Addiction is a complex, chronic disease that affects the brain and occurs due to many different underlying causes.1 Scientific research around the world continues to identify various risk factors such as genetics and environment, which contribute to the development of an addiction. However, the causes of addiction are still not fully understood.15
Understanding more about what causes addiction may help you or a loved one prevent the development of an addiction. To help you better understand the nature of addiction, this article will look at:
- How genes affect the development of addiction.
- How environmental factors affect addiction.
- Ways to help prevent addiction.
- Types of addiction treatment.
Addiction, also known as a substance use disorder (SUD), is a relapsing disorder that involves compulsive drug or alcohol use, meaning the individual is unable to cut back or quit, even when it negatively impacts a person’s life.16 Like other chronic diseases, addiction is treatable with a tailored combination of medication and behavioral therapies that meets a person’s needs.16
Diagnosing an addiction is best done by a medical professional. However, the criteria for substance use disorders in The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) may be useful in recognizing the signs of addiction in yourself or someone you love.
If you or a loved one have experienced 2 or more of the following in the past 12 months, you may want to contact an addiction treatment professional to go over treatment options:2
- A large amount of time is spent in activities to help you obtain alcohol or drugs.
- You have tried many times to cut down or control substance use without success.
- You experience a strong desire or craving to use drugs or alcohol.
- Your substance use makes it difficult to fulfill major obligations at home, work, and school.
- You continue to use substances despite how they have contributed to personal or social problems.
- Social, recreational, and occupational activities are neglected when you use drugs or alcohol.
- You repeatedly use substances in dangerous situations like driving a car.
- You continue to use substances even though they may contribute to or cause physical and/or psychological problems.
- You develop a tolerance to substances, which means you need to take higher doses or take it more often to achieve the same effects; or you experience a lessened effect with continued use from the same amount.
- You experience withdrawal symptoms when you stop using a substance or significantly reduce the dose you take.
Causes of Addiction
It is still unclear what specifically causes addiction, as risk factors vary between each individual.16 Scientific research, shows that if a person has more risk factors for addiction, they may have a greater chance of misusing substances or developing an addiction.16
The following are known risk factors for addiction:3
- Aggressive behavior in childhood.
- Neglect from parents or guardians.
- Experimenting with drugs or other substances.
- Having access to drugs at school.
- Poverty in the community.
- Peer pressure.
Genetics and Substance Addiction
Genetics looks at how and why certain traits are passed from parents to children.4, 6 Although genes play a role in defining a person’s traits, environmental factors can also impact traits; environmental influences can even alter a trait.5
Addiction is considered moderately to highly heritable, meaning that genes can play a significant role in addiction especially the closer the genetic relationship.6 In other words, people who have first-degree relatives (parents, children, siblings) who struggle with addiction may have an increased risk of developing an addiction themselves.
Drug addiction causes, like genetics, vary from drug to drug. While there is still no definitive link between genes and drugs, scientists have made some interesting discoveries. One found that risks for cannabis use disorder may have a strong genetic component.6
Additionally, scientists have found over 400 locations in the human genome that may influence activities like smoking or alcohol use.6 This means that scientists may be getting closer to identifying certain clusters of genes that contribute to a person developing an addiction.6
A history of mental health disorders in a family or a person may also play a role in addiction.3
Environmental Causes of Addiction
A person’s environment, or the people, places, and things that they are exposed to may also influence whether they develop an addiction. Aspects of a person’s environment that may play a role in the development of alcohol and drug addiction include:3
- Peer pressure: Friends are significant in adolescents’ lives. Peers may expose adolescents to drugs and influence their beliefs on what is right and wrong.
- Unstable home environment: A person may experience various types of abuse at home and other chaotic events.
- Parental drug use and criminal activity: Children of parents who use drugs and alcohol and are involved in criminal activity are at risk of abusing substances. Parents may introduce children to drugs, model negative behaviors, and create environments that increase stress.
- Presence of drugs at home and/or school: Exposure to drugs and alcohol can provide additional opportunities for children to experiment and possibly go on to develop an addiction.
- Community attitudes and influence: If a community accepts substance use it may affect whether an individual develops an addiction.
- Poor academic achievement: If a person isn’t performing well in school, they may turn to using substances.
Although environmental factors can put children at risk of addiction, protective factors can minimize the risk of addiction.7 Children who grow up with good parental support, positive relationships, a sense of community, and anti-drug policies at school, and are able to develop self-control may be protected from some of the risk factors for addiction.3
Trauma and Addiction
Childhood experiences, both positive and negative, may have a significant impact on a person’s physical and emotional health. Adverse childhood experiences can be stressful, traumatic events that may lead to physical and emotional difficulties, and even substance use disorder.8 Examples of traumatic childhood experiences include:9
- Physical abuse.
- Sexual abuse.
- Verbal abuse.
- Physical or emotional neglect.
- Witnessing violence.
- Having a family member with a mental illness.
- Having an incarcerated family member.
- Having a family member who is addicted to drugs or alcohol.
- Parental separation or divorce.
- Stress related to military-family life such as deployment.
