Substance addiction refers to a condition where one develops heavy dependence on drugs. People use drugs and alcohol because of the pleasurable effects of drugs. Unfortunately, continuous drug use leads to development of compulsive behaviors. This often hinders one from living a normal life. Substance addition is characterized by physical dependence and emotional stress.
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When a person develops physical dependence on a drug, the body becomes biologically programmed to the presence of the drug. Consequently, the drug fails to elicit the same effect and this leads to tolerance. The brain may also develop over reaction to the drug or related stimuli as a result of physical dependence on the drug (NIDA, 2007).
The mechanisms of substance addiction still remain contentious among many people, a majority of them believing that the people who abuse drugs generally do not have moral principles. Others believe that these people can cease substance abuse by just moderating their actions. However, scientific studies have shown that drugs alter the brain in unprecedented mechanisms, triggering compulsive substance abuse.
Substances of abuse contain certain chemical ingredients that act on the brain cells, interfering with the communication mechanisms and the nerve cell’s ability to receive, transmit and process information (Webb, Snlehitta & Mlche, 2010). Drugs contain substances that mimic neurotransmitters, and they can over stimulate the brain. These changes in the brain occur gradually, impairing the addict’s cognitive and functional abilities such as self-control and the ability to resist the strong urge to take these substances (NIDA, 2007).
Risk factors for substance addiction
Various factors that have been demonstrated to predispose one to greater risk of becoming addicted to substance addiction include the, “biology, social environment, age and stage of development” (Webb, Snlehitta & Mlche 2010, p. 1881). The risk is confounded when these factors occur in combination; thus, the more the risk factors, the higher the probability that the use of substances can result into addiction.
Biological factors relate to the genetic predisposition of an individual, whereby it has been shown that genes and environmental factors increase susceptibility to addiction in more than half of the affected population (Agrawal & Lynskey, 2008). Other biological factors that determine substance addiction include sex, race, and existence of other mental disorders.
Studies have also shown that environmental factors such as family, quality of parenting, peer group, and socioeconomic status determine the occurrence of substance abuse and addiction. It has also been established that biological and environmental factors may interact with vital development stages during an individual’s life to increase susceptibility to substance addiction.
Studies show that abuse of substances in earlier development period increases the risk of addiction. This is because in these early periods, cognitive regions of the brain responsible for judgment and self-control are not fully developed. This subjects young individuals to greater risk of substance abuse (Wong, Mill & Fernandes, 2011).
Theories of Substance Addiction
In general, substance addiction theories fall into three categories, classified as the disease model, the physical dependence model and positive reinforcement model (Webb, Snlehitta & Mlche, 2010). Early perceptions on people having problems associated with substance abuse regarded them as sinners or criminals, and any form of assistance for these individuals originated from court action or religious bodies.
These early perceptions, called the demonology model, suggested that some form of evil spirits made people to adopt unconventional or deviant behaviors. It is in the late 19th century that substance addiction gained medical recognition, thus the subsequent rising of theories to explain substance addiction and diagnosis.
Most of the early theories proposed that the use of drugs for pleasurable reasons eventually made people to develop dependency as they sought the rewards. Most of the proposed theories fail to explain the whole spectrum of addiction, while others are narrowly focused and mainly covering substance abuse alcoholism or addiction to narcotics or individuals (NIDA, 1980).
Early Description of the process of Drug Addiction
Some early theories explaining substance addiction are discussed as follows. The cognitive-affective-pharmacogenic control theory of substance addiction. This theory was based on the interaction of a person’s personality and the substance with the pharmacological effects. The cognitive state of the individual significantly influences the transition from drug use to drug addiction.
This theory suggested that conflict triggers the process of addiction. When individuals fail in achieving social or individual expectations, conflict sets in and this eventually induces anxiety. The theory posed that the substance abusers ability to cope with the anxiety gets diminished, thus they perceive that they have little control of the situation (Carey, 2008).
This results into development of low self-perception and self-depreciation. The person may become overwhelmed by the anxiety; thus they may seek a means of decreasing the feeling, often through substance use. The resulting relief and ecstatic feeling enhances the person’s self-perception and control (NIDA, 1980).
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Since these effects of drugs are temporary and often further the anxiety feelings on being withdrawn, they cause stronger feelings of powerlessness and even lower self-perception. Persistent substance use reduces the person’s coping skills as one does not develop adaptive mechanisms and tolerance, thus precipitating more intense substance use.
This creates a continuous cycle, with each use stratifying the benefits of the substances. The cognitive-affective-pharmacogenic theory resembles the modern cognitive theories that associate one’s internal thoughts with the resultant maladaptive habits. Studies show that a person’s belief in the potential to take control is a great predictor of behavior (Ambermoon et al., 2012).
