Want to Prevent Addiction? Assess Your Risk Factors

Want to prevent addiction? Of course you do – even if it’s not your own. Maybe it’s your child or friend or significant other’s substance use you’re worried about. So the obvious question then is, “How?”

[But before I continue, there’s been a great deal of research and advanced understandings about the term addiction (drug addiction or alcoholism), which is now diagnosed as a severe substance use disorder, as well as the terms alcohol or drug abuse. This article provides clarification. For the purposes of this article, I’ll use the terms most of society uses – abuse and addiction.]

Now back to the opening question, “Want to prevent addiction?”

If you’re like most people, you think the answer is pretty simple – something like, “Just don’t go overboard,” or “Just say ‘No’,” or “Just cut back.”

All are understandable answers, but they won’t “just work” if someone’s drinking or other drug use has crossed the line from abuse to addiction, or they have one or more of the key risk factors for developing addiction.

Why? It’s because of what addiction is.

“Addiction is a chronic brain disease that has the potential for both recurrence (relapse) and recovery,” according to The Surgeon General’s Report on Alcohol, Drugs and Health, 2016, pg. 1-6.

As for how assessing risk factors comes into this discussion, let me first provide the following.

Understanding Simplified Disease Concept to Help Prevent Addiction

Disease by its simplest definition is something that changes cells in a negative way. When cells are negatively changed in a body organ, it changes the health and function of that body organ.

Cancer cells in the lungs, for example, change the health and function of the lungs, causing lung cancer. Addiction changes cells in the brain, which in turn changes the health and function of the brain, resulting in this brain disease, aka brain disorder.

This brain disease develops, and its development starts with a person abusing alcohol or other drugs.

Drinking patterns common to alcohol abuse, include:

  • routine binge drinking (drinking 4 or more standard drinks on an occasion for women and 5 or more for men)
  • routine heavy drinking (drinking 8 or more standard drinks/week for women or 15 or more for men).
  • a standard drink means the amount of ethyl alcohol in the alcoholic beverage is the same. 12 ounces of regular beer, 5 ounces of table wine, 8-9 ounces of IPAs or lagers and 1.5 ounces of 80-proof liquor (vodka, gin, tequila…) are all considered one standard drink.
  • “normal” or “low-risk” drinking is defined as no more than 7 standard drinks/week, with no more than 3 of the 7 on any day, for women; and no more than 14 standard drinks/week, with no more than 4 of the 14 on any day, for men.

Drug use patterns common to drug abuse, include:

  • taking prescribed medications for which you’ve not had a complete medical evaluation to determine the safety and efficacy of the prescribed medication for your condition.
  • using legal drugs in types/potencies/quantities for which you’ve not been medically evaluated as safe to use
  • using illegal drugs.

When a person abuses alcohol or other drugs, they cause chemical and structural changes in their brain. These changes make their brain more vulnerable to the risk factors for developing addiction, which leads to the next topic.

