Information on chronic pain and addicton

Christopher Frandrup, M.D., DABPM, FIPP

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Why Pregnancy Back Pain Occurs (And What To Do About It!)

Why Pregnancy Back Pain Occurs (And What To Do About It!) |

Why Pregnancy Back Pain Occurs (And What To Do About It!)

It’s no secret that pregnancy brings sweeping changes in a woman’s body from head to toe, but what about from front to back? Approximately 75% of pregnant women experience some degree of pregnancy back pain. Here’s why, and here’s what to do about it.

Why pregnancy back pain occurs

It seems obvious to state that growing a child brings about tremendous changes in a woman’s body, but pregnancy back pain is not only about the what, but also the where. Pregnancy shifts a woman’s center of gravity as the baby grows. The average woman gains between 25 and 40 pounds during pregnancy. A growing baby puts pressure on blood vessels and nerves in the pelvis and lower back. Little by little, weight shifts forward. Without thinking about it, it is common for women to compensate for this shift by moving their shoulders back. After nine months of this compensation, the lower back begins to feel compressed and tight.

Ligaments and connective tissues are also getting more fluid and relaxing to make way for shifts in the pelvis that occur during childbirth. This results in tremendous structural instability within the body, including the spine.

Another reason for pregnancy back pain is muscle separation in the abdomen. As a woman’s belly expands, the rectal abdominis muscles (two parallel muscles on the abdomen) separate to make room. This separation weakens the abdominal muscles in general. Weak abdominal muscles increase the chances for pregnancy back pain.

What to do about pregnancy back pain

While it is common, pregnancy back pain does not have to be inevitable. There are several things pregnant women can do from the moment they see two pink lines to prevent pregnancy back pain.


In the first trimester of pregnancy, when hormones are coursing through your body and wreaking havoc, it can be difficult to get motivated to get moving. Add fatigue to hormones and it’s a perfect storm of zero motivation.

Exercise, however, is imperative for a healthy pregnancy in general and to prevent pregnancy back pain specifically. When fatigue is high and hormones are raging, simple pelvic tilts to keep the muscles of the abdomen toned may be the only thing you can do. As you begin to feel better and more energetic, increase your exercise. Aim for low-impact workouts that engage the entire body. Think swimming, walking, and biking for full-body toning.

Prenatal yoga is also a great way to keep the back strong and healthy and to prepare for childbirth. Prenatal yoga focuses on breath as well as movement and can also help deal with the stress that may arise throughout pregnancy.

Improve your posture

Exercise will help with energy levels and keeping stress levels low, but poor posture when you aren’t exercising can still result in a sore back. If you are used to standing with poor posture, it can be challenging to re-train your body to stand correctly, but since it is already changing, pregnancy is a great time to make adjustments.

As a general rule, imagine that, when viewed from the side, there is a straight line that connects the ears, top of the arm bones, hip bones, knees, and ankles. Many of us slump forward, removing the curve in our backs, but pregnant women often have an exaggerated curve due to the weight of the baby. Learning how to stand correctly aligned helps the spine do the major work of supporting the body and allows the muscles to work more effectively with each other.

Try chiropractic care

Chiropractic care during pregnancy can be a great tool to help treat pregnancy back pain when it arises. When looking for a practitioner, ask if they have experience treating pregnant women, both before and after giving birth. Labor and relaxed, loose ligaments and tendons allow bones to actually shift during the powerful contractions of labor. Quality chiropractic care can help relieve back pain during pregnancy and may also help shorten labor, delivery, and recovery time post-partum.

Consider acupuncture

Acupuncture is an ancient Chinese medical practice that works with energy flow in the body. Practitioners believe that any sign of illness or pain in the body is a result of blockages in energy. These blockages are released when acupuncturists place hair-thin needles into specific points on the body to release the energy and allow it to move freely.

There is evidence that acupuncture can help with back pain, so it stands to reason that acupuncture could provide relief from pregnancy back pain. Large scale studies have shown that at the very least it provides relief similar to some medications. This is a plus for pregnant women who don’t want to (or can’t) take certain types of medicines. Additionally, acupuncture has few, if any, side effects and is rated as safe for people of all ages and conditions.

Consider drug-free post-partum solutions

Even if you have not experienced pain during pregnancy, pregnancy back pain may occur postpartum. Major shifts occur in the musculoskeletal system during pregnancy, labor, and delivery. A new study has found that osteopathic manipulative therapy (OMTh) in postpartum women can help reduce their back pain by as much as 70%.

