Factors affecting addiction

The origins of addiction are

quite complex and not fully
understood by psychologists.
Addiction occurs when
people become physically
dependent on a substance
through repeated use.

There are two basic

approaches to the origins of
addiction. The disease
model of addiction argues that addiction has biological roots and is a problem
with which the individual will struggle throughout his/her life. The addiction is
believed to have a genetic origin.

On the other hand, the social cognitive model of addiction (also called the social
learning model of addiction) argues that children learn addictive behaviours by
observing role models (e.g. parents, peers and media celebrities), and because they
tend to see the positive consequences of this behaviour, they begin to imitate it.

Most psychologists today combine the two approaches into what is referred to as a
Biopsychosocial approach. When using this approach, several factors may play a
role in substance abuse and/or addiction. These include:

Genetic predisposition.
Personality factors such as neuroticism and/or self-esteem
Environmental factors such as availability of substances
Cultural attitudes
The media
The nature of the substance - that is, whether it can lead to physical addiction.
Genetic vulnerability

Before looking at the role of genetics in addiction, first, let's look at what happens
to the addicted brain.

In order to develop a genetic argument for the origins of addiction, psychologists

carry out family and twin studies. If addiction has a genetic component, we should
see addictive behaviours running within families - and in cases of twins, identical
twins (MZ) should have a higher rate of both of them having addictive behaviour
than fraternal twins (DZ).

The argument that addiction is potentially genetic is based on the argument that
there are physiological roots of addiction and that it is not solely a psychological
phenomenon. The sensitivity of the dopamine system is one biological explanation
for addictive behaviours. Research on rats carried out by James Olds in the 1950s
showed that when the nucleus accumbens - a part of the limbic system which is
high in dopamine pathways - was stimulated, rats continued to press a lever to get
"a hit." This early research indicated that dopamine and the nucleus accumbens
may be the biological roots of addictive behaviour. The question, then, is if there is
a gene or set of genes that may make some people more prone to addiction than
others?
Kendler & Prescott (1998) have examined the patterns of marijuana and cocaine
use by female twins and found that genetic factors play a major role in the
progression from drug use to dependence. The researchers interviewed 1,934 twins,
ranging in age from 22 to 62. In the study, drug "use" involved at least one
nonprescribed use of a drug; "dependence" was based on the DSM-IV definition
and included characteristics such as physical symptoms of tolerance or withdrawal,
taking larger amounts of the drug or using it over a longer period than intended, or
spending large amounts of time seeking, obtaining, and recovering from the effects
of the drug.

Their research indicated that family and social environmental factors are
influential in determining whether an individual begins using drugs, but the
progression from the use of cocaine or marijuana to abuse or dependence was due
largely to genetic factors. The study found that concordance rates - both twins
using, abusing, or being dependent on drugs - were higher for identical than
fraternal twins. For example, for cocaine dependence concordance was 35 percent
in identical twins and zero for fraternal twins.

Tsuang (1998) found that in males, genetic influences are stronger for abuse of
some drugs than for others. Tsuang and his colleagues studied drug use in 1,874
identical male twin pairs and 1,498 fraternal male twin pairs. The researchers found
evidence to suggest that genetic influences contribute to a common vulnerability
for abusing marijuana, sedatives, stimulants, heroin or opiates, and psychedelics.
The genetic influence for abuse was greater for heroin than for any other drug.

One of the genes that researchers are focusing on is the DRD2 gene which codes
for the number of dopamine receptors available in the mesolimbic dopamine
system. A person with fewer dopamine receptors is unable to 'feel' the effect of
dopamine as well as someone with a higher number of dopamine receptors, and so
needs higher levels of dopamine to produce the same effect as a person with more
dopamine receptors. People with the DRD2 A1 variation of the gene have fewer
dopamine receptors, and also seem more vulnerable to addictions.

In a study of 103 alcohol-dependent males, Ponce et al (2008) found that 39%

carried the DRD2 A1 allele. He found that those with the allele had a higher
prevalence of alcoholism in the family and an early onset of alcohol abuse.
However, the research on the DRD2 A1 gene has been inconsistent.

Evaluation of genetics research

There are some methodological considerations when discussing biological

research on the factors that influence addiction. First, much of the research is
reliant on self-reported data - that is, the people that sign up for the studies report
both the level of their own addiction and the addictions of their twins or other
family members. In addition, the results of the research are inconsistent - that is,
there is not a high level of reliability. Different drugs seem to have different levels of
concordance in twins. Is this the nature of the drugs or does this have something to
do with the way that the genes work?

In addition, there are also questions about the nature of the argument. When
discussing the origins of addiction, are we talking about the initiation of drug use -
that is, why the person started using the drug in the first place? Or are the genes
responsible for the level of addiction? It is difficult to separate out these issues.
Although twin studies seem to indicate that there is a some genetic component to
addiction, it is not yet clear which genes are responsible and what role they may
play in addiction.