Risk Factors For Developing Addiction

There are five key risk factors that contribute to a person developing the disease of addiction. They are 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’re one drink or one drug use away from alcoholism or drug addiction. It means you want to be 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. In other words, genetics can predispose you to developing addiction if you abuse alcohol or other 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.
  • Mental Illness– Mental illnesses (aka mental health disorders), 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’s cells communicate with one another is different (for a variety of reasons) than someone who does not have one. It’s not uncommon for a person with mental illness to turn to a substance to soothe the symptoms of the mental illness or their drug or alcohol use to exacerbate their mental illness. The important take-away is that both mental illness and addiction must be medically at the same time in order to fully heal the brain.
  • Childhood Trauma– Childhood trauma refers to extremely stressful or traumatic events occurring before age 18. It has a profound impact on the neural circuitry of a child’s brain (meaning how or if brain cells “talk” to one another) because of the way trauma affects the fight-or-flight stress response and the brain’s wiring, mapping & developmental processes. Examples of childhood trauma, aka ACEs or Adverse Childhood Experiences, include: verbal, physical and emotional abuse, physical and emotional neglect, sexual abuse, domestic violence in the home and parental divorce. Consider reading my article on PACEs Connection for deeper understanding, “The Developing Brain & Adverse Childhood Experiences (ACEs).”
  • 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). Additionally, an infant, child, adolescent or adult’s interactions within their home, school, community, workplace or school environments will also influence their brain development.
  • Early Use – This is incredibly important to understand because the adolescent brain is not the brain of an adult. That Prevent Addiction _ Brain Development Age 5-20means the adolescent brain reacts differently with drugs and alcohol than does the adult brain AND the harm of substance abuse during key developmental processes makes adolescent substance abuse ESPECIALLY problematic. To understand brain development, what you’re seeing in the image to the right and why early use is a problem, consider reading this chapter excerpt, “Basic Brain Facts,” from my latest book, 10th Anniversary Edition If You Loved Me, You’d Stop!

Assessing Your Risk Factors to Prevent Addiction

With the above understanding, you now will have talking points for conversations with a loved one about not using alcohol or other drugs or taking a second look at their use in order to prevent the development of addiction.

With the above understanding, you can now take it upon yourself to use caution if you decide to use a substance knowing you have one or more risk factors.

When a person understands the basics of how a person develops addiction and the role risk factors play in that development, they are better able to take actions necessary to prevent it. These might include the decision not to drink or use other drugs or to change a drinking or drug use pattern that makes their brain vulnerable to their risk factors.

Bottom Line

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”). From there, they may be open to seeking effective treatment, including treatment for underlying risk factors, such as mental illness or childhood trauma.

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Note: This article first appeared under the same title on February 6, 2014. It was updated October 29, 2021. Comments may be those on the earlier post.

 

Lisa Frederiksen

Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com
Lisa Frederiksen is the author of hundreds of articles and 12 books, including her latest, "10th Anniversary Edition If You Loved Me, You'd Stop! What you really need to know when your loved one drinks too much,” and "Loved One In Treatment? Now What!” She is a national keynote speaker with over 30 years speaking experience, consultant and founder of BreakingTheCycles.com. Lisa has spent the last 19+ years studying and simplifying breakthrough research on the brain, substance use and other mental health disorders, secondhand drinking, toxic stress, trauma/ACEs and related topics.
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11 Comments

  1. Herby Bell on February 9, 2014 at 1:14 pm

    How? indeed. I spoke to a number of High School classes recently on this subject and was thrilled once again by being in the presence of such hope and creativity. My general observation and “take-away” was that kids WILL make healthy choices even in the presence of their risk taking years, when and if they know how. Largely, they don’t in our culture. It never ceases to amaze me how children who become adults are really NOT given this family and life saving information when THEY ARE STARVING FOR IT. Can’t tell you how many students approached me after the talks asking why they had not heard this information before. Or what to do about a parent who, (also without the benefits of this information) is drinking uncontrollably at home.

    Also can’t tell you how many times I said, “BreakingTheCycles.com” to these wise, wise, young humans as a fantastic resource to learn. I’m hoping your Google Analytics blows a head gasket very soon…

    Thank you for the ongoing, high educational importance in these posts, Lisa. Each link within the posts anchors and deepens your point after point of valuable, researched information.

    As a person in recovery and in retrospect, I just want(ed) to know how to get and stay well. Thanks for teaching us in such a compassionate and actionable way.

    • Lisa Frederiksen on February 9, 2014 at 4:23 pm

      100% agree with you on this, Herby, “kids WILL make healthy choices even in the presence of their risk taking years, when and if they know how.” That’s been my experience when talking with high school student and young adult groups, as well.

      I’m very much looking forward to our joint-talks with community groups to share some of the science you and I both write, speak and consult on in conversational exchanges with those wanting to better understand addiction and overall brain health in general.

