All over the world, people are searching for reasons of drug addiction and abuse.  Family members of addicts wonder why people start using drugs.  Researchers investigate what causes people to use drugs.  Unfortunately, there is no easy answer to these questions.  The factors underlying substance abuse and addiction are as varied as the addicts themselves.  That being said, there are a few broad categories of factors leading to drug abuse: genetic background or family history of substance abuse, environmental factors, and co-occurring conditions that make substance abuse more likely.  By understanding why people start using drugs, it may be possible to improve treatments and help people struggling with substance abuse to achieve and maintain sobriety.

The Genetics Behind Addiction

Genetic factors are not the only cause of drug addiction, but scientific studies and anecdotal observation indicate that addiction can run in families.  While having a family history of addiction increases the chances that an individual will become an addict, it does not ensure that this will happen.  Many people with a genetic predisposition to addiction live functional, addiction-free lives.  However, understanding the genetics behind addiction may help those who do become addicted face and treat their substance abuse problems.  Scientists are working to identify which genes are involved in addiction.  In some cases, the gene has been identified but its role has not yet been determined; in other cases, scientists have identified the gene and understand how it works.  Here are a few of the genes that have been identified in humans so far:

  • DRD2: a gene for a dopamine receptor.  Dopamine is a neurotransmitter involved in the brain’s reward pathways.  Many illicit drugs are addictive because they trigger dopamine production.  People addicted to alcohol or cocaine are more likely to carry the A1 variant of this gene.
  • CYP2A6: one version of this gene makes people feel nauseous and dizzy if they smoke.  This protective version is found more commonly in non-smokers than smokers.
  • ALDH*2: a version of the gene for alcohol dehydrogenase, an enzyme involved in alcohol digestion.  People with two copies of this version rarely become addicted to alcohol.

Other genes have only been identified in animal models thus far, and researchers continue to look for the genetic counterpart in humans.  In mice, the following genes have been identified:

  • Cnr1: a cannabinoid receptor.  Mice without this gene are less responsive to morphine than mice with the gene.
  • Htr1b: a receptor for serotonin, a neurotransmitter involved in mood regulation.  Mice lacking this gene are more attracted to cocaine and alcohol.
  • Creb: mice without this gene are less likely to become dependent on morphine.
  • Per2: mice with a defective version of this gene consume three times more alcohol than mice with the regular version.

These examples show that an individual’s genetic makeup can give them a biological tendency to addiction.  When they consume drugs or alcohol, their body reacts differently than other people.  People prone to addiction may respond more strongly to drugs or alcohol, feel a stronger high.  Other people are born with protective genes that make them less receptive to the effects of drugs or alcohol, or even physically ill when exposed to these substances. 

Environmental Influence on Addiction

When discussing environment in terms of addiction, the environment typically refers to the family or peer environment of the person in question.  For teenagers, this means the parents, siblings, and friends; for older adults, it includes friends, roommates, and spouses or partners.  The behavior of the people around an individual, and what kinds of behavior they consider acceptable, have a strong impact on whether or not a person will become involved in substance abuse.  Some family environmental factors that contribute to addiction include:

  • Poor relationship with parents
  • Unstable home environment
  • Permissive attitude of parents toward substance abuse
  • Parents with a substance abuse problem

Factors outside of the family include:

  • Poor performance in school
  • Friends who use drugs or alcohol, or accept substance abuse as normal
  • Availability of drugs and alcohol from friends
  • Permissive attitude of the school or community toward substance abuse

In short, having family and friends who use drugs or alcohol, or who think that drug and alcohol use are acceptable behavior, makes it more likely that a person will engage in substance abuse.

Co-Occurring Conditions and Substance Abuse

It is not uncommon for people with a substance abuse disorder to have a mental health condition as well, known as a co-occurring condition.  These mental health conditions include bipolar disorder, anxiety, and depression, among others.  It is difficult to say whether or not one causes the other–some people with a mental health problem may attempt to self-medicate with substance abuse, and other people may abuse drugs and alcohol, then suffer from a mental health condition as a result.  Once an individual suffers from one condition, he or she is more likely to suffer from another.  Some experts estimate that as many as 60% of patients with a mental health issue struggle with addiction, and vice versa.  For example, people with bipolar disorder are more likely to be alcoholics than other people.  Women with bipolar disorder, in particular, are seven times more likely to be alcoholics.  No matter what type of substance abuse is the problem or which mental health issue occurs with it, doctors and scientists studying addiction have observed that a relapse of one problem typically causes a relapse of the other.  For example, if an alcoholic in recovery who has previously struggled with depression starts drinking, he will most likely fall back into depression.  For this reason, it is important to understand both conditions when treating either one.

Struggling with two conditions at once complicates treatment for both.  In most cases, the first step has to be detox from drugs or alcohol; it is impossible to treat the mental health problem while intoxicated.  But the discomfort of the detox and withdrawal process can cause the patient’s mental health to decline.  Clinicians must work as a team to address both issues effectively.

Case Study: Savannah

Savannah, who began using drugs when she was only ten years old, is a clear example of how environmental factors can contribute to drug abuse.  Both of her parents used drugs; in fact, Savannah’s mother was the first person to give her drugs, prescription painkillers.  Her home life was very unstable; after her parents split up, she lived with her mother and sister in a shelter, then moved in with her father, then her grandparents, then ran away and stayed with a friend.  All of the adults in her life, except her grandparents, accepted and condoned her drug use.  Her life was saved when she was arrested and placed in a treatment facility as part of her probation.  Savannah relapsed a few times and even ended up in juvenile detention, but eventually overcame her addiction and has been sober for several years.  She now works as a project coordinator for a corporate moving company, regularly attends meetings, and serves a sponsor for teens struggling with addiction.  Savannah is a clear example of the power of treatment and perseverance in overcoming addiction.

If you or someone you love struggles with substance abuse, call our toll-free number today.  We can help you find the treatment approach that is right for you.