Drug addiction isn’t always what you think it is. Addiction can be the over consumption of any substance that leads to harm. Many people see addiction as a choice and people are looked down upon in society. The average person does not understand why some people become addicted to drugs while others do not. For the last fifty years, doctors have attempted to understand how people become addicted and how to stop the addiction from happening. Dr. Mate Gabor, an experienced doctor in drug rehabilitation believes drug addiction comes from adverse childhood experiences. Adverse childhood experiences are traumatic childhood experiences such as violence in the family home, lack of nurture from parents or neglect to one’s basic needs. These experiences shape who we are on a neurological and biological level. On the other side, Doctor Nora D. Volkow is the director of the National Institute of Drug Abuse and believes drug addiction has been identified as,” addiction as a chronic brain disease with strong genetic, neurodevelopmental, and sociocultural components.” (Volkow pg. 712). Doctors Mate and Volkow are both right. Drug Addiction is caused by all these components dopamine deficiency, genetic predisposition, and adverse childhood experiences.

Let’s get scientific for a second, the dopamine receptors found in the temporal lobe of the brain by the pituitary gland regulate growth and development in the human body. A human’s dopamine receptors grow as a human grows from a child to an adult. Drugs activate a dopamine receptor in the brain. Dopamine is what creates motivation in our brain that is then passed down to the body. Without motivation, a person cannot live their day-to-day life and function. Doctor Volkow found that, “ DA (Dopamine) in the NAc (Neuronal circuitry) will increase upon exposure to drug cues, which will trigger the desire to take the drug (craving) also during their consumption, which will sustain the motivation to continue consuming them.

This may explain why drugs are more likely to result in compulsive patterns of administration than natural reinforcers.” (Volkow and Morales pg. 714). An addict’s only motivation is to continue using drugs that will satisfy what the body is missing. The overconsumption of a drug reduces production of natural dopamine in the human body. Lack of natural dopamine to sustain the human body adds to that craving for more drugs at higher doses as the body becomes accustomed to a certain drug. The continued use of higher doses is why many drug addicts become more desperate and many die sooner trying to reach a high enough level of dopamine.

Genetic predisposition is the biological vulnerability an individual will have to become addicted. Doctors such as Volkow believe that, “The speed with which addiction emerges is influenced by genetics, with some individuals transitioning faster than others due to genetic vulnerabilities.”( Volkow pg. 714). Thus, the individual will be more likely to develop an addiction if they try any drugs that activate the dopamine receptors in their brain. These drugs include alcohol, heroin, cocaine, meth, prescription pills and many other “street” drugs. Once a drug enters the body, it flows through the bloodstream and makes its way to the brain. Once in the brain, the dopamine receptors activate and send signals through the body. In Dr. Volkow’s studies on drug addiction, she used voluntary drug administration to show that the levels of dopamine rise significantly when cocaine and heroin are in the body. 

A non-drug user’s brain releases dopamine but does not create that craving effect for drugs because drugs have not been introduced yet. Over time, Volkow found that receptors in the brain would release enough dopamine to the decision making (dorsal striatum) part of the brain to crave the drugs. Both of these drugs activate a dopamine receptor in the brain and keep the body asking for more drugs which makes the addiction hard to stop. The repeated abuse of the drugs causes damage to the dopamine receptors. The predisposition is a factor that contributes to who may fall into addiction and who will not. That lack of the happy feeling has to be replaced and Volkow’s data shows,“…changes in reward and motivation, resulting in increased motivation toward drugs and drug cues and in decreased motivation for non-drug reward and cues, executive control, resulting in reduced ability to control the urge to take the drug, triggered by cues, emotional states, or an impaired ability to delay gratification, as well as mood and interoceptive circuits, resulting in an enhanced sensitivity to stressors and dysphoria or the so-called ‘‘dark side of addiction’’. ( Volkow and Morales pg. 719). The consequences of drug abuse become apparent in the body over time and it makes it hard to “cure”.

A real example of this hypothesis occurred with a family member of mine whom I grew up with about half of my life. Their mother and father were both heroin addicts. Once born, they were separated from the parents and adopted into a family who did not expose him to any drugs but did expose them to traumatic experiences from the ages three to eighteen.  They did not develop a healthy amount of dopamine during childhood and were predisposed to drug addiction plus growing up in a toxic environment. I grew up in that toxic environment with them for just a few years, I can’t imagine all the physiological trauma they endured.

Adverse childhood effects

The amount of dopamine is more than a genetic predisposition, adverse childhood experiences also play a critical role. Adverse childhood experiences are any experiences that are harmful physically or mentally. Examples of adverse experiences are physical abuse, verbal abuse and neglect. 

Dr. Mate once said, “If you want to understand addiction you can’t look at what’s wrong with the addiction, you have to look at what’s right about it.”

Mate is not insinuating that addiction is ever a positive outcome but rather that addiction happens as a result of trauma. He does not believe genetics tell the story of why a person becomes a drug addict. In a way he is correct, because dopamine generates the “happy” feeling a person receives from positive social interaction. Parental affection, positive reinforcement, good health, a good caretaker, and an overall healthy environment are factors that contribute to healthy levels of dopamine in the brain. When Mate says,” we have to look what’s right about it,” he means that the person has to be understood. Figuring why they are an addict is key to why they keep relying on drugs. There are pain receptors (nociceptors) in the brain that will cause a person to feel more pain when they are exposed to abuse. The only way to alleviate this pain is to self-medicate. I have found that only abused people become drug addicts. The example of Jonna Doe is only one scenario. There have been others who have had different familial situations and have still fallen into addiction.

Many people in society believe that drug addiction is a choice not a disease. James Frey, a former addict and author of “A million little pieces” believed addiction was a decision. Frey went through an extensive period of alcoholism and treatment. In Frey’s books, he identifies his trauma as the reason for his addiction to alcohol. Frey claims,”…There is always a decision. Take responsibility for it. It is a decision. Each and every time.” (Frey pg. 291). James Frey was an alcoholic for many years and was not exposed to drugs by his parents but did have a medical condition that caused him great physical pain as a baby. That physical pain paired with the neglect of his parents to aid him was the stem of his addiction. Frey’s adverse childhood experiences led him to alleviate his pain with drugs. The neglect of not being treated for his pain, his father verbally abusing his mother and him were both recurrent traumatic factors. Adverse childhood experiences can vary from person to person and affect them differently. In most cases children who were sexually and physically abused are more prone to soothe their painful memories with drugs. Others are neglected, ignored by their parents but not physically abused and use drugs as a form to fill that empty feeling with a happy or full feeling. At any point, drug addiction can spiral out of control. In both of these cases, neither were nurtured by their parents, not enough dopamine was created to have healthy brain activity so once introduced to drugs they got hooked. The brain is being “reshaped” when a child has traumatic experiences. 

Drug addiction does not begin with one factor and cannot be solved in one way. The study of drug addiction will continue to search for a “cure”. Identifying that drug addiction is an issue, it is not enough to stop it from happening. Society’s callous attitude towards addicts is just another obstacle. Society has to contribute to this cure. Creating meaningful relationships, nurturing children and giving kindness are all ways to create healthy dopamine in someone else’s brain. The long-term effects of having small bursts of dopamine can keep people from seeking it in drugs.

If you want to read more first hand accounts about drug addiction and adverse childhood effect read: Cupcake by Cupcake Brown, A Million little pieces by James Frey, Go ask alice by anonymous and Running with Scissors by Augusten Burroughs.