Sunday, February 7, 2016

Addiction: A Closer Look at the Environment of Abuse

Black tar heroin from coastal Mexico clawed its way into the lives of more Ohioans in 2013, contributing to 983 overdose deaths, a 41 percent jump over the previous year, according to Ohio Department of Health data.

The spike in heroin overdoses was the most glaring statistic in a report showing yet another record year for drug-related deaths in Ohio: 2,110 people died in 2013 — the most recent year for which figures are available — compared to 1,914 in 2012, which also was a record.”

(Alan Johnson and Catherine Candisky. “Heroin feeds record number of Ohio drug deaths.” The Columbus Dispatch. May 01, 2015.)

These figures are shocking. Six people a day in Ohio lose their lives to the drug epidemic. Why are unbelievable numbers of people becoming addicted to opioid substances? Is it nature or nurture? Understanding addiction requires thorough investigation, and, after reviewing the research, many questions still remain – important questions that beg to be answered.

We should understand that the National Institute on Drug Abuse (NIDA) maintains that no single factor can predict whether a person will become addicted to drugs. Yet, NIDA estimates that about 23 percent of individuals who use heroin become dependent on it.

The risk for addiction is influenced by a combination of factors that include individual biology, social environment, and age or stage of development. The more risk factors an individual has, the greater the chance that taking drugs can lead to addiction.

The effects of genetics and environment on addiction can often be hard to separate, and many statistics cited in the media fail to take this into account. People read simplified explanations for causes of addiction and readily accept them for conclusive reports.

For example, scientists know that children of alcoholic parents are likely to inherit many of the genes that would make them predisposed to alcoholism.
But, add to this risk that these children are also more likely to grow up in an environment that is conducive to alcohol addiction – i.e. they have parents (role models) who drink, and they have alcohol available in their homes. These children may also spend time with friends who like to drink and find drinking socially acceptable, or they may drink in response to stressful factors in their environment such as problems at school.

Studies of identical twins are important tools to understanding the role of the environment in addiction. Some neuroscientists estimate that the risk of addiction for the general population is about half genetic and half environmental.

It is important to understand that while people cannot control their genetic makeup, they can control some of the factors in their environment. There are also parts of their environment they can regulate.
Neuroscientists believe some environmental factors have an extremely significant impact. For example, their research supports that the earlier someone starts using alcohol and/or drugs, the more likely he is to become addicted: research has calculated that 50% of kids who are regular drinkers by age 14 will become alcoholics.

(NIDA Chief Studies the Brain of Addicts; AP/ December 26, 2007.)
In contrast, it was found that those who refrain from using drugs before age 21 have a low likelihood of addiction later in life. Accordingly, an environment where alcohol and/or drugs are readily available to kids at a young age increases the risk substantially
(Adoption Model Used to Understand The Impact of Genetics and Environment On Drug Abuse Risk. March 7, 2012.)
Parents help create the environment of children at risk. An important environmental factor is the amount and quality of emotional and social support a child receives. Teens who reported having an adult they trusted and could talk to, for example, have a lower risk of addiction than those who don’t.

One study actually involved teens who all had a particular genetic risk factor for addiction but different levels of parental support. Those who lacked involved and supportive parents had three times higher rates of drug use than those with high levels of parental support. “In families that were characterized by strong relationships between children and their parents, the effect of the genetic risk was essentially zero,” said Steven Beach, one of the researchers.

(Emily Bazalon. “A Question of Resilience.” New York Times Magazine. April 30, 2006.)

(“Genetic Risk for Substance Abuse Can Be Neutralized By Good Parenting.” February 12, 2009.)

The influence of environment on addiction is not limited to children. The environment also affects adults who become addicted. It has been established that people who are genetically predisposed to give in to peer pressure are more likely to become addicted if they also encounter an environment where their peers press them to take substances. People who are genetically predisposed to addiction are at a very high risk in such an environment where peer pressure is great.
Here is no secret: By avoiding addictive substances and situations in which they are available, people can reduce the risk that they will become addicted. Even if someone has a genetic predisposition to become addicted to heroin, they will not become addicted if they never try it. This may sound inane, yet prevention is the key to ending the opioid epidemic. Large-scale prevention is presently a vision with work in progress. It has yet to be realized.
Yet, what about exposure itself? A number of studies have shown that when animals are raised in an “enriched environment” prior to drug exposure, their vulnerability to addiction was reduced. In such conditions, the enriched environment can be seen as preventive.
According to one of the studies by Marcello Solinas and Mohamed Jaber, carried out by a group of researchers at the Institut de physiologie et biologie cellulaire in Poitiers, a positive and stimulating environment helps defeating cocaine addiction.
The researchers showed that exposing mice to an "enriched environment" during cocaine withdrawal removes abnormal behavior related to addiction. An enriched environment, for mice, is defined as an environment which stimulates their curiosity, providing social and physical activity as well as exploration.

(Marcello Solinas et al., “Reversal of cocaine addiction by environmental enrichment.” Proc Natl Acad Sci USA, 2008.)

My Belief

How can we best help those seemingly trapped in an environment conducive to addiction? And, God knows here Appalachia we live in such a place. I believe it requires significant “brain work,” for every individual – actively gaining an education that not only stresses the danger of risks but also instills a new philosophy that some pain and discomfort are essential human conditions necessary to survival and existence.

Our present Prescription Nation is taught to avoid discomfort at all costs and to suppress it when we suffer it by using body-altering and mind-altering chemicals. In other words, at the first notion of pain – physiological or psychological – we know we must seek pills or other substances to quell the hurt.

In addition, we have allowed ourselves to become conditioned to using substances to enhance good times – to make us happy, to free our inhibitions, to increase our sexual performance, to heighten our lows, to peak our every reality to new and greater heights. What is good party without a “buzz” or a night out without chemical enhancement?

Yet, in my opinion, all chemical dependency has its price. Masking reality, drugs offer only temporary relief or enjoyment. If we could keep the influence of drugs under control, most of us would have no problem with substances. But, you and I know that is not the case. We must simply look at the facts: for example, 23 percent of those using heroin become addicted.

I think until we make an uber-change in our lifestyle and seek natural, non-chemical means to combating manageable pain and discomfort, we will see addiction climb. Even when we do use substances that have the potential for harm, we often ignore the maxim “Everything in moderation.” And, we must realize that merely experimenting with some drugs like heroin is ingesting poison, no matter the setting or the situation.

What about the environment itself? Dr. Kelly Lundberg, Associate Professor in the Department of Psychiatry and Clinical Consultant with the Utah Addiction Center at the University of Utah, says, “A person may have many environments, or domains, of influence such as the community, family, school, and friends. Their risk of addiction can develop in any of these domains.”

Here are Lundberg's suggestions about addictive environments:
  1. The single biggest contributing factor to drug abuse risk is having friends who engage in the problem behavior. If an individual's friends have favorable attitudes towards drug use, this can also increase risk.
  2. An individual's connection with the community in which they live plays a big part in their likelihood of abusing drugs. Statistics show that if a person's community has favorable attitudes toward drug use, firearms and crime, their risk is increased.
  3. Family conflict and home management problems are contributing factors in drug abuse risk. Also, if parents have favorable attitudes towards drug use or use drugs themselves, often their children will be more likely to abuse drugs.
  4. A student's performance, participation, and commitment to school can be a major risk factor in addiction.

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