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Family History and Addiction Risk: What You Need to Know to Beat the Odds



You grew up in a family of substance users. You know that your risk for developing an addiction to drugs or alcohol is greater because of this hereditary factor. But what exactly are your risks? And is there anything you can do to reduce your risk?

According to the National Council on Alcoholism and Drug Dependence (NCADD), the single most reliable indicator for risk of future alcohol or drug dependence is family history. In an article written for NCADD, Robert Morse, MD, former Director of Addictive Disorders Services at the Mayo Clinic and member of NCADD’s Medical/Scientific Committee, says, “Research has shown conclusively that family history of alcoholism or drug addiction is in part genetic and not just the result of the family environment…millions of Americans are living proof. Plain and simple, alcoholism and drug dependence run in families.”

How Family History Affects your Chances for Addiction

Family history affects your chances of addiction in many ways. Genes are one important factor. But alcoholism and drug addiction are “genetically complex.”

Recent research has identified numerous genes, and variations within these genes, that are 005associated with the addictive process. One way genes affect a person’s risk for addiction involves how genes metabolize alcohol. Another is how nerve cells signal one another and regulate their activity. Such changes in genes can be passed down from one generation to another.

Perhaps the strongest evidence for heredity’s role in addiction comes from twin studies and adoption studies. Studies of twins found a 60% rate of similarity regarding addiction in identical twins vs. a 39% rate of similarity in fraternal twins. Studies of children adopted in infancy and studied for addiction risk in adulthood found that biological sons of alcoholics were four times more likely to become alcoholics, even when the adoptive parent had no issues with addiction, so the l factor of family environment was minimal.

But genetic predispositions are not the only factor in predicting the role of family history in addiction risk. Environmental aspects also play a role, even though they may be less significant in some cases.

Researchers have identified several family-related risks for increased vulnerability:

  • Family dysfunction (conflicts or aggression)
  • A parent who is depressed or has other psychological issues
  • One or more parents who abuses or is addicted to drugs or alcohol

Additional social and personal issues that contribute to risk include:

  • Limited social skills
  • Fragile self-esteem
  • Minimal or no support system
  • Personal history of impulsivity, aggression or difficulty managing emotions
  • A history of trauma or abuse (high risk for post traumatic stress)
  • Other psychiatric disorders such as depression, anxiety or bi-polar disorder
  • Friends or acquaintances who are regular users and who provide easy access to drugs or alcohol

Addressing and Reducing Risks

An alternative viewpoint regarding a family history link for addiction comes from a National Institute of Health (NIH) meta-study of 65 published papers documenting 766 study participants who were college or university students. Controlling for alcohol consumption and use disorders, family history was reviewed as the variable. The meta-study found that students who had family histories of alcohol or drug problems did not drink more but they were likely to be more at risk for problems that are associated with drug or alcohol use (ex: causing shame or embarrassment to someone; passing out or fainting; or having problems with school).

The bottom line is that there are still a lot of uncertainties when it comes to assessing drug and alcohol risks as they relate to family history. The good news is that even if you come from a family with a troubled history, or a history of addictions, that does not mean you will automatically become an addict. The risk is higher, but there are ways to prevent that from happening. You can choose to be proactive and greatly reduce your addiction risk.

Here are a few suggestions to reduce your addiction risk:

  • Avoid under-age drinking or substance use; early-onset of use increases risk
  • Choose abstinence or carefully monitor your consumption
  • Avoid associating with heavy drinkers or substance users
  • Manage your psychological health; seek assistance from a mental health provider if you are highly stressed, anxious or depressed
  • Participate in workplace or school prevention programs

Intervention Strategies

Should you already find yourself dealing with an alcohol or drug issue, here are some intervention strategies provided by the National Institute of Health, in their publication, Alcohol Alert:

