 the excessive and compulsive use of substance
 for their effect on the mind.
 tolerance to the drug, an increasingly higher dose of the drug is needed.
 withdrawal : it will cause physical problems.

 They interact with nerve circuits, centers, and chemical messengers Results;


I Feel Good – Euphoria & Reward
I Feel “Better” – Reduce negative feelings
 This Feels “Normal”
 I’m craving it, tolerating its effects, withdrawing and feeling sick

 Unemployed or employed
 Multiple or no criminal justice contacts
 Difficulty coping with stress or anger

Highly influenced by social peer group or a loner
 Difficulty handling high-risk relapse situations or craves excitement

conscious decision or a chronic, relapsing illness
 changes that occur in the brain can turn drug abuse into a chronic, relapsing illness.
First, there is an activation of the brain's "pleasure pathway.


More specifically, genetic factors contribute 40% to 60% to the risk for alcoholism addicts who become dependent early in life are the most genetically predisposed to the disease




Environmental factors:
 family's beliefs and attitudes
 exposure to a peer group that encourages drug use


Biologic factor
 Enviroment
 psychologic

 influences of family, peers, and availability
 children and adolescents. favorable attitudes or actual use of drugs by parents
 absence of parental support, chaotic living conditions, divorce or separation, and inconsistent parenting styles
 coherent and consistent parenting styles are "protective" against substance abuse
 Have easy access to drugs

 Peer group :modeling and social reinforcement

Availability: For example, living in college dormitories versus living with parents
 gender :male; Although males and females selfreport similar reasons for using drugs
 18 and 44 years of age
 unmarried
 lower socioeconomic status.

 woman's risks for problem drinking include:
 the influence of her partner's drinking,
 her degree of depression,
 her sexual history (including sexual orientation and sexual dysfunction),
 a history of violent victimization (physical and sexual)


Genes may influence traits such as impulsivity, which can make a person more likely to become alcoholic.
 Genes may also influence the level of dopamine in the brain

COMMUNITY
Availability of Drugs
Community Laws and Norms Favorable
Toward Drug Use
Transitions and Mobility
Low Neighborhood Attachment and
Community Disorganization
Extreme Economic Deprivation
INDIVIDUAL / PEER
Alienation and Rebelliousness
Friends Who Engage in the Problem
Behavior
Favorable Attitudes Toward the Problem
Behavior
Early Initiation of the Problem Behavior
Constitutional Factors

FAMILY SCHOOL
Family History of the Problem Behavior Early and Persistent Antisocial Behavior
Family Management Problems
Academic Failure Beginning in Late
Elementary School
Lack of Commitment to School Family Conflict
Favorable Parental Attitudes and
Involvement in the Problem Behavior

 Have depression, bipolar disorder, anxiety disorders, and schizophrenia,PTSD
 Have low self-esteem, or problems with relationships
 Live a stressful lifestyle, economic or emotional
 Live in a culture where there is a high social acceptance of drug use








Family history of addiction. the effects of many genes
Being male. twice
Having another psychological problem. depression, attentiondeficit/hyperactivity disorder or post-traumatic stress disorder
Peer pressure. young people ;strong factor in starting to abuse drugs.
Lack of family involvement. A lack of attachment and lack of parental supervision.
Anxiety, depression and loneliness. coping with painful psychological feelings.
Taking a highly addictive drug heroin and cocaine


Emotional and psychological immaturity
 Difficulty relating to family

Difficulty sustaining long-term relationships
 Educational and vocational deficits

 Mood Disorder+: 24-40% have a co-occurring substance abuse disorder
 Alcoholism+: 65% of females and 44% of male alcoholics have co-occurring mental health disorder(s)
 THE MAJOR ONE = DEPRESSION
19% of female alcoholics, 4x the rate for men
 antisocial personality





 crack, heroin or cocaine can bring about addiction more rapidly if a group of people were to take crack every day for six months, versus another take alcohol, the number of crack addicts would be a lot higher than the number of alcoholics.
For some people trying a substance even once can be enough to spark an addiction. Crack, also known as crack cocaine or rock, is a freebase form of cocaine that can be smoked.
start consuming a drug earlier in life have a higher risk of addiction
How the body metabolizes (processes) the substance - in cases of alcohol


 physiological positive reinforcement (euphoria) social positive reinforcement (enhanced peer status)
 Physiological negative reinforcement :in warding off a withdrawal reaction
 Social negative reinforcement :escaping from a noxious home, school, or vocational life.
 peer cluster theory

environmental cues are present during drug use-> drug’s behavioral and physiological effects. With repetition the cues become conditioned stimuli, experiences as drug craving.

