Are some people more prone to addiction than others? Why?

Introduction

Being prone is having a natural inclination or tendency to suffer from, do, or experience something regrettable or unwelcome. Addiction is a state of dependency on a particular substance, thing, or activity. The disease is characterised by a strong physiological and/or psychological need; there is a compulsive inability to resist the particular substance, thing, or activity, despite the anticipation of adverse consequences. Therefore, being prone to addiction is having a natural inclination or tendency to suffer from a state of dependency on a particular substance, thing, or activity. “Are some people more prone to addiction than others? Why?” Our research team has examined the former claims and current claims of this issue. We considered factors such as genetics, neurology, mental disorders, environment, and development. Whether these factors increase the risk of addiction or not will determine if some people are more prone to addiction than others.

The Association of Medicine of Canada. (2012). Early brain & biological development and addiction: Different kinds of addiction. Addiction e-Learning for Undergraduate Medical Education. Retrieved from http://chec-cesc.afmc.ca/resource/different-kinds-of-addiction-an-ebbda-video-podcast.

This podcast was developed by the Association of Faculties of Medicine of Canada and was create for the purpose of undergraduate medical eduction. It is funded by many different faculties of medicine, medical organizations, and individual donors. It focuses on introducing the different kinds of addiction (substance and behavioural), as well as over-viewing the basic mechanisms of addiction. This is useful to understand before talking about addiction because a basic knowledge is required to grasp the articles, podcasts, and books that cover different possible factors of genetics. It is important to understand that the same reaction takes place in the brain for almost all addictions,; the release of dopamine when involved with an addictive substance or behaviour results in an eventual under-stimulation of this area when not involved in reward mimicking behaviour. This leads to the drive of addiction by making your body strive toward this release of dopamine and become more dependent on it. This information can be used as a basic introduction to the vocabulary and science behind addiction and to grasp more difficult scholarly articles on the different factors and influences on addiction.

Former claims

(NOTE: the following article was a four-part series on the history and future of the addiction-disease concept.)

White, W. L. (2000). Addiction as a disease: Birth of a concept. Counselor, 1(1), 46-51, 73. Retrieved from http://www.williamwhitepapers.com/pr/2000HistoryoftheDiseaseConceptSeries.pdf.

A) Addiction as a disease: Birth of a concept

This author is an emeritus senior research consultant at Chestnut Health Systems: Lighthouse Institute and a past-chair of the board of Recovery Communities United. He has a master’s degree in Addiction Studies and has worked full time in the addictions field since 1969 as a street-worker, counselor, clinical director, researcher, and well-traveled trainer and consultant. He is particularly interested in addiction recovery and policy. This article examines how America, as a country, and Americans, as citizens, understand and respond to alcohol and other drug (AOD) problems. It is the first in a series on the history and future of the disease concept of addiction. He considers how ideas and language are used to frame alcohol and other drug problems. This framework is historically and culturally specific, and is going to act as a lens when perceiving the world, such as how we understand and respond to alcohol and other drug problems. This conceptualization of chronic drunkenness as a disease did not originate in America, but rather was brought to America by European immigrants. There was a breakdown of community norms, shift in consumption patterns, and increase in overall alcohol consumption between 1790 and 1830. He highlights the stages leading to the disease concept of addiction. The early writings struggled to distinguish drunkenness as a vice, from drunkenness caused by disease. This differentiation is important because it determines whether people are viewed immoral or moral respectively. People increasingly gained more understanding of addiction, and the ideas and language used to frame alcohol and other drug problems were changing. The terms “drunkenness” and “intemperance” gave way to a more medicalized language that designated this newly formulated disease and the sufferer: inebriety/inebriate, dipsomania/dipsomaniac, and alcoholism/alcoholic. This is a useful article because it provides a historical perspective on how people viewed addiction in previous times in history. The transition from drunkenness as a vice to drunkenness as a disease led to them being viewed by society much differently.

B) The addiction-disease concept: Its rise and fall in the 19th century

William’s second series is mainly focused on 19th century alcoholic mutual aid societies. He exemplifies the application of this concept, and foremost role the concept of disease plays in 19th century. He also provides examples from some of the earliest critics of the disease concept to support his idea behind his topic. The concept of “disease” is a metaphor for personal soberness because very little attention was given to the intake of abstinence in public. As the American culture developed, variety of drugs embraced along with it. They called it, “the Opium Disease”, where it is not the man who eats opium however opium that eats the man. In addition to that, culture perception of opium emerged in response to eating and injecting opium. Among white middle aged women it was considered to be a disease, while the smoking of opium for Chinese was labelled a vice. According to William, alcohol, opiates and cocaine were exposed in some products to cure the disease of drunkenness, while some took religion approach believing that God plants will power in every individual to choose whether to drink and at some point the power hinders the temptation to drink at some point. He sums up the whole concept that co-existed through out 19th century in three alternative views: One, where the source of the problem was in the person but it was defined under the terms of vice and sin. Two, the source of problem is in the person but it was portrayed in the type of the drug. Third, drug problems were because of aggressive nature where use of other drugs was being promoted to cure that nature.

