Download Etiology of Substance use Disorders

Etiology of Substance Use Disorder
Running head: ETIOLOGY OF SUBSTANCE USE DISORDER
Patricia Beier
Moraine Park Technical College
Jerry Van Kirk, M.Div., Th.M., ICS
1
Etiology of Substance Use Disorder
2
Many of our cultures have indulged in alcohol and drugs for different reasons,
such as religious beliefs, traditions and customs or to cope with life trials. As a result
alcohol and drugs have contributed to health problems, crimes, economic hardship,
broken homes and loss of loved ones. In the 1900s treatment was less available compared
to the present-day for the individual who may be struggling with alcohol and drugs.
Unfortunately, the abuse of alcohol and drugs has been an ongoing problem in the United
States for many years. Today, the United States has several types of treatment facilities,
such as inpatient and outpatient programs for the individual that may be struggling with
alcohol and drug addictions (Fleckenstein, Hanson and Venturelli, 2009).
According to the National Institute on Drug Abuse (NIDA) addiction is a chronic
brain disease that causes compulsive drug seeking and use despite harmful consequences.
Actually, the abuse of drugs leads to changes in the structure and function of the brain. It
is because of these changes that it is so challenging for a person who is addicted to stop
abusing drugs. Although it is true that for most people the initial decision to take drugs is
voluntary, over time the changes in the brain caused by repeated drug abuse can affect a
person’s self control and ability to make sound decisions, and at the same time send
intense impulses to take drugs (NIDA, 2011).
A physiologist and alcohol researcher by the name of Elvin Jellinek introduced
the stages of alcoholism as a disease. He studied and identified types of alcoholism
stages, which provided important data for the medical association to consider prior to
accepting the disease concept. Unfortunately, some people rejected the idea that it was a
disease. Nevertheless, in 1990, the Western Journal of Medicine published an update to
the disease concept of alcoholism, noting that further evidence concludes that alcoholism
Etiology of Substance Use Disorder
3
is a disease. Jellinek’s work contributed to the disease model, which is the belief that
people abused alcohol because of some biologically, caused condition. Actually, research
showed that the brain enzymes and the alterations of neurotransmitters such as dopamine
and serotonin are significantly impaired from chronic drug use. Furthermore, drug use is
not a dysfunction of will power or morality. It is disease of multiple biological,
psychological and sociological dimensions (Walding, (2010).
A family history of drug and alcohol abuse may be the most powerful risk factor
for the development of drug dependency. Studies have shown that “genetic factors are
believed to contribute 40 percent to 60 percent to the risk of alcoholism” (Medscape,
2010). Researchers have studied adopted children of alcoholics and of nonalcoholic
parents. They found that children of alcoholic parents were likely to grow up to be
alcoholics themselves, even in cases where the children were raised by nonalcoholic
adopted parents. This is an interesting concept because most of the people I know have a
parent or another relative in the family that is addicted to alcohol or drugs. My father was
an alcoholic but my mother never drank or abused drugs. It is possible that I received that
genetic feature from my father. Nevertheless, the biological factor contributes to
addiction, leading to the American Psychiatric Association (APA) classifying drug
dependence as a psychiatric disorder because of the similarities of a mental illness. It is
important to mention that the central nervous system rewards sensors are sensitive to
drugs, making the experience more pleasurable for the user. On the other hand, some
people who experiment with drugs dislike the experiment and are less likely to become
addicted to drugs and/or alcohol (Fleckenstein, Hanson and Venturelli, 2009).
Etiology of Substance Use Disorder
4
Studies have shown that in some cases psychological influences are major in the
development of addiction. According to Daugherty and O’Bryan there are at least four
psychological traits that can contribute to alcoholism and addiction: sensation seeking,
gregarious, rebellious and impulsive. I can relate to these traits because that was how I
used to be. I certainly did not follow the rules or make many plans. I needed to be around
a group of people all the time, and I just lived in the moment. The psychological factor
also influences one’s choices and can result in high-risk choices such as driving a vehicle
while intoxicated, hurting an innocent person or themselves. Furthermore, the social
influences of friends, family, culture and advertising can affect the choices one makes
(Daugherty and O’Bryan, 2004).
