The question of nature vs. nurture pops up in many areas of psychology and medical sciences, but few issues spark as much of a contentious debate as the question of a potential cause of addiction. Substance abuse behaviors have a tendency to run in families, but that only compounds the question of whether the issue is hereditary or the product of upbringing. Even those who say that drug abuse has genetic and epigenetic components will note that heredity, while capable of posing larger challenges, does not dictate a person’s destiny.
Genetic Risk Factors
Virtually all human beings have some degree of genetic disposition to be influenced by drugs and alcohol as is evidenced by the fact that substance abuse problems have appeared across every human society with access to mind-altering substances that could be swallowed, smoked or otherwise consumed. There is a documented variance, for example, in alcohol responses across different genetic groups worldwide. The alcohol flush reaction, when the skin turns redder and a person experiences a headache and a heightened heart rate, is documented to appear much more often in populations of East Asian descent than any other groups.
Other genetic factors contributing to substance abuse issues are being turned up on a fairly regular basis. There has been a demonstrated relationship between a marker for anxiety, the CREB gene, and withdrawal issues. In a study of rats with the gene, an increased preference for alcohol was noted, mirroring what might sometimes be described in humans as self-medicating behavior.
Some individuals seem to be naturally hardwired to not form addictions. One study showed that between 60 and 80 percent of individuals who showed signs of addiction in their teens or 20s were able to become free of substance abuse problems and remain so from their 30s onward with many quitting once they aged out of social cohorts that pressured them into consumption. Conversely, that also means that a large minority were still having trouble with drugs and alcohol. This leads to questions about why certain groups of users can kick the habit, often with little help, while others require extensive medical supervision.
It is also notable that the addictive power of a specific drug may vary due to genetic factors. For example, research into tobacco consumption indicated that nicotine addiction, one of the most notoriously difficult habits to kick, can be 75 percent accounted for by genetic factors. The tendency to become addicted is considered 60 percent genetic, and the capacity to kick the habit is considered 54 percent genetic.
The Complexities of Brain Genetics
We know that one proven cause of addiction is brain receptor activation. Dopamine, in particular, tends to figure heavily into the mechanics of addiction. The chemical is used by the brain to reinforce the desire to:
- Have sex
Dopamine has even been shown to play a role in addictive patterns not related to drugs, such as is seen in individuals who experience addictions to pornography or video games. Virtually anything that gives you a sense of thrill or accomplishment gooses your dopamine levels.
In the case of drug use, some drugs are more dopamine-driving than others. Cocaine can rewire the brain’s reward centers so thoroughly that users have been shown to experience a dopamine release simply from seeing images of paraphernalia. It also can change perceptions of risk, nudging a user to engage in increasingly dangerous conduct in order to get a fix.
What makes the genetic linkage to these brain chemicals so hard to sort out is that human brain development is coded by a massive number of DNA sequences. Many of these genes don’t directly code for anything that creates a particular brain cell, and a number do other brain-related tasks, such as the SOD1 gene that fixes damaged neurons. A malfunction in the SOD1 gene is believed to drive the development of ALS. Given that a variety of drugs trigger brain damage, it is possible that some people may have the genetic makeup needed to quickly rebuild neurons that are damaged while others’ bodies may struggle to fix the damage.
Mental health problems often track with issues involving substance abuse. While slightly more than 13 percent of the general public will have signs of a drug- or an alcohol-related disorder at some point in their lives, individuals with diagnosed mental health troubles used illegal drugs or misused legal substances at a rate more than twice that. We also know that many types of mental health disorders, such as schizophrenia, have some genetic component.
Environmental Risk Factors
Multiple situations might prod a person toward drug or alcohol consumption, including:
- Residing in or near economically depressed areas where drug trafficking is a way to make a living
- Being exposed to regular peer pressure
- Having a family life where there’s little pushback against substance abuse
- Being subject to social standards that dismiss the dangers of use
In some cases, such as when kids grow up in impoverished settings, there may even be a confluence of some or all of the above risk factors. It has been shown, for example, that people who live in poverty are less likely to be able to kick drug habits on their own.