      Thanks so much for your comment!!

  2. Cathy Taughinbaugh on February 10, 2014 at 1:58 pm

    Great content here Lisa. You are so right on that the conversation about not using alcohol or drugs is stopped way too soon and the parents do not discuss the reasons why. All kids should be familiar with their risk factors from an early age and have open communication with their parents often on this topic. Thanks so much for all that you do and I hope your Google analytics does blow a head gasket very soon. 😉 Take care.

    • Lisa Frederiksen on February 10, 2014 at 2:21 pm

      I have to say, “Me, too,” to you and Herby on the hopes for my google analytics blowing a gasket :)! Wouldn’t it be something else if we could get this sort of education into elementary schools and homes when children are young? Well. the work we all do is a piece of the puzzle to make that happen. Thanks so much for your comment and support, Cathy!

  3. Leslie Ferris on February 11, 2014 at 5:55 am

    Thank you so much Lisa. Indeed, and obviously, what we as a society are doing right now to fight the massive addiction epidemic and it’s ugly consequences aren’t working. Prevention, with this knowledge as power, is the key to stopping it before it starts. One day hopefully these risk factors which you so beautifully explain will be common knowledge to all!

    • Lisa Frederiksen on February 11, 2014 at 8:20 am

      You’re welcome. I know myself that finally learning about bulimia in a small 2-column inch piece in a Newsweek magazine was what finally put a name to what I’d been doing for 11 years – binging and purging (ages 17-28 and my 16th year anorexic). It also shared what the woman had done to stop and that was how I stopped, myself, back in the early 1980s. So I agree – knowledge is power and hopefully this can get into the hands of people (parents, teachers, community leaders, youth group leaders…) that can use it best to prevent the cycle. Thanks for your comment!

  4. Bill White, Licensed Counselor on February 11, 2014 at 2:42 pm

    Great information – all, Lisa. But, OMG! Those five risk factors nailed me right between the eyes. I mean, it wasn’t as though I didn’t already know there would be a match. But it was kind of a cool experience to go “Check, check, check, check, check” as I reviewed the list. Oh, and needless to say, I didn’t “Just say ‘no.'” This is important information, Lisa. And such an easy reference for anyone. Now if s/he will only use it. Thank You!!!
    Bill

    • Lisa Frederiksen on February 11, 2014 at 4:38 pm

      Thank you thank you, Bill. I so hope it helps people and really appreciate you helping to spread this information to your readers.

  5. Jody Lamb on February 15, 2014 at 7:26 pm

    Thank you for breaking this down in an easy to follow format, Lisa. With prescription drug abuse on the rise and half of U.S. adults being regular drinkers, it’s extremely important that people understand risk factors for addiction. In my family, addiction continues its multi-generational cycle. I’ll be sharing this with them.

    And, this is very important information for parents: “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.” Thank you, Lisa, for everything you do.

    • Lisa Frederiksen on February 16, 2014 at 8:42 am

      Thank you, Jody! As one with similar familial experiences, it’s great to hear you’ve found this information helpful, too. I love your video for Children of Alcoholics, BTW, http://www.youtube.com/watch?v=j_qEglrLReQ, and will be sharing it with parents or significant adults in the lives of children with a parent who drinks too much. One of the best things we can do is break the cycle and that happens when we talk to children and validate that what they are experiencing is real, it’s not them and it’s not “normal.”

  6. TCI on February 22, 2014 at 12:23 pm

    Thank you for this brilliant article. It makes a lot of sense. A smart kid will understand the risks. This explanation counteract against the thinking of “all my friends drink and they have no problem”. Unfortunately, when you cross the line of addiction it is hard to come back. Your brain doesn’t help you register that you have a problem. This is the case with any type of addiction. You either need an intervention or hit the bottom. These days there are materials online like videos that can be used to explain what would happen if you became addict. As a parent, brother or sister you should watch out for your loved ones and step in to make the person understand the problem.

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