  • Motivational Interview: This strategy focuses on enhancing your motivation and commitment to changing your behavior, if you are currently abusing drugs or alcohol. Typically you would work with an addictions counselor or mental health professional and discuss your beliefs, choices and behaviors associated with substance use. The purpose of the interview is to help you develop a realistic view of your use, problems associated with it and your treatment goals and expectations.
  • Cognitive–Behavioral Interventions: These strategies are taught by a counselor or therapist, or they can sometimes can be accessed via an online self-help program. They help you change your behavior by helping you recognize when and why you drink excessively or use illegal substances. Cognitive-behavioral approaches challenge irrational expectations about substance use and raise your awareness of how drugs or alcohol affect your health and well-being. They provide tools for mentally and emotionally addressing denial, resistance, self-criticism and shame.
  • Drug-Free Workplace programs: Many workplaces now help their employees who are abusing alcohol or drugs. Lifestyle campaigns encourage workers to ease stress, improve nutrition and exercise, and reduce risky behaviors such as drinking, smoking, or drug use. Other programs promote social support and volunteerism. Many Employee Assistance Programs offer employees referrals to substance abuse or other treatment programs, and may help pay for treatment.

Remember, the risk for alcohol and drug addiction does run in families. But you can manage the risk and avoid an addiction problem in your own life. Be proactive in monitoring your substance use, manage your mental and emotional health and seek support if you need it. The final outcome will depend on you and the choices you make today, not on your history.
Complete Article HERE!

“Porn” problems unlike any known addiction in largest neuroscience study

Like I’ve said all along…

When studying addictions, there are known relationships between certain stimuli and reactions in the brain. These reactions have, in some instances, become the benchmark for what constitutes an addiction and addiction-based behaviors.  There has been heated debate over the very existence of porn “addiction” and what that addiction would look like when studied.

porn addiction, no such thing

In the largest neuroscience study of porn addiction to date, research conducted at UCLA found a clear reversal of the brain’s typical addiction response in study participants when they were shown sexual images. With the use of brain wave monitoring, participants who reported major problems controlling their viewing of sex films showed decreased brain reactions when shown the sexual images, rather than heightened activity as having a “porn addiction” would suggest.

The study shows that the brain does not react the way an addict’s brain would react to cues for their drug of choice. In fact, the study shows that the hypothetical “sex addict” brain reacts in the opposite way that a drug addict’s brain reacts, questioning whether sex addiction actually exists.

“This finding is important, because it shows a reversal of a part of the brain response that has been consistently documented in other substance addictions and gambling disorder,” Prause said. She also noted that this was consistent with their previous study, in which participants served as their own control and no relationship existed between the severity of their sex film problems and their brain response.

Many self-identified “hypersexual” people say they have an uncontrollable urge for sexual stimuli, and that it has resulted in negative life consequences such as loss of jobs or loss of relationships. For this reason, many clinicians have suggested that “sex addiction” be diagnosed much like drug addiction.

“While we do not doubt that some people struggle with their sexual behaviors, these data show that the nature of the problem is unlikely to be addictive,” said Prause.

The study involved 122 volunteers, both men and women. Some had problems controlling their viewing of sex films and met suggested criteria for problem use of pornography by three different questionnaire measures. Others denied any problems with their viewing of sex films. The 122 participants viewed images and were monitored using electroencephalography (EEG) that measures brain waves. The images were of sexual and non-sexual scenes. They included photos of people skydiving and of a man and woman engaging in intercourse, among others.

The study measured the late positive potential (LPP). Co-author Greg Hajcak described, “The LPP reflects electrical activity of the brain that is recorded at the scalp and time-locked to the presentation of pictures.” The LPP is a very common measure in studies of emotion. “The size of the LPP reflects the intensity of an emotional response, and reflects brain activity occurring in the visual system and ancient subcortical structures,” explained co-author Dean

“Hundreds of studies have found that the LPP is larger for emotional compared to neutral pictures,” described Hajcak, “and previous work from myself and my colleagues have shown that cocaine addicts have an increased LPP to cocaine-related pictures.” To test for correlation with hypersexuality, one would expect the brain to show high rates of activity when shown sexual images. In this study, a reverse effect was shown.

“The extent that individuals struggle with attempts to control urges or other internal states such as thoughts or emotions may change how problematic pornography viewing becomes,” co-author and psychologist Cameron Staley added. “Labeling a person’s attempt to control urges a ‘sexual addiction’ may interfere with therapy approaches such as Acceptance and Commitment Therapy (ACT) that can reduce distressing sexual behaviors.”

The study appears in the current online edition of the scientific journal Biological Psychology (…).

