A study conducted by “The National Center on Addiction and Substance Abuse” reviewed over 20 years of research and more than 80 Family, Twin, and Adoption studies. Through this research, it was suggested that genetics make up 50 percent of the likelihood of developing an addiction. Although a direct link to a genetic marker for addiction has not been identified, the pattern of substance abuse within families and the similarity of substance abuse among identical twins have shown strong evidence that genetics play a significant role in the development of addiction to alcohol, tobacco, and other drugs. This information has many implications for prevention and treatment. Education for children and adolescents about the increased risk of addiction from family history can help prevent experimentation and casual use of substances.
An individual with a family history of addiction may be more prepared to abstain from substance use, given the right intention and support. In a case where the development of addiction has already occurred, knowledge about genetic predisposition can help to address barriers to change and provide a more empathetic understanding of why the person is using and finding it hard to stop. A person with an addiction often experiences high levels of shame and guilt, and there may be a feeling of moral failure or that they are a terrible person. Understanding that there are underlying factors driving the addiction can reduce such feelings and help the individual to move forward in creating behavioral change.
Historically, addiction has been viewed as a problem of morals and character. A person lacking self-control becomes trapped in the cycle of use and abuse. Understanding the implications of addiction as a complex interaction of genetic makeup and environmental influences has only been explored scientifically in the past thirty years. Although very few reliable statistics are available to measure genetic or environmental risk factors, research has shown a high correlation for both in the development of addiction. As the foundation of addiction is still not fully understood, it is essential for treatment providers working with individuals who have an addiction to be aware of potential risk factors.
Genetic Predisposition
Genetic factors make up about half of the likelihood that an individual will develop addiction. This is due to the effects of environmental factors on gene expression. Genes affect the degree of rewarding effects of a substance. This can be described as how good or bad a substance makes a person feel, which can determine whether the person decides to retake it. Genes also influence the development of tolerance to a substance and the withdrawal symptoms when the substance is taken away. Both tolerance and withdrawal can be strong indicators of addiction.
Some people inherit a predisposition to alcoholism or specific substance abuse. Several genetic factors can influence how the body and mind react to alcohol and drugs. Behavioral genetics is the study of genetic and environmental influences on behaviors. Through genetic research, scientists are beginning to understand how genes influence an individual’s vulnerability to addiction. These findings have potential medical applications, such as gene therapies and tests, to determine the most effective treatments for particular patients.
Environmental Factors
Environmental factors play a significant role in the development of substance abuse and addiction. These factors include a wide range of situations. However, they frequently point to aspects of a person’s surroundings, such as the influence of family and friends, socioeconomic status, quality of life, educational experience, and acculturation. A person is more likely to develop substance abuse and addiction if close family members are substance abusers or if a person is around others who abuse substances. Children and adolescents living in impoverished areas are at risk for developing substance abuse and addiction.
This is due to a lack of supervision and an absence of economic improvement and educational advancement. High stress, lack of connection to school, lack of parental involvement, availability of drugs within the school, and antisocial behaviors are all risk factors that have been associated with dropping out of school. Students who also have learning and behavioral problems are also at high risk for increased substance abuse. Acculturation also provides an increased risk of substance abuse. This is particularly true for those who move from one country to another, as they are often not accepted into the new culture and turn to substance abuse as a way to cope with the resulting emotional pain. The use of tobacco, alcohol, and marijuana by immigrant and native adolescents of the same age and grade represents acculturation. It has been linked to the increased use of these substances by immigrants.
Co-occurring Disorders
Drugs and alcohol can contribute to developing mental disorders, and cognitive disorders can contribute to drug and alcohol abuse. All psychiatric disorders can contribute to substance abuse or dependence. Some specific co-occurring disorders are more familiar with particular substance dependence disorders. Although it may not be clear which started first, treatment of both mental disorders and substance dependence is essential. Research has shown that treatment of one disorder alone will not predict improvement of the other. The individual must receive treatment for both the substance abuse and the mental disorder for recovery. Using thorough assessment techniques, we can explore the mental disorder symptoms and a timeline of the use of substances in the evolution of both disorders to develop a detailed diagnosis. A common and severe co-occurring disorder with alcohol abuse is significant depression.
Major depression is characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, tiredness, and poor concentration. An individual will often feel these symptoms and drink in an attempt to alleviate them. This will only make the depression worse in the long run. As depressants, alcohol, and sedative-hypnotic drugs are frequent tools for people with anxiety disorders to “self-medicate.” An anxiety disorder is characterized by unrealistic fear and worry, often with physical symptoms such as an increased heart rate, sweating, or rapid breathing. It is possible that alcohol abuse can cause an anxiety disorder, considering the range of substance-induced anxiety disorders with symptoms that mirror that of a specific anxiety disorder.
Inversely, the individual may have developed an anxiety disorder and later turned to alcohol as a tool to alleviate the anxiety. Alcohol and anxiety disorders are commonly found together, and it is often difficult to tell which one started the cycle. Effective treatment of the anxiety disorder and alcohol abuse will usually cause a remission of the anxiety disorder. Dually diagnosed panic disorder is among one of the most debilitating anxiety disorders. It is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, and dizziness. Often, the symptoms of panic disorder will lead to heavy use of healthcare services to rule out medical conditions that the patient believes cause the symptoms. This frequent use of medical services is an excellent opportunity to suggest continued substance abuse and dependence treatment.