Drug and alcohol addiction and abuse is rising. Researchers have found that “fear mongering” educational efforts to combat it in adolescents doesn’t work. New science has discovered that certain personality types are predictably predisposed to addiction risk, and that educational efforts can be targeted to them effectively.
- Dr. Natalie Castellanos Ryan, Assistant Professor of Psychoeducation, University of Montreal
- Maia Szalavitz, author, Unbroken Brain: A Revolutionary New Way of Understanding Addiction
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Drug Abuse and Personality
Reed Pence: Drug and alcohol addiction has become a public health crisis, rivaling anything America has faced over the last 50 years. According to a new report from the Surgeon General, and the report have the facts to back that up. More than 20 million Americans have substance abuse disorders, more than 66 millions of us binge drink every month, and since 200 the overdose epidemic has killed more than half million Americans. But how effective are we at combating it? There’s simply no way law enforcement can keep up and education? That hasn’t been successful either. Million of us remember grade school and middle school anti-drug programs like D.A.R.E – Drug Abuse Resistant Education, that research has shown are ineffective.
Dr. Ryan: So you do have now, quite a bit of evidence showing that these programs do not work and there’s even some studies showing that they can have negative affects, so students that receive their program or other kind of programs where its based on fear-mongering result in some students using more substances further than those.
Reed Pence: That’s Dr. Natalie Costellanos-Ryan, assistant professor of psycho-education at the University of Montreal. She’s a member of a team there that’s researching drug education for kids and she says traditional fear-mongering approaches don’t address why teenagers start using in the first place.
Dr. Ryan: Some young people will start using substances for internal motivations, some others will just use for peer pressure or to belong to a social group. Normally what happens is that use with internal motivations to use drugs, because of genetic vulnerability and maybe environmental vulnerability, and personality vulnerabilities. And will start using these substance regardless of the messages they’re given and they may then influence their peers.
Maya Salavitz: They don’t take into account why somebody would ‘want’ to use drugs. They don’t take into account that lots of people use drugs in order to feel more comfortable socially, in order to experience some sense of safety, in order to intensify their feelings, all the “Just Say NO” and the scare stories do is tell you what not to do – they don’t tell you what to do to deal with what’s going on with you.
Reed Pence: That’s Maya Salavitz, author of the book, Unbroken Brain – A Revolutionary Way of Understanding Addiction. She has personal experience with the failure of drug education; she says it did absolutely nothing to keep her from a six year path of psychedelics, cocaine and heroin starting in high school. She says, scare-tactics may make sense to the sense who develop the curriculum, but teenagers are at a developmental stage where they seek risks rather than being scared of them. She says teens are also at an age where authority figures such as police officers are probably not their favourite people. So having them teach the class may reduce it’s effectiveness. It also reveals the motivation of these kind of programs, which conflicts with the Surgeon Generals plea that addiction be considered as more than a moral failing.
Maya Salavitz: The whole point of D.A.R.E and the whole point of criminalizing drug use IS to stigmatize it and especially to stigmatize the people who get in trouble. I keep arguing all the time, yeah – if we really believed addiction is a disease we would decriminalize all drugs and we would treat it like any other disease, which is that you have to have respect and support for your patients, not treat them like dirt.
Reed Pence: Addicts are not all the same, Salavitz says, and drug education programs based on the assumption they are, are doomed to fail.
Maya Salavitz: One of the problems with the way we currently approach addiction is it’s really one-size-fits-all and we think there’s this one addictive personality that sort of is lying, manipulative, horrible, bad person personality. And actually the data does not find that. People with addiction are pretty much as varied as other people, except they tend to be on the extreme. So, somebody who is extremely bold and careless and antisocial is at high risk, but so is somebody who is extremely careful and compulsive and anxious.
Reed Pence: The school based anti-drug program, developed by the University of Montreal team, is based on a personalized approach. Their research has found that person’s personality traits are very important in determining whether they’re at risk of getting in trouble with drugs. For traits in particular raise the risk of addiction and Ryan says they can be used to predict which middle-schoolers are going to be in trouble with drugs a few years down the road. Those students can then be targeted to receive prevention effort tailored to their personality type.
Dr. Ryan: They all score on a certain level on all these traits, but those that are scoring particularly high on traits like; impulsivity, sensation seeking, hopelessness and anxiety sensitivity – those are the for traits we have most evidence on – were showing they are particularly vulnerable to future problems with substance abuse and mental health issues.
Reed Pence: Of the four traits that raise the risk of addiction, Ryan says ‘impulsivity’ is the most well researched.
Dr. Ryan: When we talk about impulsivity, we refer to the tendency to speak or act without thinking; it’s related to cognitive deficits that make it hard for us to stop behavior once we start. So for example, for youth with high impulsivity that have trouble stopping drinking once they’ve started, so they’ll tend to drink and try any substance and they can’t put stops on their behavior.
Reed Pence: A second risk raising personality is known as ‘sensation seeking’. They look for excitement, crave fun and have a very low tolerance for boredom.