Withdrawal creates a craving or desire for the drug and plays a very strong role in recurrent patterns of relapse
Sensitization occurs when the effects of a given dose of a drug increase after repeated administration.

 repeated presentation of the environmental cues, absent the drug, should extinguish the conditioned association.
 he emergence of withdrawal symptoms as a result of exposure to conditioned
 cues can contribute to drug use relapse


It has been argued, that substance abusers differ from others:
 beliefs about potential benefits of the drug
 ability to cope with the stress of everyday life

 self-reported motivations
 reasons for which type of substance use:
 motivations for alcohol and marijuana abuse include
"getting away from problems,“
 cocaine and amphetamines involve "staying alert and awake.“
 "self-medicating" motives increase with consumption ,pain relive

 Memory problems – short-term loss

Impaired abstraction
 failed problem-solving strategies
 Loss of impulse control
 These deficits are similar to those with brain damage

The mesocorticolimbic pathway from the ventral tegmental area to the nucleus accumbens and the frontal cortex is a key component of the brain reward system for drug reinforcement

Front of Brain
Amygdala is not lit up
Amygdala is activated
Back of Brain
Nature Video Cocaine Video








 no evidence for "addictive personality“ distinct personality syndrome: interpersonal alienation, poor impulse control, manifest emotional distress childhood and the quality of parenting received
Sensation seeking
Depressed mood
Low self steem

Risk Factors Domain
Early Aggressive Behavior Individual
Lack of Parental
Supervision
Family
Substance Abuse
Drug Availability
Peer
School
Poverty Community
Protective Factors
Self-Control
Parental Monitoring
Academic Competence
Anti-drug Use Policies
Strong Neighborhood
Attachment


Family Management Problems
 Favorable Attitudes Toward the Problem
Behavior
 Social Skills (protective)
 Bonding (protective)

Adolescence
Persons
Individual
Risk Factors Protective factors
Behavioral disengagement coping
Negative emotionality
Conduct disorder
Favorable attitudes toward drugs
Rebelliousness
Early substance use
Antisocial behavior
Positive physical development
Emotional self-regulation
High self-esteem
Good coping skills and problem-solving skills
Engagement and connections in two or more of the following contexts: at school, with peers, in athletics, employment, religion, culture

Infancy/Early Childhood
Individual
Family
Persons
School, Peers, Community
Risk Factors
Difficult temperament
Protective factors
Self-regulation
Secure attachment
Mastery of communication and language skills
Ability to make friends and get along with others
Cold and unresponsive mother behavior
Parental modeling of drug/alcohol use
Reliable support and discipline from caregivers
Responsiveness
Protection from harm and fear
Opportunities to resolve conflict
Adequate socioeconomic resources for the family
Support for early learning
Access to supplemental services such as feeding, and screening for vision and hearing
Stable, secure attachment to childcare provider
Low ratio of caregivers to children
Regulatory systems that support high quality of care

Family Substance use among parents
Lack of adult supervision
Family provides structure, limits, rules, monitoring, and predictability
Supportive relationships with family members
Poor attachment with Clear expectations for behavior and parents values

School, Peers,
Community
School failure
Low commitment to school
Associating with drugusing peers
Not college bound
Aggression toward peers
Norms (e.g., advertising) favorable
Presence of mentors and support for development of skills and interests
Opportunities for engagement within school and community
Positive norms
Clear expectations for behavior
Physical and psychological safety toward alcohol use
Accessibility/ availability








Age of onset
Alcohol and drug use tends to begin in mid-to-late adolescence, though it is greater among individuals who experience early puberty .. A delay in drinking until 20- to 21-years-old reduces the risk of developing alcohol-related problems Youth perception that parents approve of their alcohol or drug use
One of the most consistent risk factors for adolescent drinking is perceived parental approval
(Donovan, 2004). Reported maternal care perception has been shown to be significantly lower among alcohol and those who use multiple drugs (Gerra et al, 2004).
Peers engaging in problem behavior
Associating with drug- or alcohol-using peers, or being rejected by peers, can create problem behaviors and influence attitudes and norms related to substance use (O'Connell et al, 2009).
Exposure to peer problem behavior is correlated with increased alcohol and other substance use in the same month (Dishion et al, 2000). Those who drink in a social setting, or who have peers who do so, are more likely to abuse alcohol later in life (Beck et al, 1996).
Early and persistent problem behaviors, risk-taking, and high sensation-seeking
Early aggressiveness or antisocial behavior persisting into early adolescence predicts later adolescent aggressiveness, drug abuse, and alcohol problems (Hawkins et al, 1995).







Parental monitoring (or perception of monitoring)
Adolescents who report low parental monitoring are significantly more likely to use a variety of substances (Shillington et al, 2005). Positive parental style and close monitoring by parents are proven protective factors for adolescent’s use of alcohol and other drugs (Stewart, 2002).
Parent or older sibling drug use (or perception of use)
Familial alcohol-using behaviors are strong predictors of adolescent alcohol use
(Birckmayer et al, 2004). In a 2003 study, alcohol initiation most often occurred during family gatherings. Moreover, a family history of alcoholism was a significant risk factor for the development of adolescent problem drinking (Warner et al,
2003).
Low perception of harm
Low perception of harm towards alcohol and drug use is a risk factor for use
(Henry et al, 2005). Individuals with attitudes or values favorable to alcohol or drugs are more likely to initiate substance use







Strong parent and adolescent relationship and family cohesion
Adolescents who have a close relationship with their parents are less likely to become alcohol involved (Birckmayer et al, 2004).
Youth access and availability
The majority of alcohol consumed by youth is obtained through social sources, such as parents and friends, at underage parties and at home (Birckmayer et al, 2004). Availability of alcohol or illegal drugs leads to increased use
(Hawkins et al, 1995).
Poor school achievement and low school bonding
Adolescents who have a low commitment to school or do poorly are more likely to become alcohol involved