Nobody likes people who say "I'm right and you're not." We've all learned to be diplomatic, so nobody's feelings get hurt. Even when we're completely certain we're right, we realize it's good manners to say, "I'm sure there are ways you're right, too," or, "No doubt we both have something useful to contribute to this."
But science is different. The scientific enterprise is about getting closer to the truth, by discovering or creating new understandings, and discarding older ones that we know are misguided. In science, we cannot patiently accommodate mistaken ideas because it's good manners. Some people may still believe that the Earth is flat. Yet it would be very bad science to say, "Hey, no problem. We can both be right! Let's make a theory that the earth is round and also sometimes flat. Everyone will be happy."
Somehow in the field of addiction, "making nice" has managed to grab a powerful foothold. Ask nearly any psychiatrist about the nature of addiction, and she is likely to support the notion that it is a "biopsychosocial" phenomenon. This word, invented in the late 1970's, was intended to act as a sort of tepid catch-all which included every possible factor in the development of addiction: biological, psychological and social. Everyone's model got a seat at the table. Today the "biopsychosocial" explanation has become standard for virtually every psychiatric problem. And why shouldn't it be popular? "Biopsychosocial" may be the most diplomatic medical term ever invented.
But the goal of diplomacy is to smooth out disputes; the goal of science is to resolve them.
Biology, sociology and psychology represent three separate pathways to behavior. If a woman is exposed to rabies, she may begin acting aggressive and erratic, a pattern of behavior that is only biological. If a man lacks food and shelter, he may be more inclined to break the law to get what he needs to survive, a pattern of behavior that is fundamentally social. And if you keep responding to disappointments by drinking or gambling heavily, this pattern of behavior is only psychological.
The lines get blurred sometimes in the study of addiction because so many of these contextual factors appear in confounding lockstep: you are indeed more likely to be an alcoholic if your father was an alcoholic; you are indeed more likely to abuse drugs if your peer group does. But it is a fanciful leap to conclude from these correlations that a family pattern means that addiction is hereditary, or that a peer group can somehow make you an addict. After all, there are powerful emotional experiences at the heart of these circumstances as well.
Invoking the "biopsychosocial" label can obfuscate the explanation that hews most closely to what we know about how people work, namely, that addiction arises out of emotional factors which, when treated and understood, can evaporate the addiction for good.
Speaking personally rather than scientifically, I wish I could make friends with everyone and include biological and social factors in the understanding of human addiction. I happen to love biology: I was a biology major in college and did my honors thesis in embryology. In medical school, my favorite of the basic sciences was Histology: deciphering microscopic slides of different tissues.
But science isn't about what you love, or about being nice. And it's not about deciding that every field has an equal understanding of why we exhibit complex and meaningful behaviors. Sadly, "biopsychosocial" is doing more good for the theorists than for addicts.