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Addiction

4 Environmental Addiction Factors Crucial In Recovery

There are many complex factors that dictate whether addiction develops.

Americans in colonial times drank 3-5 times as much alcohol as we do now… Just imagine putting down an average of 5-10 drinks per day!!!

In the last few decades, there has been much debate about which aspect of our lives has the most significant influence on our behavior. In the area of addiction, I have separated the four primary camps (as I refer to them in The Abstinence Myth) to include spiritualists, traumatists, biologists and environmentalists—all theoretical frameworks that put forward excellent reasons why someone struggles with addiction.

However, the best explanation for addiction draws on all four of these camps. Understanding and accepting the factors that contribute to our thoughts, feelings, and actions can not only be useful, but very empowering when you’re on the road to recovery.

Today I want to focus on the environmental domain, which not only contributes to addiction, but also maintains it. Environmentalists and social scientists believe that external factors and forces dictate our behavior. Addiction, according to supporters of this camp, is primarily a result of external, and not internal, factors. For example, we know that alcohol and drug use increases during adolescence (ages eighteen to twenty-four), because this is a time when young people socialize with each other and are susceptible to “peer-pressure.”1

Once you are familiar with the environmental factors that are relevant to YOUR life, then you can take action to create change and improve the odds that you’re the one with the control—not the addiction. You’ll also find helpful tips for partners and family members who want to support a loved one in addiction recovery—since they make up a substantial portion of the environmental influence.

Four Environmental Domains that contribute to addiction

As mentioned, members of the “environmental camp” believe that social systems and external factors drive human behavior. The way I see it, this camp is made up of four environmental sub-domains that play a role in the development of addiction.

The Family Domain

There’s no denying that our early life experiences and familial interactions play an important role in the development of our mental health. You may not realize, however, just how critical those interactions and parenting styles can be and how they can contribute to later addiction.

Identify the factors

Parents who have favorable attitudes toward drug use or use drugs themselves often have children who are more likely to use and drugs, and with the increased probability of use comes an increase in the probability of problems.

Additionally, parenting styles identified as authoritarian (highly demanding, little positive feedback, harsh punishments) or avoidant (difficulties responding to emotional needs of child and child learns to hide their emotions) also lead to increased substance use problems when compared to an authoritative (high responsiveness and high demand) parenting style. Better work on those boundaries early!

A NIDA funded study also found that addiction was more likely in individuals who had a sibling or spouse who had an alcohol or substance addiction. The closer the siblings were in age, the greater the relationship.2 While some may want to attribute the sibling connection primarily to biology, there is a substantial environmental influence for shared childhood households and it is obvious that the spousal relationship is largely environmental. Although, as we’ll discuss later, these factors are not truly independent at all.

If you can relate to these experiences, then you may begin to form a picture of the critical influence of family and why you have an addiction.

Opportunities for Change

I’ve mentioned the risk factors in the family domain which contribute to addictions, but family can also play a protective role. Research suggests that family support (and psychoeducation provided to family members) during the recovery process leads to higher recovery success in people with addictions.

If you have a family member with an alcohol or substance use disorder, then your support (both practically and emotionally) can go a long way in aiding the recovery of your loved one’s addiction.

The Peer Domain

It will come as no surprise that the people we surround ourselves with do have an impact on the choices we make and the way we behave. While you may associate “peer-pressure” with adolescence, the same factors that underlie this phenomenon can persist well into the adult years (I mean, who doesn’t still get affected by friends when it comes to fashion style, car-choice, and so many more factors?)

Identify the factors

Friends and peers who use alcohol or drugs are the MOST significant contributor to substance use problems, especially earlier on in life.

Teenagers whose best friend drinks alcohol are twice as likely to try it themselves. Young people who are exposed to alcohol earlier are more likely to have problems with drinking as an adult.3

Even in adulthood, if you socialize with people who have favorable attitudes toward alcohol and drugs, then this is likely to influence your attitudes and behavior too.

Opportunities for Change

In the same way that family can be an instigator for change, so can peers. Research has shown that young people in addiction treatment who connect with other young people in similar conditions or circumstances (and in recovery) have better longer-term recovery rates.4 Many treatment programs incorporate peer support groups in both inpatient out outreach settings. In the IGNTD Recovery Hero program, our online group support and weekly chats form the basis of many of our participants’ core recovery support.

The Work/School Domain

Did you know that the type of job you have and your work setting can contribute to your addiction? The school or occupational environment in which you spend most of your time can impact your mental health, coping capacity and healthy or unhealthy behaviors.

Identify the factors

Stress in the workplace can lead to addiction. When under pressure, people draw on their default coping strategies—whether helpful or unhelpful—to help them manage how they are feeling. For those in the retail and food industries, the stress levels are incredibly high, and so too is the risk of alcohol and substance addiction.

According to a 2015 study by the Substance Abuse and Mental Health Services Administration, the food service and hospitality industry have the highest rates of substance use disorders and third-highest rates of heavy-alcohol use of all employment sectors.

In the school environment, a student's performance, participation, and commitment to school can be a major risk factor in addiction. A lack of social structure can also contribute while some structures, like the Greek system, can exacerbate substance use struggles.5

Opportunities for Change

Research has shown programs addressing alcohol and other drug use in the workplace to be cost-effective, contributing to the health and well-being of the employee and organization.

