Addiction is the physical and psychological inability to stop consuming a certain substance (i.e. drugs, alcohol) or doing a particular activity, even if it’s harmful. It's a compulsive and irresistible act. When a person is addicted to a substance, they cannot control their urge to use it, no matter how destructive their behaviour has become. Addiction is not a sign of weakness but simply a disease just like any other as it affects the part of the brain responsible for feelings of pleasure and relaxation. Addiction can have a serious impact on a person’s behaviour because addictive substances have properties that can impact judgment, actions, and more. When someone becomes addicted to drugs or alcohol, their brain chemistry has been altered to the point that they cannot stop using harmful substances, and their ability to function normally has been compromised. Addiction results from a combination of several factors, mainly genetic, environmental and social.
Genetic Factors:
There are between fifty to a hundred genes influencing addiction, such as monoamine oxidase A (MAOA), the serotonin transporter (SLC6A4), and catechol-O-methyltransferase (COMT) just to name a few, and a variation in several genes each contributes to a small amount of risk. Some behavioural patterns such as impulsivity, risk-taking, and stress response, which are due to specific personal and physiological traits, may make some people more prone to addictive disorders than others. These patterns may be partially influenced by genetic variation. Moreover, differences in personality and physiology may affect different stages of addiction. These stages of addiction are chronologically defined as the initiation of drug use, regular drug use, abuse/dependence, and relapsed use.
Drugs act on the brain’s reward system which signals using the neurotransmitter dopamine. A study published in the PNAS (1) scientific journal revealed one of the genetic factors as a type of RNA called human endogenous retrovirus-K HML-2 or HK2 that has inhabited the human body for around 200,000 years regulates the activity of dopamine. This integration is more frequently found in people with substance use disorders and is associated directly with drug addiction.
Several genes involved in alcohol metabolism have also been implicated in the development of alcohol addiction and susceptibility to dependence on other drugs.(2) Two of these are alcohol dehydrogenase 1B (ADH1B), which is involved in the conversion of ethanol to acetaldehyde; and aldehyde dehydrogenase 2 (ALDH2), which converts acetaldehyde into acetate. Acetaldehyde is toxic and its accumulation leads to “flushing,” an unpleasant physiologic reaction involving headache, nausea, and heart palpitations.
Polymorphisms in alcohol metabolism genes that affect acetaldehyde levels can have a profound impact on drinking behavior. For example, the ADH1B*2 allele rapidly oxidizes ethanol, and is protective against alcoholism; this effect is most evident among East Asian populations, in which the frequency of this allele is high. Individuals carrying at least one of these alleles are far less likely to develop alcoholism. Similarly, people carrying even one ALDH2*2 allele are strongly protected against alcoholism, as this allele is essentially dominant negative and carriers have severely reduced rates of acetaldehyde conversion, resulting in the experience of negative physiologic effects associated with alcohol use. Basically, the people who have these genes experience many negative physical side effects because of alcohol consumption, and therefore the cost outweighs the perceived benefit, and they are less likely to go back to consume more alcohol.
Many of the genes associated with addiction appear to influence dependence on multiple other drugs as well, suggesting a large portion of the risk for drug use disorders is dependent on genetics. However, advances in genomic technologies are improving our ability to address many of the complexities associated with addictive disorders, including genes of small effect and the presence of gene-environment interaction. The future prevention and treatment of addictive disorders will hopefully benefit from the success of gene-finding techniques in conjunction with functional, developmental, and pharmacologic studies of the genes identified
Environmental and Social Factors
A person may have a strong history of addiction but the genes for addiction may not be expressed or penetrated in certain individuals while other people with the same family history get addicted almost immediately. The reason for this is the environment. The community in which a person lives has a tremendous impact on the degree of addiction, for example by regulating things like the ease of gaining access to substances such as alcohol, drugs, etc.
The effect of family
Drug addiction in a family results from three factors:
Effect of pathological families on young people's behavior
Easy access to drugs
Influence of groups of people of the same age
Drug addicts come mostly from incomplete and pathological families. A pathological family is one where the parents are victims of mental illnesses and/or substance and drug addiction, thus resulting in child neglect and the parentification of older children. The main family factors of drug addiction are family atmosphere, the strength of family ties, sense of family happiness, the structure of authority in the family, and alcoholism. In families where there is warmth and love, children do not or rarely take drugs. Addiction is more likely to develop in families where there is ill will and hostility. One study concluded that 78.1% of all drug users surveyed grew up with a single parent. Another study has reported that school-aged children with smoking parents were less likely to consider that smoking is harmful to health (67.7%), and had more peers who smoked (30.3%) (3). These statistics clearly imply that parents and family play a significant role in the presence of drug addiction in the child.