Authors on the study are Dr. Nicole Prause, Liberos LLC (; Dr. Vaughn R. Steele, The Mind Research Network, UNM-Albuquerque; Dr. Cameron Staley, Idaho State University, Pocatello, ID; Dr. Dean Sabatinelli, University of Georgia, Athens, GA; Dr. Greg Hajcak, Stony Brook University, Stony Brook, NY.

This research was conducted in the UCLA Department of Psychiatry and Biobehavioral Sciences (, which is the within the David Geffen School of Medicine at UCLA for faculty who are experts in the origins and treatment of disorders of complex human behavior. The lead author is the founder at Liberos LLC, a company in the UCLA startup program devoted to neuroscience research and the treatment of human sexual problems.
Complete Article HERE!

Sex Addiction, or Too Much of a Good Thing?

This last post of 2010 will start with a declaration. One of my famous “Thus Sayeth Dr. Dick” sorta things, if you please.


I categorically reject the concept of sexual addiction that has been floating around in the popular culture for the last 20 years or so.

And yes, I know this will rankle a bunch of you, but you’ll just have to get over it. You see, there is no such thing as a sexual addiction. Period!

Nowadays people bandy about the term addiction as if it can be applied to any and all obsessive behaviors. I have an addiction to chocolate; I’m addicted to shopping; I’m addicted to video games; I’m addicted to porn—or, I’m a sex addict. NONSENSE!

That being said, I hasten to add that I do believe there are sexual obsessions and compulsive sexual behaviors, plenty of ’em in fact. However, obsessions and compulsions are not addictions, and addictions, while they may involve irresistible impulses, are not the same thing as compulsions. Get it? Got it? Good!

I want to be absolutely clear about this. An addiction is a very specific condition. It denotes a dual dependency, physical as well as a psychological.

  • A physical dependency occurs when a substance is habitually used to a point where the body becomes reliant on its effects. The substance must be used constantly, because if it is withheld, it will trigger symptoms of withdrawal.
  • Psychological dependency occurs when the substance habitually used creates an emotional reliance on its effects. There is no functioning without it. Its absence produces intense cravings, which if not fed will trigger symptoms of withdrawal.

Check it out. With the help of my handy-dandy dictionary, a good place to start in discussions of this sort, I discovered these three very distinct definitions:

Addiction: The need for and use of a habit-forming substance (as heroin, nicotine, or alcohol) characterized by well-defined physiological symptoms upon withdrawal. Broadly: persistent use of a substance known by the user to be harmful. A state of physiological and psychological dependence on a drug.

Compulsive: Driven by an irresistible inner force to do something; i.e., a compulsive liar.

Obsession: A persistent disturbing preoccupation with an often unreasonable idea or feeling.

See? Different words. Different meanings. Not a particularly complex notion to grasp, right?

And listen, just because a bunch of yahoo afternoon talks show hosts and even a load of my esteemed professional colleagues banter these words about like they were interchangeable doesn’t make it so. In fact, we do ourselves a huge disservice by muddling these very specific concepts into a jumble. My fellow therapists should be the first to recognize this because finding help for an addiction or an intervention for an obsessive/compulsive disorder will be as specific as the problem itself.

One thing is for certain: identifying one of the things, as the other will complicate the problem solving. It’s like going to the doctor with a headache, and when the doc asks where does it hurt, you point to your stomach. It just won’t do.

Hi Dr. Dick,
I recently found out my boyfriend has been cheating on me. He wants me to forgive him, but he keeps on doing the same thing over and over again. He’s like addicted to sex or something. I love him very much, but I feel dirty just by being around him and knowing what he’s doing. It also makes me feel stupid putting up with all of this and at the same time I still love him, please give me some advice. Thank You.
— Darlene

Before we turn our attention to your boyfriend’s behavior, let me make a quick observation about you. You’re a big fat ball of contradictions, huh? How can you say that you love the person that makes you feel dirty and stupid? You’re deceiving yourself about at least one of those feelings. And if I had to guess, I’d say what you’ve got with your man ain’t love—it’s an obsession.

Your boyfriend probably has you figured out by now, and he knows that you will tolerate his misbehavior, which gives him tacit permission to do whatever he feels like doing. From where I sit, you’re the real sap. If you’re really serious about reining in your wayward BF, you’d better come up with a clear, unambiguous message about what you will and will not tolerate. Until you do precisely that, he’ll just think that he can roam wherever he wants and whenever he wants.