White, W. L. (2000). The rebirth of the disease concept of alcoholism in the 20th century. Counselor, 1(2), 62-66. Retrieved from http://www.williamwhitepapers.com/pr/2000HistoryoftheDiseaseConceptSeries.pdf.

This article reviews the disease concept of alcoholism from 1900-2000. During this time alcoholics and addicts went from being patients that often received sympathy to either 'criminals' or 'moral weaklings'. In the early 20th century the author outlines that most attention to addiction was around the danger of the addicted person rather than the disease itself. At first, addiction was believed to be a symptom of an underlying psychological disturbance and not a disease itself. AA believed that calling it a disease made the patients sound sick and therefore hopeless which is part of the reason they avoided the word. In 1942-1970 the modern alcohol movement took place where it focused on alcoholism rather than just alcohol and help provide institutional funding for research and education. In this time period they also began to think of alcoholism as a disease and something that would benefit for therapeutic treatments. Along with this treatment, the use of methadone maintenance became popular to treat narcotic addictions. 1n 1980 addiction became a disease and has significant research and public health awareness toward it. The use of the word disease forced the medical and public health spheres to take the responsibility in treatment and research. By the end of the 2000's, there is still no consensus as to how best to treat addiction or even how to think of it. Although advances have been made in things like genetics and its relation to genetics, it is still not clear. The history of addiction is very interesting because we get to see what has been tried out in the past, what we have improved on, and how it all started. It is also useful in developing strategies for change when there is a clear understanding of what has worked historically and what has not.

White, W. L. (2001). Addiction disease concept: Advocates and critics. Counselor, 2(1), 42-46. Retrieved from http://www.williamwhitepapers.com/pr/2000HistoryoftheDiseaseConceptSeries.pdf.

William L. White is a Senior Research Consultant at Chestnut Health System. This article is about the controversial question whether drug use is a disease, an illness, a sickness, a malady, an affliction, a condition, a behavior, a problem, a habit, a vice, a sin, a crime, or some combination of these. There have been debates over this question from the past years. This article deals with the advocates and critics in relationship to the Addiction Disease Concept which is known as DC in short. According to William, both advocates and critics of the addiction disease concept (DC) include recovering people, physicians, psychiatrists, addiction counselors, addiction researchers, alcohol/drug policy experts, and leaders in the arenas of business, law, theology, and education. In this series of the article, William emphasizes how the DC advocates describe addiction as a chronic disease suffered by the biologically susceptible drinker and that theses a difference between addicts and non-addicts. According to William’s article, the advocates describe alcoholism as a true medical disease which is rooted in abnormalities in brain chemistry bio-chemical aberrations that are inherited (genetically) by the majority of alcoholics or is attained through extreme and constant exposure to alcohol and other drugs. The advocates argue how it is good to have DC as it is beneficial for the prevention of addiction and treatment, and it encourages help-seeking behavior. The DC conclude by stating that the addiction disease concept works as an organizing construct for both the individual and society because the DC provides an organizational construct in which the addicted clients, and his surroundings such as his family can understand the problems, the causes, the symptoms, treatment and the outcomes. Whereas William describes the critics as those against the notion of addiction being a disease, stating that alcoholism and addiction does not exist , but rather describing it as a symptom of an underlying emotional disorder or a failed attempt at self-cure of that disorder. Another factor that is pointed out by the critics, and is emphasized by William is that drug problems are due complex personal, interpersonal and environmental factors that has nothing to do with inheritance and the focus should be on how to alter drugging behavior to prevent harm. Thus, arguing that the DC is not beneficial, and all the DC cares about is making profits. They argue that the DC should be abandoned as it fails to help clients to an extent that they should because it is harmful as it takes away the addicts freedom, and responsibility and it dissuades addicts from seeking help. But according to William's, the critics and been accused of killing people with their opinions and ideas. The article clearly states both sides of the DC, the advocates who support it, and the critics who are against it, and it states the problems and concerns with both the sides and how they conflict each other.

White, W. L. (2001). A disease concept for the 21st century. Counselor, 2(2), 44-52. Retrieved from http://www.williamwhitepapers.com/pr/2000HistoryoftheDiseaseConceptSeries.pdf.

