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Hooked: Assessing Risk and Protective Factors in Addiction

 

“I have absolutely no pleasure in the stimulants in which I sometimes so madly indulge. It has not been in the pursuit of pleasure that I have periled life and reputation and reason. It has been the desperate attempt to escape from torturing memories, from a sense of insupportable loneliness and a dread of some strange impending doom.”
― Edgar Allan Poe

Addiction can be defined as a “persistent compulsive use of a substance known by the user to be harmful.” From a scientific standpoint, one must consider the effect that drugs and alcohol have on the brain. In essence, substances are capable of changing the way that the brain experiences pleasure.

“Although it is true that for most people the initial decision to take drugs is voluntary, over time the changes in the brain caused by repeated drug abuse can affect a person’s self-control and ability to make sound decisions, and at the same time create an intense impulse to take drugs.”
– WebMd

When considering the scientific implications of addiction, it is also important to take into account the social and environmental factors. Why, for example, does one person who experiments with drugs in adolescence become an addict and another adolescent with similar behaviors does not? Researchers have approached this question head on and have identified the factors that put people at risk for addiction as well as those factors that serve as protection.

RISK FACTORS

While it can prove difficult to pinpoint a specific cause for an individual’s addiction, researchers have identified some of the most common risk factors. The presence of one or more can increase a person’s likelihood for becoming addicted. According to HBO’s Understanding Addiction Series, the most widely recognized risk factors for drug and alcohol abuse are mental illness, genetics, social environment, early use of drugs, and childhood trauma.

Mental Illness

The terms co-occurring and dual diagnosis are often employed in addiction treatment programs and indicate that the drug or alcohol abuser also carries a mental health diagnosis. Depression, anxiety, and mood disorders are common in those with addiction. Oftentimes, it is the presentation of the symptoms of these illnesses that lead addicts to seek relief through self-medication. A comprehensive treatment program will address both the addiction and the underlying mental health issues.

Genetics

Drug and alcohol addiction run in families. In fact, research from the National Council on Alcoholism and Drug Dependence “shows that genes are responsible for about half the risk for alcoholism and addiction, and while genetics are not the sole determinant, their presence or absence may increase the likelihood that a person will become alcohol or drug dependent.”

Social Environment

A living environment where friends or family members engage in regular drug or alcohol use can also influence the development of addiction. Children who grow up in homes where substance abuse is commonplace are more likely to view drug and alcohol use as a social norm. It’s also important to note that environmental influence is not limited to one’s home.

The presence of substances in schools, workplaces, and social gathering places can prove a significant influence in the development of drug and alcohol abuse as well. While peer pressure tends to be associated with adolescence, many addicted adults report that their unhealthy behaviors were influenced by colleagues in the work environment.

Early Use of Drugs

There is a strong link between early experimentation and the development of addiction. According to Addiction Center, “Over 90% of those with an addiction began drinking, smoking or using illicit drugs before the age of 18.” A young person’s accessibility to drugs and alcohol can, therefore, play a significant role in hindering or perpetuating future addiction.

Childhood Trauma

“You didn’t wake up one day and decide to become an addict. More likely, if you have trauma in your history you woke up with the conscious or unconscious desire for what all trauma survivors want: safety and control. The good intention behind your addictive behavior, then, has its roots in positive outcomes, including relaxation from the hyper vigilance of fear; relief from the upswell of memories; restoration from the inability to choose your behavior.”
– Michelle Rosenthal

Neglect and abuse can impact the development of a child’s brain. These “interruptions” of normal development have been connected with the development of addictive behaviors in adolescence and adulthood. According to DualDiagnosis.org, “In Vietnam veterans seeking treatment for PTSD, between 60 and 80 percent also require treatment for substance abuse.

PROTECTIVE FACTORS

As one might assume, the more of the aforementioned risk factors that a child is exposed to, the more likely he or she is to become addicted to substances. While awareness of risk factors can prove critical, an understanding of protective factors is equally important. Wikipedia defines protective factors as “Conditions or attributes…in individuals, families, communities or the larger society that help people deal more effectively with stressful events and mitigate or eliminate risk in families and communities.

