“All illnesses have some heredity contribution. It’s been said that genetics loads the gun and environment pulls the trigger.” – Dr. Francis Collins
“Your genetics load the gun. Your lifestyle pulls the trigger.” – Dr. Mehmet Oz
Welcome to installment 5 of the of the science of addiction, Nature and Nurture Decide. Am I saying that nature (the genes that you inherited) or nurture (the environment in which you grew up) make you an addict? Absolutely not, but heredity and environment do control at what point you will become an addict, if you choose to use. This installment will discuss the roles of heredity and the environment in addiction. I believe that like most things in nature, our tendency toward addiction lies somewhere within a range from “almost can’t become an addict” to “almost can’t avoid it”. As always, I hope that you will see that the things that I present match your own direct observations or experiences.
Blame it on Mom and Dad
I think that everyone can agree that there is a genetic component to addiction, after all, we all know families that have generations of addicts, typically alcoholics. So obviously to some degree, whether you become an addict or don’t, is just the roulette wheel of genetics. Likewise, we may know people who became addicts and we look at the situation in which they grew up and we say “of course they are an addict, they never had a chance”. My son had a friend whose father wasn’t around and whose mother was a crack addict. He and his brothers all ended up becoming addicts, what other outcome could you expect? Mom and Dad gave you your genes and they raised you, so obviously it is their fault. Well, they did contribute but we don’t choose the genes that we pass on, at least not yet, and parents may not have complete control over where you grew up. AND to paraphrase the quotes above, you pulled the trigger when you used.
What Do We Tell Our Adolescents and Young Adults?
I mentioned early in this series that I believe that we must be honest when we try to educate our youth about addiction. When I was in high school, drivers ed consisted of a football coach showing us movies of car accidents and people laying in the road moaning. This was supposed to scare me into being a better driver. It didn’t work and if we try to scare our youth away from drugs with exaggerated, worst case stories, that won’t work either. We might as well be honest with them, they already see more than we want. So:
- Not everyone who uses becomes an addict right away, but many do.
- Some people use for a short time and walk away and never use again while others become addicts.
- Some people start with marijuana or alcohol and move on to harder drugs and some don’t.
The problem is, you don’t know how easily or at what point you will become an addict, until you are one. When you are messing with addictive substances, you are playing Russian roulette. You don’t know which chamber is loaded until the gun goes bang and it’s too late.
If you are my age, you may remember a Three Stooges episode in which a pair of professors argue over which controls a person’s behavior, nature or nurture. They attempt to use the Three Stooges to prove their points and the episode ends in, wait for it, a pie fight. The truth is it is both nurture (our environment) and nature (our genetics). It has been hypothesized that genetics accounts for a little over half of our tendency for addiction and environmental factors account for the rest. I think that this is based on the observation that individuals in seemingly ideal situations still become addicts. There is research being carried out right now that is attempting to identify the genes that increase an individual’s tendency to be an addict. If this gene, or series of genes, or combination of genes can be identified we could possibly cure addiction. As we discussed in Part II, addiction hijacks a system that exists to help us survive. We will need to be very careful messing with such a system, so genetic engineering is unlikely to be the answer any time soon.
Environment
The NIDA (National Institute of Drug Addiction) has also looked at populations and statistics and came up with environmental risk factors and protection factors for addiction. Risk factors are situations that appear to increase the probability that an individual may become an addict. They do not make you an addict, but they make it easier for you to become an addict. Likewise, protection factors cannot prevent addiction, but they make addiction less likely. Some of the risk factors include:
- Living with parents or siblings that are addicts.
- Living in a community where addiction is common and accepted.
- Access to addictive substances at a young age.
- Being raise by parents that were neglectful or abusive.
- Living in a community where there is a lot of despair or hopelessness, typically due to poverty.
In my observations, some addicts seem to be driven by low self-esteem. Isn’t that what each of those risk factors above would cause? Many addicts speak of pain, be it physical or emotional, as the force that drove them to use drugs or alcohol to try to alleviate that pain. Even though I believe that addicts must accept responsibility for their actions that allowed addiction to take hold of them, we know that some people unintentionally became addicts through the misapplication of opiate pain killers to relieve physical pain.
So, I and My Loved Ones Are Safe Because…
One reason that people may prefer to see addicts as being weak minded or morally bankrupt is because it allows them to take comfort in the knowledge that they and their loved ones are not like that. We will be fine because we are strong, responsible people is greatly preferred to admitting that it can happen to literally anyone. As we said before, environment has a huge impact on the chance that someone will become an addict, but genetics apparently holds just a little bit more control.
Time For My Soapbox, Once Again
At this point I want to talk briefly about my experience but I must start by confessing that when I discuss my son, I frequently say “I and me” when I should be saying “we and us”. My wife and I were a team when it came to raising our sons and talking with them. When I write, I tend to think inwardly, and I forget the team. I hope that you and my wife will both give me a pass on that. My sons had a load of protective factors: two parents at home; parents active in their school and sports; a nice home in a rural area; not a lot of money but never having to do without the things that we needed; parents that praised them when they did well; and parents that held them accountable for the things that they did. We were the perfect parents, at least that’s how I remember it.
Our youngest son was probably an alcoholic before he could drive, though he never drove drunk that I am aware of. We know that he was using heroin by the start of his senior year in high school. How could this be, given the environment in which he grew up? Genetics, probably. Low self-esteem, definitely. But the reason doesn’t matter, the point is it can happen to ANYONE. Contrary our experience, I am sure that there are many situations where there are numerous risk factors, yet the individual did not become an addict.
Genetic Roulette
As we stated earlier, you don’t know at what point you will become an addict until it is too late. I was lucky. I binge drank in college a lot and then I stopped and that was the end of it. In truth, the thought of my wonderful bouncing boy, bouncing on me when I was hung over or just seeing me hung over was not something I ever wanted to experience. Who knows, perhaps another year of drinking like I did in college and I would have become an addict. I GOT LUCKY. If you used addictive substances, no matter how much or how little, and you are not an addict, you got lucky. It is simply our genetics and we don’t get to take credit for that. Many decades ago people believed that certain genetic markers (eye color, hair color, skin color) indicated that one group was superior to another. We abandoned those ideas long ago. Isn’t it time that we abandoned the idea that having genes that make us less likely to be an addict makes us better than someone who was caught in addiction?
Do you have thoughts or experiences to share? Please comment, let’s work together and help each other to understand this problem.
I hope that you will join me next week for “A Science Summary and My Thoughts”.