If the two of you are supposed to be living in a sexually exclusive relationship, and he’s taking his business elsewhere, then he’s got a problem, too. However, I caution you against thinking that his sexual behaviors are an addiction. Because they’re not.  And thinking they are will not help you find the solution to the problems you folks are having.

There are root causes for his behavior, just like there are root causes for your behavior. To get to the bottom of all of this, each of you will need to invest a good deal of time and energy with a qualified therapist. One can only hope that there’s a big enough bank of goodwill between the two of you to carry the day because overcoming your obsession and his compulsions will demand all of your emotional resources.

Dear Dr. Dick,
I have been in a relationship for five years now and truly love my partner, however I can never seem to get enough sex. I am 30 and he is 29, but I constantly find myself in the chat rooms lookin’ for younger guys to have sex with. It’s more than just a hobby—it’s a habit! I’ve actually lost jobs because he’d be out of town and I’d spend almost every waking hour on the PC with a cocktail looking for sex, not caring about anything else. It’s like I’m addicted to sex. He knows I have played around (I actually have talked him into three-ways a few times), but he has no idea how extreme it’s become. I don’t know what’s wrong with me. I’m not unhappy with him. I just can’t seem to stop wanting sex with younger guys. Any suggestions?
— Brian

It’s interesting that you should tell me about your compulsive sexual behavior in the same breath that you tell me of your love for your partner. As you’ve probably guessed already, there isn’t really much of a connection between the two. Love and sex are two very different things. Sometimes they go together, but not always or even often for that matter.

It appears to me that you’ve really got two problems happening simultaneously: First, your compulsive prowling of the internet for sex (complicated, I might add, by your alcohol consumption). Second, the deception you’re practicing on your partner. Let’s deal with each of these in turn.

Your particular sexual activity, like any compulsive behavior (overeating, excessive shopping, etc.), is more than just a bad habit. It’s a serious psychological dysfunction. Take it from me: breaking this behavior pattern will be nearly impossible without some professional help. If the problem is as serious as you say, then you’d better seek help right away. This sort of thing, if left untreated, will not only destroy your relationship, it will ruin your life. When you seek that professional help, I encourage you to include information about your alcohol consumption. If there is an addiction in all of this, it’s the alcohol, not the sex. And in your case, the addiction may be fueling the compulsion.

Now, regarding your relationship. It’s imperative that you come clean with your partner about your sexual obsessions and compulsions, as well as your probable alcohol addiction. Not only will you feel better about not lying to him anymore, you’re going to need his support in overcoming the difficult obstacles you face. I suggest that you attend to this right away. There’s not a moment to lose.

Good Luck

A Boy’s Own Story

What follows is an exchange I had recently with a young Catholic Canadian man.

Hi Dr. Wagner

My Name is Jack, I am a catholic teenager who is wondering if the act of masturbation is still considered to be a sin. Also is it really considered to be gravely disordered and always morally wrong? I am 18 years old and I am somewhat late going through changes physically. I do believe that it is a natural way to find out about ones body and how it can be used. I have heard that it is not a sin but a natural and healthy thing to do. I have also heard that it is a sin. I have heard mixed reviews I have heard that a vast majority of both boys and girls do it. I can understand if one does it while thinking about other people then it is a sin but if one is doing it to get rid of old stuff then does it count as a sin. I have done it recently and I am going through puberty. There are no thoughts, images or fantasies involved. I do think that it is better then having a nocturnal emission and having to clean your underpants and to hide it so no one think that I wet the bed. I also believe that it is better to masturbate rather than waking up to find a sticky mess in my underpants, which has happened to me, and it was not fun. I don’t want to have to go to bed worrying about a mess in the morning. I have also heard that it can help reduce the risk of prostate cancer. Is it normal to feel confused about it after doing it? I am planning to talk to my parents and a priest to see what they think of it. If my parents say that it is natural and a normal thing to do does that mean it is all right to do. The only tricky thing is that I am not entirely sure how to approach the subject with them. I have mentioned it to my mother and she doesn’t seem to be bothered by it. She said that it is better to do that than to be out having intercourse with girls. I haven t done it in 3 weeks and I feel conflicted over it I see both views on the issue and I am not sure. I don’t want to feel guilty for doing something that has been labeled natural and normal. I love and believe in god and want to know what the views are on it. I do not have any addiction whatsoever I have very good control over myself nor do I need counseling or therapy. I am just a curious teenager wondering if masturbating is a sin or not.

