Ask An Expert: Was I Born to be an Addict?

In the ongoing debate of nature vs. nurture, addiction as a disease has landed itself right in the middle of this controversy. If one is genetically predisposed to addiction, does that mean that the individual does not have a choice in the matter? Indeed, this is a bleak outlook for anyone suffering from substance abuse. If this were entirely true, however, wouldn’t that mean that no one could recover from addiction without somehow altering that genetic component?

Those who argue for a genetic cause point to a couple simple facts: one, substances do not affect everyone in the same way. For example, a drug which typically causes euphoria in some individuals may cause panic attacks in others. Also, some racial and ethic groups have different tolerances and reactions do specific substances than do others. Yes, there appears to be individual, biological characteristics which affect whether or not someone will be addicted to a certain substance.

Two, there is a verifiable genetic phenomenon which occurs in some persons, which results in decreased dopamine receptors. These receptors are responsible for pleasure, so if a person generally feels less pleasure, he or she may be more apt to self-medicate or compensate for this abnormality.

To complicate matters, it is common for abusers of one substance to use or abuse another. This is often referred to as an “addictive personality”. This concept itself is highly debated, and posits that many addicts simply have a tendency toward addiction, and that’s why you often see people who abuse multiple substances. Indeed, there tends to be common elements among addicts, lending some credence to this idea. Detractors point to the fact that addiction is linked to changes in brain chemistry, which has nothing to do with individual personality traits. So what does all this mean?

In all likelihood, addiction is a problem that is multi-causal and complex. Yes, genetic differences in individuals likely play a part in a person’s predisposition to addiction. However, they are certainly not the only factors. In fact, even neuroscientists agree that risk for addiction is probably 50% environmental. Environmental factors which commonly contribute to addiction include the availability of the substance, peer pressure, and family life. There are many more.

Also, the substance itself, as noted above, may alter brain chemistry, thus “hijacking” the parts of the brain responsible for pleasure. What we end up with is a compilation of multiple factors, all of which play a part in creating an addict. And when treatment is effective, some of these factors can be be mitigated or eliminated. For example, when a patient enters detox, he will immediately be unable to access the substance, allowing his brain to resume pre-addiction functioning.

To summarize, even if you were predisposed to be an addict, that tendency is not the only factor fueling your addiction. Believing that you do not have any choice, or that no one can help you, does not do you any favors. Simply put, you must believe that recovery is possible.

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