Question

Substance Abuse and Addiction

What causes addiction?

A Answers (2)

  • General: Most experts agree that a combination of biological, psychological, and environmental factors may predispose certain individuals to developing addictions.

    Substance abuse: Initially, individuals may abuse drugs to get high. This desire to get high may stem from underlying causes, such as depression, bipolar disorder, stress, or low self-esteem. Others may try drugs out of curiosity or peer pressure. Once a person becomes addicted to a substance, it causes chemical changes in the brain that leads to intense drug cravings.

    Recent studies suggest that trauma, substance abuse, and sexual risk behaviors are all interrelated For instance, women who were sexually abused (as a child or as an adult) may have a hard time refusing unwanted sex and may use drugs as a coping mechanism.

    Some research suggests that genetics may play a role in certain types of drug addictions. For instance, people with family histories of alcoholism are more likely to begin drinking before the age of 20 and to become alcoholics.

    Individuals who experiment with illegal drugs and alcohol before the age of 16 have an increased risk of becoming drug addicts.

    It has also been suggested that tobacco, alcohol, and marijuana are gateway drugs that may lead to experimentation with more serious drugs, such as heroin or cocaine. However, this theory has not been proven, and it is considered controversial.

    Gambling addiction: The exact cause of gambling addiction remains unknown. It has been suggested that chemicals in the brain, called serotonin, norepinephrine (noradrenaline), and dopamine, may be involved. These chemicals, also called neurotransmitters, allow nerve cells in the body to communicate. Serotonin helps regulate mood and behavior, norepinephrine helps the body handle stress, and dopamine causes the sensation of pleasure. It has been suggested that all three of these neurotransmitters may be involved in compulsive gambling.

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  • AHoward J. Shaffer, PhD, Addiction Medicine, answered
    Nobody starts out wanting to develop addiction, but people do gravitate toward certain substances or behaviors for specific reasons. Most of these objects of addiction offer people pleasure or, at the very least, the absence of displeasure. But often, the picture is more complex.

    To a degree, people choose substances or activities that fill a real or perceived need. People who are anxious by nature, for example, sometimes turn to alcohol because it calms them and makes them feel more comfortable in social settings. Likewise, people who have persistent pain sometimes start taking opioids (among the most powerful painkilling drugs) to relieve their pain. People who are concerned about their finances sometimes gravitate toward gambling, particularly if they had a formative experience in which they won a lot of money.

    In some cases, people discover the benefit of a certain substance or behavior in a social setting. Others go in search of a benefit they hope to find. The point is that objects of addiction offer people psychological, social, or biological rewards. Often those rewards are compelling, so the substance or behavior remains appealing, even if it also comes at a cost.

    One key element in overcoming addiction involves recognizing the value it holds. Once you understand the value you derive from your addictive behavior, you can seek alternate—and less destructive—methods for filling that need.

    Clearly, not every anxious person who tries alcohol becomes dependent on it; not every person who is in pain and tries opioids becomes opioid dependent; and not every financially challenged person who gambles becomes a compulsive gambler. Why, then, do some people develop addiction while others do not? Experts are still struggling with this question, but they do know that genes, the environment, and mental health all play a role.
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