- [Presenter] I think that talking about
risk factors for drug abuse can be really difficult.
And that's just because there are
so many different factors that feed into it.
And also, I don't want to put
too much emphasis on any one cause.
I don't want to demonize any one thing.
So I want to say right off the bat,
that there is no one thing
that can lead to drug abuse or addiction.
Instead, there are numerous factors
that relate to each other in complicated ways.
And I also want to mention that the presence
of any, or even all of these risk factors
does not actually guarantee that an individual
will become addicted to any substance,
or will even use at all.
Alright, well with all of that said,
now I am going to talk about
some risk factors for substance abuse.
So things that seem to correlate
with substance abuse later in life.
And we're going to talk about biological risk factors,
psychological risk factors,
and sociocultural and environmental risk factors.
And let's start off with the biological factors.
We know that if a child has a parent who abuses substances,
they are more likely to abuse them as well.
And this in combination with the fact
that identical twins have more similar rates
of addiction than fraternal twins,
seems to imply that there could be
a genetic component to addiction.
This is also supported by the fact
that adopted children tend to resemble
their biological parents more than their adopted parents
in term of addiction rates.
But even if genetics are involved,
even if someone can have a genetic predisposition
to substance abuse, this does not guarantee
that a person will develop a substance abuse problem.
Instead, it might make them more vulnerable to having one.
Another biological risk factor,
has to do with the D2 receptor,
which is a type of dopamine receptor
in the reward circuitry of the brain.
Some studies suggest that individuals
with fewer D2 receptors, might have
a higher risk of addiction than
those with a typical amount of receptors.
We know that many substances are associated
with an increase in dopamine
within the rewards circuits in the brain.
And we also know that the body
tries to counteract the effects of drugs
through down regulation, so over time
the body will take away dopamine receptors
if too much dopamine is present.
And this would stop an individual
from feeling pleasurable experiences
both when they take the drug,
meaning that they'll have to take more to get the same high,
but also in basically everything else in their life.
And you can see how all of this would be particularly bad
for individuals who had fewer D2 receptors to begin with.
Having fewer receptors might also explain
why individuals seek out drugs in the first place.
Because it takes more stimulation
for them to naturally get a reward signal.
Another biological risk factor for addiction
has to do with comorbidity.
Meaning that individuals with certain psychiatric disorders,
might be more likely to have
substance abuse problems as well.
One of these disorders is
attention deficit hyperactivity disorder, ADHD.
And this actually make a lot of sense to me,
because individuals with ADHD tend to be impulsive.
And as we will talk about later
when we talk about psychological risk factors,
impulsivity in general, seems to be
a risk factor for addiction.
Other disorders that can sometimes
go hand in hand with addiction,
are anxiety disorders and depression.
And we're not entirely sure why this is the case,
but some researchers have suggested
that it might be because these individuals
are trying to self medicate for their conditions.
However, we should also remember that this is a correlation,
and even though we might be tempted to conclude
that mental disorders lead to substance abuse,
that might not be the case.
It could be that substance abuse leads to mental disorders.
Or perhaps could trigger mental disorders
in those who have a genetic predisposition.
Or maybe both mental illness and substance abuse problems
could be generated by a third factor.
Maybe some genetic vulnerability for both.
Either way, it's important to keep in mind
when we discuss all of these risk factors,
that correlation does not imply causation.
Now let's move on to psychological risk factors.
One thing that tends to get asked a lot,
is if there is such as thing as an addictive personality.
And the answer is, kind of.
While there is no one single personality trait
that causes a person to become addicted,
researchers have identified a number of personality traits
that seem to be present in many individuals
with substance abuse problems.
One of these is impulsivity,
and I don't mean that in a fun,
let's drop everything and go to the beach, kind of way.
When we talk about impulsivity here,
we mean an inability to control oneself.
The inability to inhibit one's actions,
even when faced with negative consequences.
This is also sometimes referred to,
as behavioral disinhibition.
Another component is sensation seeking.
The need to seek out high levels
of external stimulation and new experiences.
So a constant need for new, more thrilling things in life.
Things like skydiving or extreme sports,
or trying novel foods.
Risk sensitivity also plays a role.
So individuals who focus solely
on the benefits of the experiences
without thinking about the risks.
Or maybe failing to see how the risks might apply to them.
The last personality factor
that I want to talk about is neuroticism,
or being abnormally tense and anxious,
and sensitive to stress.
And these individuals might be at risk,
because they might attempt to minimize
their stress reactions through self medication.
There are other psychological factors
that can play a role, that aren't personality traits.
For example, we also know that individuals
who tend to score high on aggression tests,
so individuals who have feelings of aggression
and aggressive behaviors, who also tend to act out
at school or at home, they also seem to be
at a higher risk of developing addiction later in life.