When you study or work in an environment that actively promotes good mental health and a healthy lifestyle, then you are more likely to absorb these messages, feel safe to ask for help, and have the confidence to overcome an addiction. If you find that your work/school environments do not promote healthy habits, it is often possible to change these patterns through active engagement and discussion with decision makers. After all, this is your life!

The Community Domain

Your connection, or lack thereof, to the community in which you live plays a big part in the likelihood of developing an addiction. Additionally, social norms in a given context, culture and time define what is even identified as a problem.

Identify the factors

Research shows that if an individual’s community has favorable attitudes toward alcohol and drug use, then their risk of developing a problem is increased.

Still, drinking averages have changed dramatically over the years. As mentioned above, the average amount of alcohol consumption in the U.S. has dropped to only 1/5th of what it used to be in colonial times! Now, if everyone was drinking five times more alcohol 200 years ago (on average), it is safe to assume that the threshold for calling someone a problem drinker, or "alcoholic," was also higher. We don't have great records from this time, so documentation is difficult, but moderate drinking standards have changed, meaning what used to be normal drinking is now considered deviant or excessive. Society’s rules and standards define the way we measure “addiction” and also create the perception of those who struggle and what is or isn't OK (this is where shame and stigma come from).

Opportunities for Change

Funded by the National Institutes of Health's National Institute on Alcohol Abuse and Alcoholism (NIAAA), a new report concluded that individuals with substance abuse problems who are living in a collaborative housing setting would have their addiction treated more effectively than abusers not residing in a community-based facility.

This means that people who reside with other people in similar circumstances who are in treatment are less likely to feel stigmatized and shamed.

But it goes much deeper than that: if social norms play such a crucial role in what addiction is, then it has to be obvious that biology alone (or psychology alone) cannot be the primary culprits in its development. And if we can understand that the lens through which we see “addicts” can have an incredible influence on their success and quality of life then we have to adjust our way of talking about addiction wholesale.

Other factors to consider

We have looked at the four big environmental domains, but there are a couple more factors worth mentioning that can also increase drug use and addictive behavior. These include:

Media consumption: Children and adolescents who are frequently exposed to media (advertisements, TV shows, and movies) containing alcohol and substance use can lead to addiction. The portrayal of alcohol and drugs in a favorable light can influence child and adolescent attitudes and behaviors around alcohol and drugs.

Proximity to drugs: Access to alcohol and drugs is one of the biggest contributors to first use (and ongoing use) of alcohol and drugs by children and young people.

Take home message

While environmental factors can contribute to a substance use problem, they can also help during the recovery process. If you’re seeking treatment for addiction, then you want to be aware of all the factors that contribute to your problem and not “box yourself in” by only focusing on the factors others believe to be important.

While we may think we have little control over biological factors (there is actually quite a bit we can do there too), and psychological factors can take time to resolve, the environmental domain is something you CAN make changes in with substantial payoff and relative ease. Whether it's enlisting the help of your family, connecting with other people in your circumstances (who are motivated towards recovery), and ensuring the environments you work or study in are conducive to recovery, there is much you can do.

Here’s a little trick I recommend for everyone I work with that can help if there is a specific room or place that you tend to drink/use in more frequently. This room, or location, in your environment has become a trigger for your behavior. When you enter it or get near it, you likely begin craving or thinking about your drinking, using, or engaging in your addictive/compulsive behavior. But here is where biology and environment can meet. Since your brain recognizes specific aspects of this place in order to create the overall picture and therefore the connection with the behavior, there’s an opportunity to intervene! Change the look of the room as completely as possible—move furniture around, paint the walls or add wallpaper or art, change the scent and the lighting. If you do this, you’ll notice that much of the power of the trigger has dissipated because your brain now thinks of this location as different. It’s a quick and easy fix for the vexing problem of bedroom/living-room/kitchen drinking that, while not a silver bullet, should give you a little relief. Here’s what’s important though—if you simply continue using in that room moving forward you’ll create the exact same old relationship with the new environment… So beware.

If you have a family member with an addiction and you’ve begun to lose hope, then you’ll find that what you say and do will make an impact on your loved one. Learn about the multitude of factors relevant to your loved one and try to have inclusive and supportive conversations with them about what you learn. Your support and understanding could go a long way.

I find environmental factors the most helpful in leading clients to see how powerful their surroundings, community, relationships, and home can lead toward health or relapse. Our environment has an incredibly strong influence on our behavior and the way we see the world.

If you want to learn more about the environmental domains and other factors that contribute to addiction (biology, trauma, and religion), then you can read about it in my book, The Abstinence Myth.

References

ADDIN EN.REFLIST 1. Wechsler H, Dowdall G, Moeykens M. of Binge Drinking in College. Jama. 1994;272:1672-1677.

2. Kendler KS, Ohlsson H, Sundquist K, Sundquist J. Within-family environmental transmission of drug abuse: a Swedish national study. JAMA psychiatry. 2013;70(2):235-242.

3. Kuperman S, Chan G, Kramer JR, et al. A model to determine the likely age of an adolescent's first drink of alcohol. Pediatrics. 2013;131(2):242-248.

4. Tracy K, Wallace SP. Benefits of peer support groups in the treatment of addiction. Substance abuse and rehabilitation. 2016;7:143-154.

5. Cashin JR, Presley CA, Meilman PW. Alcohol use in the Greek system: Follow the leader? Journal of Studies on Alcohol. 1998;59(1):63-70.

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