Jennifer Caudle, DO, assistant professor of family medicine at Rowan University School of Osteopathic Medicine, pointed out that this type of care can relieve pregnancy back pain with little or no risk to the new mother, improving quality of life for both mother and child. She noted:

“Women who’ve recently given birth are rarely studied beyond screening for postpartum depression and delivery complications, even though it’s well documented that low back pain is a common issue that hinders their quality of life during an already stressful time. This study shows that osteopathic manipulative therapy can relieve their pain without medication that could be passed to a breastfeeding infant.”

Pregnancy back pain is common but not inevitable. If you have experienced (or are currently experiencing) pregnancy back pain, what worked to help you find relief?

What Herniated Disc Treatment Works?

What Herniated Disc Treatment Works? |

What Herniated Disc Treatment Works?

Herniated disc is one of the most painful, debilitating lower back pain conditions that a person can experience. The pain caused by herniated disc is different for each person who experiences it and can even change as the condition progresses. Because this condition can be unpredictable, a herniated disc treatment that works can also vary from person to person.

Herniated disc treatment – What is herniated disc?

The spine consists of 33 individual vertebrae, each stacked upon a fluid-filled sac that keeps the bones cushioned from rubbing against each other. This fluid-filled sac is called an intervertebral disc. It is made up of a jelly-like interior (the nucleus pulposus) and the outer layer that contains the nucleus pulposus (the annulus fibrosis). When an intervertebral disc herniation occurs, the outer layer becomes weakened, allowing the nucleus pulposus to leak out. The cushion between the bones is gone, and the result can be very painful.

A herniated disc can be caused by a number of different factors:

  • Time: The continued action and pressure of gravity as people age can begin to wear down the annulus fibrosis.
  • Injury: If the spine is injured (i.e., as a result of a car accident or other trauma to the back), the intervertebral disc may be weakened and begin to leak.
  • Improper use: A sudden, awkward movement such as lifting a heavy object improperly can cause a herniated disc.

Symptoms of a herniated disc are as varied as the condition itself.

  • Pain: Pain location varies depending on which disc is herniated. A herniated disc in the lower back can produce pain in the buttocks, thigh, and calf (and possibly the foot). If the disc is herniated in the neck, pain may be shooting in the arm and shoulder area.
  • Tingling or numbness
  • Weakness

Over time and left untreated, disc herniation can cause permanent nerve damage.

Herniated disc treatment – Risk factors to watch out for

There are several risk factors that increase the likelihood that a person will experience a herniated disc.

  • Age: Because herniated discs can be caused by bone deterioration, older adults have a higher incidence.
  • Genetics: There is a potential hereditary connection to disc herniation.
  • Weight: Being overweight or underweight increases an individual’s risk for developing herniated disc.
  • Lifestyle: Smoking contributes to bone density loss and can increase the spine’s vulnerability to fracture, either from injury or wear-and-tear. Excess consumption of alcohol and prolonged use of steroids can also contribute.
  • Occupation: Occupations that feature repetitive motion and twisting or bending increase a person’s risk of a herniated disc.

Herniated disc treatment – What works?

What herniated disc treatment works varies widely depending on many different factors. These include:

  • Location of the herniation
  • Activity levels
  • Other health conditions
  • Severity of the herniation

For some patients, a course of over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) combined with targeted exercise and strengthening may be all that is necessary. Most treatment plans are guided by the following steps.

Step 1: Anti-inflammatory medications

Whether over-the-counter or prescribed, a herniated disc treatment generally begins with a period of anti-inflammatory drugs used to control pain and inflammation. For some patients, this is enough to allow them to begin exercise or other activities to heal the herniated disc.

Step 2: Injections

Epidural steroid injections or nerve blocks may be recommended for those patients who find no relief with NSAIDs. These injections target the affected nerves directly. Steroid injections are anti-inflammatory and offer pain relief but have only been proven effective for approximately 50% of patients. Nerve blocks numb the nerve so that other treatments can begin.

Step 3: Physical therapy or chiropractic care

Because a herniated disc can be the result of decreased space between the vertebrae, doctors may recommend chiropractic care to help lengthen the spine and physical therapy to strengthen the supporting muscles. Physical therapists may design an exercise plan, offer manual therapy, apply hot and cold treatments, or administer electrical stimulation.

Step 4: Surgical options

Surgery is an option that is exercised only after all other options have been tried. If pain and numbness persists, the pain management specialist may recommend a surgical procedure called a discectomy. This procedure removes the herniated material that is pressing on the nerve and causing pain.

