Addiction: Childhood Trauma, Stress and the Biology of Addiction
Gabor Maté, MD
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Keywords

addiction
trauma
stress
development
vulnerability
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Abstract

Rather than choice, chance or genetic predetermination, it is childhood adversity that creates the susceptibility for addiction.

Humans and animals require nurturing from a caregiver in order to survive, When a child does not receive consistent, secure interactions, or experiences painfully stressing ones, maldevelopment results. In vivo studies have shown that marked alterations in neurotransmitter systems occur within one week of separation from the mother, whereas animals receiving various kinds of nurturing contact during their infancy have shown more efficient brain circuitry for reducing anxiety as adults. Moreover, in vivo studies have demonstrated that animals exposed to prenatal stress exhibit characteristics of drug addiction, alcoholism and increased risk of self-administration of drugs.

Early trauma has consequences for how human beings respond to stress. Trauma in children, such as sexual, physical or emotional abuse or abandonment alter the child’s physical stress mechanisms and, as a result, the child is more reactive to stress throughout their adult life. Studies of drug addicts find high percentages patients have experienced childhood trauma of various sorts, including physical, sexual and emotional abuse.

The three dominant brain systems in all addictions—the opioid attachment-reward system, the dopamine-based incentive-motivation apparatus and the self-regulation areas of the prefrontal cortex—are all exquisitely fine-tuned by the environment. To various degrees, in all addicted persons these systems are not functioning properly

Accordingly, this article explores the relationship between childhood emotional loss or trauma and addiction, demonstrating a fourth brain-body system implicated in addiction: the stress-response mechanism.

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