What Science Says About Teen Addictions
And What It Means for Parents of Teens

A new federal study released September 2006 concludes that alcoholism often begins in the teen years. Funded by the National Institute on Alcohol Abuse and Alcoholism and published in Pediatrics Magazine, the survey of more than 44,000 people shows that of all the people who are alcoholics, 47% developed their addiction before age 21, and 15% before age 18.

The researchers took into account other factors such as race, gender and family history of alcoholism and adjusted their figures accordingly. The new research does not necessarily mean that teen drinking causes alcoholism in later life, just that it starts earlier than we thought.

"The conventional image is that people who have alcoholism are middle-aged. "That's not the case," according to Ralph Hingson, author of the study and director of the Institute. "The problem begins much earlier in life."

Hingson said that the reason that people who drink heavily in early life are at higher risk for addiction may have something to do with the biology of the human brain.

The new federal study seems to back up conclusions by other scientists in the field, including Dr. Anna Rose Childress, a researcher with the University of Pennsylvania School of Medicine. Dr. Childress is using brain-imaging techniques to discover what subtle differences in brain biology have to do with alcoholism and drug addiction. In an article published in a 2006 anthology entitled Rethinking Substance Abuse, she concludes, "We are not all created equal when it comes to our ability to manage our impulses toward immediate rewards."

The human brain has what Dr. Childress calls a "STOP/GO" system that evolved to help the species survive by finding food, sex, and other natural needs. "GO" circuitry responds to stimuli in the environment, such as food smells and sexual cues, and rewards the person with pleasure every time he seeks out and gains a desired object. The brain's "STOP" circuitry puts on the brakes by higher-level thinking. It determines whether that the reward would be dangerous or disadvantageous in the end to the individual.

Hereditary plays a part in creating differences between "GO" and "STOP" circuitry. These differences may predispose a person toward addiction. Dr. Childress writes that it seems to be a combination of genes, and not just a single one, that produces such a predisposition. Yet she is careful to point out that we also know through studies of identical twins reared separately from each other that environmental factors also play a part in the development of addictions.

Adolescence is a critical period for addictions to develop, because while a teenager's "GO" system is working in full force, his "STOP" system is immature. Teenagers notoriously respond to sexual stimulation, take dangerous risks, and make decisions weighted in the moment rather than for long-term consequences. It takes until after age twenty or so for the parts of the brain that involve decision-making and higher level thinking (the "STOP" system) to fully develop.

This is a change of thinking for the scientific community, which used to believe that all key brain development took place in the first few years of life. But in one study that compared the brains of children ages 12 to 16 to those of adolescents ages 23 to 30 and revealed that the frontal cortex, which processes complex information, the hippocampus and other areas continue to develop and "fine tune" into early adulthood.

Most teens who drink, smoke or use drugs do not become addicts. However, a genetic predisposition combined with the critical period of adolescence can tilt the scales toward early addictions.

Brain images of addicts often show that they have a lower than average number of receptors for dopamine, a chemical that makes a person feel positive, energetic, and aroused. A person with normal numbers of such receptors may try cocaine or heroin and find the experience to be overwhelming and unpleasant. However, for the person with a below average number, the drug brings "perfect pleasure" or as one addict described it, "orgasm only stronger." This may explain why one teen can take or leave a drug and another becomes addicted.

Because their center of reason - their "STOP" circuitry-- is not fully developed, teenagers have a harder time controlling their impulses to drink or use drugs. It is harder for them to ignore environmental triggers that cause cravings for their substance. Passing a bar or seeing pictures of beer bottles can set off the "GO" system. Teens with Attention Deficit Disorder are particularly vulnerable because they have poor impulse control to begin with. For this reason, if these teens have taken drugs like Ritalin since childhood, they are actually LESS likely to become alcoholics or drug addicts.

In an interesting study of monkeys, some were able to let go of cocaine addictions by becoming "alpha monkeys" or those in leadership roles. Dr. Childress believes these monkeys found pleasure in dominating the others and risk-taking and were able to "reset" their dopamine receptors. There may be an implication for humans in that those with a genetic tendency toward addiction could find stimulation through socially acceptable daredevil activities like fire fighting or police work.

Someday doctors may routinely screen children through brain imaging and prescribe preventative medications for those with a predisposition for addiction. Such drugs could reset the "GO" system to more protective levels.

In the meantime, it is important for parents to realize that there is a lot about addiction that science does not completely understand. Teens can lose years of their lives in addiction during a critical time when they should be developing healthy identities and finding careers.

If you have a teen that has a serious problem with drugs or alcohol, you should get help, according to Dr. J.C. Garbutt, a professor of psychiatry at the University of North Carolina at Chapel Hill. "Stick with it even if the adolescent does not want treatment - few do. The alterative could involve the risk of legal, health, relationship problems and even death."