Midterm Paper
Write a 10-page paper that compares the theories that drug misuse
results from biological processes versus the environmental processes. Be
sure to address the TEDMED talk below. The paper should be in Times New
Roman, 12-point font, with one-inch margins, double spaced. Include the
following headings:
(1) INTRODUCTION: The extent of the addiction problem;
(2) COMPARE & CONTRAST: (A) The biological process theory and (B) the environmental process theory
(3) CONCLUSION: Which theory explains how addiction begins and should be treated
(4) WRAP-UP
VIDEO: TEDMED Talk “Let’s quit abusing drug users” (Poverty and addiction)
Knowledge: What are the basic ideas of origin (etiology) of addiction, based on research
This is a “teach-back” assignment.
Start by putting the headings on your page. In the introduction, explain
why addiction is a BIG problem and a BAD problem. Use statistics from
the powerpoints and Begun’s text.
In the “compare and contrast” section, have one subheading” biological
theories that explain the research on genetics, reward pathway,
neurochemistry and neuroanatomy of addiction…how different drugs work in
the brain. Under the subheading of environment, the theory includes
your information about social justice, the graphs of the alcoholic mice
(effects of trauma and poverty on becoming an alcoholic) and the brains
(effects of heredity, environment, and drugs from abstinence to
addiction/loss of control) ( Can be found in PowerPoint Begun Ch.1,
Module 3). Explain how the biological theories and environmental
theories are similar and different. In conclusion, explain which theory
you think is a better explanation of drug use. You can talk about Dr.
Carl’s findings to help you decide which is the better explanation.
Under the subheading of Wrap-Up, pull it all together by reiterating how
big and bad a problem substance use disorders are and what you have
shown in the paper.
This is a 10 (9-11) page paper. Please don’t go over. The face page and
the reference page don’t count. If you include the graphs, don’t let
them take up more than ½ page each.
Knowledge: What are the basic ideas of origin (etiology) of addiction, based on research
[Primary Course Text1] Begun, A. (2020). Theories and Biological Basis
of Substance Misuse, Part 1, (licensed under a Creative Commons
Attribution-NonCommercial 4.0 International License) (online, no
charge). https://ohiostate.pressbooks.pub/substancemisusepart1/ .
This book is not for sale or rent but may be downloaded and copied.
[Course Text 2] Uppers, Downers, All Arounders: Physical and Mental Effects of Psychoactive Drugs, 7th
DS Inaba, WE Cohen
Please utilize course text in references
Origins Of Substance Abuse
Drug use is not a recent habit in society; the practice began several decades ago. As noted by Inaba and Cohen (2004), the use of psychoactive substances is at least 4,000-10,000 years old. Notably, drugs, legal and illegal, have long been used and abused for medicinal and recreational purposes leading to global concerns over addiction. This concern is, notably, rooted in recent statistics by the World Health Organization (WHO), which reveals that approximately 35 million people globally have drug use disorders and require treatment services (“World drug report”, 2019). This statistic is alarming considering the colossal burden associated with drug addiction, such as the financial costs required for treatment, the cost burden on families, and the associated adverse health impacts that constrain people’s productivity and sometimes lead to fatality.
Besides being a big issue, addiction is a bad problem because it affects the drug addict and society as a whole. For example, a WHO report shows that tobacco kills more than 8 million people annually, out of which 1.2 million are non-smokers exposed to second-hand smoke (“Tobacco”, 2020). Drug addiction has a far-reaching impact, which necessitates a proper understanding of substance abuse’s biological and environmental origins to enable social workers to develop effective treatment options for current and potential addicts.
Biological Theories
Recent developments in science and medicine suggest that biological processes such as genetics are a potential source of substance abuse. This perspective was evidenced by prior studies that examined the importance of genetic make-up in predicting alcohol dependence. In one study, scholars examined the rates of alcoholism in sons of alcoholics adopted in infancy and their brothers who were raised by alcoholic parents. Findings from this study revealed that both the adopted and nonadopted sons had a high risk of alcohol abuse (Goodwin et al., 1974). Further studies conducted by Hrubec and Omenn (1981) also showed that monozygotic twins had a higher probability of developing alcohol addiction compared to their dizygotic counterparts. These research findings solidify the view that substance abuse genes can be passed down from parents to children during the formation of a zygote. Arguably, children have up to 100% of their parents’ DNA, which implies that parents can transmit genes that trigger alcohol abuse, such as amygdala and serotonin, to their children. The interplay of genes explains why adopted children with alcoholic parents have a high chance of developing substance abuse like their unadopted counterparts.
