Want to prevent addiction? Of course you do – even if it’s not your own, maybe it’s your child’s or friend’s or signifiant other’s substance use you’re worried about. So the obvious question, then, is, “How?”
And if you’re like most people, you think the answer is pretty simple – something like, “Just don’t go overboard,” or “Just Say ‘No’.”
While these are good suggestions and have their place in the prevention effort, they generally don’t work because they are only one part of the answer. Yes, it is true. If you don’t use a substance (Just say, “No”), you won’t become an addict. But this message doesn’t resonate with teens and young adults for two reasons: 1) their brains are “under construction,” and 2) they’ve observed scores of friends and family members who do abuse a substance and don’t become addicts/alcoholics.
As far as the “just don’t go overboard” option – that may not be possible for some people no matter how determined they are to keep their alcohol use within low-risk limits or their prescription drug use within prescribed limits. Why? Because those people – like the MAJORITY of the world’s population – are not aware that addiction is a developmental disease. That’s right – a developmental, chronic, often relapsing, brain disease. This means a person is not born an addict/alcoholic, NOR is their use of their drug or alcohol any longer a “choice,” IF they have the UNTREATED brain disease of addiction.
So, then what makes a person develop addiction?
Their risk factors. There are five key risk factors (explained below). And it is those risk factors that will contribute to how and why one person’s brain develops the brain disease of addiction and another person’s does not, even if both are abusing their drug or alcohol to the same degree. [Note the distinction between abusing and being addicted.]
So the better prevention message is, “Assess your risk factors, and if you have one or more, it will be especially important you don’t go overboard or just say, “No.”
Here’s how this works.
It Starts with Alcohol | Drug Abuse Changing Brain Function
This is the easy one – “Just don’t go overboard” or “Just say, ‘No'” – both apply here. And the reason for this is alcohol or drug abuse (abuse being the operative word, here) chemically and structurally change the way the brain works. It is these chemical and structural changes that will make a person’s brain more susceptible to their risk factors – meaning, their risk factors will cause their brain to interact differently with alcohol or drugs. And here’s the “chicken or the egg” piece of this – their risk factors will also make their brain more vulnerable to alcohol or drug use (not even abuse) in the first place; an interaction that in and of itself can compel their brain to abuse the substance, eventually giving rise to the development of the disease. For more on how the brain becomes addicted, check out The Addiction Project > Addiction and the Brain’s Pleasure Pathway: Beyond Willpower.
Assess Your Risk Factors to Prevent Addiction
There are five key risk factors that contribute to a person developing the disease of addiction – genetics, childhood trauma, mental illness, social environment and early use. Please remember – just because you have one or more risk factors doesn’t mean you are one drink or one drug use away from alcoholism or drug addiction. It means you want to be very, very careful in your use of drugs or alcohol because your brain may not interact the way another person’s brain does and the only brain you need to worry about is your own.
Genetics – It’s not that there is a specific addiction gene – at least not one that has not been identified, yet. Rather it’s the idea of genetic differences. There are roughly 25,000 genes in our DNA, and the way they turn on or off determines how we look and how our bodies work. So just as we are born with (inherit from our parents) certain genetic differences that determine our eye shape or skin color, for example, so too are there genetic differences, such as higher or lower levels of dopamine receptors or lower levels of the enzymes in the liver that break down the alcohol in one standard drink, that can influence how one person’s brain or body will interact with the chemicals in alcohol or drugs. These genetic differences are passed along from one generation to the next. So looking at your family history – mom, dad, grandparents, siblings, aunts/uncles – to see if they had/have addiction is one way to determine if you are predisposed to it, as well. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) > Genetics of Alcohol Use Disorders, “genes are responsible for about half of the risk for alcoholism.”
Mental Illness – Mental illnesses, such as depression, anxiety, bipolar, PTSD, ADHD, are also brain changers / brain differences. In other words, the way a person with mental illness’s brain cells communicate with one another is different (for a variety of reasons) than someone who does not have one. This is important to understand because “[t]hirty-seven percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness,” reports the National Alliance on Mental Illness (NAMI). To learn more about mental illnesses, check out the NAMI > Mental Illness (there you will find detailed information on various kinds of mental illnesses, as well treatment options).