Dr. Ryan: Normally sensation seekers are pretty well adapted young people; they do well at school, they’re very popular, but they do have a tendency to be sort of first to try drugs and alcohol, and they do particularly have troubles with binge drinking. But they don’t suffer from any other kind of mental health issues.
Reed Pence: Another trait that creates drug risk is ‘hopelessness.’ People with that trait look at things negatively, are more vulnerable to depression, and often use drugs to numb their negative thoughts. This is the trait that Salavitz put her at risk – she was high achieving, even gifted, but never thought she was good enough.
Maya Salavitz: I was really isolated socially and really lonely and really sad about it, and I thought that I was just sad and that it was unfixable. So, when I heard about psychedelic drugs I thought, “Wow! These seem to open up new worlds to you – I would like to try that.”
Reed Pence: The fourth personality trait Ryan’s team has identified is what she calls ‘anxiety sensitivity.’ That refers to a persons tendency to be highly sensitive to body sensations when they’re anxious.
Dr. Ryan: Some of them feel overwhelmed with these feelings. So for example, we all feel butterflies in our stomach or heartbeat raised when we’re anxious and not think much of it, but somebody high on anxiety sensitivity will start kind of panicking about the heartbeat change or the butterflies in the stomach, and might think the worst thing could happen – you know, that they might throw up. They might be using substances to calm themselves down or cope with their anxiety.
Reed Pence: But not only do different personality types use drugs for different reasons, Ryan says they also often use predictably different drugs. Sensation seekers are likely to binge drink, looking to get wasted. Hopeless types are more likely to numb their feelings with opioid painkillers. Some differences are even more striking – if they try same drug, people with different temperaments are likely to have completely different physical reactions to them.
Dr. Ryan: For example, adolescents or adults that drink alcohol may experience a change in their hear rate, so they’re heart rate will go up and they’re more likely to experience a high from the alcohol. Whereas, adolescents or individuals that are high on hopelessness or anxiety sensitivity will not experience a change in heart rate or will experience a decrease in heart rate.
Reed Pence: More successful drug prevention efforts will be the likely beneficiary of all these findings. The University of Montreal program called ‘Preventure,’ is aimed at middle schoolers. It begins with a questionnaire for students.
Dr. Ryan: The personality questionnaire is very simple, we use one that is particularly brief to be able to include in longitudinal studies, 23 items, and the questions for sensation seeking for example, would be “I would like to sky-dive” or “parachute out of a plane,” “I would like to learn how to ride a motorbike” – very general questions about kind of whether you like novel experiences, or you like trying new things – the kind of thing that adolescents won’t mind talking about or answering questions about. Whereas, if you ask them directly about their substance abuse then they feel a bit more nervous about answering those kind of questions.
Reed Pence: Ryan says those two-dozen questions are enough to predict with 70-80% accuracy, which students are at risk of abusing drugs a few years later.
Dr. Ryan: That’s a high of those we can detect that will develop problems, but scoring high on these traits does not mean that you ‘will’ definitely develop a problem. We are seeing that if we look at those that we select as high risk, it’s between 50 and 60% of that develop substance abuse problems or related mental health problem. Which means, roughly they could have a 1 in 2 chance.
Reed Pence: Knowing which kids are at risk and the personality types behind that risk, allow Rya’s team to intervene. Salavitz says, at risk kids are funneled t two 90-minute workshops where they learn how to cope with their particular deficit.
Maya Salavitz: They test the kids months before they introduce the programs. So that by the time they introduce the program, they’ve forgotten about this personality test they took like six months ago. So, then they offer these workshops about shaping your own personality for success, so they select into the one that’s related to impulsivity they select the impulsive kids into there. And the one that’s related to hopelessness, they select those kids into there. And of the course the smart ones realize, “Hey, all of us share the same thing here” and they ask they will be told honestly. But the thing about it that is really good is that it doesn’t label them as being “at risk.” It just says, this is a personality trait that you have, sometimes people have difficulty managing this trait – here is some ways you can do it.
Dr. Ryan: The regiments include cognitive-behavioral techniques used to basically target maladapted thinking or what we call “thinking errors” that are kind of unique for that personality trait. And we teach them coping skills, to learn how to better manage their personality vulnerability.
Reed Pence: The Preventure program has been tested in the UK, Canada, The Netherlands, and Australia. And Ryan says the results are extremely promising – for example, in one test binge drinking about attendees dropped by more than 40% compared to control group of high risk children who did not attend. But the benefits don’t stop there.
Dr. Ryan: There’s some evidence showing that those that received the programs have an influence on their peers and substance use of their peers are also reduced. So, it’s a selective program but can have beneficial effects to the whole school cohort.
Reed Pence: Aiming prevention efforts to children before their problems with drugs begin has been standard for decades. But now we’re beginning to find out the reasons kids start using and giving them the skills to address those needs in another way. You can find out more about all of our guests through links on our website, radiohealthjournal.net. You can also find archives of our programs there, as well as on iTunes and Stitcher. I’m Reed Pence.