Besides genetics, research also shows that biological processes such as neuroanatomy changes can lead to substance addiction. The human brain is structured in such a manner that each part has its distinct functions and the neurons work interdependently in sending signals. However, when a person takes a drug, it may affect the functionality of structures such as the prefrontal cortex. Notably, this cortex enables people to think, plan, solve problems, make decisions and exert self-control over impulses (“Drugs, brain, and behaviour”, n.d.; Siddiqui et al., 2008; Collins & Koechlin, 2012). Nevertheless, in the instance of substance intake, the balance of the circuits in the prefrontal cortex, basal ganglia, and extended amygdala shifts, thus impairing decision-making, causing impulsivity and lowering self-control (Goldstein & Volkow, 2011; Goldstein & Volkow, 2002). This change in the brains’ neuroanatomy results in drug addiction as drug users experience more difficulties resisting the urge to continue taking drugs.
Furthermore, a growing body of literature reveals that other biological processes, such as the reward pathway, can lead to drug addiction. Notably, the basal ganglia, which is part of the brain’s reward circuit, plays a role in positive forms of motivation such as pleasurable effects of healthy activities like eating and forming habits and routines (Begun, 2020). Like creating positive forms of motivation, the reward circuit can also be altered by drugs to form negative habits and routines. As noted by the National Institute of Drug Abuse, drugs over-activate the reward circuit, leading to the production of euphoria (“Drugs, brain, and behavior”, n.d.). Subsequent use of the drug triggers the circuit to adapt to its presence and form a pleasurable effect of using the drug. Other scholars perceive this mechanism as the “hijacking” of the brain circuit involved in responses to natural rewards such as sex and food (Potenza, 2013). The altered reward pathway eventually leads to addiction as the body begins to yearn for pleasure exclusively from drug use.
Environmental Theory
Besides biological factors, scholars theorize that substance addiction can originate from environmental factors such as inherited genetics. Notably, Edenberg (2007) notes that genes, such as ALDH2*2, are involved in controlling alcohol metabolism in the human body to prevent abuse of drugs such as alcohol from becoming a disorder. Suddendorf (1989) also observes that this gene enables the body to break down alcohol to acetaldehyde, which is converted by the aldehyde dehydrogenase (ALDH2) into acetate, oxidized to carbon dioxide and water, and eventually excreted from the body. Therefore, drug addiction may originate from the available level of a protective allele in a person’s body.
In the context of protective genes, drug addiction is dependent on a person’s drug tolerance level. As opined by Begun (2020), a drug user may need to use increasingly higher doses of the substance to achieve the same psychoactive effects as previously experienced at lower doses when tolerance to a substance develops. On the one hand, the prevalence of high levels of ALDH facilitates acetaldehyde metabolism, which increases a person’s drug tolerance. On the other hand, individuals with low amounts of the enzyme experience lower alcohol metabolism, which leads to reduced drug intolerance. This information suggests that addiction can originate from the availability of genes involved in controlling drug metabolism. Arguably, individuals with higher levels of such genes are likely to develop substance addiction than their counterparts due to the increased drug tolerance levels.
Furthermore, the environmental theory suggests that addiction originates through multiple processes in a person’s immediate environment, such as substance exposure. This view is supported by Dr. Carl, who argues that drug addiction is triggered by a subject’s unlimited access to a drug (“Let’s quit abusing drug users”, 2015). The correlation between addiction and unlimited substance is also proven through laboratory experiments involving animal subjects, particularly mice and rodents. For example, laboratory tests conducted by Chu et al. showed that enough exposure of rodents to a significant percentage of ethanol would produce dependence and increase operant self-administration (cited by Griffin, 2014). Researchers may observe a similar response to addiction in humans. Arguably, when people are continuously exposed to a substance, they may eventually develop an addiction.
However, the view of the correlation between continuous exposure to substance abuse and addiction has also been contended by scholars who argue that there must be other intervening factors for a drug disorder to occur. In his presentation, Dr.Carl argues that addiction can only happen if the drug is the only substance that an individual has exposure to (“Let’s quit abusing drug users”, 2015). Dr.Carl adds that a drug disorder may not occur if a drug user is provided with an attractive alternative, as was proven in a prior experiment. Notably, findings from Dr.Carl’s experiment revealed that drug users would choose money half of the times as they would drugs when given an option between money and drugs (“Let’s quit abusing drug users”, 2015). Findings from this experiment suggest that individuals that are continuously exposed to drugs may not necessarily become addicts. However, addiction chances become higher if drugs are the only available substance a drug user can access.
