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Health and medicine
Course: Health and medicine > Unit 9
Lesson 6: Drug abuse and drug addictions- Drug abuse and drug addiction
- Overview of psychoactive drugs
- Psychoactive drugs: Depressants and opiates
- Psychoactive drugs: Stimulants
- Psychoactive drugs: Hallucinogens
- Routes of drug entry
- Drug dependence and homeostasis
- Reward pathway in the brain
- Tolerance and withdrawal
- Risk factors for drug use and drug abuse
- Substance use disorders
- The development of substance use - Why do people use legal and illegal substances?
- Why do some people but not others develop substance use problems?
- Treatments and triggers for drug dependence
- How does substance use develop into substance abuse
- Drug use prevention - school programming and protective factors
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Risk factors for drug use and drug abuse
Visit us (http://www.khanacademy.org/science/healthcare-and-medicine) for health and medicine content or (http://www.khanacademy.org/test-prep/mcat) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Brooke Miller.
Want to join the conversation?
- How did drugs like alcohol or cigarettes became socially accepted?(17 votes)
- I totally agree with that. Why do we accept things that cause cancer and death? That's just taking up more room in our hospitals. We shouldn't allow any drugs at all in America even cigarettes. We want to help people let's eliminate it. I get that people might get upset when drugs are gone and go nuts. Without drugs for people addicted to them can cause them to be suicidal or dangerous. I get that but I think that we shouldn't have allowed them in the first place.(1 vote)
- Why do people take drugs in the first place? How did they start taking drugs?(2 votes)
- Any number of reasons really. Some people are just predisposed to addiction; it's in their genes. Others start because they think it's a good getaway from whatever they are going through in life. Something tough happens, but then take some drugs and feel great. That's the mindset for a lot of people.
For others, it's almost an accident. This is personal... but my father became a drug addict in his late 40s. He had surgery, and the doctors gave him Oxycontin (a narcotic drug) for the pain. It's very easy to get addicted to those pills, and it went downhill for him very fast. He started to abuse them regularly, and it ate up the rest of his life.
So... there are really any number of reasons someone starts taking drugs.(10 votes)
- I have a few questions: What kinds of drugs can damage your brain and make you go crazy? Are there any "bad" drugs that are used for medicinal purposes? What in drugs and cigarettes makes it so addictive?(1 vote)
- A drug is any substance other than food that causes a physiological change in the body. Medications are drugs. Aspirin is a drug, so is caffeine and alcohol. Cocaine is considered a 'bad' drug, yet is used in nasal surgery to numb the area and reduce blood flow. Opioids are used to reduce pain and are prescribed by physicians. Heroin is an opioid and is considered a 'bad' drug. What makes a drug 'good' or 'bad' is related to the effects it creates. Using cocaine to numb the nose and stop bleeding during surgery is a limited use with a positive outcome and thus is 'good'. Using cocaine all the time for it's stimulant properties causes hallucinations, paranoid delusions, and can lead to heart attacks and strokes and thus is 'bad'. Addiction is a compulsive engagement in something despite adverse consequences. So, someone who is addicted to cocaine enjoys the stimulant effects of the drug and keeps using it, even though this increases their chances of experiencing delusions and increases their risk for stroke or heart attack. Drugs can be very useful to humanity and can save lives - and those same drugs, when misused or overused can destroy lives.(5 votes)
- AtBrooke says that communities with low SES are more likely to influence drug abuse, what is SES? 8:33(2 votes)
- SES stands for socio-economic status. Communities with lower average income and lower levels of education are considered lower socio-economic status.(2 votes)
- Is there any way to measure your D2 receptors?(2 votes)
- Can drugs be used to help cure cancer(1 vote)
- Yes, chemotherapy(I might have spelled it wrong) is a "treatment" for luekemia(I might have spelled it wrong(again)) and it includes using drugs.(1 vote)
- who do people become addicted to drugs(1 vote)
- There is a particular pleasure-causing neurotransmitter that is repeatedly being stimulated to achieve the "good feeling." Problem is, it's slowly deadening and killing your neurons in the process!(1 vote)
- when was drugs first used??(0 votes)
- Drugs were first used during the Neolithic Period in a place with very fertile land called Mesopotamia.(1 vote)
- Hoe does drugs effect reflex action?(0 votes)
- Self reflection can be defined as the capacity to exercise introspection and the willingness to learn more about one’s fundamental nature and purpose. It is usual to use the term introspection interchangeably with the term self reflection because they mean more or less the same thing. Self reflection is the opposite of external observation which refers to the process of the individual looking outside of themselves to the physical world.(1 vote)
- what does impulsive mean? i'm not very good at defining words so i wouldn't know(0 votes)
- Impulsive is doing something on an impulse - it is done without forethought(1 vote)
Video transcript
- [Presenter] I think that talking about risk factors for drug abuse
can be really difficult. And that's just because there are so many different factors
that feed into it. And also, I don't want to put too much emphasis on any one cause. I don't want to demonize any one thing. So I want to say right off the bat, that there is no one thing that can lead to drug abuse or addiction. Instead, there are numerous factors that relate to each other
