Risk Factors and Causes of Substance Use Disorders
What is a Substance Use Disorder (SUD)?
Substance use disorders are influenced by a blend of genetic, environmental, and personal factors. Understanding the causes of substance use disorders is crucial for effective prevention and treatment.
Substance use disorders are a widespread epidemic, with over 20 million people having at least one SUD. Substance use disorders not only affect an individual’s health and well-being but also have significant social and economic impacts.1
Recognizing the nature of these disorders is key to developing targeted treatments and support systems that address the underlying issues and promote long-term recovery.
What Characterizes a Substance Use Disorder?
SUD is a complex medical condition. It involves a problematic pattern of use of substances like alcohol or other drugs. This problematic use causes significant impairment and distress in the individual’s life.
- A craving or strong urge to use the substance
- Desire or failed attempts to reduce or control substance use
- Using substances when it leads to failure in fulfilling major role obligations at work, school, or home
- Using substances despite having persistent interpersonal problems caused or worsened by substance use
- Using substances in situations where it is physically hazardous
- Continuing to use substances despite knowing that it is causing or worsening physical or psychological problems
- Needing more of the substance to achieve the desired effect or a diminished effect with continued use of the same amount (tolerance)
- Experiencing withdrawal symptoms when decreasing or stopping use
SUD can affect almost every part of an individual’s life. It can lead to a range of serious health and social consequences. There is no exact way to determine the causes of substance use disorder, but there are many risk factors that contribute to its development.
Genetics and Causes of Substance Use Disorders
Polygenic Nature
Genetic Interactions with Environmental Factors
Family Studies and Twin Studies
Environmental Factors That Can Contribute to Substance Use Disorders
Early Exposure to Substances
Childhood and adolescence is a critical period for brain development. Early exposure to drugs or alcohol during this time can increase the risk of developing an SUD.
The developing brain is more susceptible to the chemical changes caused by substance use. This can lead to long-term changes in brain function and behavior.7
Peer Influence and Social Networks
Access to Drugs or Alcohol
Stress and Trauma
Importance of Knowing and Understanding the Risks of SUD
Adverse Childhood Experiences and Causes of Substance Use Disorders
Adverse childhood events (ACE) and trauma can impact an individual’s risk of developing an SUD. How these early experiences lead to addiction is complex.
Here is how ACE scores can relate to the causes of substance use disorders:
Increased Vulnerability to Stress
Emotional and Psychological Consequences
Impaired Cognitive Development and Coping Skills
Early trauma can impair cognitive functions such as attention, decision-making, and impulse control. This makes individuals more prone to risky behaviors, including substance use.
Individuals who experience childhood trauma may also find it difficult to develop healthy coping skills. As a result, they may turn to substance use to manage or escape from their emotions and memories.
To treat substance use disorders, programs must understand and strive to reduce the impact of early adverse experiences.
The Relationships Between Mental Health Conditions and Substance Use Disorders
Co-occurring substance use and mental health disorders are common. Almost 9.2 million adults in the U.S. have a co-occurring disorder.11
This relationship is complex and bidirectional. Mental health problems can raise the chance of developing an SUD, and substance use can cause mental health issues.
Here’s how mental health conditions are related to the causes of substance use disorders:
- Self-medication hypothesis: Individuals with mental health conditions often turn to substances to self-medicate or ease their symptoms.
- Shared vulnerability: Mental health disorders and SUD often have similar causes, like genetics, brain chemistry, and stress. This shared vulnerability can predispose individuals to both types of disorders.
- Impaired judgment and coping skills: Mental health conditions can impair judgment and reduce effective coping skills. This can lead individuals to make choices that increase their risk of substance misuse.
- Induction of new disorders: Chronic substance use can lead to the development of new mental health disorders. Excessive alcohol consumption can cause depression, while chronic stimulant use can lead to anxiety or psychosis.
- Neurobiological changes: Using substances can change how the brain works, especially concerning rewards and stress. This can increase the vulnerability to mental health disorders.
An Interdisciplinary Approach
Neurobiological Causes of Substance Use Disorders
- Changes in brain structure
- Neurotransmitter imbalances
- Alterations in the brain’s reward pathway
Changes in Brain Structure
Neurotransmitter Imbalances
Substances can also affect levels of other neurotransmitters like serotonin, GABA, and glutamate. These neurotransmitters play roles in mood regulation, anxiety, and excitability.
The Reward Pathway
How Do Social and Cultural Environments Influence the Causes of Substance Use Disorders?
Socioeconomic Disparities and Poverty
Cultural Factors
Lack of Access to Education
Healthcare Access
Do Personality Traits and External Factors Contribute to Substance Use Disorders?
Similarly, external factors like stress may interact with features of our personality to increase the likelihood of substance misuse. For example, an individual who is impulsive and under stress may be more likely to use substances than an individual who has better emotional regulation.
Internal Influences
External Influences
What Developmental Factors Contribute to the Causes of Substance Use Disorders?
Early Childhood
Adolescence
During adolescence, the brain goes through major changes, especially in the parts that deal with risk and control. Those individuals who are inclined to take risks and have friends who use substances are more likely to experiment with drugs or alcohol.
Importance of Community Resources and Support During Adolescence
- Recreational activities
- Mentorship programs
- Substance use education
The Importance of Addressing Substance Use Early
Substance Use Disorder Treatment with Continuum Outpatient Center
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Resources
- https://my.clevelandclinic.org/health/diseases/16652-drug-addiction-substance-use-disorder-sud
- https://learn.genetics.utah.edu/content/addiction/genes
- https://www.genome.gov/genetics-glossary/Polygenic-Trait
- https://www.nature.com/articles/nrg2536
- https://www.webmd.com/mental-health/addiction/drug-addiction-genes-environment
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3661209/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3664402/
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/add.15336
- https://istss.org/ISTSS_Main/media/Documents/ISTSS_TraumaStressandSubstanceAbuseProb_English_FNL.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968319/
- https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/co-occurring-disorders
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462342/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC80880/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1920543/
- https://www.health.harvard.edu/blog/poverty-homelessness-and-social-stigma-make-addiction-more-deadly-202109282602