This is Your Brain on Addiction

Being aware of risks can help one avoid addiction

Addiction surrounds us.

American talk shows offer the public a cortege of alcoholics who have lost their homes, emaciated heroin users who would prefer a needle to a meal and gamblers who would sell their wedding ring just to slide two more quarters into a casino slot machine. For many, addiction has become a way of life.

But is the danger of addiction, especially on college campuses, really as epic as we are led to believe?

For many years, scientists have concluded that family history plays a critical role in determining an individual’s predisposition to addictive behavior. But genetic composition only partially explains the ever-tightening grip of addiction. Recent research has found that levels of a single substance in the brain, called dopamine, are responsible for the alteration of people’s moods.

Nicotine, other addictive drugs and certain behaviors accelerate the release of dopamine, a neurotransmitter, and help to create the sensation of pleasure in the brain. As a result, what might begin as excessive experimentation or recreational drug or alcohol use can unintentionally lead to dependence.

Although not all chemical abuse and behavior serves as a precursor to addiction, the impact witnessed on many college campuses has administrators concerned. "Alcohol abuse in particular is the major wellness problem on all college campuses," said Greg Roberts, vice president for student affairs at St. Thomas.

Statistics prove Roberts’ concerns to be valid. A 1997 Harvard University survey of 14,500 students at 116 colleges found that more than half of the students drink to get drunk. Of those surveyed, 41.5 percent usually binged when they drank (binge drinking was defined as five or more drinks in a row during the two weeks prior to the survey), and more than one in five students drank on 10 or more occasions in the past 30 days.

Dana Farley, coordinator of the St. Thomas Wellness Center, believes that there are two main reasons for excessive drinking on university campuses. "First, students come to college with a desire to fit in, even at the expense of their own health," he said. "And second, new students especially tend to overestimate the frequency and quantity of how much people drink. There is an imaginary peer group with a perceived level of drinking and students try to drink to that imaginary norm."

In 1998, the Wellness Center conducted a health survey of its own to determine how drug and alcohol abuse was affecting the performance of students at St. Thomas. The survey, which was completed by 63 percent of all St. Thomas undergraduates living on campus, found that 41 percent admitted to having missed a class due to drinking or drug abuse, 30 percent reported doing poorly on a test or project for the same reason, and more than 25 percent admitted that they had driven under the influence.

Despite the sometimes-alarming role that drugs and alcohol play in the lives of many college students, most abusers are not destined to become addicts. The three keys that determine whether or not addiction becomes reality for a user are the frequency of use, the amount used and the duration of the abuse.

According to the University of Maryland Office of Substance Abuse Studies, if people who experiment with a drug find that the rewards of taking the drug outweigh the negative consequences, they will be more likely to use again. Over time, if users continue to avoid negative consequences such as concern about being caught or having a bad reaction to impure illicit drugs, they will be more likely to form an attachment to the drug or even the ritual of taking the drug. The next step becomes a strong psychological desire for the drug in order to reach a high or relieve discomfort. At this point, becoming an addict is a very real concern.

Given the severity of an addictive relationship, Farley said that most college students are "more likely to enter into abusive relationships with drinking or other drugs than they are to meet the full criteria for dependency or addiction."

Farley is quick to point out that there is good news, too. According to the St. Thomas health survey, the number of students who abstain from alcohol has increased from 20 percent in 1994 to 28 percent in 1998. And the percentage of binge drinking has decreased from 62 percent in 1997 (the same year the Harvard survey took place) to 46 percent in 1998.

Two particular areas of abusive behavior that remain a concern for St. Thomas administrators are the use of nicotine (mainly from smoking) and gambling.

According to the Sixth Triennial Report to Congress from the Secretary of Health and Human Services, nearly 33 percent of the general population had smoked a cigarette during the past year. In comparison, 52 percent of St. Thomas students responding to the 1998 health survey admitted to having used tobacco in the past year.

When considering the role tobacco plays in the overall health of our population, it is difficult to ignore the projected impact that repeated use of tobacco might bring. The triennial report states that tobacco kills more than 430,000 U.S. citizens each year — more than alcohol, cocaine, heroin, homicide, suicide, car accidents, fire and AIDS combined.

And in Minnesota, a state that continues to support an increased presence of gaming casinos, gambling addiction also has gained momentum. The health survey found that nearly 10 percent of St. Thomas students admitted to gambling more than they intended to in the past 12 months — one of the initial signs that there might be a problem with gambling. The nearly 10 percent representation at St. Thomas is consistent with 1997 data from the Harvard Medical School Division of Addictions, where it was reported that 9.3 percent of college students satisfy some, but not all, criteria for full gambling addiction. Only 2 percent of St. Thomas students, however, admitted to feeling as though they could not stop gambling even if they wanted to.

In recent months, St. Thomas students discovered firsthand the influence and consequences that gambling problems can have on one of their peers. In February, a sophomore was charged with attempting to swindle a large sum of money from the university. The Rev. Dennis Dease, president, received a fax stating that the individual had information that would "damage the reputation of St. Thomas," and that this individual would offer the information to local media unless $20,500 in cash was delivered to a sand volleyball court in Little Canada.

The allegations soon were determined to be unsubstantiated. With the help of the St. Paul Police Department, a similar fax received by Plum’s bar was traced to the student’s apartment. The student had sent many similar threats to local colleges and businesses demanding a total of $75,000 in an effort to cover a sports-gambling debt.

Fortunately, there is good news regarding addiction.

There are signs that the public’s perception of addiction is finally beginning to change. For years, addiction was considered by many to be a direct result of personal failure on the part of the addict. After all, American culture was built on the premise that with hard work and determination you can accomplish anything that you set out to do. As a result, substance or behavioral addiction was often viewed as a lack of willpower or responsibility, and public discourse on the effects of addiction and the understanding of the behavior was relegated to the privacy of hospitals and treatment centers.

Now that we are gaining more knowledge about the way the brain works and the process of addiction, more people are willing to speak openly about their own experiences and struggles with addiction. "Talking about addiction has come out of the closet," said Farley. "New college students are now aware of family problems related to addiction and know that they must be aware of the risks."

And with the recent favorable statistics about alcohol and drug use at St. Thomas, Farley, Roberts and others who work on wellness issues have an opportunity to broaden their focus. Not only can they continue to offer support for prevention, but they also can teach harm reduction (no fighting, eliminate the risk of sexual assaults, no drinking and driving, etc.) to those students who continue to engage in abusive relationships with alcohol, drugs and other high-risk behaviors.

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Arnot Ogden Medical Center

Addictive ProfilePeople with certain histories and personality traits tend to be more likely to become addicted. Addiction seems to run in families, although the specific addictions can vary (for example, an alcoholic father might have a workaholic daughter). Some factors that can place a person at risk for addiction are:• As a child, having addicted parents or other adults • As a child, having too much, too little or uncertain love, discipline or safety • A tendency to find others who are also addictive• Feelings of insecurity, loneliness, or being different• Difficulty using positive emotions such as love, joy and intimacy, in times of troubleProvided by the Arnot Ogden Medical Center, www.aomc.org