William L. White is a Senior Research Consultant at Chestnut Health Systems and the author of Slaying the Dragon: The History of Addiction Treatment and Recovery in America. The article is about the reformulation of disease model which provides a balanced focus on agent (the drug), the vulnerability of the host (the drug consumer) and the environment. It is basically, the redefining of the term ‘disease’ and the specification of terms and conditions that would declare the addiction of drugs as “disease”. According to White, this modernized model would focus on acknowledgement of differences and creation of wider menu of treatment goals to apply to overlapping population. Though, its one of the major challenge is to define the interaction between the addiction disease and other chronic diseases. The new model needs to explore techniques that would avoid the severity of comorbid conditions. It would also lay a heavy emphasis on the responsibility that the individual needs to carry to manage the health issues in a long term recovery. The article clearly states the problem that might arise even after the formulation of the new disease model and recommendations to avoid them. The identification of the arising problem is the strength of the article however it fails to provide the solution to it.

Current claims

Genetics

The Association of Medicine of Canada. (2012). Early brain & biological development and addiction: Early experiences and gene expression. Addiction e-Learning for Undergraduate Medical Education. Retrieved from http://chec-cesc.afmc.ca/resource/different-kinds-of-addiction-an-ebbda-podcast.

The podcast was developed by the Association of Faculties of Medicine of Canada in hopes of providing scientific research for undergraduate medical education. The podcast includes lectures from Dr. Bryan Kolb, Dr. Pat Levitt, Dr. W. Thomas Boyce, Dr. Judy Cameron, and Dr. Michael J. Meaney and sponsorship from The Norlien Foundation. Epigenetic's is the main idea in this podcast. It is the idea that your gene expression can be modified through experiences and therefore passed on to your children across your lifespan. Experiences can turn certain genes on that were originally off which in turn can alter brain activity, chemistry, and most importantly the expression of the gene itself. The podcast claims a few things: toxic stress in children can effect the expression of their genes in a negative way which could lead to addiction, genes and the environment turn chemicals on during development of neurotransmitters (like dopamine) which is proved to have an effect on the likelihood of become addicted. The change of gene expression can be seen in depression, which is the reflection of a change in the brain organization and neural structure. This podcast was fairly easy to understand and presented a few different sources of information for different professionals. The intended audience was for undergraduate medical students and in the video they used graphs and visual examples. The value of this information is significant because it could lead to information about how to prevent negative gene expressions that leads to addiction. Although the podcasts were titled under addiction, many of the talk of gene expression did not relate it to addiction which left the listener drawing their own conclusions. It would have been beneficial for them to analyze the specific relationship between certain gene expressions, epigenetics, and addiction. Most people think addiction is something you either have or you do not due to genetics. This information emphasizes that genes are not static and addiction is a reflection of your environment and the resulting gene expressions. This information could be used to create strategies for change to avoid the negative expression of genes and addiction. This podcast supports that genetics do play a role in addiction, but it also goes further to say that these gene expressions can be caused by the surrounding environment.

Uhl, G. (2011). The role of genes in addiction. Brain Science Institute. Retrieved http://www.brainscienceinstitute.org/brain_talk/the_role_of_genes_in_addiction.

George Uhl has his M.D. And Ph.D. He is a professor of neurology and neuroscience, mental health, and chief of a molecular neurobiology research brand. He is part of The John Hopkins Center for Substance Abuse Treatment and Research. Here they offer treatment, educational services about addiction, and conduct research. The role of genes in addiction is getting closer to identifying the specific genes at fault. In this study, they found through analyzing smokers who quit smoking that certain genes can either aid in quitting or allow addiction to happen much more easily. This research was conducted at The John Hopkins Center. The information is presented in a short, easy to follow podcast. The website also has extra links you can browse if you are interested and want more information. This information is significant because neuroscience is getting closer to being applied to addiction which would allow for screening for genes and risk of becoming addicted, addiction treatment programs, and new targets for drug programs. Since the podcast is short it does not go into very much detail about the study they conducted. It would be beneficial to hear more about the study, their conclusion, and what direction they are headed with their findings. This podcast supports the idea that genes do play a role in addiction and need to be looked at in order to find a treatment.

Neurology

Stevenson, J. R. (2008). An assessment of the neurobiological and behavioral changes that occur during abstinence following chronic alcohol drinking. (Doctoral dissertation). Retrieved from ProQuest Dissertations and Theses. (Accession Order No. AAI3315726).

