Critically discuss the factors that may have led to John
developing a substance use disorder.
When looking into the possible factors that lead to the development of substance abuse
disorders in individuals one must use aspects from multiple approaches to generate a full picture to
say why this may happen to an individual such as John in this case. The approaches that are looked
at determining the potential factors are, the neurological approach, the psychological approach, the
socio-cultural approach. These approaches are applied to John and his behaviours to determine
what possible factors that have contributed to his diagnosis of the disorder.
The neurological approach uses biological explanation to address the causation of a patient’s
condition, specifically looking into the genetics and biochemistry of the individual. In the presented
case of John there is no stated evidence to say that he has a genetic vulnerability to becoming a
substance abuser. However, if this was further investigated you may be able to find possible links in
his heritage showing a possible genetic link such as his mother or father also being diagnosed with
the disorder. One other way to assess if there is a genetic factor is if John were to do a DNA test,
doing so may show that John has a specific gene sequence that predisposes him to being susceptible
to developing the said disorder. A study conducted by Comings et al (1994) investigated this and was
able to determine that the D2 (DRD2) dopamine receptor gene was responsible for putting people in
the vulnerable position of developing a substance abuse disorder. The study was able to show a 21%
increase of the presence of this gene in alcoholics when compared to a control and it also had a
higher increase of 32% in alcohol dependent individuals, these findings are consistent with other
studies showing association with severity of alcoholism and researchers were able to conclude that
this gene was significantly associated with substance abuse and dependance. As stated, before in
the provided details there isn’t any specific notation of John’s genetics but if investigated this could
, PSY2090 Psychology and Mental Health Essay
highlight a factor into why John has developed the disorder.
Another neurological point to look at is the biochemistry side of the argument with the idea
of neuroadaptation. Neuroadaptation is the process of how continued ingestion of a substance, in
this case alcohol, causes a change in neurotransmitter activity in the brain. Due to this the brain halts
production of its own neurotransmitters, this leads to the person becoming reliant on the ingested
substance to produce the effects that would’ve been produced normally by the neurotransmitter.
Evidence for this in alcoholics comes from Mira Bühler and Karl Mann (2011), findings in their study
found reduced volumes of grey and white matter and disruptions to neurotransmitter systems,
concluding that chromic alcohol use causes neurological changes. It was also concluded that these
changes can be reversed with sustained abstinence of the substance. Further studies have
investigated the neurological changes associated with excessive alcohol consumption such as one by
Sprow and Thiele (2012), they demonstrated the effects on multiple neurological systems such as the
GABAergic and dopaminergic systems and how these systems come to rely on the effects of alcohol
to function as intended. The consumption of alcohol also affects the activation of the reward center
(pleasure pathway) of the brain, indirectly stimulating dopamine activity. The repeated heavy
exposure also causes an increased sensitivity of the pleasure pathway in response to alcohol, so
more dopamine is released when exposed to alcohol making one want to seek out more when
drinking but also drink more often for this. With this knowledge applied to John it could be said that
a neurological change is a key factor in why he has developed a substance abuse disorder, the
neurological change has led to more frequent and heavier drinking for John as his brain how relies
on the alcohol for its effects on neurotransmission but requires more to achieve the effect it once
had.