I live in Ontario where the ministry of education has released a updated sexual education curriculum where it mentions that masturbation is natural and normal. There is a part of me that really wants to do it as I feel it takes the edge off. I have heard that some catholic organizations are backing it. This leaves me confused if it is still considered to be a sin. I also believe that it is a crucial part of understanding how ones body works and learning about oneself. I do find it a little hard to understand that we can somewhat accept the sexual orientation of people but people still consider touching ones genitals to be a sin.

Thank you
God Bless

Dear Jack,

Thanks for your question. Might I add, you are exceptionally articulate for a teenager.a boy's own story

If ya ask me, Jack, and you are actually asking me, you’ve pretty much answered all of your own questions. And that tells me you are on the right track.

You ask about Catholic sexual ethics. Before you wrote, did you know that I was a Catholic priest for 20 years? And, not to boast, I am the only Catholic priest in the world with a doctorate in human sexuality. This later part explains why I no longer practice as a public minister. It’s a real long story and I’d be happy to tell you all about it sometime, but for now know that I didn’t go quietly. I wrote my doctoral thesis, Gay Catholic Priests; A Study of Cognitive and Affective Dissonance, back in 1981. And once word got out about this groundbreaking research, the writing was on the wall, so to speak, for my public ministry. I fought for my priesthood and ministry for 13 year, but it all pretty much came crashing in on itself in 1994. If you’ve got nothing better to do, you can read about it HERE.

Enough about me, let’s get back to you and your questions. Although, I wanted to mention that when I was in seminary, way back when god was young, in the late 1960’s and early 70’s, enlightened spiritual directors were already beginning to advise us seminarians that masturbation wasn’t sinful or disordered. Of course, even now you’ll find orthodox hard-liners who insist that self-pleasuring is a moral sin, but they think all sexual expression is sinful. Here’s a tip: you’re never gonna find consensus on any sexual matter.

Like you, I found it difficult to believe all that mortal sin stuff that the hardliners promote. I mean, if mass murder and genocide are mortal sins, how could a little wank be their equal. It just don’t make no sense, right?

However, I can’t agree with you that masturbation might be sinful if there are fantasies involved. Remember, using your mind is an essential part of learning about your sexuality. That being said, most teenage boys are randy at the drop of a hat, so maybe you don’t need to be all that specific with your sexual mental imagery.

I also caution you to be careful when tossing around words like normal and natural. What’s normal and natural to some may be abnormal and twisted to others. But you’re right; few people, professional as well as lay people, these days would consider self-loving anything but normal and natural.

For you edification I suggest you use the search function or CATEGORY pull-down menu in the sidebar of my site and search for pertinent topics, like masturbation, wet dreams, sexual response cycle, etc. You’ll find a wealth of information about all these topics in both written and podcast form.

the shadowI too reported, back in 2011, on the startling new data that came out of Australia about masturbation. Australian researchers questioned over 1,000 men who had developed prostate cancer and 1,250 men who had not, about their sexual habits. They found those who had ejaculated the most between the ages of 20 and 50 were the least likely to develop prostate cancer. The protective effect of poppin’ one’s nut was greatest while the men were in their 20s. And get this; men who ejaculated more than five times a week were a third less likely to develop prostate cancer later in life.

I also contend that masturbation is the most basic building block to all of our sexual expression. When you know how your body works; when you are familiar with your sexual response cycle and are confident about talking to others about it; you’ll be better situated to be a good sexual partner to another.

In the end, I encourage you to continue to think for yourself when it comes to things sexual. I can see that you are already doing that, so keep it up. Continue to ask questions and consider the input you get from others, myself included; but then make up your own mind. When you own your sexuality and your sexual response, you’ll be a grown-up. Notice I didn’t say you’d be an adult. That’s because there are lots of adults out there who don’t own their sexuality and sexual response and despite being grown up, they’re not grownups.

