Altered Pathways: Drug Abuse and Age of Onset

By Volkow, Nora D. | Addiction Professional, May/June 2006 | Go to article overview

Altered Pathways: Drug Abuse and Age of Onset


Volkow, Nora D., Addiction Professional


Research indicates how young people can benefit from early intervention

To the question of whether drug use early in life heightens the risk for substance abuse problems later on, we can answer an assured "yes." What is less clear is why this happens. Clinicians who see patients with substance abuse problems are likely accustomed to sifting through layers to uncover other influencing factors, such as dysfunctional family relationships, mental illness, or negative peer associations. Identifying environmental or psychosocial stressors may, in fact, be the most obvious place to start with a patient who presents with substance abuse problems. Less obviousand adding to the tangle of contributory factors-is the role of the brain itself, particularly a brain transformed by drugs.

Research supported by the National Institute on Drug Abuse (NIDA) has taught us that the brain continues to develop through adolescence and into early adulthood. We now know that age matters when it comes to substance abuse, and although we still don't know exactly how it matters, we suspect that the brain's inherent plasticity during this time has consequences related to age af first exposure, duration of use, and other temporal variables.

Adding genetic factors to the mix further increases causal complexity. Is early onset of drug use a genetic marker, for example, or a causal factor that increases risk for later abuse? In any case, because the transition from drug use to drug abuse and addiction typically occurs between adolescence and young adulthood, characterizing the factors underlying this developmental period is crucial to understanding the path to long-term substance abuse.

Research points the way

Innovative research is helping to shed light on the various ways in which drugs can change the course of brain development and behavior. Recent studies have delved into the role of the brain to see how exposure to drugs at different points along a developmental trajectory changes the brain and leaves individuals more vulnerable to later problems. This research is enhanced by the availability of new technologies and neuroimaging tools that allow us to study the human brain like never before, literally to see into the brains of people addicted to drugs and discover how drugs are affecting brain function. This capability, along with advances in genetics to identify genes of vulnerability or protection, will help tailor interventions that can have the greatest impact.

Longitudinal studies looking at physical, psychosocial, and environmental variables have identified risk factors such as having a parent who abused substances, higher levels of overactiveness, and deficits in social functioning. Current studies aim to elucidate further the risk factors during adolescence, including how peers and the frequency and content of parent-child communication about drug use influence behavior.

Other NIDA-supported research is investigating the development of substance use, abuse, and disorder, guided by a biopsychosocial model reflecting the complexity of factors involved: biological, sociocultural, parenting, peer, school, and cognitive-emotional, and how they all interact and transact across the developmental trajectory Studies to identify developmental pathways and biological mechanisms of vulnerability to substance use will inform early intervention and prevention strategies, will provide insight into why teens engage in risk-taking behavior, and will ascertain who is more (or less) susceptible to drug abuse and to long-term negative consequences. …

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