For more serious and unresponsive pain due to a herniated disc, the entire disc may need to be removed. This is a rare procedure that also includes inserting metal hardware to connect the remaining vertebrae for stability.

If a patient experiences sudden loss of bowel or bladder control, this is considered a medical emergency that is often addressed with surgery. This condition can become very serious very quickly, and patients should go to the emergency room if this arises.

Prevention before treatment for a herniated disc

As with many lower back pain conditions, the best way to treat a herniated disc is to take steps to prevent it from occurring in the first place. There are ways to keep your lower back safe and healthy.


Regular exercise that focuses on strengthening the abdomen and lower back is the best way to prevent a herniated disc. Rather than spending hours doing crunches, exercises that focus on the whole body are just as valuable. Swimming, standing poses in yoga (including planks), and targeted exercises for the back are excellent ways to help strengthen the muscles that support the spine.

Eat well

A well-balanced diet that includes plenty of calcium and vitamin D-rich foods helps maintain strong muscles to support the spine. A healthy diet also helps maintain an appropriate weight for your frame.

Stop smoking

Among other things, smoking contributes to a loss of bone density that can contribute to spinal fractures and herniated discs. Quitting smoking is one of the best things you can do for your health, with benefits that start just 20 minutes after your last cigarette. It may be difficult, but there are many resources out there to help.

Herniated disc treatment can be as varied as the herniated disc itself. Have you ever experienced herniated disc? What treatments worked for you?

Cortisone Shot In The Knee – What To Expect

Cortisone Shot In The Knee - What To Expect |

Cortisone Shot In The Knee – What To Expect

With any type of machine, the longer you use it, the more stress and strain is placed on its moving parts. This holds true with our bodies as we age. A common feature of aging is osteoarthritis. Osteoarthritis affects our joints and is seen as a “wear and tear” condition that is simply a function of our joints being used repetitively for a long period of time. We feel osteoarthritis most keenly in our weight-bearing joints. Knees in particular can be very painful. There are many different types of treatments for knee pain related to osteoarthritis or other conditions. A common procedure after rest, ice, and non-steroidal anti-inflammatory drugs (NSAIDs) is to get a cortisone shot in the knee. If you are considering a knee joint injection, here’s what to expect.

What is a cortisone shot in the knee?

A cortisone shot in the knee is a minimally-invasive procedure that involves injecting a corticosteroid into the knee. Corticosteroids help to suppress the immune response that is triggering inflammation. This inflammation is caused by the rubbing of bone on bone in the knee joint. Rubbing occurs in the joints as cartilage naturally wears thin over time.

A cortisone shot is just one type of knee joint injection. Others may include hyaluronic acid (HA) or platelet rich plasma (PRP). HA injections are generally aimed at restoring lubrication in the knee joint. PRP works to use the patient’s own red blood cells to repair damage. A cortisone shot in the knee focuses on relieving pain and inflammation specifically.

Conditions treated with a cortisone shot in the knee

Osteoarthritis is the most common source of knee pain, but there are other conditions that can affect this complex joint. Four bones make up the structure of the knee: the patella, fibula, tibia, and femur. Cartilage and ligaments connect all of these bones and keep them stable.

The posterior and anterior cruciate ligaments (the PCL and ACL) connect at the center of the knee joint and help stabilize the knee through rotation. The lateral and medial ligaments also help stabilize and support the joint, while the medical meniscus cartilage provides cushioning.

Damage, injury, or deterioration in any part of this joint can cause knee pain. In addition to pain caused by osteoarthritis, some of the most common pain conditions treated with a cortisone shot in the knee include:

  • Cartilage tear
  • Tendinitis
  • Bursitis
  • Gout

Each of these conditions causes inflammation, pain, and limited mobility.

The procedure

Before any treatments occur, a pain management specialist will take a complete medical history. A thorough physical examination that includes range-of-motion tests will be conducted.

In some cases, the doctor may request imaging such as X-ray or MRI to confirm a diagnosis. A cortisone shot in the knee may not be the first treatment offered if the pain is mild and can be managed in other ways.

If a cortisone shot in the knee is recommended, the knee will be thoroughly cleaned and sterilized. A local anesthetic is used most often, but patients may request mild sedation if that is more comfortable.

The pain management specialist uses fluoroscopy (live X-ray) to guide a very thin needle into the joint space of the knee. Proper placement of the injection is important for both patient safety and pain relief. Once located, a corticosteroid is injected into this space.

