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Commentary
November 1998

General and Specific Inheritance of Substance Abuse and Alcoholism

Arch Gen Psychiatry. 1998;55(11):964-965. doi:10.1001/archpsyc.55.11.964

DRUG ABUSE and dependence are prevalent behaviors that are pernicious in their effects on individuals, families, and communities. However, while it is true that many addictive drugs have the ability to consistently elicit common neurochemical responses, a critical observation is that individuals are differentially vulnerable to addiction. The origins of differential vulnerability are either innate (genetic) differences in neurochemistry and behavior, environmental differences, or a combination of both. In Western cultures, we have attempted to prevent and reverse the course of addictions using interventions based in both moral and biomedical frameworks. An addiction is a bad choice (sin) to be chastised and it is also an affliction (disease) to be treated. The fact that we have failed too often with either approach suggests that a better understanding of the origins of addiction could be useful, to help people make better decisions and to improve the basis of intervention.

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