Cassandra: Case Study
There is evidence that substance abuse and other mental disorders associated with substance abuse such as anxiety and depression have strong genetic links. In the case of Cassandra, her father and her brother both have had substance abuse issues. For example, "a NIDA-sponsored study of alcohol dependent patients treated with naltrexone found that patients with a specific variant in an opioid receptor gene, Asp40, had a significantly lower rate of relapse (26.1%) than patients with the Asn40 variant (47.9%)" (Genetics of addiction, 2008, NIDA). However, the genetics of addiction are not like the genetics of sickle cell anemia, in which a single, targeted variation causes the illness. At best, there are certain genetic patterns which increase the tendency to develop certain addictions, in the presence of other social factors.
Cultural influences, such as an environment where addiction is the norm rather than the exception can lead genetically vulnerable people like the individuals in Cassandra's family to develop addiction. However, epigenetics, or how genes can be...
"Changes in gene expression in brain reward regions are thought to contribute to the pathogenesis and persistence of drug addiction" (Renthal & Nestler 2008). Drug addiction can effectively rewire the brain's reward-seeking mechanisms. Drugs cause a flood of 'feel good' chemicals to flood the brain and eventually the brain stops making adequate amounts on its own, requiring more and more of the drug on the part of the addict not simply to feel high but just to feel 'normal.' Thus although the brain of addicts may begin as somewhat different from those without a predisposition for addiction, the act of addiction itself causes brain changes that foster and support chemical dependence.
Cassandra has grown up in a home where violence is the norm, specifically violence against women. The males in her immediate family acted violently towards the women in their lives as well as were substance abusers. This might indicate that their substance abuse has roots in anxiety and depression, given that it is very common…
