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When it comes to a behavior that undermines one’s self-interest or one’s survival in a dramatic fashion, drug addiction tops the list. Most people are at a loss to understand why anyone would over-indulge in substance use to the extent of personal peril. Is the fleeting pleasure of a drug high worth all the troubles that follow? Is it really the drug high that users are after? Addiction has been described in different ways. In the past it has been considered a moral failing, a character flaw. Not long ago the idea of addiction as a disease has gained popularity and to this day many still subscribe to the idea. More recently, with the advent of better technology that peers into the animal and human brains, scientists have come to the conclusion that addiction is a brain disease.
In other words, as a result of chronic drug use, the brain of a person who suffers from substance use disorder or SUD (the newly minted DSM nomenclature for a spectrum of drug use) has been altered significantly (structurally and functionally). This description of addiction explains the outcome. It does very little, however, in explaining why people with SUD are inclined to fry their brains. For the addiction professionals or policy makers to conceive reasonable treatment or drug prevention strategies, they have to have a good grasp of the etiology of SUD as a starting point.
As it turns out, finding an explanation for the cause or causes of SUD involves knowledge of distinct but related fields of study. Attachment Theory and the study of Psychological Trauma have one thing in common in their view of addiction or addictive behavior. It is a symptom of what has gone wrong or is going wrong in the person’s life and how past learning or experience has shaped his brain. Neuroscience research has provided unequivocal support for this. Two crucial life events have far reaching consequences to future adaptations. The first is the nature of early attachment to caregiver and the second is psychological trauma. Our emotional life or capacity to regulate emotions is shaped by both early attachment and adverse childhood experience. The ability to regulate emotions in turn determines our social adaptation or ability to form and sustain human relationships.
Caregivers who fail to provide adequate avenue for infants to form healthy attachment produce children who later have emotional regulatory deficits and suffer from dysfunctions in forming social connections or relationships. We often characterize these children as maladjusted, meaning they do not only lack the ability to form healthy interpersonal relationships but also lack the ability to use relationships for self-regulation. Normally, when we are in distress we seek out the comforting presence or words of people close to us, a self-regulatory strategy. This social behavior has its roots very early in our development when we seek the safety and comfort of nearby caregiver as we engage in exploring a new and strange world around.
In the same vein, children who early in life suffer from neglect or chronic traumatic experience, fail to develop self-regulatory abilities and form healthy relationships. With their sense of safety compromised, they are in constant state of alarm, and the slightest risk of danger is perceived as a mortal threat. The brains of these children have well-developed danger alarm system but lack the cognitive capacity for a realistic threat appraisal. Their brains have been altered by experience or environment in a way that their perception and judgment of reality is faulty, a condition that if not addressed makes them prone to self-defeating behavioral strategies most of their lives.
ABOUT THE AUTHOR Dr. Fernando B. Perfas is an addiction specialist who has written several books and articles on the subject. He currently provides training and consulting services to various government and non-government drug treatment agencies regarding drug treatment and prevention approaches. He can be reached at email@example.com.