The entire procedure takes between 15 and 30 minutes. In many cases, pain relief is dramatic and occurs within 24 to 48 hours. Patients need only take minimal time off (usually just the day of the procedure).

Effects from knee cortisone shots

A cortisone shot in the knee is most effective for the first shot, with its pain-relieving effects diminishing slightly with each shot after. The effects of a shot can last from four to six weeks. Results can be improved if other lifestyle and supportive changes are made to manage knee pain.

Cortisone shots will not be injected directly into a tendon. If the pain management specialist believes that an inflamed tendon is the cause of pain, they may choose to place the injection near the tendon instead.

Potential side effects

Although a cortisone shot in the knee is minimally-invasive and non-surgical, there is a slight risk of side effects. Side effects are rare and generally mild. Short-term, less serious side effects can include:

  • Bleeding
  • Swelling, pain, or bruising at the site of the injection
  • Allergic reaction
  • Face flushing
  • Synovium inflammation
  • Insomnia
  • Temporary increase in blood sugar

Over time and with more injections, side effects can become more prevalent and serious. Tendons and cartilage may become weaker. Other long-term side effects of cortisone shots in the knee are:

  • Easy weight gain and puffiness
  • Easy bruising
  • Acne
  • Thinning skin
  • High blood pressure
  • Increased risk of osteoporosis
  • Cataracts
  • Bone damage (avascular necrosis or osteonecrosis)

Is a cortisone shot in the knee effective?

A meta-analysis of high-quality studies in the UK found that a cortisone shot in the knee was effective for relieving inflammation and pain in both the short and long term. The analysis also found that although there is concern for cartilage damage due to the corticosteroids, most cases of damage were due to the underlying disease, not the cortisone shot in the knee.

Another study compared the results of knee injections versus placebo groups and found clinical and statistical evidence that cortisone shots in the knee offered more pain relief at one week than placebo.

Finally, a meta-analysis in 2015 looked at all types of treatments for knee pain and found that a cortisone shot in the knee was the most effective. This meta-analysis included 137 studies with over 33,000 study participants total. The focus was on short-term pain relief, with the reviewers noting that long-term data is not robust enough to include.

In all of the research above, researchers are careful to note that a cortisone shot in the knee may address the symptoms of pain and inflammation in the short-term but underlying causes must be addressed for proper treatment. A knee joint injection may allow pain patients to begin other treatments, such as physical therapy, so that a holistic pain management plan can be implemented.

As with all potential treatments, talking to your doctor is the first step. Have you ever had a cortisone shot in the knee? Was it effective for your knee pain?

Cells May Remember Pain, New Pain Research Says

Cells May Remember Pain, New Pain Research Says |

Cells May Remember Pain, New Pain Research Says

While new pain research in the last decade has led to some deep understandings of why people hurt the way they do, the causes of chronic pain have often been elusive. Why do some people develop chronic pain after an injury or trauma while others move past the acute phase of pain without developing chronic pain? The answer may lie in the memory of cells. New pain research from King’s College London has found that some cells carry the memory of pain. This indelible footprint may explain why pain becomes chronic in some patients and not others.

New pain research targets cause of chronic pain

Regardless of cause, chronic pain of all types has one trait in common: a highly sensitized nervous system that overreacts to pain. Researchers at King’s wanted to examine why some nervous systems responded this way after injury while others returned to their previous state. They wanted to see if there were any changes in the epigenetics of cells in the immune system that might cause the changes in the nervous system. Epigenetics is the study of genes to see which traits are expressed and which remain hidden.

First author Dr. Franziska Denk from the Wolfson Centre for Age Related Diseases at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London believes that the goal of this study was to reveal the reasons why the nervous system would continue to be overly active, saying:

“We already knew that chronic pain patients have nerves that are more active…it is unclear why these nerves should remain in this overactive, highly sensitive state, even when the initial injury or disease has gone: the back pain from two years ago that never quite went away or the joints that are still painful despite your rheumatoid arthritis being in remission.”

Dr. Denk and his team hypothesized that due to nerve damage, cells were no longer able to perform one of their most basic functions – replacing damaged cells with new cells that function properly. Dr. Denk noted:

“Cells have housekeeping systems by which the majority of their content are replaced and renewed every few weeks and months — so why do crucial proteins keep being replaced by malfunctioning versions of themselves?”

The research team found that in mice, pain left epigenetic “marks” on cells. Some of the cells continued to function normally. This led researchers to believe that although these marks don’t necessarily mean chronic pain is inevitable, they may mean that cells carry the memory of the injury and may have changed behavior in the future. This changed cell behavior can include things like the inability to replace themselves or repair damage.

