9.3 Risk Factors Associated with SUD
VIDEO: The Best Explanation of Addiction I’ve Ever Heard
In the following video Dr. Gabe Maté explains the reality of SUDs, describing how SUDs almost always stems from trauma.
To move beyond traditional constructions that view problematic substance use and SUD as an individual choice, it is necessary to consider the multiple risk factors that can influence a person’s likelihood for developing a SUD (Stockwell & Young, 2020). Problematic substance use and SUDs are biopsychosocial in nature, with research identifying numerous complex and overlapping factors that can contribute to an increased susceptibility to problematic substance use behaviours (Jemberie et al., 2020). Risks for developing a SUD are believed to be additive. The more exposures one has, and the more diverse types of exposures, increases levels of risk (Ewald et al., 2019; McLellan, 2017).
Psychological Factors
- Over 50% of people who engage in problematic substance using behaviours are also experiencing a mental health issue (CMHA, n.d.c).
- Psychological states, such as stress, can impact an individual’s behaviour consciously and unconsciously, potentially contributing to an increased likelihood of substance use and problematic substance use (Goeders, 2003).
- In addition to the connection between trauma, stress, brain changes, and risk of SUDs in adulthood (Stockwell & Young, 2020; Ewald et al., 2019), one of the biggest contributing factors in life-long problematic substance using behaviour and SUDs is early childhood stressors and trauma that have a lasting impact on how the brain handles stress (Moustafa et al., 2018).
Childhood Trauma
- There is a strong association between childhood trauma and problematic substance use (Ewald, et al., 2019).
- Over 60% of individuals who experience substance use disorders were physically and/or sexually abused during their childhood (Moustafa et al., 2018).
- People who use opiates (e.g., heroin) experienced high rates of childhood trauma, such as receiving injuries due to physical punishment, penetrative sexual abuse, emotional abuse, and physical neglect (Moustafa et al., 2018).
- Studies have demonstrated how early life stressors, like the ones noted above, lead to permanent changes to the brain’s stress circuitry (Moustafa et al., 2018), especially since the brain is still developing (Stockwell & Young, 2020).
Genetic/Biological Factors
- There is an inherited genetic component relating to SUD, with some people inheriting a vulnerability to the addictive properties of psychoactive substances (e.g., alcohol, nicotine, opiates, etc.) (CMHA, n.d.c).
- About half the risk for substance use disorder is determined by genetics, but a genetic predisposition does not always mean that a person will develop a substance use disorder (CISUR, 2017).
Psychosocial Environment
- The more an individual is exposed to stressors in their social and physical environments, the more likely they are to cope with that stress by using substances (Koob, 2008).
- Attitudes towards substance use to which people are regularly exposed (i.e., at home, with friends, at work, in the community) “can influence whether or not they will develop substance use problems” (CMHA, n.d.c, para. 11).
Examples of environments that can contribute to substance use and SUDs include:
- Home: Growing up in a family where there is lots of conflict, stress and/or substance use, leads to a greater risk of developing SUDs, especially at a younger age.
- School: Peers play an influential roles in the lives of young people. It is through peers that young people are typically introduced to using psychoactive substances (e.g., alcohol, cannabis, nicotine, MDMA). If a young person’s friends consume psychoactive substances, they are likely to follow suit.
- Work: There are certain forms of work or work environments that can contribute to substance use and SUDs including: high stress jobs, shift work, forms of frontline work that can expose workers to traumatic events on a regular basis, etc.
(CISUR, 2017).
Individual Circumstances
- People often turn to drugs or alcohol because they believe it will help them cope with difficult feelings or circumstances (CISUR, 2017).
- People may depend on certain drugs to help them calm down when feeling stressed or make social situations easier. Relying on substances to help “get through” different life situations, however, can eventually lead to substance use problems (CISUR, 2017.).
- People experiencing structural vulnerability or disadvantages in their lives (e.g., tied to colonization, capitalism, housing insecurity, socio-economic disadvantage, etc.) can lead to an increased susceptibility to substance use and SUDs (See Chapter on the SDoH).
Click the link to learn more about the causes of SUDs:
Factors that Impact Addiction & Problematic Substance Use
VIDEO: Decolonizing Substance Use & Addiction
In the following TED Talk, Len Pierre Pierre discusses substance use and SUDs through an Indigenous lens.
Although certain risk factors can increase an individual’s susceptibility to problematic substance use, not everyone who has existing risk factors will develop a SUD (CISUR, 2017). Understanding the risk factors for the development of substance use problems is crucial for moving beyond existing drug-related stigma and working towards the implementation of effective policies, treatments and intervention programs (CISUR, 2017). Ultimately, the acknowledgement of SUDs as a biopsychosocial condition, as well as its de-stigmatization among policy makers and practitioners, are essential components for comprehensive and multifaceted strategies that will protect and address the needs of people experiencing SUDs (Jemberie et al., 2020).
