The document discusses several risk factors for alcoholism and drug addiction. Some key risk factors include starting alcohol or drug use during adolescence, having a family history of substance abuse or experiencing abuse as a child, and having certain psychiatric or behavioral disorders. Adolescents who begin drinking or using drugs are much more likely to develop an addiction compared to those who begin later. Those with a family history of substance abuse or a personal history of abuse or neglect are also at higher risk. Certain psychiatric conditions like depression, anxiety, bipolar disorder and ADHD can increase one's risk as well. Race and gender can also influence risk levels, though biological and cultural factors affecting risk among groups are not fully understood.
2. INTRODUCTION
According to the U.S. National Institute of Alcohol
Abuse and Alcoholism, about 70% of American adults
always drink at low-risk levels or do not drink at all.
35% of Americans do not consume alcohol. Also,
about 28% of American adults drink at levels that put
them at risk for alcohol dependence and alcoholrelated problems.
In 2010, there was an estimated 22.6 million
Americans over the age of 12 that were current or
former illicit drug users, and used within the last 30
days. This equates to about 8.9% of the population aged
12 or older. The most commonly abused drug (other than
alcohol) in the United States by individuals over the age of
12 is Marijuana, followed by prescription painkillers,
cocaine and hallucinogens.
The risk factors for alcohol dependence & drug
addiction include the following:
AGE (ADOLESCENCE & ELDERLY)
GENDER
FAMILY HISTORY & ABUSE
RACE & ETHNICITY
PSYCHIATRIC & BEHAVIORAL DISORDERS
3. AGE (ADOLESCENCE)
Anyone who begins drinking or using drugs in adolescence is at risk for developing an addiction. The earlier a person
begins, the greater the risk.
•
About 50% of under-age Americans have used alcohol.
•
About 2 million people ages 12 - 20 are considered heavy
drinkers, and 4.4 million are binge drinkers.
•
A survey of over 40,000 adults indicated that among those
who began drinking before age 14, nearly half had
become alcoholic dependent by the age of 21. In
contrast, only 9% of people who began drinking after the
age of 21 developed alcoholism.
•
In 2009, 10% of youth aged 12 to 17 were current illicit
drug users.
•
In 2010, almost 3% of 12th graders had used cocaine in
the past year, 8% had used the opiate Vicodin, 5% had
used inhalants, nearly 5% had used "Ecstasy," and
about 1.5% had used anabolic steroids.
4. AGE (ELDERLY)
Although alcoholism usually develops in early adulthood, the elderly are not exempt. In fact, doctors may
overlook alcoholism when evaluating elderly patients, mistakenly attributing the signs of alcohol abuse to the
normal effects of the aging process.
Recent census data estimates that nearly 35 million people in the United States are 65 years or older.
Substance abuse among those 60 years and older (including misuse of prescription drugs)
currently affects about 17 percent of this population. By 2020, the number of older adults with
substance abuse problems is expected to double.
5. GENDER
The rates of drug abuse are currently lower in women than in men. Nevertheless, the number of women using and abusing
prescription and illegal drugs is on the rise. Adult men are 2 to 3 times more likely than women to have a drug
abuse/dependence disorder, but this current gender difference may reflect differences in opportunity, rather than
vulnerability to drug use. In 2010, as in prior years, the rate of illicit drug use among persons aged 12 or older was
11.2% for males and 6.8% for females.
Most alcoholics are men, but the incidence of
alcoholism in women has been increasing over the
past 30 years. According to the U.S. Centers for
Disease Control, about 17% of men and 8% of
women meet criteria for alcohol dependence at
some point in their lives.
Studies suggest that women are more vulnerable
than men to many of the long-term consequences
of alcoholism. Women are more likely than men to
develop alcoholic hepatitis and to die from cirrhosis,
and women are more vulnerable to the brain cell
damage caused by alcohol.
6. FAMILY HISTORY & ABUSE
Such adolescent users are also
more apt to underestimate the
effects of drinking and using drugs
and may make judgment errors.
Individuals who were abused as
children have a higher risk for
substance abuse later in life.
People at highest risk for early
drinking or drug use are those with
a history of abuse, family violence,
depression, and stressful life
events. People with a family
history of alcoholism and drug
addiction are also more likely to
begin using before the age of 20
and to become addicted.
In one study, 72% of women
and 27% of men with substance
abuse disorders reported
physical or sexual abuse
or both. They also had worse
response to treatment than
those without such a history.
7. RACE/ETHNICITY
Overall, there is no difference in alcoholic
prevalence among African-Americans,
Caucasians, and Hispanic-Americans. Some
population groups, however, such as Native
Americans, have an increased incidence of
alcoholism while others, such as Jewish and
Asian Americans, have a lower risk.
Although the biological or cultural causes of
such different risks are not known, certain
people in these population groups may have
a genetic susceptibility or invulnerability to
alcoholism because of the way they
metabolize alcohol.
2012 Rate of Substance Abuse
(ages 12 or older)
American Indians/Alaska Natives
21.8%
Two or More Races
10.1%
African Americans
8.9%
Hispanics
8.8%
Whites
8.7%
Native Hawaiians/Pacific Islanders
Asians
0.0%
5.4%
3.2%
5.0%
10.0%
15.0%
20.0%
25.0%
8. BEHAVIORAL DISORDERS
Studies indicate that substance abuse is strongly related to impulsive, excitable, and novelty-seeking behavior, and
such patterns are established early on. Specifically, children with attention deficit hyperactivity disorder (ADHD),
a condition that shares these behaviors, have a higher risk for substance abuse in adulthood. The risk is
especially high in children with ADHD and conduct disorder.
9. PSYCHIATRIC DISORDERS
Psychiatric problems can begin either before or after the onset
of the addiction. In many cases, alcohol or addiction leads to
psychiatric symptoms. 37% of alcohol abusers and 53% of
drug abusers also have at least one serious mental illness.
Severely depressed or anxious people are at high risk for
alcoholism, smoking, and other forms of addiction. Likewise,
a large proportion of alcohol-dependent people suffer from an
accompanying psychiatric or substance abuse disorder. Either
anxiety or depression may increase the risk for self-medication
with alcohol.
Depression is the most common psychiatric problem in
people with alcoholism or substance abuse. Alcohol abuse is
very common in patients with bipolar disorder and schizophrenia.
Long-term alcoholism itself may cause chemical changes that
produce anxiety and depression. It is not always clear, then,
whether people with emotional disorders are self-medicating
with alcohol, or whether alcohol itself is producing mood swings.