Childhood Trauma – Childhood trauma has a profound impact on the neural circuitry of a child’s brain (meaning how or if brain cells “talk” to one another). It “injures a child’s brain. It impairs the brain’s physical development and function. You can see the effects of trauma on a brain scan,” writes ACEs Too High, a fantastic organization working to raise awareness and mitigate the consequences of ACEs (Adverse Childhood Experiences – childhood trauma). This in turn has a profound impact on how a child copes – how they express anger, fear, powerlessness, how they interpret and respond to other people’s words and actions, how or if they trust, how they learn – it can even lead to mental illnesses, such as anxiety and depression. These brain changes in turn have a profound impact on whether that child’s brain will seek drugs or alcohol for their brain-soothing qualities, as well as how that child’s brain will interact with drugs and alcohol if they use.
Childhood trauma includes verbal, physical and emotional abuse and sexual abuse, for example. It also includes domestic violence in the home and parental divorce. For more on ACEs, visit ACEs Too High and visit the source of this research, the ACE Study, which was a collaboration of the Centers for Disease Control (CDC) and Kaiser Permanente’s Health Appraisal Clinic in San Diego involving over 17,000 Kaiser patients.
Social Environment – If a person lives or works or goes to school in an environment where heavy drinking or drug use is the norm, that person will likely drink or use drugs to that same level. Unfortunately, that same level may not work in their brains the way it works in the brain of their co-workers, family members, fellow students or friends (and frankly, it’s likely not working all that well in those other brains, either). To learn more about what is considered “normal” or “low-risk” drinking, visit NIAAA’s website, Rethinking Drinking. As for “normal” or “low-risk” drug use, visit Single Question Drug Screen – Abuse | Addiction.
Early Use – This is incredibly important to understand because the adolescent brain is not the brain of an adult. That means the adolescent brain reacts differently with drugs and alcohol than the brain of an adult AND the harm of substance abuse during key developmental processes makes adolescent substance abuse ESPECIALLY problematic.
Telling the adolescent brain, ages 12-15, to “just say ‘no'” doesn’t work because the adolescent brain is telling the adolescent to “take risks,” “turn to your peers,” and if their peers are saying, “yes” to risks, drugs and/or alcohol, likely that adolescent will, too. This does not mean they’re a bad kid; it simply means their brain’s instinctual wiring (that which activates during puberty) is in charge. The Partnership at Drug Free.org’s Guide to the Teen Brain>Why Teens Act This Way explains this science.
Lastly, early use – early abuse of drugs or alcohol – wires in brain maps around the finding, seeking, using, hiding, covering up, recovering from at an especially vulnerable time because it’s occurring during the time the brain is going through it’s CRITCAL cerebral cortex development and its strengthening and pruning processes. For more on this, please check out Underage Drinking – How Teens Can Become Alcoholics Before Age 21 and It’s Time to Tell the Whole Truth About Puberty
Just because a person has risk factors does not mean they will develop addiction. It takes abusing a substance to chemically and structurally change the brain to make the brain more susceptible to its risk factors. HOWEVER, the risk factors can also make the brain more “driven” to use and abuse a substance.
So the prevention message has to be two-fold – “don’t go overboard” or “just say, ‘No'” AND here’s why – the “why,” of course, is your risk factors.
So please pass this along – share it with your spouse, close friend, community leader, teachers, parents, school administrators and perhaps most importantly, youth | your child, because of their particular vulnerability.
Assessing your risk factors (or helping someone else to assess theirs) can be the key to addiction prevention. It can also be the key to a person with addiction recognizing they have this disease (it’s more than they “drink too much”) and agreeing to seek treatment for it, which of course will require treatment for any of their underlying risk factors (mental illness, childhood trauma, as examples).