Each adverse childhood experience increases the risk of earlier drug use among adolescents and future problems with addiction.8
There is a strong link between a person’s mental health and the development of a substance use disorder.11 People may use drugs and alcohol to self-medicate or cope with mental health issues. Those who suffer from an anxiety or mood disorder, such as depression or bipolar disorder, are twice as likely to also have a substance use disorder.11 Those with conduct disorder or antisocial personality disorder also have an increased risk of alcohol or drug addiction.11
A person is said to have a co-occurring disorder or dual diagnosis when more than one disorder or illness presents in the same person, for example, the presence of a mental health disorder and a substance use disorder.11
Both the cause of addiction and development of mental health disorders may be impacted by factors such as genetics, history of trauma, and the environment.11
In the United States, 7.7 million people have co-occurring mental health and substance use disorders.13 It’s difficult to determine if or how one lead to the other or which came first, but there does appear to be a relationship between co-occurring disorders.13
Neurotransmitters in the brain, such as dopamine, are impacted by substance use, but they also play a role in various other mental health conditions.11 Brain changes resulting from mental health disorders may impact or lead to substance use and vice versa. Also, changes in the brain due to a mental health disorder may impact how a person experiences the effects of substances.
Treatment of mental health disorders may reduce the likelihood of future drug use.11 In some cases, treating substance use disorders may also decrease the severity of mental health disorders.11 Treatment for co-occurring disorders among adults and adolescents may include medication, family therapy, cognitive behavioral therapy (CBT), and group therapy approaches.
Addiction is a serious but preventable and treatable condition. Early intervention and preventive measures may decrease the risk of substance use and addiction in children and adolescents. Prevention includes affecting how people think, feel, and act regarding substances and substance use.14
The following methods may be helpful at reducing and/or preventing substance use:7, 14
- Increase the sharing of valuable information about mental health and SUDs.
- Education that’s specifically about prevention
- Presenting alternatives to substance use, such as fun activities and hobbies
- Strategies to affect policy changes that impact social and home environments
- Improve resources for communities to prevent substance misuse.
- Access to addiction and mental health services and providing education about referrals
Promoting protective factors among children and adolescents may also prevent addiction. Protective factors include:7
- Impulse control: The ability to manage urges or delay gratification.
- Parental monitoring: Monitoring children’s behaviors, supporting their physical and emotional needs, setting limits, and enforcing discipline.
- Academic achievement: Encouraging and promoting success in school, as well as involvement in extracurricular activities outside of school.
- Antidrug use policies: Advocating for drug-free schools and enforcing policies and laws.
- Strong neighborhood attachment: Developing meaningful connections outside of the home with members of the community.
Preventive strategies may be less effective if a person has an existing addiction. People struggling with addiction may benefit from substance addiction recovery programs to help reduce their use.
Types of Addiction Treatment
Several different types of treatment exist to help people struggling with addiction. Treatment can be beneficial at any point during a person’s substance use or recovery and should be tailored to a person’s needs. Treatment options include:
- Detox: An important first step in the treatment process to help a person safely and comfortably withdrawal from substances. Detoxification is available at both inpatient and outpatient facilities at varying levels of intensity.
- Inpatient or residential treatment: A type of treatment that involves staying at a facility and participating in several recovery services for a set period. Inpatient treatment can be helpful for people who prefer to be in a structured, drug-free environment, void of temptations or triggers.
- Outpatient treatment: A type of recovery program that allows people to visit the facility to receive treatment services, but still live at home. People may come anywhere from a few hours a week to 20 hours a week, depending on their level of care. Outpatient programs may include detox, therapy, 12-step groups, medication, and drug counseling.
- 12-step programs: These include 12-step based groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) and are free to join. The only requirement is that you have a desire to stop using substances. The meetings provide individuals with a supportive and encouraging environment. Non-12-step programs, such as SMART Recovery, are also available.
- Dual diagnosis: Dual diagnosis programs specialize in helping people who struggle with both addiction and mental health issues. Treatment may involve group, individual, and family therapy, and medication management.
Health Insurance Providers and Coverage Levels
Visit the links below to find out more about insurance coverage levels for drug and alcohol rehab.
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- American Psychiatric Association. (2020). What is a Substance Use Disorder?
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). Arlington, VA: American Psychiatric Publishing.
- National Institute on Drug Abuse. (2014). Drugs, brains, and behavior: The science of addiction.NIH Pub No. 14-5605.
- National Institute of General Medical Sciences. (2021). What is genetics?
- Genetic Science Learning Center, University of Utah. (2004). What are Traits?
- National Institute on Drug Abuse. (2019). Genetics and Epigenetics of Addiction DrugFacts.
- National Institute on Drug Abuse. (2003). Preventing drug use among children and adolescents: A research-based guide for parents, educators, and community leaders.
- Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010). Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population. Depression and anxiety, 27(12), 1077–1086.
- Substance Abuse and Mental Health Services Administration. (2021). Recognizing and Treating Adverse Child Traumatic Stress.
- National Institute of Mental Health. (2019). Post-traumatic stress disorder.
- National Institute on Drug Abuse. (2010). Comorbidity: Addiction and other mental illnesses.
- Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health.
- Flynn, P. M., & Brown, B. S. (2008). Co-occurring disorders in substance abuse treatment: Issues and prospects. Journal of Substance Abuse Treatment, 34(1), 36-47.
- Substance Abuse and Mental Health Services Administration. (2017). Focus on Prevention. HHS Publication No. (SMA) 10–4120. Rockville, MD: Center for Substance Abuse Prevention.
- National Institute on Drug Abuse. (2021). How Science Has Revolutionized the Understanding of Drug Addiction.
- National Institute on Drug Abuse. (2020). Drug Misuse and Addiction: What is addiction?