He is a man in his 40s. Intelligent, articulate, and well-mannered. But only when he is not high on drugs, which is not too often. He has a hard time holding on to a job and has been fired from work countless times after his bosses got the wind about his drug addiction. He is a college graduate. He could have carved a stellar career for himself; instead, he now borrows money to buy drugs. Bad genes? Dysfunctional family? Could be, but are you sure?
She is a young mother of two adorable kids. But she is hardly around to laugh and play with her children, preferring instead to shut herself in her room and drink till she passes out. Her marriage is on the rocks. The children are not cared for properly. Her house is a mess. Irresponsible mother? Bad wife? Actually, she may not be entirely at fault.
Those who know—scientists, physicians, and counselors—do not write off these people because they know that they didn’t make their choices willingly and knowingly. Addiction is not a moral flaw.
It does not take too long for someone who had just been “experimenting” with an addictive substance to start misusing it. Addiction usually follows. A host of genetic and environmental factors contribute to addiction.
Addictive disorders have moderate to high heritability. The instance of a person developing substance use disorder is greater the closer he is to an addicted family member. But then it is also true that close relatives live in similar environments and are exposed to similar environmental addiction triggers. So in most cases, addiction is caused by an interplay of genetic and environmental factors.
What compounds matters for persons misusing drugs and alcohol is that prolonged exposure alters brain chemistry, usually temporarily. The result is that they are then led by their brains to sustain their addictions.
Addictive substances tweak the reward system of the brain, which is a cluster of specific neural circuits that make us regard certain experiences as being “pleasurable” and remember these. Naturally, these memories make us crave these experiences. Mother Nature has intended for us to recognize life-sustaining activities like eating and having sex as being “pleasurable.”
Unfortunately, addictive substances too bring on such feelings of pleasure because they all flood the brain with the happy hormone dopamine. For instance, low-to-moderate consumption of alcohol has been shown to decrease depression. Heavy drinking clouds the senses—a broken relationship does not hurt much nor do the debts seem big after downing a couple of drinks. For many people, drinking becomes an escape from a reality that they believe they cannot control. The brain remembers these pleasurable experiences and makes the person reach out for the bottle often and even when he is not feeling the blues.
These changes take place at the cellular level, so addiction is difficult to shrug off.
Furthermore, there is a vicious cycle at work here. Addiction wreaks havoc in the lives of the addicted individual. He may not be able to fulfill his professional and personal responsibilities satisfactorily. The results are not hard to fathom. Job losses, broken relationships, financial woes, and health problems bring on stress that in turn, compels him to seek pleasure in drugs or alcohol. Remember that bright college graduate or that young mother? Maybe they were compelled by their emotional stresses to take to addictive substances, and now they cannot keep away from them.
The etiology of addiction is complex and diverse. But the consequences are same for everyone—precious lives going to waste, talents frittering away, and families being ripped apart. With understanding comes compassion, cure, and HOPE.