Certain people are at risk for substance abuse and for developing addiction disorders. Their vulnerability might originate from a variety of factors, including their genetic endowment, family background, psychological factors, and social norms. Overall, these factors make the person value drug use highly, even though the decision might be against their long-term interests. Please note that a risk factor for one person may not be the same for another. Most people at risk for drug abuse do not become addicted.
1. Genetic Vulnerability
Individuals’ preferences to engage in one behavior versus another are shaped by their genetic endowment in interaction with their past experiences. The interactions between one's genetics and social environment may explain why some people become addicted and some do not (Kreek et al., 2005). For example, due to genetic vulnerability, children of alcoholics are at higher risk for future problems with alcohol, and many of these children show high levels of impulsivity.
2. Cultural Attitudes
The value that a person attaches to using drugs is strongly influenced by the community in which the person lives (Wilson, 2005). For example, students drink more on campuses that have a strong drinking culture, few alcohol-control policies on campus, and easier access to alcohol through special promotions and low pricing by local stores and bars (Sher and Rutledge, 2007). Social norms help to define the circumstances in which it is appropriate to drink and how much alcohol should be consumed.
3. Financial Incentives
Evidence shows that people will stop using when the costs become too high (Dalrymple, 2006). Many of the states that have the lowest smoking rates are those that have been the most aggressive about indoor smoking laws and about state taxes that drive up the cost of cigarettes. In general, when the price of cigarettes increases, people smoke less. Increases in taxes on alcohol generally lead to reductions in alcohol consumption and reductions specifically in binge and other kinds of excessive drinking.
Impulsivity is a personality trait that has often been identified as a risk factor for alcohol and substance misuse (MacKillop, 2016). Addicted individuals assign lower values to delayed rewards than to immediate ones. The excessive preference for immediate rewards despite longer-term consequences leads to problems with addiction.
The self-medication theory of addiction suggests that suffering is at the heart of addictive disorders (Khantzian, 2012). That is, individuals with deficits in skills relevant for modifying emotional reactions and tolerance for negative emotions use drugs in an attempt to manage negative or distressing states. Alcohol is frequently used as a way of coping with social anxiety. The drinking removes, at least temporarily, the stress of anxiety. Mate (2010) suggests that addictive behaviors ultimately driven by our unwillingness to allow ourselves to really feel and experience pain, frustration, fear, and all the negative emotions that are part of being human. Instead, we choose the chemical shortcut to avoid those emotions—and end up becoming trapped there.
Addicts commonly lack enough positive human contacts to sustain happiness, and they resort to drug intake partly as self-medication (Panksepp, 2012). The feeling of isolation is a major source of unhappiness. The experience of loneliness is painful. That is why we sometimes turn to ice cream or other fatty foods when we are sitting at home feeling alone in the world. Problems with self-regulation specifically attributed to loneliness have manifested in alcohol abuse, drug abuse, eating disorders, and even suicide. Moreover, heavy drug users may avoid or alienate friends or family who are not using. The social control hypothesis suggests that the absence of caring friends and family lead people to neglect themselves and indulge in health-damaging behaviors, such as eating unhealthy foods and not exercising.
7. One Step at a Time
Choices that create an undesirable way of life are made one day at a time. They are not made at the level of a long-term lifestyle consideration. On any occasion, using drugs (or overeating) produces limited harm. The damage occurs after repeated indulgences. No one would choose to be an addict. One day of drug use does not mean addiction. As the days accumulate, the addictive behavior emerges. Consequently, a person who never chose to be an addict ends up an addict (Hyman, 2009). Similarly, someone who has a second helping of dessert every night ends up 20 pounds heavier without any intention.
Dalrymple T. (2006). Romancing opiates: pharmacological lies and the addiction bureaucracy. New York, NY: Encounter.
Heyman G.M. Addiction: A disorder of choice. Cambridge, MA: Harvard University Press; 2009.
Khantzian, E. J. (2012). Reflections on treating addictive disorders: a psychodynamic perspective. The American Journal of Addictions, 21, 274-279
Kreek et al. (2005), Influences on impulsivity, risk taking, stress responsivity and vulnerability to drug abuse and addiction Nat. Neurosci., 8 (11) (2005), pp. 1450-1457.
MacKillop J (2016). The Behavioral Economics and Neuroeconomics of Alcohol Use Disorders Alcohol Clin Exp Res. Apr;40(4):672-85.
Mate, Gabor (2010) In the Realm of Hungry Ghosts. Berkeley, California: North Atlantic Books
Panksepp J, Biven L, 2012. The Archaeology of Mind: Neuroevolutionary Origins of Human Emotions. New York: W.W. Norton
Sher, K. J., and Rutledge, P. C. (2007). Heavy Drinking across the Transition to College: Predicting First-Semester Heavy Drinking from Precollege Variables. Addictive Behavior 32: 819–835.
Wilson, Thomas M, Drinking Cultures: Alcohol and Identity. Oxford, Berg, 2005.