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Biological Model for Understanding Addictions

January 10, 2011

In my last blog, I touched upon the topic of addictions. My goal over the next few blog entries will be to describe some of the different theories used for understanding how addictions develop in the first place. The word that I believe best captures these multiple theories is known as the bio-psycho-social-spiritual approach. It represents an integrative approach to both understanding and treating addiction. In today’s blog I will address the “bio” portion of this word, or the biological model of understanding addictions.

The biological approach is also known as the “disease model” of addictions. This theory regards addiction as a disease, just like arthritis, cancer, diabetes, or heart disease. Similar to many diseases, there is no cure for the ailment, only a control. For example, someone suffering from heart disease must make significant changes to their diets and overall lifestyles (engage in more physical activity, abstain from fatty foods, quit smoking, etc.). There is no single pill or remedy for curing their illness, but rather a series of choices that can minimize the harm created by the disease. These choices help them to control the disease rather than cure it. If there is a cure, the individual must nonetheless continue to make significant life changes in order to prevent the disease from resurfacing. Such is the case with addiction.

There is also evidence to support that the disease of addiction can be inherited, or that some individuals may be more predisposed to developing an addiction than others. Support for this belief comes from twin studies. In these studies, identical twins that were separated at birth (i.e., raised in completely different environments) were found to have similar levels of alcohol exposure at different points in their lives. Even though both siblings may have been raised in different alcohol-free homes, they were just as likely to develop alcoholism.

The application of this evidence suggests that those of us with alcoholism (or addiction) in our family history (parents, uncles, grandparents, great-grandparents, etc.) are also at-risk for developing addiction at some point in our lives. The caveat to the biological theory of addiction, however, is that while one may have a genetic predisposition to developing addiction, there must be an interaction with the environment in order for the addiction to fully manifest itself. In other words, even though we may have a family history of addiction, this genetic predisposition must regularly interact with the environment in order for us to meet the criteria of “addiction” or substance dependence. Having addiction in your family does not mean that you will also develop an addiction. It only means that you may be more susceptible to developing an addiction than individuals who do not have a family history of addiction.

If you live in the Toronto area and would like to discuss addiction in your life, my contact information can be found on my website (www.richardamaral.com). For more information, you can also visit the Canadian Centre for Substance Abuse (www.ccsa.ca).

Dr. Richard

2 Comments
  1. addictiondownfall permalink

    Hello I am searching for any biological reasons for addicition. I can trace addictions back in my family tree and I have a struggle with slot machines. However at the moment I am concentrating on sharing a tip a day for those of us on a recovery path. Thank you for your post. Many people focus on the addict as an individual who should be able to just say no. It is much more complex than that as your post states.

    • Hello Addictiondownfall,

      Yes, addiction is much more complicated than a simple “choice.” As for more information on the biology of addiction, there is some significant research from about 5-years ago that suggests a strong relationship between anxiety and alcoholism. The researchers looked at the levels of a particular protein (CREB) associated with fear, emotion, and anxiety in a group of rats that preferred alcohol and compared it with a group of rats that did not prefer alcohol. (Remember that all animals, including humans, have the exact same cell structure). What they found was that the alcohol-preferring rats had significantly fewer CREB proteins than the non-alcohol preferred rats.

      So, what does this have to do with alcohol consumption? Alcohol and drug use (and other compulsive behaviours such as gambling), particularly in small doses, helps to reduce anxiety. The finding that the rats with fewer CREB proteins (and therefore, higher anxiety) preferred alcohol suggests that they were self-medicating: They were using alcohol to help minimize their feelings of anxiety! For those of us with alcoholism in our family tree, we can now begin to hypothesize that our relatives likely had a biologically-based anxiety disorder and were self-medicating with alcohol.

      You can find a link to the actual article on the Journal of Clinical Investigation (http://www.jci.org/), a peer-reviewed academic journal. Just enter the search terms “CREB anxiety alcoholism.” You can also google “anxiety and alcoholism” for good summaries of related articles.

      Keep on the path of recovery, and keep up the valuable posts…

      Richard

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