What kinds of people do you think are at high risk for addiction?

 

Further Reading

Stanton,

What kinds of people do you think are at high risk for addiction? Why do you believe that fear of a drug problem may actually make people more susceptible to addiction?

Thanks!

Carrie Trebucq

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Dear Carrie:

It is true that people who feel susceptible to being out of control, and being controlled by outside forces, are more likely to be addicted. When the distinguished psychopharmacologist, Louis Lasagna, discovered that placebo often functioned as well as narcotics for patients, he discovered that those who reacted to placebo also reacted more strongly to the drug, morphine, in the experiment.

As I wrote in Love and Addiction, according to Lasagna and his colleagues, these individuals “were more anxious and more emotionally volatile, had less control over the expression of their instinctual needs, and were more dependent on outside stimulation than on their own mental processes, which were not as mature as those of nonreactors.”

Likewise, when a group teaches its members that a substance has an incapacitating effect, one that will overpower them, then the members of that group indeed more often become addicted to the substance.

George Valliant is a great disease and AA advocate. Nonetheless he was confronted with the fact that Irish Americans in a sample of ethnic Bostonians he tracked for decades were seven times as likely to become alcoholics as Italian, Greek, and Jewish Americans in his study. He offered the following explanation: “It is consistent with Irish culture to see the use of alcohol in terms of black or white, good or evil, drunkenness or complete abstinence, while in Italian culture it is the distinction between moderate drinking and drunkenness that is most important.”

Groups that recognize and address this distinction are thus most successful in avoiding alcoholism. And they encourage sobriety, rather than abstinence, because they believe self-control can, and should, be achieved. Groups that fear an activity or substance to the point of abhorrence are less successful in coping with that involvement.

Of course, this has tremendous implications for our tactics in combating drug and alcohol abuse. There is a string of research telling us that, not only do our prevention programs have minimal impact, they often backfire, causing more abuse and addiction! This is because such programs constantly emphasis the addictive power of drugs and alcohol, thus exacerbating the tendencies of those most vulnerable to the belief in their own incapacity and ready to accept that a substance is more powerful than they are.

References

Hallfors, D., Cho, H., Livert, D., and Kadushin, C. (2002). Fighting back against substance abuse: Are community coalitions winning? American Journal of Preventive Medicine 23:237-245.

Lasagna, L., Mosteller, F., von Felsinger, J.M., and Beecher, H.K. (1954) A study of the placebo response. American Journal of Medicine 16:770-779.

Vaillant, G.E. (1995). The natural history of alcoholism revisited. Cambridge, MA: Harvard University, p. 289.

Werch, C.E., and Owen, D.M.. (2002). Iatrogenic effects of alcohol and drug prevention programs. Journal of Studies on Alcohol 63:581-590.