Finally, a genetic argument is both reductionist and deterministic. Although a

genetic factor may have to interact with the environment in order to produce a
behaviour the argument still posits that if an individual has the correct set of genes,
then he is more likely to be addicted to the substance.

ATL: Reflection

Do you think that it is helpful to know that you might have a gene that could lead
to addiction? Why or why not?

If you think that it is helpful, would you recommend that all teens get their DNA
tested so that they would better understand the risk of addiction?

The role of stress

Stress has an effect on our physiology. These effects may also have an influence on
the likelihood of addictive behaviour. Some people smoke or drink when they feel
stressed. They use smoking or alcohol as a way of coping, but this may lead to
addictive behaviour.

Morgan et al (2002) carried out a study in non-human primates to show how social
factors can influence the level of dopamine receptors and the propensity to self
administer drugs. First, dopamine levels were measured in monkeys that had been
individually housed. Then, the monkeys were housed in groups for 18 months.
Those monkeys that were high in the social hierarchy also experienced higher
levels of dopamine receptors. The monkeys that were submissive saw a decrease in
their level of their dopamine. When self-administered cocaine was made available
to the monkeys, the subordinate animals took more cocaine than the dominant
monkeys. This suggests that environmental stressors can produce profound
biological changes that have important behavioral association, including
vulnerability to cocaine addiction.

In humans there is a lot of research that shows a strong correlation between

childhood abuse and later development of drug & alcohol dependency. Cleck &
Blendy (2008) found that the longer the abuse continues the greater the later
chances of dependency. But unlike the well-controlled monkey study by Morgan et
al, research on the role of abuse is solely correlational in nature and it is not
possible to isolate variables to determine a cause and effect relationship. However,
if we generalize the findings from animals, we can perhaps find an explanation for
this correlational data.

ATL: Inquiry

Many of the studies of addiction are done with animals. However, animal models
for addiction could be seen as problematic.

Read through the following article on the use of animal models in the study of
addiction.
Create a graphic organizer that examines the pros and cons of using animals in
research on addiction.

Social cognitive learning theory

Much research on smoking focuses on individual factors—for example, how

attitudes or cognitions may predict smoking behaviour. According to Ogden (2012),
this is a problem because it takes individuals out of their social context, and a
person’s behaviour and beliefs are developed through interaction with the social
world. Social cognitive learning theory includes this aspect.

Social Cognitive Learning Theory argues that we learn behaviour by observing the
behaviour of others. It is important that we identify with the person modeling the
behaviour and that we feel that the model has received some positive outcome for
the behaviour. This is the concept of vicarious reinforcement.
One important set of role models is our parents. Bauman et al (1990) found that
among American adolescents, if the parents did not smoke, then their children
were less likely to smoke. 80% of adolescents whose parents did not smoke had
never tried smoking, whereas over 50% of those with parents that smoke did.
Murray et al. (1984) found that in families where the parents were strongly against
smoking, the children were up to seven times less likely to smoke.

Another very important factor in smoking is peer-group pressure. For adolescents,

the peer group is a source of social identity and learning social norms - and this
may include smoking. Unger et al. (2001) carried out a cross-cultural survey on
adolescent smoking in a sample of 5143 Californian adolescents with a mean age of
13.

The study found that European American students who had close peers who
smoked were more likely to smoke than other students (e.g. Asian American and
Hispanic students). The researchers explained that in individualistic cultures,
adolescents typically create their own youth culture, characterized by rebellion, in
order to set themselves apart from their parents. In collectivist cultures, the bond
between the teen and the parents is considered important. Rebellion is not
tolerated, so adolescents are more likely to conform to the roles and norms that
parents prescribe for them.

Peer influences have been found to be among the strongest predictors of drug use
during adolescence. It has been argued that peers initiate youth into drugs, provide
drugs, model drug-using behaviours, and shape attitudes about drugs.

However, Social Cognitive Learning Theory simply shows why individuals may
initiate drug use. It is not a predictor of which individuals will develop abuse or
addiction. In addition, when it comes to peer influence, it is important to
remember that we have some level of choice of the groups to which we belong. It is
possible that the use of drugs among peers is not simply because of the influence of
others, but because of some common traits which attracted individuals to that peer
group.
Checking for understanding
1. What does it mean when there is a 35 percent concordance rate of addiction in
MZ twins?

2. What are some of the difficulties to determining the factors that affect addictive
behaviour?

3. What role is it assumed that dopamine plays in addiction?

4. Why is it believed that stress plays a role in addiction?

5. What are the limitations of the Social Cognitive Learning Theory argument
about addictive behaviour?