a major contributing component.
Psychosocial factors such as stress, trauma, and adverse childhood experiences have been linked to emotional pain leading to self-medication. Genetic and epigenetic factors associated with brain reward pathways and impulsivity are known predictors of addiction vulnerability.
This review attempts to present a biopsychosocial approach that connects various social and biological theories related to the addiction crisis. The emerging role of nutrition therapy with an emphasis on gastrointestinal health in the treatment of opioid use disorder is presented.
The biopsychosocial model integrates concepts from several disciplines, emphasizing multicausality rather than a reductionist approach. Potential solutions at multiple levels are presented, considering individual as well as population health. This single cohesive framework is based on the interdependency of the entire system, identifying risk and protective factors that may influence substance-seeking behavior.
Nutrition should be included as one facet of a multidisciplinary approach toward improved recovery outcomes. Cross-disciplinary collaborative efforts, new ideas, and fiscal resources will be critical to address the epidemic.
