How Does Addiction Start?
One of the most commonly asked question is “how does addiction start?” We hear this question asked by addicts in recovery, and also by family members and loved ones. The short answer is that it varies by the individual. Each person goes through their own journey to addiction – and to their recovery.
Does Genetics play a role?
That is the $10-million-dollar question. Science cannot provide a definitive equation to explain how much genetics play a role in addiction and how much is determined by life experiences, but there are many educated opinions. Neuroscientist Dr. Nora Volkow of the National Institute on Drug Abuse (NIDA), believes that addiction can be explained by dopamine in the brain. Another addiction expert, Canadian physician Dr. Gabor Maté, believes “emotions are deeply implicated in both the development of illness, addictions and disorders, and in their healing.” The National Council on Alcoholism and Drug Dependence (NCADD) states that genetics make up only 50% of the risk for alcohol and drug dependence. For example, if one sibling underwent a trauma and the other did not, that might explain why only one becomes an addict. Another factor may be personality and it’s not clear how much a personality is formed by nature vs. nurture. There are a multitude of studies on this topic, but as we all know, studies need to be studied in order to determine their accuracy. Most studies can present facts in a way that support the author’s hypothesis.
What science tells us
The science shows that any number of influences can play a role. Environment, emotional issues, trauma (mental or physical), and peer pressure all can play a role. Of course, the first action of getting high is a personal choice but beyond that, many influences come into play. A person with deep rooted anxiety, depression or mild mental illnes can be especially susceptible to addiction. Such people lack the ability to resist the “escape” or “relief” offered by certain substances. When someone consumes drugs, the brain does not function as it would normally, and it begins to release more dopamine than it usually would. The reabsorption of the dopamine is blocked by the way the drugs alter the brain’s chemistry, causing a prolonged sensation of happiness or euphoria, longer than a person would experience if they were not using drugs. Since humans have hedonistic tendencies, the brain will begin to ask for more and more of that good feeling, every time requiring just a little bit more than before, thus increasing the dosage of the drug needed to feel that wonderful effect once again, but also building tolerance. Before long, simple things that are not related to the drug don’t seem to make them happy, only the drug does. Things that someone used to enjoy now seem dull and pointless, and anything that has to do with consuming the drug that releases that good feeling becomes a priority. An addiction has been born. Peer pressure is also an influence. Those friends that regularly get high and push a person to do the same to “fit in” can be a powerful influence. Still, the responsibility to partake is solely the individual’s choice. People who start using opioids or anti-depressants (and other narcotics) can fall into addiction before they even realize they have a problem. As the addiction progresses, the individual loses all sense of self-awareness and is unable to distinguish between right and wrong, in some cases. Even in mild cases, the addiction changes the way a person reasons. Excuses are made, denial steps in and the addiciton escalates.
What seemed to be under control is suddenly not
Nobody starts out intending to develop an addiction, but many people get caught in its snare. Consider the latest government statistics:
- Nearly 23 million Americans—almost one in 10—are addicted to alcohol or other drugs.
- More than two-thirds of people with addiction abuse alcohol.
- The top three drugs causing addiction are marijuana, opioid (narcotic) pain relievers, and cocaine.
In the 1930s, when researchers first began to investigate what caused addictive behavior, they believed that people who developed addictions were somehow morally flawed or lacking in willpower. Overcoming addiction, they thought, involved punishing miscreants or, alternately, encouraging them to muster the will to break a habit. The brain registers all pleasures in the same way, whether they originate with a psychoactive drug, a monetary reward, a sexual encounter, or a satisfying meal. In the brain, pleasure has a distinct signature: the release of the neurotransmitter dopamine in the nucleus accumbens, a cluster of nerve cells lying underneath the cerebral cortex (see illustration). Dopamine release in the nucleus accumbens is so consistently tied with pleasure that neuroscientists refer to the region as the brain’s pleasure center. All drugs of abuse, from nicotine to heroin, cause a particularly powerful surge of dopamine in the nucleus accumbens. The likelihood that the use of a drug or participation in a rewarding activity will lead to addiction is directly linked to the speed with which it promotes dopamine release, the intensity of that release, and the reliability of that release. Even taking the same drug through different methods of administration can influence how likely it is to lead to addiction. Smoking a drug or injecting it intravenously, as opposed to swallowing it as a pill, for example, generally produces a faster, stronger dopamine signal and is more likely to lead to drug misuse. Brain’s Reward Center Scientists once believed that the experience of pleasure alone was enough to prompt people to continue seeking an addictive substance or activity. But more recent research suggests that the situation is more complicated. Dopamine not only contributes to the experience of pleasure, but also plays a role in learning and memory—two key elements in the transition from liking something to becoming addicted to it. According to the current theory about addiction, dopamine interacts with another neurotransmitter, glutamate, to take over the brain’s system of reward-related learning. This system has an important role in sustaining life because it links activities needed for human survival (such as eating and sex) with pleasure and reward. The reward circuit in the brain includes areas involved with motivation and memory as well as with pleasure. Addictive substances and behaviors stimulate the same circuit—and then overload it. Today, the science shows that when these factors are combined, the only way to break the cycle of addiction is prolonged addiction treatment and mainteenace. Only the addict can choose when he/she is ready to quit. Finding addiction treatment early rather than later will always be the best apporach.