Good luck, pup

Hi Richard,
Thank you for responding. You have cleared come of the confusion. I guess I got confused because when I would masturbate I would feel like I let my self down.
Thank you again
God Bless

One thing you should know is there is generally a sort of “let down” phase after orgasm. (See information about the refractory phase of the sexual response cycle HERE.) Your body can’t stay in that heightened state of arousal so there’s often a “deflated” feeling.

There’s even a name for if. It’s called post-coital tristesse. And you should know that it’s a physiological phenomenon rather than an emotional one.

Feelings of elation and wellbeing that accompany arousal and orgasm can sometimes morph into a sense of shame during this “deflated” phase. People with lot of scruples about sex are particularly vulnerable to this.

Thank you for clearing that up and for the reassurance that it is natural and normal and not considered to be a sin.
— Jack

Slut Shaming

Name: Martin
Gender: Male
Age: 50
Thanks in advance for your assistance, Dr. Dick.
Here’s my dilemma; I’m so in love with my partner, he’s actually the man of my dreams. We met much later in life, he being 45 and I’m 50.
I was married before w/children, out now as a gay man and all is well with my children’s relationship.
My partner has always known he was gay, has had numerable relationships, and was a sexual addict. He has wanted me to understand his past in relationship to his level of happiness now, stating that he was a bottom slut only because he was never truly in love or satisfied.
He wants me to believe that “I’m the one” that has changed his life-long addiction to strange dick up his ass.
I can’t seem to get past his past slut behavior, and oftentimes get so pissed off because he wants me to meet and develop friendships with many of these past fucks (primarily because they were military buddies also).
Why can’t I accept his slutty past and stop the suspicions?
Why do I get so upset just knowing that he was a total bottom slut??
How can I get him to understand that I have no desire to know any more about his sexual past and just focus on creating our lives???

Martin, Martin, Martin! How you do go on, darling.bullshit

Take a look at your language, why don’t ‘cha? Could you possibly be any more pejorative when speaking of the sexual experiences of someone who has lived a different lifestyle than you? I doubt it. Look at how many times you use the word “slut” to describe the man you say you love. I’m gonna call you out on that. You simply can’t tell me you love someone that you have so little regard for.

Your man wants you to understand his past, but you won’t take it at face value. You belittle his experience, possibly because it doesn’t match your own very limited, sexually exclusive, predominately heterosexual lifestyle.

circle jerkListen, lots of gay men (and some straight men) have loads of sex for lots different reasons. Sometimes just for the fun of it…or, as your man suggests, just to be a big old bottom slut. There’s absolutely nothing wrong with that. One can be happily sexual without loving each and every one of his partners. And the sex can be really good too. Just as one can have very unsatisfying sex with somebody one loves deeply. Sex, intimacy, and love are not necessarily dependent on the one another. No need to make such a tangle of it all, Martin.

I also want to reinforce my belief that there’s no such thing as a sex addict. Compulsive behavior? Sure! Out of control behavior? You betcha! Self-denigrating behavior? Absolutely! Sexual addiction? No way!

Try for just a minute to extricate yourself from your sex-negative mindset by exchanging the notion of eating when you talk about your friend’s sexual exploits. Would you have the same revulsion if your guy said he had shared food with lots of other guys? Some of it was fast food that didn’t satisfy all that much. Sometimes he ate just because he wanted to, not because he was hungry. And now he wants you and he, as a couple, to be friends with some of the men he ate with. Sounds perfectly reasonable to me!fingering his ass

Your man is inviting you to open yourself up and see life and sex as most openly gay men do. This is fundamentally different from how some formerly closeted men see life and sex. If you let him, he just might help heal you of your sex-negativity.

Finally, jealousy is one of the worst human emotions. It’s actually a kind of hatred, you know. Sometimes it’s hatred of another, but it is always self-hatred. You say you love this man; again, I challenge you on that. It’s clear to me that you have a much greater love of your provincial notions about sex then you have for this guy.

Here’s a tip, Martin. Jettison the unhealthy attitudes about sexual expression and give your guy a chance to be himself, not the idealized man you’ve made him out be, or think he should be. You’d be well served by working with a sex-positive therapist to help you get over this. Do it now, because if you hesitate you will surely ruin the very relationship you claim to treasure.

Good luck

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