in complicated ways. And I also want to
mention that the presence of any, or even all of these risk factors does not actually guarantee
that an individual will become addicted to any substance, or will even use at all. Alright, well with all of that said, now I am going to talk about some risk factors for substance abuse. So things that seem to correlate with substance abuse later in life. And we're going to talk about
biological risk factors, psychological risk factors, and sociocultural and
environmental risk factors. And let's start off with
the biological factors. We know that if a child has a
parent who abuses substances, they are more likely
to abuse them as well. And this in combination with the fact that identical twins
have more similar rates of addiction than fraternal twins, seems to imply that there could be a genetic component to addiction. This is also supported by the fact that adopted children tend to resemble their biological parents more
than their adopted parents in term of addiction rates. But even if genetics are involved, even if someone can have
a genetic predisposition to substance abuse,
this does not guarantee that a person will develop
a substance abuse problem. Instead, it might make them
more vulnerable to having one. Another biological risk factor, has to do with the D2 receptor, which is a type of dopamine receptor in the reward circuitry of the brain. Some studies suggest that individuals with fewer D2 receptors, might have a higher risk of addiction than those with a typical amount of receptors. We know that many
substances are associated with an increase in dopamine within the rewards circuits in the brain. And we also know that the body tries to counteract the effects of drugs through down regulation, so over time the body will take away dopamine receptors if too much dopamine is present. And this would stop an individual from feeling pleasurable experiences both when they take the drug, meaning that they'll have to
take more to get the same high, but also in basically
everything else in their life. And you can see how all of
this would be particularly bad for individuals who had fewer
D2 receptors to begin with. Having fewer receptors might also explain why individuals seek out
drugs in the first place. Because it takes more stimulation for them to naturally get a reward signal. Another biological risk
factor for addiction has to do with comorbidity. Meaning that individuals with
certain psychiatric disorders, might be more likely to have substance abuse problems as well. One of these disorders is attention deficit
hyperactivity disorder, ADHD. And this actually make
a lot of sense to me, because individuals with
ADHD tend to be impulsive. And as we will talk about later when we talk about
psychological risk factors, impulsivity in general, seems to be a risk factor for addiction. Other disorders that can sometimes go hand in hand with addiction, are anxiety disorders and depression. And we're not entirely
sure why this is the case, but some researchers have suggested that it might be because these individuals are trying to self medicate
for their conditions. However, we should also remember
that this is a correlation, and even though we might
be tempted to conclude that mental disorders
lead to substance abuse, that might not be the case. It could be that substance
abuse leads to mental disorders. Or perhaps could trigger mental disorders in those who have a
genetic predisposition. Or maybe both mental illness
and substance abuse problems could be generated by a third factor. Maybe some genetic vulnerability for both. Either way, it's important to keep in mind when we discuss all of these risk factors, that correlation does not imply causation. Now let's move on to
psychological risk factors. One thing that tends to get asked a lot, is if there is such as thing
as an addictive personality. And the answer is, kind of. While there is no one
single personality trait that causes a person to become addicted, researchers have identified a
number of personality traits that seem to be present
in many individuals with substance abuse problems. One of these is impulsivity, and I don't mean that in a fun, let's drop everything and go
to the beach, kind of way. When we talk about impulsivity here, we mean an inability to control oneself. The inability to inhibit one's actions, even when faced with
negative consequences. This is also sometimes referred to, as behavioral disinhibition. Another component is sensation seeking. The need to seek out high levels of external stimulation
and new experiences. So a constant need for new,
more thrilling things in life. Things like skydiving or extreme sports, or trying novel foods. Risk sensitivity also plays a role. So individuals who focus solely on the benefits of the experiences without thinking about the risks. Or maybe failing to see how
the risks might apply to them. The last personality factor that I want to talk about is neuroticism, or being abnormally tense and anxious, and sensitive to stress. And these individuals might be at risk, because they might attempt to minimize their stress reactions
through self medication. There are other psychological factors that can play a role, that
aren't personality traits. For example, we also know that individuals who tend to score high
on aggression tests, so individuals who have
feelings of aggression and aggressive behaviors,
who also tend to act out at school or at home, they also seem to be at a higher risk of developing
addiction later in life. Age can also play an important role. People who begin using
substances as adolescents, have a much great chance of having a substance abuse disorder later in life. Let's move on to
environmental risk factors. And here especially, it is
important to keep in mind, that the presence of any