It is documented that the psychological theories deals with mental or emotional
states that can include: escape from reality, boredom, inability to cope with anxiety,
constantly desiring intoxicants, self- destructiveness, and conscious and unconscious
ignorance regarding the harmful effects of abusing drugs. There are some similarities
with substance abuse and mental disorders. The APA has established categories of
diagnosis for disorders such as behavioral and substance abuse. The Diagnostic and
Statistical Manual of Mental Disorders (DSM-IV) points out some of the criteria for
substance abuse, which can be identified by the occurrence and consequences of
dependence, abuse, intoxication, and withdrawal (Fleckenstein, Hanson and Venturelli,
2009).
Although not every person who experiments with drugs and alcohol becomes an
addict or an alcoholic, no one is immune from addiction. Research has shown that other
factors can lead to developing a substance use disorder such as, being a male, having
Etiology of Substance Use Disorder
5
another psychological problem, peer pressure, lack of family involvement, anxiety,
depression, loneliness, and taking a highly addictive drug (Mayo Clinic, 2011).
Unfortunately, dependence on drugs can create a number of life-changing
complications. They can include:
Health problems. Drug addiction can lead to a range of both short- and long-term mental
and physical health problems. These depend on what drug is taken.
Unconsciousness, coma and sudden death. Taking some drugs can be particularly
risky, especially if you take high doses or combine them with other drugs or
alcohol.
Getting a communicable disease. People who are addicted to a drug are more likely to
get an infectious disease such as HIV, either through unsafe sex or by sharing
needles.
Accidents. If you're addicted to a drug, you're more likely to drive or engage in other
dangerous activities while intoxicated.
Suicide. People who are addicted to drugs commit suicide more often than others.
Family problems. Behavioral changes may cause marital or family strife.
Work issues. Work performance may decline, and you may be absent from work more.
Problems at school. Academic performance and motivation to excel in school may
suffer.
Legal issues. These can stem from stealing to support your drug addiction, driving while
under the influence of drugs or alcohol, and disputes over child custody.
Etiology of Substance Use Disorder
6
Financial problems. Spending money to support your habit takes away money from
your other needs, could put you into debt, and could lead you into illegal or
unethical behaviors.
All in all, alcohol and drug abuse has been a major problem in the United States
for years. It is said that addiction is a complex disease that can have certain risk factors
such as biological, sociological and psychological. Studies have shown that addiction can
be the result of a brain disorder which the transmitters (Dopamine) are considered a
pleasure pathway. Drug abuse is a gradual process and it may take longer for one person
to become addicted to drugs and alcohol than for another. Most people who become
dependent on drugs began to make high risk choices that interfered with one’s lifestyle,
such as legal, mental and physical aspects. If the user wishes to get sober, the user might
need to change their environment and habits. It is suggested that most people learn
behavior, either positive or negative, and may need to learn new and healthy habits.
Drugs are more potent than in the past and the usage has increased since the 1960s.
People use drugs for many reason such as liking it, wanting it and needing it. However,
only needing the drug defines addiction. Today, the APA recognizes substance abuse as a
disorder and with help, the individual can arrest the disease (Medscape, 2001).
Reference
Etiology of Substance Use Disorder
Daugherty, R. O’Bryan, T. (2004). Prime for Life. Version 8.0. Prevention Research
Institute, Lexington, Kentucky.
Etiology of drug dependency, 2011. Retrieved on February 16, 2011, from
http://www.medscape.com/viewarticle/406713_4.
Fleckenstein, A, E., Hanson, G., R., & Venturelli, P., J. (2009). Drugs and society
10th Ed., Jones and Bartlett Publishers. Sudbury, Massachusetts.
Mayo Clinic (2011). Drug addiction, Retrieved on February 16, 2011, from
http://www.mayoclinic.com/health/drug-addiction/DS00183/DSECTION=risk-.
National Institute on Drug Abuse (2011). Understanding drug abuse and addiction.
Retrieved on February 17, 2011, from
http://www.drugabuse.gov/infofacts/understand.html.
Walding, A. (2010). The disease concept. Retrieved February 2, 2011, from
http://www.livestrong.com/article/240394-disease-concept-of-alcoholism/.
7