What About Personal Responsibility for Addiction?
Listening to countless speakers at AA meetings made me question my assumption that drug addicts — starting with me — were only getting what we deserved. No one held a gun to our heads and made us take drugs. We did them voluntarily, enthusiastically. Didn’t we bear the blame for our descent into dereliction?
Then I met more than a few people who were third-generation alcoholics, whose parents and grandparents preceded them into addiction. Even more were second-generation. They were kids who grew up in chaotic, sometimes violent homes full of fear and shame. They never got the love and care they longed for and were ill-equipped emotionally or psychologically to deal with the deep pain that resulted. Was it any wonder they latched onto the medicine that made them feel worthy when their parents, and sometimes grandparents, had done the same?
I also heard innumerable stories of people who fell right over the edge of abuse from their first experience with alcohol or drugs. These people seemed to be “born addicts“ whose affliction emerged when they took their first drink or drug.
So where does personal responsibility start and where does it end?
Neuroscientists say the risk of addiction varies depending on the interplay of genetic and environmental factors. Brain changes that result from drug abuse (fewer dopamine D2 receptors in their Limbic “reward” systems, for example) have also been found in people who never used drugs, indicating they were inherited. These people have a high risk of addiction. In contrast, others have genetic makeups (greater numbers of dopamine receptors, for example) that protect against addiction. Researchers conclude there’s wide genetic variation for risk of addiction along a scale that at one end makes people highly pre-disposed to it, and at the other end, predisposed not to get it. (For more, click on Genetic Components of Addiction.)
Environment also plays a significant role. A tumultuous one can exacerbate the risk while a supportive one can offset some of the genetic risk (For more, click on Environmental Factors in Addiction).
Thus, the question of personal responsibility is a chicken-and-egg situation. Which comes first, the drinking/drugging or the genetic and environmental factors that make a minority of people highly vulnerable to the emotional benefits they find in addictive drugs?
Addicts drink and use drugs as medicine, as their antidote to deeply felt emotional inadequacy. Experiencing drugs as the solution to their perceived personality defects may very well be the way a genetic predisposition to addiction feels.
Most people don’t get the kind of profound emotional benefit addicts get from drugs.The vast majority of drinkers don’t become alcoholics. Most drug users don’t become addicts. Most people aren’t pre-disposed to addiction. Those who become addicts are.
Children aren’t responsible for their genetic makeups or the environments they grow up in. If those who develop addiction have an elevated genetic and/or environmental predisposition to addiction, how voluntary is their drug use?
