The Stage Sequential Nature of Drug and Alcohol Use
It's based on first acknowledging what they call the stage sequential aspect of drug use, i.e. the idea that the trail from no substance or alcohol use to an alcohol or substance use disorder happens in a step-wise fashion, then recognizing that at each step, different genetic and environmental factors affect the trail of each individual in varying degrees.
Here's what their model seems like:
Stages of Alcohol/Drug Use, Genes, and Environment
Opportunity. This is the pre-use stage of alcohol and/or drug use. When alcohol or drugs are available, researchers conclude that individual alcohol or drug use is influenced by both genetic and environmental factors.
Genetic Factors: Genes linked to novelty seeking and risk taking.
Environmental Factors: Parental monitoring, neighborhood socioeconomic status.
Initiation of Use. This describes the first phase of alcohol or drug use. Researchers identify both genetic and environmental factors that affect the average person experience of alcohol or drug use, which, subsequently, has an impact on continued use or cessation of use.
Genetic Factors: Genes linked to subjective experience of alcohol/drug use.
Environmental Factors: Accessibility to alcohol or drugs, community norms around alcohol and drugs.
Continuation of Use. This describes the phase between initiation – your choice to make use of – and disordered use, i.e. addiction. Again, researchers identify both genetic and environmental factors that influence the transition from initiation or sporadic alcohol/drug use to regular or heavy alcohol/drug use.
Genetic Factors: Genes linked to drug/alcohol metabolism.
Environmental Factors: Peer influence, early trauma, i.e. childhood neglect or abuse.
Disordered Use and Treatment. This is the phase of use that was previously called addiction or dependence. We now describe someone in this phase as an individual living with an alcohol or substance use disorder. Little research has been performed in relation to aftereffect of genetics on treatment, while alanon orange county environmental factors linked to treatment are well-known.
Genetic Factors: Preliminary evidence suggests that people who have genes that produce them prone to early initiation of use may also be prone to clinical interventions aimed toward cessation of use.
Environmental Factors: Family history of treatment, social stigma around alcohol/substance use disorder treatment, socioeconomic factors related to gain access to to effective treatment.
This framework gives health scientists in addiction research discrete and manageable areas upon which to concentrate their research. In addition it allows them to focus on their work at specific populations, when applicable, and know what factors are at play for that population during each phase.
For instance, an investigation team may study the combined genetic/environmental effect on a person with a genetic risk for elevated novelty-seeking behavior who also experiences an environmental risk factor such as childhood abuse or neglect, and apply that research to the Opportunity stage identified above.
Or, an investigation team may study the combined genetic/environmental effect on a person who features a genetic risk linked to alcohol metabolism but lives in a environment that does not condone alcohol use, and apply the outcome of that research to the Continuation of Use stage. The combinations aren't infinite, but they are numerous, and this framework can help researchers focus their efforts and develop evidence that pharmaceutical companies, doctors, and clinicians may use to produce practical treatment and/or prevention applications.
