I was inspired to write this post after my friends had introduced me to a series of episodes of Border Security Australia’s Frontline on YouTube, which I got hooked on for a while. I realized that probably every country like them is trying to tackle and fight the global burden of addiction, of drug abuse and alcoholism.
A WHO report provides these alarming numbers from worldwide: 2 billion alcohol users, 1.3 billion smokers and 185 million drug users. As the definition of happiness continue to blur in today’s world and we tend to succumb to stress, pressure, depression, anxiety, and insecurity, the bumpy ride of adolescence is most easily struck by addiction and illicit substance use. Our teenager friends then caught in a hormonal tornado start believing that only alcohol, cigarettes, inhalants, and drugs could set their quickest path towards joy and pleasure, but in reality all of these only produce a short-lived state of euphoria. At this point, I am reminded of what Wayne Gerard Trotman said instead, “Happiness is not to be found at the bottom of a bottle or from the tip of a needle; it is not to be found amidst a cloud of smoke or within a sugar-coated pill. If you look for it in these places, you will find naught but despair.” Explicitly, addiction means a persistent compulsive use of a substance known to be harmful and the state of being addicted goes beyond substance dependency. Researchers link addiction to environmental factors such as family and community experiences like familial substance use, child abuse and neglect, socio-economic status, peer culture, cost and availability as well as individual factors for instance sexual abuse and emotional abuse, occupation etc. Either alone or in combination, such risk factors leaves a detrimental impact on the society including road accidents, delinquent behavior, juvenile crime, infectious diseases, and alike. Treatment interventions are multidimensional but one question arises concerning the measures of success, what if the risk factors are within you, in your genes, in the brain, in your biological make-up and the developmental stages. The resilience or vulnerability to teenage substance use is increasingly being confronted by such genetic, neurological and developmental factors which become more important for progression to heavy substance use.
A disease model states addiction as a brain disease. It also considers addiction irreversible once acquired. A developmental model, on the other hand is based on the fact that immaturity or developmental arrest causes addiction. While human development occurs throughout the lifespan, the most significant development occurs during childhood and adolescence. As human beings mature, they increase their capacity to defer acting upon immediate selfish desires and emotional impulses, use rational thought to make wise choices, and consider their actions in the larger context of their relationships and society as a whole. The capacity to understand oneself in relation to the ‘big picture’ is what “develops” in development. The psychopathological model strongly sees mental disorders as the cause of addiction. These disorders might include cognitive difficulties, mood disturbances, and other mental illnesses. In fact, addiction and other mental health disorders commonly occur together called co-morbidity. The idea that alcohol and drug dependence share a genetic liability with each other has been proved by researchers who have also identified numerous genes as risk factors for dependence on alcohol and other drugs. These include genes involved in alcohol metabolism as well as in the transmission of nerve cell signals and modulation of nerve cell activity.
The combination of pharmacological and behavioral therapies appears to be the most effective in treating dependence. Neuroscience is a fast growing field of scientific research. Though the knowledge base is far from complete, there is a considerable amount of useful data with enormous potential for influencing policies to reduce the burden of disease and disability associated with substance use. Finally, emerging technologies and therapies to prevent and treat dependence and related problems pose difficult ethical issues. These issues should be addressed by national and international scientific and policy communities as a priority.
One question that arises concerning the measures of success: is a treatment considered successful only if complete abstinence is obtained? Or, is a reduction in the amount, frequency or harmful use of a substance sufficient as a measure of success?