The effect of peers
A study involving 1,969 adolescents showed that a friend’s cigarette smoking, alcohol drinking, and drug use activities, significantly predict an adolescent’s risk activities over one year (4).
Peer influence is also one of the top reasons given by adolescents for why someone their age would pick up smoking. Adolescents do offer cigarettes to their peers and smoking is typically initiated in the context of peer groups (5), and studies showed that ‘Cigarettes offered by peers’ was a common reason given by adolescents for picking up their first cigarette (43.3%) (6).
Adolescents also tend to pick up their cigarettes
when they were ‘wanting acceptance from friends’ (36%) (7). Peer pressure and the feeling of wanting to ‘fit in’ play big roles in the development of drug addiction especially in teenagers and adolescents.
To conclude, addiction is a disease that people are victims of, and there are a number of reasons as to why a person gets addicted in the first place. Labelling all addicts as evil does little to address the reason why they became addicted in the first place, especially since these reasons are often far beyond their control. This Alcohol Awareness Month, I hope that you realise that there’s more to addiction than what meets the eye.
Written by Swara Rajurkar
1. Karamitros, T., Hurst, T., Marchi, E., Karamichali, E., Georgopoulou, U., Mentis, A., . . . Magiorkinis, G. (2018). Human endogenous Retrovirus-K HML-2 integration Within RASGRF2 is associated with intravenous drug abuse and modulates transcription in A CELL-LINE MODEL. Proceedings of the National Academy of Sciences, 115(41), 10434-10439. doi:10.1073/pnas.1811940115 https://www.pnas.org/content/pnas/115/41/10434.full.pdf
2. Edwards, A. (2009). Genetic Influences on Addiction. https://www.researchgate.net/profile/Alexis-Edwards-3/publication/265199897_Genetic_Influences_on_Addiction/links/5640a26d08ae24cd3e408ba8/Genetic-Influences-on-Addiction.pdf
3. Family Process and Peer Influences on Substance Use by Adolescents. (2013, September 1). PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799532/
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5. Kirke, D. M. (2004). Chain reactions in adolescents’ cigarette, alcohol and drug use: similarity through peer influence or the patterning of ties in peer networks? Social Networks, 26(1), 3–28. https://doi.org/10.1016/j.socnet.2003.12.001
6. Alexander, C., Piazza, M., Mekos, D., & Valente, T. (2001). Peers, schools, and adolescent cigarette smoking. Journal of Adolescent Health, 29(1), 22–30. https://doi.org/10.1016/s1054-139x(01)00210-5
7. Tang, S. M., & Loke, A. Y. (2012). Smoking initiation and personal characteristics of secondary students in Hong Kong. Journal of Advanced Nursing, 69(7), 1595–1606. https://doi.org/10.1111/jan.12019
8. Trogdon, J. (n.d.). 10 Powerful Tips for Beating Any Kind of Addiction. Productive Club. Retrieved April 26, 2021, from https://productiveclub.com/how-to-overcome-addiction/
9. Frontiers in CNS Drug Discovery (Vol. 2). (n.d.). Bentham Science Publishers.https://books.google.com.sg/books?hl=en&lr=&id=MMQYDgAAQBAJ&oi=fnd&pg=PA26&dq=addiction+inheritable&ots=Iacn2EfkgS&sig=6m5iChmtFuutgZZn2vc88-tkCjk&redir_esc=y#v=onepage&q=addiction%20inheritable&f=false
10. Wang, S. (n.d.). Opioid Addiction, Genetic Susceptibility, and Medical Treatments: A Review. MDPI. https://www.mdpi.com/1422-0067/20/17/4294/htm
11. Mavrikaki, M. (2019, January 23). Your genes and addiction. Harvard Health Blog. https://www.health.harvard.edu/blog/your-genes-and-addiction-2019012815730
12. Shores, B. T. (2017, October 24). How Your Environment Affects Addiction. Tranquil Shores. https://www.tranquilshores.org/blog/2017/october/how-your-environment-affects-addiction/
13. Genetics and Genomics: Unraveling New Opportunities for Addiction Treatment and Education. (n.d.). Taylor & Francis. https://www.tandfonline.com/doi/abs/10.3109/10884602.2012.669914?journalCode=ijan20
14. Genetics and Epigenetics of Addiction DrugFacts. (2020b, June 16). National Institute on Drug Abuse. https://www.drugabuse.gov/publications/drugfacts/genetics-epigenetics-addiction
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