Part of the appeal of this internship was having an opportunity to learn more about addiction, and how to help and educate people. My sister is a drug addict, and has been for the better part of nearly two decades. She’s been to jail, rehab, and other types of treatment countless times, but has yet to find a way to stay clean and sober for more than a year.

My sister and I are total opposites. Our lives have taken very different paths. She dropped out of high school, had children at a young age, and struggled with addiction since her teenage years.

I graduated high school, attended college right after, always had a part-time or full-time job, got married, and had children.

Not that there is a right way or a right order to do those things, but this just shows you how we have lived our lives differently despite having a somewhat similar upbringing.

But the question I have is why did she develop an addiction to drugs, but I didn’t?

Most people will say, well it’s a choice she made. Those people are ignorant to how addiction works and don’t realize that it is in fact a disease but that in itself is a whole other blog post.

Science can tell you how drugs alter the way the brain works. But there is no concrete answer as to why some people get addicted while others don’t. But scientists and psychologists do have some guesses and possible theories. Here is what I have learned, and hopefully it is helpful to you too…

There are risk factors for addiction. According to centeronaddiction.org, they are:

• Genetic predisposition
• Certain brain characteristics that can make someone more vulnerable to addictive substances than the average person
• Psychological factors  (e.g., stress, personality traits like high impulsivity or sensation seeking, depression, anxiety, eating disorders, personality and other psychiatric disorders)
• Environmental influences (e.g., exposure to physical, sexual, or emotional abuse or trauma, substance use or addiction in the family or among peers, access to an addictive substance; exposure to popular culture references that encourage substance use)
• Starting alcohol, nicotine or other drug use at an early age

Having one or more of these risk factors doesn’t mean you will become an addict, but the more risk factors present, the more likely someone will develop addiction.

Most people are surprised to see genetic predisposition on that list. I know I was at first. But did you know that up to half of your risk of addiction is based on genetics? If another family member has struggled with addiction, it is likely that you too may struggle with addiction. I think that is interesting, because you think watching someone, like a parent, struggle with addiction would be enough to turn someone away from that substance, but that isn’t always the case. For example, healthline.com says that if someone has a parent who is or was an alcoholic, their child may choose not to drink. But that doesn’t mean they can’t or won’t develop other addictions to things like gambling or smoking. Genetics certainly do play an interesting part in addiction.

Psychological factors and brain characteristics can include the presence of dual diagnoses. I talked about this a few weeks ago. For a refresher, visit: https://baconstreet.org/////////2018/07/dual-diagnosis-how-mental-health-addiction-go-hand-in-hand/ Underlying mental health conditions can increase your chances of addiction, and vice versa. Drugs and/or alcohol may be used to self medicate, but addiction will make the symptoms of mental health conditions more severe in the long-term.

Environmental factors may include having parents who are not involved, as well as abuse, and/or neglect. Children may turn to drugs or alcohol and develop an addiction because they use it to cope with their emotions. Peer pressure and the availability of drugs are also an environmental factor that play a role in developing an addiction.

Early use plays a role as well. What age was someone why they first started to use? In this instance, drugs and alcohol use at a young age can have a huge impact on brain development that can cause problems in the long run, and can make those early users more susceptible to addiction as an adult.

Once addiction starts, it is sustained by the changes made in the brain, even after just one use. In other words, it rewires the limbic system, or reward circuit, (among other areas) of the brain, making it nearly impossible to quit ‘cold turkey.’ For a refresher on that, visit this blog post: https://baconstreet.org/////////2018/07/drugs-and-the-brain/

OK, so we have all of that out of the way. We know there are risk factors. But those risk factors don’t mean that someone will definitely become addicted. So how can I answer the question why my sister is a drug addict, yet I am not?

There are only theories at this point. According to psychologytoday.com, “the problem of why some individuals become addicts remains an open question but biological psychologists may be zeroing in on a solution. It has long been known that addicts have under active dopamine systems and suffer from a decreased capacity to experience pleasure in their ordinary lives. So it is quite possible that there is a genetic abnormality in the dopamine system of those individuals that occurs before addiction starts.” So because those people don’t get the same level of pleasure from work, family, etc., it may explain why they seek that stimulus through other routes.

This genetic dopamine abnormality may also be related to a lack of social inhibition found in some addicts. Psychologytoday.com uses this example to explain: “Alcoholics ignore many of the social conventions about alcohol use, for instance: it should be social; it should never begin before noon; it should be restricted to the evening meal; never have more than three drinks, and so forth.”

So I haven’t offered myself, or you, any concrete answers because there aren’t any yet. Addiction is complex and there are a lot of unknowns. This is one of them. We need to remove the stigma around addiction so we can start to treat it like the disease it is and we can dive deeper into how the brain works, among other things, to answer these types of questions.

Looking back at the risk factors, there are certainly many that my sister has that I do not. Maybe some of the reason can be explained from that. But when scientists point to genetic abnormalities that exist before addiction begins, that could also be why. Just because something is genetic doesn’t mean every member of the family has it, just that they have a predisposition to it. There are a lot of things that could be the reason why, but still, there is no concrete answer yet.

What I can tell you is this…we know there are risk factors for addiction. That is something we can pay attention to in the meantime. If someone meets one, several, or all of them, watch for the signs of addiction. Know that it may be a possibility. This will at least help you be proactive in acting quickly to get someone help who may end up needing it.

Thanks for reading,

Hope