The reality is that a person first has to have access to drugs to develop a habit. This is why some people may not start drinking heavily until they get to college, for example. Someone might have lived in a household where drinking was actively discouraged, and they may have also lived in an area where getting alcohol and drugs required some degree of effort. Relocate that same individual to a setting where consumption is openly condoned and supply is readily available, and the situation can shift dramatically.
Nature and Nurture
When hunting for a cause of addiction, it becomes very clear that a number of complex genetic and social interactions take place. It may be better to think of addiction as a problem that is a combination of nature and nurture rather than nature vs. nurture. This can make things feel difficult for people who want a sense of control, such as parents who want to know where they went wrong when their child develops a substance abuse habit.
Family attitudes can play a role in preventing or driving addiction, especially during the teenage years. By providing a supportive environment, a family may help a child who has undiscovered genetic predispositions avoid triggering them by not fostering anxiety and depression. On the flip side, a family that’s more rigid might create a sense that even one drink of alcohol is the end of the world, leading to a cycle of shame when a teen does have a drink.
It is easy to see, however, that generations of a family with a potential genetic disposition to drug or alcohol issues might never run into trouble simply because they aren’t exposed to them. The growing opioid crisis, in particular, has brought these concerns into stark relief. A high school honor roll student who has never so much as sipped a beer might be prescribed an opiate-based painkiller following a wisdom tooth extraction, forming an addiction that might be fed by illicit drug-seeking behavior once the prescription runs out. Conversely, a patient exposed to high amounts of opiate painkillers over a period of years due to a serious spinal injury, for example, might never form an addiction.
We also see that environmental pressures, especially recently introduced ones, can drive substance abuse problems. The rise of the abuse of amphetamines, particularly the prescription drug Adderall, among college students is such a case. The drug is often used merely to stay more alert, allowing for longer study and work sessions. It is not typically shot up, and it can be obtained from a doctor, so it sometimes isn’t seen as a junkie’s kind of drug. This sort of judgment of the social status of who does and doesn’t use drugs can drive the perception that a particular drug isn’t sleazy or that it’s a tool being used to accomplish something specific.
While nature vs. nurture can be a tug of war, we know that one aspect of nurture is incredibly important: The ability of a family to be supportive at all stages makes a major difference. While even the most supportive family might have a member who forms an addiction, the key is that support and love are still there when it comes time to seek treatment.
Nurturing support comes in a variety of forms. Emotional support and psychological support are a big deal, but the ability of a family member to do something as simple as picking up an individual in recovery and getting them to a counseling session can be invaluable. The lack of this type of support is one of the reasons that individuals from at-risk groups, including racial and sexual minorities, may have a harder time dealing with substance abuse troubles.
The nature vs. nurture argument does have salience when it comes to the question of how someone might undergo treatment. Individuals who have few, if any, genetic risk factors may require different treatment regimens than those who have many. As a counselor works with a person trying to kick-start the recovery process, the pace of an individual’s progress will be noted.
It should be understood that, regardless of the source of the problem, recovery is a lifelong effort. People who have strong genetic dispositions to addiction may need to be more focused on their programs, but it’s prudent to not be complacent just because you think you might be more of a nurture case. Setbacks can and do occur to both groups of recovering individuals.
The biggest thing to keep in mind is that a steady commitment to recovery does the most good regardless of the challenges along the way. If someone you care about isn’t ready for recovery, make a point to let them know you will be there for them when they decide to take a step.
For individuals who come from backgrounds where such support may be scarce, seeking support from friends, co-workers and even social workers can fill some of the gaps. The critical thing is that someone supportive will be there for you. If you feel there’s no one there to support you, counselors and addiction group meeting members can provide support. With a desire to get better and a support plan in place, you will have a chance to get better.