Jennifer Rice Stevenson is a clinical researcher who performed the addiction test on mice and studied the neurobiological and behavioural changes that occur during substance abuse. The research was under the direction of Dr.Clyde Hodge a Ph.D. in behavioural pharmacology. Stevenson did the research to fulfill the requirement for the degree of Doctor of Philosophy in the Neurobiology CurriculumPrimary goal of this research was to characterize the neurobiological and behavioural changes that occur during protracted abstinence following chronic voluntary alcohol drinking. The data presented in their research indicates that abstinence from voluntary alcohol drinking leads to the emergence of depression and anxiety like behaviour and reductions in neurogenesis. According to Stevenson, the reason why people are prone to addiction is because changes that occur as a result of drinking forms alteration in the brain reward and stress systems. These manifest themselves through neuroadaptions in the nucleus accumbens, amygdala, hippocampus, pre-frontal cortex, and many other regions. To prove their point this article examines two sets of experiments on mice that undergo into randomly assigned experiments. Direct numbers from the source are used in order to demonstrate the causality of substance intake. The mice were randomly divided, and allowed to self-administer ethanol (10% v/v) vs H2O in the home cage for 28 days. Alcohol was then removed for 1-d or 14-d, and mice were tested in the forced swim test to measure depression-like behaviour. After 14 days, but not 1 day of abstinence from alcohol drinking, mice showed a significant increase in depression-like behaviour. The significant increase in depression-like behaviour during abstinence was associated with a reduction in neurogenesis. Similar to mice, people prone to addiction experience craving for alcohol. Abstinence-related depression is thought to increase the chance of relapse because drinking may help a person cope with negative emotions which eventually becomes habitual.

Nestler, E. J. (2005). The neurobiology of cocaine addiction. Science & Practice Perspectives, 3(1), 4-12. DOI: 10.1151/spp05314.
Eric J. Nestler is a M.D. and Ph.D. working in the Department of Psychiatry and Centre for Basic Neuroscience at University of Texas in Southwestern Medical Cener. He is active in eight research projects funded by the National Institute on Drug Abuse and the National Institute of Mental Health. The primary focuses of this article is on what does chronic cocaine abuse do to the brain to cause addiction? Author begins with a brief review of cocaine’s immediate effects on brain function, and then focuses on two recently discovered types of effects. One, alterations in genetic activity that last for weeks, and two, alterations of nerve cell structure that last for months and possibly much longer. Cocaine that is snorted, smoked, or injected, rapidly enters the bloodstream and penetrates the brain by causing a build-up of the neurochemical dopamine. This dopamine is responsible for keeping those cells operating at the appropriate levels of activity to accomplish our needs and aims – in short maintaining ones body’s homeostasis. Ingestion of cocaine interferes with this lateral control mechanism which alters a neural circuit in the brain that is fundamentally important to survival. Once someone becomes addicted, however, the frontal cortex becomes impaired and less likely to prevail over the urges. A protein called ΔFosB may constitute an important molecular “switch” in the transition from drug abuse to addiction. To prove this the writer performed a test on group of mice and give 1/3 dose cocaine. They exhibited behaviours that are considered reliable indicators exposing behaviours of normal people to the same conditions would cause addiction. Lastly, the author conclude saying that cocaine produces intoxication through its initial effects in the brain’s limbic system, and we are beginning to understand the neurobiological mechanisms underlying the drug’s later developing and longer lasting effects of craving and relapse vulnerability.

Winter, K. (2012). Effects of drugs on the brain & teen moods. A Parent's Guide to the Teen Brain. Retrieved from http://teenbrain.drugfree.org/science/moods.html.

Dr. Ken Winters is an adolescent expert who talks about teen brains and how development affects behaviour. In this article he tells us how drugs affect their brain which is a primary sign showing drug addiction. For example, when you indulge red velvet cheese cake your neurotransmitter signals you that sensation of “feeling good” and seeking more of this pleasure to ensure we’re malnourished. The sensation of feeling good is passed through main neurotransmitter called dopamine. When all drugs of abuse overload the body with dopamine level the body tries to balance the internal reward system. The body needs more of the drug to feel the same high intoxicating effect as before. This effect is known as tolerance. Dr. Ken believes that teens are especially vulnerable when it comes to the temptations of drugs and alcohol.

Mental disorders

Regier, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., Judd, L. L., & Goodwin, F. K. (1990). Comorbidity of mental disorders with alcohol and other drug abuse: Results from the Epidemiologic Catchment Area (ECA) study. The Journal of the American Medical Association, 264(19), 2511-2518. DOI: 10.1001/jama.1990.03450190043026.

