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Who becomes addicted: genes, stress and dopamine receptors

Explains why some people use drugs without developing addiction while others do: genetics (including opioid and dopamine receptor differences), chronic stress, comorbid mental illness and social context.

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Psycho
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Drug effect
Chemistry alone doesn't make a drug good or bad.

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Four sources of risk

Genetic differences, stress (especially chronic), comorbid mental illness and social context all change the odds of moving from use to addiction.

Analogy and worked example

Analogy: Two people stand in the same rain. One has a good umbrella (protective genes, low stress, support), the other has holes in theirs (a risk variant, chronic stress, isolation). Same storm, very different outcome — the drug is the rain, not the whole story.

Why might a person with low D2 receptor density find a stimulant more rewarding than someone with high density?

  1. Fewer D2 receptors = less dopamine signaling at baseline for the same release.

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