According to National Institute on Drug Abuse , “An important goal of prevention is to change the balance between risk and protective factors so that protective factors outweigh risk factors.” The following chart from Addiction Services illustrates how both types of factors manifest in various life domains:

 

Life Area Risk Factors Protective Factors
Individual
  • Begins using at an early age
  • Impulsiveness and sensation seeking (risk taking)
  • Poor social and coping skills
  • Early childhood behavior problems
  • Feeling alienated
  • Well developed social and problem solving skills.
  • A sense of self-esteem
Family
  • History and patterns of use and attitudes toward drugs
  • Inconsistency in parenting, supervision, discipline and nurturing
  • Unclear family rules, expectations and consequences
  • Family is conflict ridden, experiencing disruption
  • Good communication (in general and specifically about substance use)
  • Supervision of children and activities (including the selection of friends)
  • Rules are clear and consistently enforced
  • Child feels connected, valued and supported
  • Parents have expectations of child’s success (i.e. grades)
Peer
  • Association with peers who use alcohol or other drugs or other drugs or who engage in risk taking behaviors
  • Friends who do not use alcohol or other drugs and who do not support the behavior.
  • One or more close friends
  • Form long lasting friendships
  • Rely on friends for emotional support
School
  • Academic problems
  • Lack of commitment to school
  • Lacks a sense of belonging in the school community
  • Success and commitment in school
  • Involvement in extracurricular activities
  • School action/messages on drug use

 

As AlcoholRehab.com states, “By avoiding addictive substances and situations in which they are available, people can reduce the risk that they will become addicted. Even if someone has a genetic predisposition to become addicted to heroin, they will not become addicted if they never try it.”

Parental Involvement

Just as neglect, abuse, and exposure to substance abuse can predispose children to future addictions – parental involvement, the formation of strong child-caregiver bonds, and clearly defined limits with accompanying consistent and healthy consequences within the household environment can help children increase their self-control and can help protect young ones from future drug and alcohol abuse.

Healthy Peer Group/Neighborhood

Interacting with peers who engage in healthy hobbies and activities and who steer clear of drug and alcohol experimentation improves addiction outcomes significantly. In fact, the National Institute on Drug Abuse states, “association with drug-abusing peers is often the most immediate risk for exposing adolescents to drug abuse and delinquent behavior.”

Individual Dispositions/Attitudes

Despite the impact of genetic predisposition to addiction as well as harmful environmental factors, an individual’s attitude can make a difference. Often, a drug and alcohol free mindset is shaped through educational exposure to the risks caused by addiction. It can also be impacted by the degree of involvement in healthy extra-curricular activities and a general sense of trust for adult authority figures like parents, teachers, and law enforcement.

Academics

School programs that communicate high performance expectations and provide ample opportunities for parent involvement tend to exhibit lower rates of drug and alcohol abuse among the student population. Behavioral expectations and a positive learning environment serve as protective factors as well.

While a genetic predisposition to addiction cannot be controlled, many factors that lead to drug and alcohol abuse can. By eliminating the aforementioned environmental and social risk factors and introducing circumstances conducive to protection, society and parents can play an active role in ensuring healthier outcomes for the future generations.

Sources

  • www.merriam-webster.com/dictionary/addiction
  • www.webmd.com/mental-health/addiction/drug-abuse-addiction
  • ncadd.org/about-addiction/family-history-and-genetics
  • www.mass.gov/eohhs/gov/departments/dph/programs/substance-abuse/providers/prevention/risk-and-protective-factors.html
  • www.dualdiagnosis.org/post-traumatic-stress-disorder-and-addiction
  • alcoholrehab.com/addiction-articles/genetics-and-environment-in-addiction
  • www.addictioncenter.com/addiction/addiction-statistics

jen-anderson-addiction-counselorJen Anderson is a Licensed Clinical Social Worker (LCSW), Sobriety Coach, and former alcohol enthusiast living in Florida with her husband and son.

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