#1
http://www.nytimes.com/2011/08/02/healt ... .html?_r=1
"Most people who experiment with drugs, then, do not become addicted. So who is at risk?
Clinicians have long been aware that patients with certain types of psychiatric illnesses — including mood, anxiety and personality disorders — are more likely to become addicts. According to the National Institute of Mental Health’s Epidemiologic Catchment Area Study, patients with mental health problems are nearly three times as likely to have an addictive disorder as those without.
Conversely, 60 percent of people with a substance abuse disorder also suffer from another form of mental illness. Still, it’s unclear whether addiction predisposes someone to mental illness, or vice versa."
" But precarious mental health is not the only risk for long-term addiction. Emerging evidence suggests that drug abuse can be a developmental brain disorder, and that people who become addicted are wired differently from those who do not.
Dr. Nora Volkow, director of the National Institute on Drug Abuse, has shown in several brain-imaging studies that people addicted to such drugs as cocaine, heroin and alcohol have fewer dopamine receptors in the brain’s reward pathways than nonaddicts. Dopamine is a neurotransmitter critical to the experience of pleasure and desire, and sends a signal to the brain: Pay attention, this is important.
When Dr. Volkow compared the responses of addicts and normal controls with an infusion of a stimulant, she discovered that controls with high numbers of D2 receptors, a subtype of dopamine receptors, found it aversive, while addicts with low receptor levels found it pleasurable. "
But people are not brains in a jar; we are heavily influenced by our environments, too. The world in which Ms. Winehouse traveled appears to have been awash in illicit drugs and alcohol whose use was not just accepted but encouraged. Even people who aren’t wired for addiction can become dependent on drugs and alcohol if they are constantly exposed to them, studies have found.
"Most people who experiment with drugs, then, do not become addicted. So who is at risk?
Clinicians have long been aware that patients with certain types of psychiatric illnesses — including mood, anxiety and personality disorders — are more likely to become addicts. According to the National Institute of Mental Health’s Epidemiologic Catchment Area Study, patients with mental health problems are nearly three times as likely to have an addictive disorder as those without.
Conversely, 60 percent of people with a substance abuse disorder also suffer from another form of mental illness. Still, it’s unclear whether addiction predisposes someone to mental illness, or vice versa."
" But precarious mental health is not the only risk for long-term addiction. Emerging evidence suggests that drug abuse can be a developmental brain disorder, and that people who become addicted are wired differently from those who do not.
Dr. Nora Volkow, director of the National Institute on Drug Abuse, has shown in several brain-imaging studies that people addicted to such drugs as cocaine, heroin and alcohol have fewer dopamine receptors in the brain’s reward pathways than nonaddicts. Dopamine is a neurotransmitter critical to the experience of pleasure and desire, and sends a signal to the brain: Pay attention, this is important.
When Dr. Volkow compared the responses of addicts and normal controls with an infusion of a stimulant, she discovered that controls with high numbers of D2 receptors, a subtype of dopamine receptors, found it aversive, while addicts with low receptor levels found it pleasurable. "
But people are not brains in a jar; we are heavily influenced by our environments, too. The world in which Ms. Winehouse traveled appears to have been awash in illicit drugs and alcohol whose use was not just accepted but encouraged. Even people who aren’t wired for addiction can become dependent on drugs and alcohol if they are constantly exposed to them, studies have found.