What We Currently Know about Causes of Addiction
There has been a lot of research dedicated to learning more about the causes and risk factors of addiction. Much of it has helped with prevention, diagnostic, and treatment efforts over the years. Teaching people about the causes of addiction has made it easier to dispel myths about substance abuse and make the public a little more aware overall.
This article will look at the causes of addiction, including those that are currently known and a few theories that are being studied. Topics will be broken into categories of environmental, personal, and genetic risk factors that contribute to substance abuse. The impact of certain conditions, such as those related to mental health, will also be discussed.
Is There A Single Cause?
In the last 100 years or so since drugs were first made illegal in the United States, there has been an effort to identify the cause of addiction and dependence. People have their own motivations for trying to find out what that cause is or if there even is one. Attempts have been made by the scientific and medical communities, government agencies, religious leaders, and the addicts themselves. In the course of this search, a lot of new information has been discovered about addiction and has prompted additional questions. One of the biggest questions asks if there is a single cause that addiction can be blamed on.
Based on what has been found, the short answer is no. There is so much diversity amongst the people who develop addictions--age, gender, ethnicity, orientation, race, religious and political views, etc.--that the common thread(s) tying them together seem to be that they are all humans who have an addiction. Pinpointing a precise cause only seems to generate more discoveries and questions about addiction, which isn't necessarily a bad thing.
What has almost universally been determined about the cause of addiction is that it has something to do with the brain. As discussed previously; many abused substances have generated documented changes in the human brain on a chemical and functional level. These changes prompt dependence and require the person to continue using the addictive substance. The interpretation of these changes and the effects they have has prompted a few theories on the matter:
Addiction as a Disease--Probably the most accepted theory and the one that many members of the medical and scientific communities agree with. It still generates some controversy, as there are those who still support older theories or who feel like "disease" only adds to the stigma of addiction. This theory suggests that addiction becomes compulsory through the neurological changes that develop through usage. It may begin as a choice--which has its own contributing factors involved--but it does not remain as such. Many treatment programs follow this theory and will base their care on it.
Addiction as a Chronic Condition--An alternative to the disease theory is that addiction is more of a chronic condition than a disease. It supports some of the same treatment methods and practices, but from the angle that addiction needs continuous management to ensure sobriety. The usage of behavioral therapy as a treatment method is backed by this theory, and it adds to the idea that a person is able to take control of their addiction as they work to get better.
Addiction as a Flaw--This was, for many years, the common belief in regards to why certain people develop substance abuse issues. Personal flaws like a lack of willpower were often to blame for a person's usage and eventual addiction to drugs and alcohol. People who have been able to stop using illicit substances by quitting "cold turkey"--or all at once--are used as proof of this theory, even though doing so isn't possible for everyone and can have serious effects for some. In many cases, this theory promoted more harm than good by shaming addicts instead of helping them. Such instances still occur today around the world and have made little to no effect on curbing substance abuse.
The Impact of Risk Factors
Risk factors are aspects that can contribute to the occurrence of any disease, condition, or event. They're the chances of that thing actually happening and when. These factors come from a variety of sources and the effect they can have on something varies on a case-by-case basis. They are not a universal force, meaning that everyone and everything has different risk factors that are specific to them.
For addiction and substance abuse, risk factors often play a large role in determining the cause of someone's addiction and the chance of that being the primary source. Risk factors can also be used to determine how substance abuse can affect other parts of a person's life, as well as the progression of their addiction. They are an incredibly valuable resource in ensuring the success of treatment and recovery measures. Analysis of a person's risk factors can help treatment providers put together a plan of action to help the person recover from their addiction. It allows everyone involved to get a clearer picture of what to expect further down the road to recovery.
Risk factors can also be analyzed to determine what preventative measures will work the best and what groups or areas need attention the most. This can help those who are working to curb substance abuse ensure that they are doing as much as they can and all of their bases are covered. Authorities and leaders can use the information gained by looking at the risk factors for substance abuse and addiction, and use it to develop a plan of attack. Any changes in that information can then be used to determine if current actions are or are not effective.
Environmental factors are usually considered to be the factors present in a person's surroundings. These can include things like upbringing, experiences, and social interactions. A person's socioeconomic status is often included in this category because of how it can affect other environmental factors. Unfortunately, it can also be to blame for why many people associate substance abuse with those of a low socioeconomic status and support certain addiction stereotypes.
One of the biggest environmental factors that many people focus on when it comes to substance abuse is peer pressure. When you're a child, every adult warns you about the dangers of peer pressure. Your parents may have told you to not do something "because the other kids are doing it" or "because another kid told you to" before sending you off to school. Many people have blamed peer pressure as the culprit behind trends or mob-mentality behavior. It's the socialized stress to fit in with those around you and it can be difficult to fight against for some. Peer pressure can act as encouragement to experiment with things, even if those things are addictive substances. Peer pressure doesn't even need to be aggressive; it can work if there's enough curiosity and interest involved.