Besides continuous exposure to a substance, the environmental theory suggests that nutrition and substance availability can lead to drug addiction. This view is illustrated in the graph of alcoholic mice, which shows that when an alcoholic-hating mouse is nutritionally deprived, and alcohol is made available, the latter becomes alcoholic (Begun, 2020). Arguably, addiction in this context arises from the lack of availability of an attractive option. Notably, nutrition deprivation drives an individual to seek the only available option, whose overreliance leads to addiction.
The environmental theory also suggests that stressors, coupled with substance availability, can lead to addiction. This perspective is represented in the graph of alcoholic mice, which shows that when an alcohol-hating mouse is subjected to stress, and alcohol is made available, the mice become alcoholic (Begun, 2020). Similarly, Sinha (2008) avers that different types of chronic stressors such as loss of a parent, parental divorce, and conflict can enhance a person’s vulnerability to drug addiction. Scholars can trace stress mechanisms involved in the development of addiction back to the neurobiological processes. Notably, Inaba and Cohen (2004) note that stress increases the risk of drugs crossing the blood-brain barrier. As a result, the normal brain functioning is inhibited, leading to the development of poor habits such as drug addiction. Arguably, the brain’s interference may lead to the development of poor cognitions that contribute to addiction, such as a drug user finding pleasure in the continuous use of a drug or developing the perception that drugs relieve one’s stress.
Furthermore, a growing body of studies suggests that social injustice can inadvertently trigger substance abuse and addiction. As noted by Dr.Carl, the drug laws, notably in the United States, are not uniformly enforced (“Let’s quit abusing drug users”, 2015). This aspect may explain why in the early 1990s, about 74% of individuals serving prison sentences for drug possession were black despite this ethnic group accounting for only 13% of the people who use drugs (Begun, 2020). Despite being a social immorality, the unequal reinforcement of the drug laws also enhances the chances of addiction among drug users. For example, Dr.Carl notes that crack cocaine in the United States attracts higher legal repercussions than powder cocaine despite both being forms of cocaine. The only difference between the two types of cocaine is the form of administration and effect, whereby smoking cocaine achieves maximal concentration and affect far more rapidly than when administered through the intranasal route (Kiluk et al., 2013). Also, the literature suggests that smoking cocaine has a higher probability of dependency compared to sniffing.
However, holding all other factors constant, the variation in legal repercussions facing crack and powder cocaine dealers and users triggers dependency among powder users regardless of its lower concentration and effect than crack cocaine. Arguably, the less harsh laws governing powder cocaine enhance powder cocaine availability compared to crack cocaine, which is mainly prevalent in black communities. Subsequently, the continuous availability of powder cocaine in society raises the risk of addiction among users. This view may explain the higher prevalence of substance disorder among certain ethnicities compared to others. For example, statistics show that among past-year alcohol or drug users, Whites have higher rates of alcohol or drug use disorders- 23% than Hispanics- 21% (Wu et al., 2011). Arguably, the failure of uniform reinforcement of justice among majority and minority groups promotes substance addiction among the advantaged group.
Besides social injustice, some studies suggest that poverty is a potential trigger of substance addiction. Scholars theorize that exposure to poverty may trigger an individual to abuse substances (Smyth & Kost, 1998). However, this view is also highly criticized by researchers who view the relationship between poverty and substance abuse as complex and one that lacks a simple, direct causal correlation (Smyth & Kost, 1998). A similar point of view is also posited by Dr.Carl when he mentions that despite living in poverty and using drugs, he did not become a drug addict (“Let’s quit abusing drug users”, 2015). While the two variables may not be directly related, scholars can establish their connection through other intervening factors such as stress. Arguably, poverty is a potential trigger of chronic stress. When chronic stress occurs, it dramatically increases drugs’ ability to cross the blood-brain barrier (Begun, 2020). Therefore, the chances of addiction among drug users are exacerbated by stress, resulting from poverty.
Comparison Between the Biological and Environmental Theories of Substance Addiction
Similarity
Both the environmental and biological theories of addiction suggest that substance use may not necessarily lead to addiction. As can be noted in both theories, the continuous administration and access to substances are the primary origins of addiction. This view is well illustrated in the graph of alcoholic mice, which suggests that when an alcohol-hating mouse is continuously exposed to a substance, they become alcoholics. Similarly, the biological theory suggests that the reward circuit can only be “hijacked” by continuous substance use, which leads to the development of pleasure in the drug use and the urge to continue using the drug. The synthesis of this information shows that the two theories do not relate substance use to addiction. Instead, the continuous use, accessibility, and administration of substances are viewed as the potential cause of addiction.
