This article originally appeared on: https://www.breakingthecycles.com/blog/2021/10/29/want-prevent-addiction-assess-risk-factors/ and was written by Lisa Frederiksen
Want to prevent addiction? Of course you do – even if it’s not your own. Maybe it’s your child or friend or significant other’s substance use you’re worried about. So the obvious question then is, “How?”
[But before I continue, there’s been a great deal of research and advanced understandings about the term addiction (drug addiction or alcoholism), which is now diagnosed as a severe substance use disorder, as well as the terms alcohol or drug abuse. For the purposes of this article, I’ll use the terms most of society uses – abuse and addiction.]
Now back to the opening question, “Want to prevent addiction?”
If you’re like most people, you think the answer is pretty simple – something like, “Just don’t go overboard,” or “Just say ‘No’,” or “Just cut back.”
All are understandable answers, but they won’t “just work” if someone’s drinking or other drug use has crossed the line from abuse to addiction, or they have one or more of the key risk factors for developing addiction.
Why? It’s because of what addiction is.
“Addiction is a chronic brain disease that has the potential for both recurrence (relapse) and recovery,” according to The Surgeon General’s Report on Alcohol, Drugs and Health, 2016, pg. 1-6.
As for how assessing risk factors comes into this discussion, let me first provide the following.
Understanding Simplified Disease Concept to Help Prevent Addiction
Disease by its simplest definition is something that changes cells in a negative way. When cells are negatively changed in a body organ, it changes the health and function of that body organ.
Cancer cells in the lungs, for example, change the health and function of the lungs, causing lung cancer. Addiction changes cells in the brain, which in turn changes the health and function of the brain, resulting in this brain disease, aka brain disorder.
This brain disease develops, and its development starts with a person abusing alcohol or other drugs.
Drinking patterns common to alcohol abuse, include:
- routine binge drinking (drinking 4 or more standard drinks on an occasion for women and 5 or more for men)
- routine heavy drinking (drinking 8 or more standard drinks/week for women or 15 or more for men).
- a standard drink means the amount of ethyl alcohol in the alcoholic beverage is the same. 12 ounces of regular beer, 5 ounces of table wine, 8-9 ounces of IPAs or lagers and 1.5 ounces of 80-proof liquor (vodka, gin, tequila…) are all considered one standard drink.
- “normal” or “low-risk” drinking is defined as no more than 7 standard drinks/week, with no more than 3 of the 7 on any day, for women; and no more than 14 standard drinks/week, with no more than 4 of the 14 on any day, for men.
Drug use patterns common to drug abuse, include:
- taking prescribed medications for which you’ve not had a complete medical evaluation to determine the safety and efficacy of the prescribed medication for your condition.
- using legal drugs in types/potencies/quantities for which you’ve not been medically evaluated as safe to use
- using illegal drugs.
When a person abuses alcohol or other drugs, they cause chemical and structural changes in their brain. These changes make their brain more vulnerable to the risk factors for developing addiction, which leads to the next topic.
Risk Factors For Developing Addiction
There are five key risk factors that contribute to a person developing the disease of addiction. They are genetics, childhood trauma, mental illness, social environment and early use. Please remember – just because you have one or more risk factors doesn’t mean you’re one drink or one drug use away from alcoholism or drug addiction. It means you want to be very careful in your use of drugs or alcohol because your brain may not interact the way another person’s brain does and the only brain you need to worry about is your own.
- Genetics– It’s not that there is a specific addiction gene – at least not one that has not been identified, yet. Rather it’s the idea of genetic differences. There are roughly 25,000 genes in our DNA, and the way they turn on or off determines how we look and how our bodies work. So just as we are born with (inherit from our parents) certain genetic differences that determine our eye shape or skin color, for example, so too are there genetic differences, such as higher or lower levels of dopamine receptors or lower levels of the enzymes in the liver that break down the alcohol in one standard drink, that can influence how one person’s brain or body will interact with the chemicals in alcohol or drugs. In other words, genetics can predispose you to developing addiction if you abuse alcohol or other drugs. These genetic differences are passed along from one generation to the next. So looking at your family history – mom, dad, grandparents, siblings, aunts/uncles – to see if they had/have addiction is one way to determine if you are predisposed to it, as well.
- Mental Illness– Mental illnesses (aka mental health disorders), such as depression, anxiety, bipolar, PTSD, ADHD, are also brain changers / brain differences. In other words, the way a person with mental illness’s brain’s cells communicate with one another is different (for a variety of reasons) than someone who does not have one. It’s not uncommon for a person with mental illness to turn to a substance to soothe the symptoms of the mental illness or their drug or alcohol use to exacerbate their mental illness. The important take-away is that both mental illness and addiction must be medically at the same time in order to fully heal the brain.
- Childhood Trauma– Childhood trauma refers to extremely stressful or traumatic events occurring before age 18. It has a profound impact on the neural circuitry of a child’s brain (meaning how or if brain cells “talk” to one another) because of the way trauma affects the fight-or-flight stress response and the brain’s wiring, mapping & developmental processes. Examples of childhood trauma, aka ACEs or Adverse Childhood Experiences, include: verbal, physical and emotional abuse, physical and emotional neglect, sexual abuse, domestic violence in the home and parental divorce. Consider reading my article on PACEs Connection for deeper understanding, “The Developing Brain & Adverse Childhood Experiences (ACEs).”
- Social Environment– If a person lives or works or goes to school in an environment where heavy drinking or drug use is the norm, that person will likely drink or use drugs to that same level. Unfortunately, that same level may not work in their brains the way it works in the brain of their co-workers, family members, fellow students or friends (and frankly, it’s likely not working all that well in those other brains, either). Additionally, an infant, child, adolescent or adult’s interactions within their home, school, community, workplace or school environments will also influence their brain development.
- Early Use – This is incredibly important to understand because the adolescent brain is not the brain of an adult. That means the adolescent brain reacts differently with drugs and alcohol than does the adult brain AND the harm of substance abuse during key developmental processes makes adolescent substance abuse ESPECIALLY problematic. To understand brain development, what you’re seeing in the image to the right and why early use is a problem, consider reading this chapter excerpt, “Basic Brain Facts,” from my latest book, 10th Anniversary Edition If You Loved Me, You’d Stop!
Assessing Your Risk Factors to Prevent Addiction
With the above understanding, you now will have talking points for conversations with a loved one about not using alcohol or other drugs or taking a second look at their use in order to prevent the development of addiction.
With the above understanding, you can now take it upon yourself to use caution if you decide to use a substance knowing you have one or more risk factors.
When a person understands the basics of how a person develops addiction and the role risk factors play in that development, they are better able to take actions necessary to prevent it. These might include the decision not to drink or use other drugs or to change a drinking or drug use pattern that makes their brain vulnerable to their risk factors.
Just because a person has risk factors does not mean they will develop addiction. It takes abusing a substance to chemically and structurally change the brain to make the brain more susceptible to its risk factors. HOWEVER, the risk factors can also make the brain more “driven” to use and abuse a substance.
So the prevention message has to be two-fold – “don’t go overboard” or “just say, ‘No’” AND here’s why – the “why,” of course, is your risk factors.
So please pass this along – share it with your spouse, close friend, community leader, teachers, parents, school administrators and perhaps most importantly, youth | your child, because of their particular vulnerability.
Assessing your risk factors (or helping someone else to assess theirs) can be the key to addiction prevention. It can also be the key to a person with addiction recognizing they have this disease (it’s more than they “drink too much”). From there, they may be open to seeking effective treatment, including treatment for underlying risk factors, such as mental illness or childhood trauma.