Age can also play an important role.
People who begin using substances as adolescents,
have a much great chance of having
a substance abuse disorder later in life.
Let's move on to environmental risk factors.
And here especially, it is important to keep in mind,
that the presence of any one of these factors,
does not guarantee that a person
is going to use or abuse substances.
Instead, we are looking at a pattern
of environmental factors that might make
an individual more vulnerable to addiction.
And one of the most important environmental factors
seems to be the presence of stress in an individual's life.
Both childhood stress, as well as current stress.
And we know this both from examining the lives
of those individuals who have substance abuse problems,
as well as from a number of animal studies.
Animals who are placed in stressful environments,
tend to self administer more substances
than animals who are not exposed to stressors.
And when we talk about stressors,
we mean a lot of different things.
Some of them might be family related.
Children in families with marital instability
tend to have a higher risk,
as are individuals who suffer abuse,
whether that be physical or sexual or psychological.
And before we talked about how evidence
from family, twin, and adoption studies
all seem to show that genes
play a role in developing addiction,
but it is also possible that there might be
an added environmental effect as well
in the form of modeling and imitation.
So if a child watches a parent drink
or use other substances as a coping mechanism,
they might be more likely to model this behavior
for themselves when they face stressors in adulthood.
Lack of family involvement and family supervision
also seems to increase the risk for substance abuse.
As does not having a close family bond
between an individual and their parents and their siblings.
The friends an individual has can also play a role.
If a friend group approves of substances and uses them,
an individual is more likely to start.
And this might be true for a number of reasons,
one is that we make friends with people
because of shared interests.
And so we might hold things
that our friends believe in high esteem.
Another reason is social facilitation.
Substances are often consumed in a group setting,
and so they can serve to enhance social bonds.
We have not mentioned it yet,
but of course peer pressure can also play a role.
Individuals might be pressured
into using substances by their peers.
Either directly, by them saying that the individual
should use those substances, or indirectly,
by giving the impression that it is, or will be
an important part of peer bonding.
The community an individual is in can also play a role.
There is a higher concentration
of substance abuse within low SES communities,
and communities that are faced with poverty.
Those who lack education and don't really have
an employment history, seem to be at the greatest risk.
But I want to point out something important,
which is that while there might be more substance abuse
within these low SES communities,
there isn't necessarily more substance use.
It could be that those in impoverished communities
lack the safety net, things like education
and strong support networks, and financial stability,
that keep those in higher SES communities
from moving from use to abuse.
The availability of substances
can also make a big difference.
When substances are available,
people are more likely to use.
And the type of drug can also make a difference.
Those with a fast rate of administration,
so those that are injected or snorted or smoked,
are more likely to be abused than those
that are ingested orally, because they take effect faster.
Because they produce a faster high, a faster reward.
And this causes the brain to form a stronger association.
Which might make it more likely
that they will crave the drug again in the future.
These substances also fade faster,
which also makes users more likely
to use again to continue the high.
And you might think that all of these environmental factors
are less important than some of
the biological and psychological factors
that we talked about before,
but I want you to know that this just isn't the case.
And so I want to take a minute
to talk about a study that highlights how important they are
You might be familiar with studies
that show that a rat alone in a cage, with access to drugs
will basically use continuously,
sometimes neglecting food and water.
But I want to point out that these rats
are left alone in a cage with literally nothing else to do.
And so they're in an environment
without a lot of other options,
except for using the substance.
And to figure out what effect
this might be having on the studies,
some researchers built what was called the rat park.
Which was a large cage filled with lots of engaging toys
and fun things to play with, things like balls, and tunnels.
And it also had the best rat food that they could get,
and it had lots of rats all living together,
all with access to the enriching food and activities.
Basically it was rat paradise.
And wouldn't you know it,
even though the researchers made drugs available in rat park
the same way that they were made available
in experiments with a solitary rat in an unstimulating cage,
the rats in rat park didn't abuse substances.
And for those few rats who did use,
it was in much smaller amounts.
And this is absolutely incredible to me.
And I still remember how shocked I was
when I first learned it.
And even though it's really hard
to compare animal models to human models,
I think it's important to consider
what this might have to say about human substance abuse.
So we've talked about biological risk factors,
psychological risk factors, and environmental risk factors.
But I want to note that even though
I've discussed them separately,
these three things are actually interconnected.
Certain environmental factors might put
an individual at a greater risk for drug abuse,
but it is only when those things are combined
with biological and psychological predispositions
that they would start to take effect.
Or saying that a different way,
individuals with a biological predisposition
and certain psychological traits,
might only be at risk if they're placed within
certain environmental situations.