Furthermore, some processes of addiction in the two theories appear to complement each other. As noted, there lacks a direct relationship between poverty and substance addiction. However, scholars can establish the connection by viewing the variable through the lens of biological processes. Notably, introducing a direct factor related to poverty, such as chronic stress, helps establish a potential relationship between substance addiction and poverty. A similar aspect can be viewed in alcoholic mice’s graph, which shows a visible connection between addiction’s biological and environmental theories. For example, the graph utilizes mice with hereditary non-alcoholism coupled with environmental factors such as stress and nutrition deprivation to illustrate the manner in which the two factors lead to alcoholism. Therefore, despite focusing on different processes, the biological and environmental theories complement each other to describe substance addiction processes.
Contrast
The environmental and biological theories of addiction vary in their area of focus. On the one hand, the biological theory focuses on the human body’s chemical reactions that trigger addiction. Notably, the biological theories explore genes, neuroanatomy, and neurochemistry of addiction. On the other hand, the environmental theory focuses on the external factors that enhance a person’s susceptibility to addiction. Some of the factors explored by the environmental theory include poverty, exposure to substances, and stress. Fundamentally, environmental and biological theories explore external and internal processes, respectively.
Furthermore, the biological and environmental theories differ in their view about the controllability of addiction. On the one hand, the biological theory suggests that addiction can arise from uncontrollable factors such as genes that are passed from parents to their children. This view may explain why adopted children of alcoholic parents may still become alcoholics despite living in an alcohol-free environment. On the other hand, the environmental theory suggests that addiction can arise from controllable factors such as poverty. Arguably, reducing poverty can lower stress among individuals and potentially decrease their susceptibility to substance misuse. Therefore, unlike biological theory that views addiction as an intractable problem passed from parents to children, the environmental theory presents addiction as a controllable issue.
Conclusion
In my view, the biological theory is a better explanation of drug use because it explores the body’s interaction with substance use and the manner in which the response leads to substance disorder. Dr. Carl also emphasized this aspect when he mentioned that one-time drug use could not lead to addiction. Instead, individuals who only have unlimited access to drugs are likely to develop an addiction because the brain adapts to substance use as a pleasurable effect. This perspective is undeniably evident in real-life scenarios whereby most drug users are not addicted to drugs. This perspective lacks in the environmental theory, which merely examines external factors that may not necessarily lead to addiction, as is the case of Dr.Carl. Notably, in his presentation, Dr.Carl mentions that he grew in poverty, but he did not develop a drug addiction. This view suggests that unlike environmental elements, biological factors play a significant role in the development of substance use.
Wrap-Up
In summary, substance use disorder is a big and bad problem in society because it leads to loss of lives, increased financial healthcare burdens, and productivity loss among addicts. Furthermore, substance use disorder affects substance users and second parties, such as passive smokers. As shown in the paper, addiction is not merely caused by a person’s constant indulgence in substance abuse; it may also result from uncontrollable factors such as inherited genes from alcoholic parents. Furthermore, addiction can originate from a person’s ethnicity, as shown in the paper. Notably, individuals from races with protective alleles have a higher drug tolerance, which increases their susceptibility to addiction. Furthermore, environmental elements also significantly influence addiction, although they sometimes rely heavily on substance disorder biological processes to occur. Fundamentally, this paper’s information provides social workers with alternative ways of viewing substance addiction in society. Notably, having a broader view of the issue may help social workers develop appropriate treatment plans for individuals with substance use disorder.
References
“Drugs, brains, and behavior: The science of addiction” (n.d.). National Institute on Drug Abuse. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain
“Let’s quit abusing drug users” (2015, May 19). TEDMED. [Video]. YouTube. https://www.youtube.com/watch?v=C9HMifCoSko
“Tobacco” (2020, May 27). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/tobacco
“World drug report 2019: 35 million people worldwide suffer from drug use disorders while only 1 in 7 people receive treatment” (2019, June 26). United Nations. https://www.unodc.org/unodc/en/frontpage/2019/June/world-drug-report-2019_-35-million-people-worldwide-suffer-from-drug-use-disorders-while-only-1-in-7-people-receive-treatment.html
Begun, A. (2020). Theories and biological basis of substance misuse, Part 1. Creative Commons Attribution-Noncommercial 4.0 International License. https://ohiostate.pressbooks.pub/substancemisusepart1/
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