These authors are in psychiatric practice and research, and moreover, were funded by the National Institute of Mental Health (NIMH) for this study. The National Institute of Mental Health allocates a budget of over $1.4 billion to research on mental disorders, which aims at generating the knowledge needed to understand, treat, and prevent mental disorders. Accordingly, the authors assessed the co-occurrence of alcohol, other drug, and mental (ADM) disorders based on the estimated true prevalence rates of these disorders in the community and institutionalized population of the United States. The finding of a statistically significant association between two disorders in epidemiologic studies suggests that one disorder may cause the other or that an underlying biologic vulnerability to these disorders exists in affected individuals. They consider and report a wide range in the prevalence of co-occurring substance abuse and mental disorders over one-month, six-months, or a lifetime. Once they assessed the history of alcohol, other drug, and mental disorder co-occurrences, they could assess the probability that these disorders may co-occur in the same individual within the total population. Individuals within the total population were divided into “any mental disorder” and “no mental disorder.” They contrasted the co-occurrence diagnosis rates within each major group to determine the significance of mental disorders in substance abuse. This made it possible to determine rates of co-occurrence for specific mental and addictive disorders, thereby concluding that there is a high rate of substance abuse disorders among those with mental disorders. This helps to answer, “Are some people more prone to addiction?” The only weakness is that it examines mental disorders as predictors of substance abuse among all individuals in a given sample, ignoring the possibility that mental disorders may predict substance use, or the transition from use to abuse, more strongly rather than the onset of dependence alone. This shortcoming will be addressed in the following study. It will take an alternative approach by examining predictors of these different transitions, thereby gaining information about the precise stage at which mental disorders have their greatest predictive effects.

Swendsen, J., Conway, K. P., Degenhardt, L., Glantz, M., Jin, R., Merikangas, K. R., … Kessler, R. C. (2010). Mental disorders as risk factors for substance use, abuse and dependence: Results from the 10-year follow-up of the National Comorbidity Survey. Addiction, 105(6), 1117-1128. DOI: 10.1111/j.1360-0443.2010.02902.x.

These authors are in sociological, psychological, or psychiatric practice and research from an epidemiological perspective. This study got financial support from the National Institute of Mental Health (NIMH), as well as supplemental support from the Substance Abuse and Mental Health Services Administration (SAMHSA), the Robert Wood Johnson Foundation (RWJF), and the John W. Alden Trust. The National Institute of Mental Health, like previously mentioned, allocates a budget of over $1.4 billion to research on mental disorders. Accordingly, this study examines mental disorders as predictors of substance use, abuse, and dependence. The common approach has been to examine mental disorders as predictors of substance dependence. However, they are particularly interested in the transition between substance use, abuse, and dependence, as well as the predictors of these different transitions. They believe that primary mental disorders are associated with increased risk of later substance use, abuse, or dependence. They include mental disorders such as mood disorders, anxiety disorders, and behaviour disorders, and substances such as nicotine, alcohol, and illicit drugs. They examine the predictive effects of mental disorders on transitions from non-use to use, use to abuse, and abuse to dependence for each substance class, thereby confirming that many mental disorders were associated more strongly with transitions between substance use, abuse, and dependence rather than with the onset of use alone. They conclude that mental disorders can be conceptualized legitimately as risk factors due to the fact that they precede substance use disorders, are associated with increased probability of their initial onset, and permit the population to be divided into high-risk and low-risk groups. This helps to answer, “Are some people more prone to addiction?” It provides a nice contrast against the former study that only examined how mental disorders are predictors of substance abuse. This provides a clear answer as to which mental disorders make people more prone to the initial onset of substance use versus the transition to dependence. This is important, because many forms of disorder were associated more strongly with transitions to dependence than with the onset of use or abuse. This allows us to be precise when answering which people are in fact prone to addiction, rather than talking about people in general.

Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231-244. DOI: 10.3109/10673229709030550.

This author is in psychiatric practice and research. He is particularly interested in the study and treatment of addictive disorders, and for that reason he formulated the self-medication hypothesis (SMH). He believes that substance-dependent people suffer and self-medicate not only because they do not know, tolerate, or express their feelings, but also because they cannot regulate their self-esteem, relationships, or self-care. This was the biggest misunderstanding of the self-medication hypothesis, and moreover, the reason for this “reconsideration.” If he can clarify the relationship between mental disorders and substance abuse, then he can better communicate his idea that substance abusers are self-medicating their preexisting pathology. He does this by emphasizing that it is not so much a psychiatric condition that one self-medicates, but a wide range of subjective symptoms, such as states of distress and suffering, that may or may not be associated with a psychiatric disorder. This includes, but is not limited to, social anxiety, tension, “dysphoria,” dysthymia, distress, apathy, anhedonia, personal relationships, shyness, “dyscontrol,” and discomfort. This helps to answer, "Why?" If they cannot regulate their states, and they learn that substances could regulate their states for them, then they would depend on substances to ameliorate, relieve, or change their pain and discomfort. Impaired survival "instincts" in substance-dependent individuals, as well as the component deficiencies that threaten well-being and survival, make them more prone to addiction.

