Causes of Drug Abuse Karol L. Kumpfer, Ph.D. Professor Dept of Health Promotion and Education University of Utah

Objectives Explore the factors that cause drug abuse Identify the relationship between drug abuse and mental illness. Identify the protective processes against addiction Classify the varying behaviors of a child who is raised in a home with alcoholism or drug addiction

A Family Disease Intergenerational transmission of alcoholism and substance misuse Substance abuse is caused by both genetics and environment and the interaction of both. “Drunkards beget drunkards!”

Most Genetically Vulnerable: Type II Alcoholics Markers  Many relatives who are alcoholic or drug abusers.  Father developed substance abuse before age 15  Called “early onset alcoholism”.  12 to 18 times more likely to become addicts than the general population.  Youth inheriting this highly genetically inherited disease are also becoming drug abusers today.

Genetic Risk Factors: What would you see in a highly vulnerable youth? Overstressed Youth Syndrome  Overly Emotional  Hyperactive  Thrill-seeking  Autonomic hyper-reactivity (sweaty palms, rapid heart rate)  Rapid brain waves (less slow alpha)  If they drink alcohol their ANS and CNS smooth out (Schuckit’s research)  They report feeling much less stressed.

Genetic Characteristics Prefrontal Cognitive Dysfunction  Lateral dorsal prefrontal area of brain found recently to develop late in all youth (20-25 years of age).  Genetically vulnerable youth have even more delayed brain development.  Using alcohol or drugs during adolescence can further delay functioning of Prefrontal Cognitive area of brain.  This “Brain Disease” creates difficulty  predicting consequences of actions.

Genetic Characteristics Prefrontal Cognitive Dysfunction (cont.)  Youth tend to be less verbal and more kinesthetic or visual/spatial.  They do poorly in elementary school as they are delayed in reading, writing, and spelling.  They can have high analytic or visual spatial abilities and do better in military or college.  Society needs them as visionary leaders, company directors, artists, architects, athletes, pilots, air traffic controllers, inventors, etc.

I’m not an underachiever. You’re an over-expecter!!!

Other Genetic Characteristics Rapid Alcohol Metabolism due to genetic difference in liver enzymes.  Can get drunk on very little alcohol  Only certain ethnic groups have this—American Indian, Asians, and some Eastern Europeans, namely: Russian Jews.

Other Neurological Risk Factors Genetically inherited or biologically created neurotransmitter chemical imbalances in brain (i.e., dopamine, serotonin) causing self-medication Excessive use of alcohol or drugs creates a “Brain Disease” of neurotransmitter chemical imbalances that can take up to two years to regain balance, resulting in:  Depression  Anxiety and Panic Attacks  Paranoia

Co-morbidity (Drug abuse and mental health disorders) Affective disorders  Men – 33%Women – 55% Anxiety disorders  Men - 43%Women - 71% Conduct Disorders  Men – 59%Women – 32%

Other Mental Health Problems Narcissism Borderline personality Obsessive-compulsive behaviors Bipolar Disorder (manic/depressive)

Physiological Risk Fetal Alcohol or Drug Syndrome or Effect (FAS/FAE)  Unfortunately use of any amount of alcohol or drugs during pregnancy can damage the fetus.  Of interest is that FAS/FAE children have many of the same characteristics of genetically vulnerable children—hyperactive, emotional, verbal deficits, etc.

Environmental Risk Type II alcoholism effects about 25% of addicts, but 75% of addictions caused primarily by environmental risks. Family risk and protective factors Resilience- Nature does not completely control your destiny Some youth do not succumb to “disease of life style”!

Interaction Effects between Parent and Child Children’s temperament, personality, and behaviors affect parents behavior toward them. Children with “Difficult Temperament” have behavioral under-control and lack impulse control. They are “early starters” of conduct disorders  High behavioral activity level combined with conduct disorders is related to substance abuse.  Parents used more punitive child rearing practices

Other Interactional Effects Difficult-temperament children are often shunned by family members, teachers and peers. Youth who engage in parentally disapproved behaviors (drug use), the parent-child relationship is negatively impacted.

Relationship of Risk and Protective Factors: The Social Ecology Model Researchers at the U.S. Center for Substance Abuse tested a theory using real data on 8,500 high risk youth. While negative peer influence was still the final pathway to drug use, they found that a positive family environment protects kids from peer influence (CSAP, 2002; Sales et al., in press).

No Substance Use Family Supervision Family and Peer Norms Female: (n=5,488) Male: (n=3,023) Family Bonding Academic Self-Efficacy Self-Control Social and Community Prevention Environment Pathways to Preventing Substance Use for High Risk Youth (Kumpfer, Alvarado, & Whiteside, 2003)

Protective Processes The major protective process is a strong family  Strong parent/youth attachment  Family supervision  Good family communication  Good parenting skills  Marital harmony

Family Protective Factors (cont.) Spirituality Love Family rituals Sober, non-abusing parents Resilient parents Precise Parenting

Care-taking Ability Depressed drug-abusing mothers have more positive relationships with children than anti- social mothers With depressed mothers, children demonstrated positive affect and caring for mother. (could be signs of role-reversal and co-dependency.

Effects of Addiction on the Family Codependency Enabling Assumed roles of children  Hero Child  Scapegoat  The Lost Child  The Clown

Summary Addiction is a Family Disease. Two factors that influence the disease are genetics and environment. Interactions between the parent and child affect vulnerability. Many people with addictions also have other mental health problems.