Democrats Ask Drug Policy Office to Do More to Combat Opioid Epidemic
Twenty Democratic senators are asking the Office of National Drug Control Policy to do more to combat the opioid epidemic, according to the Associated Press.
From the founding of National Families in Action during the height of the War on Drugs to Joseph A. Califano's book, How to Raise a Drug-Free Kid, parents and communities have been touted as the keys to preventing alcohol and other drug problems among youth, and research now shows that environmental and genetic risk factors can be trumped by parental engagement during the critical adolescent years, according to Nora D. Volkow, M.D., director of the National Institute on Drug Abuse (NIDA).
“Parents are incredibly important in raising drug-free kids, but in many instances they are not there or are not involved” — absences that can have measurable effects on brain development as well as other aspects of growing up — said Volkow. For example, studies of orphans have demonstrated that the brains of children who lack connections to parents actually mature more slowly, raising the risk of drug use and other impulsive behaviors.
Half of all vulnerability to addiction can be traced to an individual's genetic background, but that hardly means that a child's fate is sealed if they have a family history of addiction. Rather, Volkow said that addiction is, in many ways, a developmental disorder that is intimately linked to the maturation of the brain from childhood through adolescence and into early adulthood.
Delivering the keynote address at the Nov. 17 CASACONFERENCESM How to Raise a Drug-Free Kid: The Straight Dope, organized by the National Center on Addiction and Substance Abuse (CASA*) at Columbia University, Volkow compared this brain development to a sculptor taking a block of stone and transforming it into a work of art.
“In childhood the brain is particularly 'plastic,'” said Volkow. “It is open to stimuli much more than as an adult, and these stimuli affect brain formation both physically and chemically.”
A child's cerebral cortex — the brain's center for memory, attention, perceptual awareness, thought, language, and consciousness — starts out larger than that of an adult, but shrinks as the brain differentiates during the first two decades of life. “The brain of an adult is much more connected than that of a child,” noted Volkow.
The frontal cortex — critical for using cognitive control to regulate desires — is the last part of the brain to fully differentiate, said Volkow, which helps explain why adolescents are especially prone to risk-taking and experimentation. As the brain advances on its “developmental trajectory” it can be strongly influenced by environmental factors, she said.
“Social stresses are crucially important,” Volkow said, pointing to the Adverse Childhood Experience (ACE) Study research showing that risk of drug abuse rises tenfold among individuals who experience five or more “adverse childhood experiences,” such as recurrent physical or emotional abuse.
“Studies of children raised in orphanages showed that their brain connectivity was much less developed than those with normal parenting,” added Volkow; the effect was most pronounced among the children who had been living in orphanages the longest. The research “directly connected the lack of parenting to delays in the development of the brain,” she said.
Children who are genetically predisposed to addiction rarely suffer from drug problems if they have parents who are actively involved in their lives, according to researchers. Those who have both genetic vulnerability and absent or uninvolved parents have a “very significant increase in drug addiction,” however, according to Volkow.
Studies of prevention programs like “Preparing for the Drug-Free Years” (PDF) and “Communities That Care” demonstrate that parents, families and communities can create an environment that is protective against youth drug abuse. Moreover, said Volkow, researchers have found that interventions can actually improve dopamine levels in the brain.
“Even though kids may be born to very adverse environments, the plasticity of the brain now gives us a path forward in terms of identifying interventions to help reverse the changes caused by these stimuli and increase the likelihood that kids will be able to stay drug-free,” said Volkow.
*The National Center on Addiction and Substance Abuse at Columbia University is neither affiliated with, nor sponsored by, the National Court Appointed Special Advocate Association (also known as “CASA”) or any of its member organizations with the name of “CASA.”