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Addiction is in the Person, not the Drug

By Geoff Thompson – MA, CCC

The March 3, 2008, issue of Newsweek magazine reported, “Geneticists have found the first few (of what is likely to be many) gene variants that predispose people to addiction, helping explain why only about one person in 10 who tries an addictive drug actually becomes hooked on it.”

One in 10. I suspect this figure bothered many who read the Newsweek article. It is certainly disconcerting to most people I know. I was the technical expert on the first crystal meth task force in Canada, whose work was praised in the federal Parliament. When I pointed out that there was no evidence that anyone could get hooked on meth after a few uses, the other task force members, with admirable candor, dismissed me outright. They had to, of course. Why bother demonizing a drug if nine out of 10 people can use it without risking addiction?

The public believes that the drug does the addicting. Their reasoning goes something like this: the addict can be anyone who does enough of a drug enough times until he or she becomes an addict. But researchers have known for years that there is nothing magical about a white powder or a liquid or a dried plant. Neuroscientist James Kalat put it this way: “Addiction is not in the drug; it’s in the person.”

It’s important not to misinterpret the science. No one believes that ninety percent of us can take a drug without risk. Anyone can suffer serious consequences for using any drug, including alcohol: DUIs, medical complications, even death. But scientists distinguish between “substance abuse” and “substance dependence.” The latter is addiction, and its defining feature is that the person continues to use a substance “despite knowledge” that it will lead to severe consequences. Abusers use drugs for a specific reason; once the reason is gone, or the drug causes them too much trouble, they stop.

Interestingly, in September, 2008, a Texas neuroscientist, Carlton Erickson, spoke in Nanaimo about the genetic predisposition. In his view, the high success rates claimed by many programs were because the clients were substance abusers and not addicts.

The genetic component is called a ‘predisposition’, which means that it is not a ‘cause’. Being born with the special brain biology is a necessary condition of addiction, but not a sufficient one. There are many people with the predisposition who are not addicts. We know, for instance, that some children growing up in addicted families are so scared of becoming addicted that they never touch a drug. We also know that the addiction rate among children in very religious families is less than the national average. It is likely that many of the kids have the genetic predisposition, but their psychology or environment works against drug use.

The implications of the genetic one in 10 dispel many popular beliefs. For example, most people still believe that addiction equals physical dependence. For decades, physical dependence was the defining feature of the addict, and anyone who experienced withdrawal after quitting the drug was an addict. This concept of addiction became controversial in 1971 when Dr. Lee Robins published her famous study on addiction in Vietnam veterans. Robins studied returning vets who had been using lots of opiates (heroin, morphine, opium) overseas.

Popular opinion at the time was reflected in the movie, The Panic in Needle Park (1971), which portrayed the powerlessness of the heroin addict. But Robins found the opposite. When the young men returned to the US, the majority gave up the habit. They went through withdrawal, of course, but they didn’t seek out the local drug dealer. 

On learning Robins’ results, many experts were astounded. They declared that all those physicians who had us convinced that addiction is a disease, over which the addict had no control, must have got it all wrong. If these soldiers could simply stop taking opiates, then how could the addict be powerless, a victim of a medical condition?

Today, however, we do not diagnose someone an addict simply because he or she experiences withdrawal. We can understand how the soldiers gave up the drug so easily, if we remember that addiction is in the person and not in the drug. The answer: they were not addicts. So why were they using so much heroin, morphine, and opium? They were in a war, and opiates are the best painkillers available. Back in the comfort of their hometowns, they no longer needed a painkiller. Only those returning vets who were addicts sought out the dealers.

Nora Volkow, head of the US National Institute on Drug Abuse, one of the US Institutes of Health, told USA Today, in its October 10, 2005, issue: “Everyone given an opiate…will become physically dependent, but not everyone will become an addict.”

And psychologist Stanton Peele reminds us in his latest book, Addiction-Proof Your Child, that many parents anxious that their kids will use drugs seem to have forgotten that they, too, used a lots of drugs and quit fairly easily.

I suspect that most readers will find this idea that addiction is not in the drug confusing. In fact, research contradicts a great deal of the popular opinion that we read in newspapers and hear in political speeches.

Perhaps there’s a lesson here. If we want to do something about the problem, it’s probably a good idea to pay more attention to reality.

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