Professor Stephen McMahon from the IoPPN at King’s College London points out that this discovery raises even more questions than it answers, noting:

“This research raises many interesting questions: do neurons also acquire epigenetic footprints as a result of nerve injury? Do these molecular footprints affect the function of proteins? And are they ultimately the reason that chronic pain persists in patients over such long periods of time?”

The study was co-funded by the Wellcome Trust, and Dr. Giovanna Lalli, neuroscience and mental health senior portfolio developer there, noted that this new pain research can be a stepping-stone to more personalized treatments for chronic pain, saying:

“People develop chronic pain for a huge variety of reasons. We therefore need an equally diverse range of treatments to tackle the different root causes. The clues from this study, suggesting epigenetic changes may be involved in pain persisting, will hopefully lead us to better understand the mechanisms underlying chronic pain.”

Epigenetics research on chronic pain treatment

Epigenetics may hold the key to unlock the mystery of chronic pain. This field of study looks specifically at environmental causes of changes in genes rather internal changes to DNA. While science may not be able to change internal factors of changes to the genotype, understanding how external forces change cells can help develop more targeted treatments based on cell behavior.

In looking at the behavior of cells that seem to carry the memory of pain, researchers may be able to learn how to heal these epigenetic marks. Previous research on the epigenetic mechanisms of chronic pain found that persistent inflammation and pain did cause stable cell change. Knowing that these changes are brought about by environmental factors, not changes in DNA sequence, may help to better target treatments to effectively “erase” that memory of pain.

Erasing the memory of a cell is possible. This may inform the next generation of treatments for chronic pain. Babraham Institute scientists and their colleagues at the Cambridge Stem Cell Institute and the European Bioinformatics Institute have found that it is possible to return human cells back to their base-state, erasing any changes due to environment. Dr. Gabriella Ficz, the doctor who conducted the epigenetic analysis of the cells as a post-doctoral researcher noted the promise this new pain research finding could hold:

“This study brings us one step closer to the ultimate aim in regenerative medicine of using patient-derived cells to avoid immune rejection in cell and organ replacement therapies. It’s all about finding out what the cell needs in order to survive and multiply while making sure that they have lost the memory of the tissue they came from. Both conditions need to be fulfilled for successful use of embryonic stem cells in tissue generation.”

Professor Wolf Reik, group leader at the Babraham Institute, explained the application to other potential conditions, including chronic pain, noting:

“We can liken this reprogramming to giving cells amnesia so they forget any previous developmental decisions they have made. Returning them to this state means that we can then control their cellular decisions, allowing us to generate the particular types of cells needed. This area has huge medical potential, for example, being able to provide reset stem cells back to a patient that we can be confident will develop into the correct cell type as required, for example, nerve cells.”

If cells affected by chronic pain can be re-set, the potential to cure that chronic pain exists.

What is a drug addiction?

Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services
Drug Facts: Understanding Drug Abuse and Addiction
Many people do not understand why or how other people become addicted to drugs. It is often mistakenly assumed that drug abusers lack moral principles or willpower and that they could stop using drugs simply by choosing to change their behavior. In reality, drug addiction is a complex disease, and quitting takes more than good intentions or a strong will. In fact, because drugs change the brain in ways that foster compulsive drug abuse, quitting is difficult, even for those who are ready to do so. Through scientific advances, we know more about how drugs work in the brain than ever, and we also know that drug addiction can be successfully treated to help people stop abusing drugs and lead productive lives.Drug abuse and addiction have negative consequences for individuals and for society. Estimates of the total overall costs of substance abuse in the United States, including productivity and health- and crime-related costs, exceed $600 billion annually. This includes approximately $193 billion for illicit drugs,1$193 billion for tobacco,2 and $235 billion for alcohol.3 As staggering as these numbers are, they do not fully describe the breadth of destructive public health and safety implications of drug abuse and addiction, such as family disintegration, loss of employment, failure in school, domestic violence, and child abuse.

What Is Drug Addiction?

Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her. Although the initial decision to take drugs is voluntary for most people, the brain changes that occur over time challenge an addicted person’s self-control and hamper his or her ability to resist intense impulses to take drugs.Fortunately, treatments are available to help people counter addiction’s powerful disruptive effects. Research shows that combining addiction treatment medications with behavioral therapy is the best way to ensure success for most patients. Treatment approaches that are tailored to each patient’s drug abuse patterns and any co-occurring medical, psychiatric, and social problems can lead to sustained recovery and a life without drug abuse.Similar to other chronic, relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed successfully. And as with other chronic diseases, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse, however, does not signal treatment failure—rather, it indicates that treatment should be reinstated or adjusted or that an alternative treatment is needed to help the individual regain control and recover.