The bad-habit theory of substance addiction
This theory posed that persons vulnerable to drugs may adopt damaging habits, which lead to development of drug addiction if they persist. The vulnerability of people to substance use is determined by the existence of risk factors, such as genes and psychosocial influence. The role of hereditary factors in substance addiction was proposed based on the observations that alcohol abuse was strongly predicted along family lines.
Various studies have also demonstrated that innate differences in response to drug abuse exist across the population, thus indicating the involvement of genes. It has been observed that many individuals are more or less able to develop substance addiction as a result of genetically controlled adverse responses to such substances.
This theory, therefore, suggests that genetic factors interact with the psychosocial environment, causing stimulus generalizations and leading to development of conditioned stimuli and addiction (Webb, Snlehitta & Mlche, 2010).
Interactive theory of substance addiction
This theory encompasses many perspectives, including the, “nonsocialized drug users, prodrug socialization, and iatrogenic model” (NIDA 1980, p. 20). The interactive theory covers psychological aspects of the substance abuse and effect of drug. The theory postulated that psychological factors directly involved in one’s life determine substance addiction.
These psychological factors include previous exposures such as beliefs and values. According to the nonsocialized drug user model of the interactive theory, lack of socialization is a strong predictor of substance addiction. This assumption was derived from studies that showed that irrespective of the personality traits of an individual, substance addicts tended to have reduced social conformity levels as compared to non-addicts.
The model suggested that individuals who do not have internalized values against substance abuse are greatly vulnerable to substance use due to environmental influences (Hagger et al., 2010). It is, thus, expected that a highly socialized individual could withstand environmental factors that increase the risk of abusing drugs as compared to an individual who is not socialized, though socialization cannot be solely attributed to substance addiction (Webb, Snlehitta & Mlche, 2010).
The prodrug model of interactive theory posed that an individual may be socialized into prodrug habits, for instance in communities that use substances in social events and rituals. This model was supported by studies that showed that most individuals involved in substance abuse learn from the parenting figures in the family.
Friends also form a prodrug socialization forces, endearing one to develop substance addiction. The iatrogenic model of interactive theory of substance addiction posed that people may initially be drawn into drug use because of therapeutic effects, eventually succumbing to compulsive habits (Berridge, 2007).
Existential theory of substance addiction
This theory entailed the phenomenal and emotional conditions of people in relation to the quality of life. The theory was based on people’s desire to meet basic necessities in order to achieve wholesomeness. Failure to meet these aspirations induces a state of despair and ill health, eventually triggering destructive and constructive habits remedies the situation.
The theory, therefore, suggests that some individuals are susceptible to developing substance addiction because of altered personality traits that interact with the drug use habits (Hagger et al., 2010).
Newer theories of substance addiction
Most of the early theories were based on reinforcement properties of substances abused, both negative and positive. These theories, however, failed to exhaustively deal with many dimensions of addiction, such as relapse of substance-seeking and substance-use habits long after the withdrawal symptoms have stopped. The recent theories, therefore, postulate that chronic substance use leads to development of various neuroadaptations responsible for addiction symptoms (Hagger et al., 2010).
Among the contemporary theories regarding substance addiction include the, “pathological shift theory, incentive sensitization theory, formation of ingrained drug habits in form of aberrant stimulus response learning, alterations in prefrontal cortical activity leading to reductions in behavioral control and decision making skills, and overlaps between limbic and cortical areas involved in addiction and memory” (Feltenstein & See 2008, p. 262).
In the pathological shift theory, it is suggested that persistent substance abuse causes a pathological alteration of the victim’s hedonic limits and disruption of the reward system equilibrium, subsequently impairing the cognitive abilities. Substance use, thus, creates a state of imbalance in the brain reward system. This affects a person’s homeostatic ability.
This theory, thus, considers increased reactivity and adaptation responses of the brain to be vital in pathological shift. The incentive sensitization theory poses that abused substances may cause changes in various neural networks, especially those that have roles in incentive and reward for natural reinforcers. Continuous use of drugs or substance time makes the victim to develop tolerance to the substance and the related stimuli, eventually causing a change from substance liking to dependence (Wood & Neal, 2009).
Substance addition has been explained through various theories, thus there is no single theory that can be said to explain substance abuse in entirety. Various mechanisms of drug and substance abuse form the basis of substance abuse, with biological and environmental factors being central in the development of substance addiction.
As such, theories such as the ‘cognitive-affective-pharmacogenic theory’, bad-habit theory and the more recent ones such as ‘pathological shift theory’ among others revolve around the interaction of the environment with the biology of the addict.
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