Environment

Bui, H. N. (2013). Racial and ethnic differences in the immigrant paradox in substance use. Journal of Immigrant and Minority Health, 15(5), 866-881. DOI: 10.1007/s10903-012-9670-y.

Hoan N. Bui holds a PHD in Social Science (with a concentration in Criminology Sociology, and Women’s Studies), along with M. A. in Criminology & Criminal Justice. She talks about topics such as gender, race/ethnicity, Criminological theories; feminist and critical criminology; and juvenile delinquency, domestic violence and immigration. In the article, Racial and Ethnic Differences in the Immigrant Paradox in Substance Use by Hoan N. Bu, she argues about mainstream culture in relationship with immigrants and drug abuse. She mentions how American culture has high drug use, and this affects the immigrants and their children because substance-use is a behavioral norm in a host society like the United States. About 37% to 48% of Americans youth, ranging from tenth to twelfth graders have tried illegal drugs. According to the article, a recent international survey of seventeen countries in Europe, South and Central America, Middle East, Africa, and Asia shown that the United States had the highest incidence of tobacco, cocaine, and cannabis use. In conclusion he states that drug use among immigrants and their children will likely grow when they become aware of the American culture. she puts slight focus on how peer effect can lead to substance abuse for immigrants. Peer effect/pressure is defined as influence from members of one's peer group. For instance during school years, children or young adults form more intimate friendships, which can affect them later on in the future. For Instance, if his or her friends will be involved into drugs, there is more of a chance that he or she will be as well, and this also includes for the immigrants. Thus, Younger children also look up to elders, and their surroundings to influence them, and to shape who they are in the future. “Increasing values of peer friendship and relationship can distance youth from families, decrease family bonds, and make the task of parental monitoring and supervision more difficult and less effective. Moreover, acculturation can jeopardize traditional family structures and social networks that serve as mechanism to help youth cope with the drug problem” says Hoan N. Bu, emphasizing on how peer pressure can result to acculturation and destroy the family values, and bonds and quite possible resulting into drug abuse which may later on lead to drug addiction. In addition, her research also stated the longer the immigrant lived in America, the higher the level of alcohol and marijuana use.

Ellen, I. G., & Turner, M. A. (1997). Does neighborhood matter? Assessing recent evidence. Housing Policy Debate, 8(4), 833-866. DOI:10.1080/10511482.1997.9521280

Ingrid Gould Ellen is a Paulette Goddard Professor of Urban Policy and Planning; Director, Furman Center for Real Estate and Urban Policy. She has written various articles and books about housing policy, community development, and school and neighborhood segregation. Margery Austin Turner is Senior Vice President for Program Planning and Management at the Urban Institute. She talks about racial and ethnic discrimination. In Ellen, and Turners article, Does Neighborhood Matter? Assessing Recent Evidence, they emphasize on how social interactions and neighborhood environment can impact on how the individuals are brought up. Ellen and Turners research indicates that social interactions and neighborhood environment can affect human behavior, and possibly lead to substance abuse depending on its surroundings. In their article, Ellen and Turner mention research about the studies of, Case and Katz (1991), which indicates that youth are more susceptible in substance abuse depending upon their surroundings, for instance if the majority of the young adults and teens who live in their neighborhood engage in such activity and behavior, the others may be influenced to do so as well. It is also stated that most of the poor families who have applied to be involved in the MTO (Moving To Opportunity) demonstration, said that their main reason for wanting to leave the high poverty neighborhoods they lived in was due to protect and prevent their children from drug abuse, and to give their children a safer and healthier environment to live in.

Quintero, G., & Davis, S. (2002). Why do teens smoke? American Indian and Hispanic adolescents' perspectives on functional values and addiction. Medical Anthropology Quarterly, 16(4), 439-457. DOI: 10.1525/maq.2002.16.4.439

Quintero, G is a cultural anthropologist and Davis, S is a member or the WHO (World Health Organization). In the Article, Why Do Teens Smoke? American Indian and Hispanic Adolescents' Perspectives on Functional Values and Addiction , Gilbert and Davis talk about New Mexico, which is one of the most ethnically diverse , and poor states in the United State. It contains 42 percent Hispanics, and 9.5 percent American Indians. Overall, it is also stated that 20 percent of New Mexico’s population is living in poverty. Gilbert and Davis emphasize on how people use drug abuse in New Mexico to fit in, and have a sense of belonging in, or being popular. In the following article, a Hispanic girl who smokes is quoted as following, “"I think [people smoke] because other people around them do it, and so they want to be like them. I mean maybe he'll like me more if I smoke." This article emphasizes on how some cultures differ, and how drug abuse/addiction is involved especially in areas where poverty is common due to factors such as stress and peer pressure. Most of his research is based on statistics and interviewing people.