What Happens to Your Brain When You Take Drugs?

Drugs contain chemicals that tap into the brain’s communication system and disrupt the way nerve cells normally send, receive, and process information. There are at least two ways that drugs cause this disruption: (1) by imitating the brain’s natural chemical messengers and (2) by overstimulating the “reward circuit” of the brain.Some drugs (e.g., marijuana and heroin) have a similar structure to chemical messengers called neurotransmitters, which are naturally produced by the brain. This similarity allows the drugs to “fool” the brain’s receptors and activate nerve cells to send abnormal messages.Other drugs, such as cocaine or methamphetamine, can cause the nerve cells to release abnormally large amounts of natural neurotransmitters (mainly dopamine) or to prevent the normal recycling of these brain chemicals, which is needed to shut off the signaling between neurons. The result is a brain awash in dopamine, a neurotransmitter present in brain regions that control movement, emotion, motivation, and feelings of pleasure. The overstimulation of this reward system, which normally responds to natural behaviors linked to survival (eating, spending time with loved ones, etc.), produces euphoric effects in response to psychoactive drugs. This reaction sets in motion a reinforcing pattern that “teaches” people to repeat the rewarding behavior of abusing drugs.As a person continues to abuse drugs, the brain adapts to the overwhelming surges in dopamine by producing less dopamine or by reducing the number of dopamine receptors in the reward circuit. The result is a lessening of dopamine’s impact on the reward circuit, which reduces the abuser’s ability to enjoy not only the drugs but also other events in life that previously brought pleasure. This decrease compels the addicted person to keep abusing drugs in an attempt to bring the dopamine function back to normal, but now larger amounts of the drug are required to achieve the same dopamine high—an effect known as tolerance.Long-term abuse causes changes in other brain chemical systems and circuits as well. Glutamate is a neurotransmitter that influences the reward circuit and the ability to learn. When the optimal concentration of glutamate is altered by drug abuse, the brain attempts to compensate, which can impair cognitive function. Brain imaging studies of drug-addicted individuals show changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control. Together, these changes can drive an abuser to seek out and take drugs compulsively despite adverse, even devastating consequences—that is the nature of addiction.

Why Do Some People Become Addicted While Others Do Not?

No single factor can predict whether a person will become addicted to drugs. Risk for addiction is influenced by a combination of factors that include individual biology, social environment, and age or stage of development. The more risk factors an individual has, the greater the chance that taking drugs can lead to addiction. For example:

  • Biology. The genes that people are born with—in combination with environmental influences—account for about half of their addiction vulnerability. Additionally, gender, ethnicity, and the presence of other mental disorders may influence risk for drug abuse and addiction.
  • Environment. A person’s environment includes many different influences, from family and friends to socioeconomic status and quality of life in general. Factors such as peer pressure, physical and sexual abuse, stress, and quality of parenting can greatly influence the occurrence of drug abuse and the escalation to addiction in a person’s life.
  • Development. Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction vulnerability. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it will progress to more serious abuse, which poses a special challenge to adolescents. Because areas in their brains that govern decision making, judgment, and self-control are still developing, adolescents may be especially prone to risk-taking behaviors, including trying drugs of abuse.

Prevention Is the Key

Drug addiction is a preventable disease. Results from NIDA-funded research have shown that prevention programs involving families, schools, communities, and the media are effective in reducing drug abuse. Although many events and cultural factors affect drug abuse trends, when youths perceive drug abuse as harmful, they reduce their drug taking. Thus, education and outreach are key in helping youth and the general public understand the risks of drug abuse. Teachers, parents, and medical and public health professionals must keep sending the message that drug addiction can be prevented if one never abuses drugs.


  1. National Drug Intelligence Center (2011). The Economic Impact of Illicit Drug Use on American Society.Washington D.C.: United States Department of Justice. Available at:, 2.4MB)
  2. Centers for Disease Control and Prevention. Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004. Morbidity and Mortality Weekly Report. Available at: (PDF 1.4MB).
  3. Rehm, J., Mathers, C., Popova, S., Thavorncharoensap, M., Teerawattananon Y., Patra, J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet, 373(9682):2223–2233, 2009.

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