Addiction 101: Risk Factors

People of all backgrounds and beliefs experience addiction, regardless of their social status, race, gender, religion, upbringing, or moral code.

It is hard to understand why some are more susceptible than others to addiction.  One child in an apparently well-adjusted middle class family develops alcohol addiction, while her siblings have successful careers and healthy families.  One child growing up in economic and social deprivations seems resistant to the negative influences around him as his parents and siblings succumb to addiction.

In general, people begin to take drugs to feel good (intense feelings of pleasure), to feel better (lessen feelings of anxiety or depression), to do better (improve athletic or cognitive performance), out of curiosity (express independence), and because others are doing it (peer pressure). No single factor determines whether a person will become addicted to drugs. Many factors can raise the risk of becoming addicted to drugs and alcohol.  The more risk factors a person has, the greater the chance that taking drugs will lead to abuse and addiction.

What defines whether a person is considered addicted? Addiction is characterized by the inability to consistently abstain, impairment in behavioral control, diminished recognition of significant problems with one’s behaviors, constant craving, and dysfunctional emotional responses.

In other words, the addicted person can’t stop despite the negative consequences, even though they want to stop.

Here are six risk factors associated with being prone to addiction:

GENETICS

Heredity is a major risk factor for addiction. Up to 50-60% of a person’s risk of addiction to alcohol, nicotine, or other drugs is based on genetics, meaning if family members have experienced addiction, the likelihood is they will more likely experience it, too. Children of alcoholics are between 4 and 10 times more likely to become alcoholics than peers with no alcoholic relatives. Children of alcoholics are also more likely to begin drinking at a young age and to develop alcohol abuse problems more rapidly. In my son’s case, both my side of the family and his father’s side of the family have a family history with ample addiction.

ENVIRONMENT

Young people who experience neglect or abuse from parents may use drugs to cope with their emotions. This trauma could be in the form of physical, sexual or emotional abuse. If a parent is abusing substances, it can lead to greater risk taking or experimentation with alcohol and drugs from the child. Lack of parental supervision can affect the risk of addiction, too. Children’s earliest interactions within the family are crucial to their healthy development and risk for drug abuse.

Peer pressure is another environmental risk factor, even when it’s not aggressive, pressure from friends to fit in can create an environment of experimentation, and if other risk factors are present, there is a chance the individual may eventually become addicted. If there are large amounts of alcohol or other drugs available, it will increase the risk as well. My son told me he started drinking to fit in and feel more comfortable in social situations with his friends. It reduced his anxiety and put him at ease with others.

DUAL DIAGNOSIS

If an individual has a substance use disorder and another mental health condition, such as depression or bipolar or PTSD, it is referred as having a “dual diagnosis” in the medical community. Underlying mental health issues can increase the risk of addiction, and an addiction can increase the severity of other mental health conditions. It creates a vicious cycle in which addiction progresses quickly and it usually makes things much worse. Either substance abuse or mental illness can develop first.

A person experiencing a mental health condition may turn to drugs and alcohol as a form of self-medication to improve the troubling mental health symptoms they experience. Research shows though that drugs and alcohol only make the symptoms of mental health conditions worse. About a third of all people experiencing mental illnesses and about half of people living with severe mental illnesses also experience substance abuse. These statistics are mirrored in the substance abuse community, where about a third of all alcohol abusers and more than half of all drug abusers report experiencing a mental illness. My son suffered from depression starting in his sophomore year of high school. I still don’t know which came first, his depression or his substance abuse.

EARLY USE

Another risk factor for addiction is the age at which an individual starts to use substances. Addiction is a developmental disease and it typically begins in childhood or adolescence. This may reflect the harmful effect that drugs can have on the developing brain; it also may result from a mix of early social and biological vulnerability factors, including unstable family relationships, exposure to physical or sexual abuse, genetic susceptibility, or mental illness. Still, the fact remains that early use is a strong indicator of problems ahead, including addiction.  Although my son did not experience any family trauma as far as I know, he did start drinking alcohol at age 13.

DRUG OF CHOICE

Some drugs tend to be more physically addictive than others and progress more quickly as an addiction. Drugs such as cocaine, heroin, and methamphetamines tend to be more physically addictive than alcohol or marijuana. Opiates, like Oxycontin and heroin, have severe withdrawal periods, which are physically painful, and will push the user to use more often to prevent withdrawal symptoms. While some addictions progress slowly over the course of several years, others may move quickly over a few months depending on the drug. The drug of choice plays a role in the risk of progressing into full blown addiction. I think my son tried every drug available to him at one time or another, but his true drug of choice was alcohol. He died of a heroin and alcohol overdose in 2013. 

METHOD OF USE

Smoking or injecting a drug into a vein increases its addictive potential. Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense high can fade within a few minutes, taking the user down to lower, more normal levels. Scientists believe this starkly felt contrast drives some people to repeated drug taking in an attempt to recapture the fleeting pleasurable state.

Addiction isn’t a matter of weak willpower or lack of morals.

The chemical reactions which happen in the brain when someone has an addiction are quite different than those that happen in someone without addiction.  That explains why one person may be able to smoke cigarettes every so often for pleasure, while another needs them on a daily basis to function.

I am going to write about the treatments available for substance use disorders in my next blog, including inpatient treatment, intensive outpatient treatment, counseling, partial hospitalizations, medication assisted treatment, recovery support services, 12-Step fellowship, and peer support. There is no one treatment that works for everyone, and it is a lifelong process to treat addiction.  Science has come a long way in understanding the disease of addiction, but so far there has not been a cure found for it.

Mary Cucarola – August 11, 2016

References

“Drugs, Brains, and Behavior: The Science of Addiction.”  National Institute on Drug Abuse https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-abuse-addiction

“Risk Factors for Addiction.” Healthline.com http://www.healthline.com/health/addiction/risk-factors

Barnes, Henrietta. Hijacked Brains: The Experience and Science of Chronic Addiction (Dartmouth: University Press of New England, 2015) 61.