Spooner, C. (2005). Structural determinants of drug use: A plea for broadening our thinking. Drug and Alcohol Review, 24(2), 89-92. DOI: 10.1080/09595230500102566

Spooner specializes in Victorian and contemporary literature and culture. In Spooner’s article, Structural determinants of drug use—a plea for broadening ourthinking, Catherine Spooner quotes, “individuals shape and are shaped by the environment”, and “the social environment is a powerful influence on health and social outcome” where she argues that environments can enact substance abuse. Catherine Spooner also points out Velleman, Templeton & Copello work, which talks about how family functioning and parenting can lead into drug addiction due to factors such as severe trauma in early life, poor parenting or poverty. Another researcher mentioned in her article is by Roomer, another researcher who states that social inequality can lead into drug abuse. “ He describes how adverse outcomes from alcohol and drug use are more related to social position than are drug use patterns, suggesting that people with low socio-economic status are more likely to experience negative outcomes from the same pattern of drug use than people with higher socio-economic status.”, says Spooner in her article. Roomers research mainly emphasizes on how poverty can lead to worse consequences for a drug user because of his status. She also talks about another researcher named, Eckersley who argues that mainstream culture has contributed into drug abuse in western countries, due to materialism and individualism. He argues that in the western world, individualism is about freedom, and expressing who we are, but instead individualism reduces social cohesion. Whereas materialism, gives us a feeling of dissatisfactions for who we are, and what we have. Thus, Eckersley illustrates the Western culture based on materialism and individualism as ‘cultural fraud’. By cultural fraud, Eckersley describes it as the images and ideals which meet economic goals but not human goals. He considers drug abuse as one of the negative outcomes of the cultural fraud. Not only does mainstream culture emphasize on cultural fraud, but access to drugs legally or illegally whether it be cigarettes still hold an economic goal which focuses on wealth and not the health of individuals.

Development

Jacobsen, L. K., Southwick, S. M., & Kosten, T. R. (2001). Substance use disorders in patients with Posttraumatic Stress Disorder: A review of the literature. Am J Psychiatry, 158(8), 1184-1190. Retrieved from http://journals.psychiatryonline.org/data/Journals/AJP/3727/1184.pdf.

Dr. Leslie Jacobsen is a graduate from Yale university, New Haven and practices in Psychiatry and Child & Adolescent Psychiatry. She expertises in 7 areas which include cocaine-related disorders. Dr. Southwick received an MD in Psychiatry from George Washington Medical School. He is also the co-author of Resilience: The Science of Mastering Life’s Greatest Challenges and a recognized expert on the psychological and neurobiological effects of extreme psychological trauma. Thomas R. Kosten, MD is a Professor of Psychiatry and Medicine at Yale University Medical School and former Chief of Psychiatry at VA Connecticut. He was the founding Director of the Division of Substance Abuse in 1994 and has directed the Yale Medications Development Center for substance abuse since 1990. This article is about substance abuse disorders particularly found among patients with post traumatic stress disorder (PTSD). Computerized and manual studies of epidemiology and clinical phenomenology reveals that there is functional relationship between PTSD and substance abuse disorder. According to Jacobsen, Southwick and Kosten, there are two primary pathways to describe this co morbidity. The first model is the result of pre-clinical work which claims that substance abuse precedes PTSD, that is, substance abuse result into higher level vulnerability to development of PTSD after exposure to trauma. However,The second pathway is supported by most published data which shows that PTSD precedes substance abuse. This is because, alcohol is used as a form of self-medication by many PTSD patients. The sedative effect hinders the PTSD symptoms. As an evidence,an experiment was carried out in which 1,007 adults were re-evaluated 3 and 5 years after initial assessment. The result revealed that pre-existing substance abuse does not increase the risk of developing PTSD in patient. Although, the article still lacks a clear evidence to prove the accuracy of each model. Also the reason why people are prone to addiction is because the substance withdrawal may result into hyper arousal of PTSD patient that can serve as a conditioned reminder of traumatic events. Thus, the research concludes that withdrawal of PTSD and substance abuse symptoms should be handled during detoxification which otherwise would make it difficult to develop effective treatment methods for severely symptomatic patients.