A person's interaction and satisfaction with their environment can shape how those risk factors affect them. One of the most significant and closely monitored environmental risk factors is adverse childhood experiences or ACEs. These are usually traumatic and stressful events in a person's youth that affect their decisions and actions as an adult. They can include assault, neglect, abuse, or major changes like parent's divorcing or the death of a relative. ACEs can also include things that a person witnessed, but was not a part of. Instances of ACEs or trauma as an adult and substance abuse are common, often involving the user turning to addictive substances in an effort to cope with what they experienced. However, a traumatic experience does not guarantee that the person will develop a substance abuse problem. It can still impact their actions later in life; a person who was physically abused as a child may enter into a profession as an adult where they act as an advocate for victims (lawyer, doctor, social worker, etc.).
There are some risk factors that dependent on the person themselves. These personal factors can include things like your viewpoints, values, and when you first encountered drugs and alcohol. Even things like your behavior and past decisions, regardless of what contributed to them, can be considered as personal factors. With these, there's more of a focus on the individual rather than outside forces that may dictate potential drug or alcohol abuse. After all, the addiction theories mentioned in the beginning of this lesson involve a person's decision to use an addictive substance in the first place.
How old a person is when they are first exposed to drug and alcohol can determine the likelihood that they will use and develop an addiction to those substances. As previous lessons have mentioned, there are addictive substances present almost everywhere--pop culture, education, social environs, etc. Even if it's in the form of preventative measures, it still counts as exposure to the idea of addiction and substance abuse. Negative or weak positive exposure at a young age to addiction carries the potential that a person may try illicit or addictive substances at a young age as well. Agencies, like the National Institute on Alcohol Abuse and Alcoholism (NIAAA), have found that there is a higher rate of substance abuse disorders amongst teens and young adults. It also opens the door for additional substance abuse-related issues, like trying stronger drugs and health complications from usage.
Factors like a person's personal values can impact their decision to try an addictive substance in the first place. Their beliefs and morals about themselves can dictate their response to being offered an illicit substance or even the judgement about their ability to handle legal substances like alcohol. Some may view this as the mentality of "my body is a temple" that many people use to reason why they avoid consuming or using certain substances. A person's beliefs can also affect their ability to recognize the early warning signs of addiction in themselves. For example, if a person has a specific image of what an addict looks like (think stereotypes) then they may use that image to fuel denial that they have developed addictive tendencies.
In recent years, genetic factors for substance abuse have drawn a lot of attention from researchers. Genetic predisposition is a significant factor for thousands of conditions, making it a strong contender in the search for a cause of addiction. Instances of addicts who have a family history of substance abuse have been cited as evidence of genetic involvement, even if there isn't an "addiction" gene. The presence of such a pattern is rather hard for people to deny, even if they attempt to pass it off as a result of environmental exposure.
Studies by the National Institute on Drug Abuse (NIDA) found that genetics can account for up to half of a person's risk for addiction and substance abuse. Rather than identifying a single gene as the culprit, they state that it may have something to do with the changes substance abuse makes to your body. Certain drugs, like cocaine, can leave behind a tangible permanent mark on DNA and basically rewrite parts of your genetic code. This mark can alter the production of certain chemicals and proteins that are tied to addiction, making it harder to stop using. There is then the potential for that particular marked strand of DNA to be passed on to your children, increasing their chances for addiction on a genetic level.
Having a family history of addiction does not mean that you can develop an addiction to the same substance as your relatives. You still have a chance of becoming an alcoholic if your grandfather was an alcoholic, but you also have a chance of developing an addiction to heroin. It's the chance of addiction in general, rather than a chance of a specific addiction. The same applies to your chances of not developing any kind of addiction in the first place. A family history of substance abuse also doesn't guarantee that you yourself will have a history of substance abuse.
A person's existing health can potentially have a greater impact than any other factor. This is because it can encompass the other categories and present risks that carry a greater weight by comparison. An addiction to prescription drugs is one such instance where health has a major impact on a person's chances for substance abuse issues. Certain prescription drugs, such as the examples discussed in previous lessons, have a high risk of dependency even when used correctly. Users can develop a tolerance to long-term prescriptions, which can prompt them to take more than what their doctor has instructed.
There is also the health impact of co-occurring disorders, especially mental health conditions. Not only is there the potential of prescription abuse with mental health, but a person may also abuse an addictive substance in an attempt to cope with their condition. In some cases, abusing drugs or alcohol is how they gain any control over their circumstances and attempt to feel normal. There is also the possibility that their mental health condition is undiagnosed or misdiagnosed and isn't getting treated due to the person's substance abuse. This can worsen the situation even further, and complicate later treatment and diagnosis.