Addiction: is it in our genes?
Figures suggest that addiction causes 150,000 deaths in the UK each year, and researchers believe we may soon be able to pinpoint the genes responsible. But is it really all in our DNA or do we make a conscious choice to become an addict?
Ever since the 1600s when King James I recorded that the worst smokers were also the worst drinkers and that some people therefore had addictive personalities, scientists and doctors have tried to discover the cause of this kind of behaviour and find ways of preventing it from happening.
This dream of an addict-less society has recently been reborn. In the last two years, dozens of studies claim to have discovered genes for various addictions. Nicotine genes, alcohol genes, opiate genes, addictive-behaviour gene mutations, thrill-seeking genes - all of them documented in medical journals and widely reported as the breakthrough we've been waiting for.
But while the idea of addiction as a disease appears to make sense and suggests the possibility of a medical cure, are we not discounting the notion of free will and self-control? Can a child really be born a self-destructive addict?
No, it cannot, says Dr Neil Wright, a psychiatrist from the Queen's Medical Centre in Nottingham. "It is nonsense that a gene can dictate addiction," he says. "Why would we carry a gene for alcoholism at all? Genes carry basic building blocks, not complex social interaction."
Dr Wright concedes that genes do have some influence on behaviour and therefore certain people may be more likely to become addicts. However, he argues that such interaction is so complicated that the idea of modifying just one gene and overriding years of habit and experience is nothing but fantasy.
The author behind one study that pointed to an addiction gene, Dr David Collier of the London University Institute of Psychiatry, says addiction is caused by a combination of genetics and environment.
"There is evidence that genes influence addiction," he says. "Very few people say they have no effect but similarly no one says it is purely genetic. It's a mixture between the two."
A medical condition?
Dr Collier's study suggested that genes which encourage thrill-seeking and make people open to new experiences could cause addiction. He also concluded some genes might affect the intensity of a drug experience in different people. Combine the two and you have someone heavily drawn to a drug that may have addictive properties.
This is why some experts believe addiction is an illness - something someone gets, cannot help, and has to be treated for. Alcoholics Anonymous strongly believes that alcoholism is a disease. The support group encourages people who drink too much to realise they have a problem that has to be tackled head on.
Doctors too tend to believe that addiction - especially drug addiction - is beyond a person's control. Why else would addicts continue down a path that gradually ruins their life and which they themselves often say they wish to end?
A different approach
So what's the answer? Despite centuries of research, there is still not one undisputed cause of addiction and no proven method for tackling the problem. The closer we appear to get to understanding it, the more elusive it becomes.
Dr Wright takes a strong behaviourist approach and believes the problem is that various myths about addiction are self-perpetuating or encouraged by people with a self-interest.
It is both easy and convenient for addicts, doctors and rehab clinics to believe that an external force causes addiction, Dr Wright argues. Addicts are protected from blame, doctors can treat it in the traditional aloof fashion and rehab clinics get to sell a neat package that you can buy to conquer the problem.
Pure pleasure seeker
The reality, he argues, is that addiction is simply the result of constant decisions made in favour of a particular activity, whether that be drinking, smoking, injecting or even working or shopping, "because fundamentally we are pleasure-seeking and irrational beings".
He says the solution is to widen a person's social experience and bring them into contact with people who do not follow the same patterns.
So is this the future of tackling addiction and is the idea of an addiction gene dead in the water? It's unlikely. For now, it seems we are no closer to knowing what turns people into addicts as we are to knowing what makes some people happy and others sad.
Alcoholics Anonymous - www.alcoholics-anonymous.org
Action on Addiction - www.aona.co.uk