Chambers, R. A., Taylor, J. R., & Potenza, M. N. (2003). Developmental neurocircuitry of motivation in adolescence: A critical period of addiction vulnerability. Am J Psychiatry, 160(6), 1041–1052. Retrieved from http://journals.psychiatryonline.org/data/Journals/AJP/3749/1041.pdf.

R. Andrew Chambers, M.D. is an associate professor of psychiatry. He is also the director of ‘Addiction Psychiatry’ fellowship program and lab director for ‘Translational Neuroscience of Dual Diagnosis & Development’. He did some research on animal models of mental illness and addictions, behavioural neuroscience, motivation and neural network modelling. Jane Rebecca Taylor PhD who recently has been designated as Charles B. G. Murphy is a professor of psychiatry and professor of psychology. She, as an author of the paper, teamed up with other Yale researchers to look for other genes that may play a role in protecting the brain from effects of cocaine and other drugs of abuse. Marc N. Potenza, M.D., Ph.D. is a professor of psychiatry, in the child study centre and of neurobiology. His researches include pathological gambling, impulse control disorders, substance abuse, addiction and gender differences. The article states that adolescents and young adults are the developmental periods who are mostly the victims of substance abuse disorder. The adolescence represents a period of heightened biological vulnerability to the addictive properties of illegal and legal sanctioned substances. The clinical evidence shows that although rates of alcohol use are similar throughout the adolescence and adulthood, the rates of dependence vary inversely with the age. Whereas, addictive disorders have two key variables, that is, the amount of drug intake and the inherent vulnerability to addiction given the fixed amount of drug intake. Another epidemiological survey revealed that the ratio of substance abuse in men is greater than in women. According to Chambers, Taylor and Potenza, sociocultural aspects of the adolescent life or marketing and availability of legal drugs cannot be fully hold responsible for onset of substance abuse disorder, there are other factors that contribute to it. All in all, the article lacks a clear representation of an experiment that support its argument that the earlier the person had been exposed to drugs, the more one becomes addicted to it.

Volpicelli, J., Balaraman, G., Hahn, J., Wallace, H., & Bux, D. (1999). The role of uncontrollable trauma in the development of PTSD and alcohol addiction. Alcohol Research & Health, 23(1), 256-262. Retrieved from http://secure.ce-credit.com/articles/100623/PTSD_Alcohol_Addiction.pdf.

Dr. Volpicelli graduated from the University of Pennsylvania Medical School in 1981. He worked as a pioneer in clinical research, education, and practice since last twenty-five years. He is also the author of "Recovery Options: The Complete Guide" and "Combining Medication and Psychosocial Treatments for Addictions: The Brenda Approach." Dr. Donald Bux graduated from Rutgers University. He have extensive experience as a research psychologist in the field of substance abuse treatment and HIV risk reduction. This article talks about the traumatic events that lead to the alcohol addiction. Both in humans and animals, traumatic events and alcohol consumption are closely related in which there is an increase in the consumption of the alcohol post trauma rather than during trauma. According to Volpicelli, Balaraman, Hahn, Wallace and Bux, this concept contradicts the tension-reduction theory. To support their hypothesis, an experiment was performed with rats which increased their consumption of alcohol after the shocks were given rather than during the shocks time. Research in human also identifies a strong relation between post traumatic substance disorder and alcohol addiction. This can be explained in terms of women who were the victim of childhood rape turned to alcohol to reduce the symptoms of PTSD. The experimentation and evidence from the real life application of the hypothesis specifies the purpose of the article. Future studies are trying to find an answer to the question as to why the alcohol consumption increases post traumatic event rather than during the trauma.

Conclusion

In conclusion, there are many possible influences of addiction. Genetics is getting closer to finding specific genes that carry vulnerability of addiction. Genetics has proven through science, and empirical as well as observational data that genes do play a role in the susceptibility to addiction. Neurology has shown that dopamine plays a significant role in addiction; specifically the prefrontal cortex, amygdala, and the cerebellum. Mental disorders make you more vulnerable to addiction because of a few reasons. Once of these reasons are that people with mental disorders often experience pain, and problems with social interaction and drugs help them alleviate the pain and problems associated with mental disorders. It has also been shown through statistical data that individuals with mental disorders are more prone to addiction. Environment plays a significant role to why some people are more prone to addiction. It ranges from neighborhood environments, to mainstream, culture, social inequality and peer pressures. All these factors can affect an individual in which it can lead them to substance abuse and further develop into drug addictions. As well as genetics, neurology, mental disorders, and environment; age and developing post traumatic disorder leads the individual towards addiction especially in adolescence period. Therefore, all the stated factors play a significant role in a individuals vulnerability to addiction.

Unless otherwise stated, the content of this page is licensed under Creative Commons Attribution-ShareAlike 3.0 License