one of these factors, does not guarantee that a person is going to use or abuse substances. Instead, we are looking at a pattern of environmental factors that might make an individual more
vulnerable to addiction. And one of the most important
environmental factors seems to be the presence of
stress in an individual's life. Both childhood stress, as
well as current stress. And we know this both
from examining the lives of those individuals who have
substance abuse problems, as well as from a number
of animal studies. Animals who are placed in
stressful environments, tend to self administer more substances than animals who are not
exposed to stressors. And when we talk about stressors, we mean a lot of different things. Some of them might be family related. Children in families
with marital instability tend to have a higher risk, as are individuals who suffer abuse, whether that be physical
or sexual or psychological. And before we talked about how evidence from family, twin, and adoption studies all seem to show that genes play a role in developing addiction, but it is also possible
that there might be an added environmental effect as well in the form of modeling and imitation. So if a child watches a parent drink or use other substances
as a coping mechanism, they might be more likely
to model this behavior for themselves when they
face stressors in adulthood. Lack of family involvement
and family supervision also seems to increase the
risk for substance abuse. As does not having a close family bond between an individual and their
parents and their siblings. The friends an individual
has can also play a role. If a friend group approves
of substances and uses them, an individual is more likely to start. And this might be true
for a number of reasons, one is that we make friends with people because of shared interests. And so we might hold things that our friends believe in high esteem. Another reason is social facilitation. Substances are often
consumed in a group setting, and so they can serve
to enhance social bonds. We have not mentioned it yet, but of course peer pressure
can also play a role. Individuals might be pressured into using substances by their peers. Either directly, by them
saying that the individual should use those
substances, or indirectly, by giving the impression
that it is, or will be an important part of peer bonding. The community an individual
is in can also play a role. There is a higher concentration of substance abuse within
low SES communities, and communities that
are faced with poverty. Those who lack education
and don't really have an employment history, seem
to be at the greatest risk. But I want to point out
something important, which is that while there
might be more substance abuse within these low SES communities, there isn't necessarily
more substance use. It could be that those in
impoverished communities lack the safety net, things like education and strong support networks,
and financial stability, that keep those in higher SES communities from moving from use to abuse. The availability of substances can also make a big difference. When substances are available, people are more likely to use. And the type of drug can
also make a difference. Those with a fast rate of administration, so those that are injected
or snorted or smoked, are more likely to be abused than those that are ingested orally,
because they take effect faster. Because they produce a
faster high, a faster reward. And this causes the brain to
form a stronger association. Which might make it more likely that they will crave the
drug again in the future. These substances also fade faster, which also makes users more likely to use again to continue the high. And you might think that all
of these environmental factors are less important than some of the biological and psychological factors that we talked about before, but I want you to know that
this just isn't the case. And so I want to take a minute to talk about a study that
highlights how important they are You might be familiar with studies that show that a rat alone in
a cage, with access to drugs will basically use continuously, sometimes neglecting food and water. But I want to point out that these rats are left alone in a cage with
literally nothing else to do. And so they're in an environment without a lot of other options, except for using the substance. And to figure out what effect this might be having on the studies, some researchers built what
was called the rat park. Which was a large cage filled
with lots of engaging toys and fun things to play with,
things like balls, and tunnels. And it also had the best rat
food that they could get, and it had lots of rats
all living together, all with access to the
enriching food and activities. Basically it was rat paradise. And wouldn't you know it, even though the researchers
made drugs available in rat park the same way that they were made available in experiments with a solitary
rat in an unstimulating cage, the rats in rat park
didn't abuse substances. And for those few rats who did use, it was in much smaller amounts. And this is absolutely incredible to me. And I still remember how shocked I was when I first learned it. And even though it's really hard to compare animal models to human models, I think it's important to consider what this might have to say
about human substance abuse. So we've talked about
biological risk factors, psychological risk factors,
and environmental risk factors. But I want to note that even though I've discussed them separately, these three things are
actually interconnected. Certain environmental factors might put an individual at a greater
risk for drug abuse, but it is only when
those things are combined with biological and
psychological predispositions that they would start to take effect. Or saying that a different way, individuals with a
biological predisposition and certain psychological traits, might only be at risk
if they're placed within certain environmental situations.