Top 3 questions about addiction

In 2022, more than 48 million people age 12 or older had a substance use disorder. In this group, nearly 29 million people had an alcohol use disorder (commonly known as alcoholism), and approximately 27 million had a drug use disorder.

According to Sharon De Peralta, PhD, DNP, a registered nurse at Sharp McDonald Center, there are many factors that can contribute to someone developing a substance use disorder. Understanding the interactions between these factors is crucial in preventing and treating substance use disorder.

Here, De Peralta answers commonly asked questions about how an addiction develops and ways to prevent the disease.

What causes someone to become addicted to drugs, opioids or alcohol?

Various factors can contribute to a person’s risk for an addiction disorder, such as:

• Genetics: Some people may have a genetic tendency that causes them to be more dependent on substances. And a family history of addiction is also associated with an increased risk, particularly when related to alcohol and opioid use.

• Environment: Being around people who use drugs or alcohol, along with challenging family dynamics, peer pressure and social norms, can increase the potential for addiction. Life events that are stressful or experienced without adequate support may also play a role.

• Psychology: Mental health issues like anxiety, depression or trauma can cause individuals to self-medicate with substances and increase the chance of addiction.

• Age and development: Starting to use drugs or alcohol at a young age is a significant risk factor for developing addiction later in life. Early exposure can cause long-term alterations to the brain.

• Socioeconomics: Easy access to substances can contribute to the risk of addiction.

Research indicates that genetic factors contribute to 40% to 60% of the risk for addiction. Certain genetics linked to dopamine receptors and neurotransmitters in the brain and genes associated with decision making and impulse control can affect how someone responds to substances.

However, it’s important to note that genetics themselves don’t cause addiction. Rather, the interactions between genetics and environmental factors, such as stress, trauma or peer pressure, influence someone’s risk.

Can substance use disorders be prevented?

There are four areas of focus for addiction prevention: education, early detection and continued support, healthy lifestyle, and community.

Informing people through school or community programs about the dangerous consequences of addiction can help them make healthy decisions. It’s important to emphasize that substance use starts by using addictive substances.

If someone is showing signs of having or is diagnosed with a substance use disorder, counseling, mentoring and promoting healthy coping mechanisms can help prevent their addiction from worsening. Additionally, establishing a treatment plan that includes therapy and support groups can address potential mental health issues.

Making healthy lifestyle choices can also be effective in preventing substance use disorders. Exercising, maintaining a nutritious diet, and fostering positive social interactions — participating in community support networks, healthy recreational activities and substance-free events — can improve overall well-being and reduce the risk of addiction.

Studies have shown that when loved ones, such as parents, also participate in these activities, the family's overall risk level is lower. Also, having open communication between parents and children about addiction can promote trust and provide guidance.

What are possible signs of addiction?

Parents and loved ones should watch for changes in behavior, appearance, mood and finances. Some common warning signs include:

• Behavioral changes: Negative shifts in behavior, such as increased secrecy, withdrawal from social activities or abandoning responsibilities at work, home or school, can be possible signs of addiction. This includes distancing oneself from family and friends and choosing to spend time alone. Additionally, participating in risky activities while intoxicated, such as driving or having unprotected sex, can indicate impaired judgment due to addiction.

• Physical changes: Significant weight loss or gain, bloodshot eyes or neglecting hygiene can all indicate substance use. Increased tolerance, when an individual needs increased amounts of a substance to feed their addiction, and withdrawal symptoms — such as nausea, sweating or tremors — when they don’t use substances are additional red flags.

• Psychological changes: Frequent changes in mood, irritability, anxiety or emotional stability may point to addiction, as can the loss of interest in activities once enjoyed.

• Economic or legal issues: Spending on drugs or alcohol can lead to financial difficulties, such as debt, or even lead to illegal activities to sustain the habit. Thus, legal issues may arise, including arrests for theft, fraud, driving under the influence or possession.

Families and friends should recognize that individuals with addiction might deny the seriousness of their substance use. Monitoring these signs, addressing them with compassion, and offering timely support and assistance from a health care professional can improve their chances of recovery.

“We need to work together to reduce the stigma of addiction,” De Peralta says. “Many people still look at a person with addiction as someone with weak morals when addiction is actually a chronic disease.”

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