ADDICTION HAS MANY FATHERS, SCIENCE FINDS

Genetics, Home Environment Are Big Factors

Margaret Masure began hurtling down the road to addiction at an age
when most kids still have training wheels on their bikes.

Daniel Payne was a bit older before he started down that path but
still years from being able to drive a car legally.

They don't know each other, but they have much in common:

They're both from small towns ­ Masure from St. Johnsbury, Vt., Payne
from Hanover, Va. They used to steal beers from their dads before
branching out into a variety of drugs.

They have been "clean" for three years, thanks in part to several
12-step program meetings each week. And they're both preaching what
they practice by working for organizations that offer support to
people and families struggling with addiction.

Their stories touch upon themes made clear recently by scientists
searching for answers about the genesis and treatment of addiction.
The questions have plagued researchers for decades, but only in the
past several years have they had the tools ­ such as technology that
provides a real-time view of brain function ­ to unravel them.

The 2004 National Survey on Drug Use and Health found that of
Americans 12 and older, nearly 8.4 million were addicted to alcohol
and nearly 5 million were addicted to other drugs. About 1.4 million
were addicted to both, according to the survey by the federal
Substance Abuse and Mental Health Services Administration.

Thanks to advances in neurobiology, "we have enormous knowledge now
of what's going on" in addicts' brains, says George Koob, professor
of molecular integrative neuroscience at the Scripps Research
Institute in La Jolla, Calif. Koob, who calls himself an
"irrepressible optimist," says he is hopeful that new insights into
the mechanisms of addiction will lead to new treatments and reduced suffering.

They might debate the terms used to describe addiction, but top
scientists in the field pretty much agree on what it is.

"The inability to stop is the essence of what addiction is," says
Nora Volkow, director of the National Institute of Drug Abuse, part
of the National Institutes of Health. As Payne, 27, puts it, "my
favorite drug was more and all."

That's not to say that people who can't make it through the day
without latte grandes or Ghirardelli chocolate are addicts, says
Volkow, a self-professed "chocoholic" who has pioneered brain-imaging
studies of addiction. Caffeine does activate some of the same brain
circuits as the drugs of addiction, but only very mildly, she says.
Caffeine can be habit-forming, but Starbucks devotees won't risk jail
time or divorce to feed their habit.

Nor is addiction the same as dependence, although the American
Psychiatric Association's diagnostic manual says it is, says Volkow,
who's pushing to drop that wording. "Addiction is much harder to
treat. Everybody given an opiate (such as morphine) will become
physically dependent, but not everybody will become an addict."

But some do. Why?

For many, alcohol or drugs offer a quick fix, Koob says. "You're
using the drug to fix something that should be fixed by perhaps
getting a good night's sleep or pacing yourself." But the drug
eventually wears off, leaving the user feeling even worse than
before, and the cycle begins anew, Koob says.

If you want to know whether a child will turn to alcohol or other
drugs for a quick fix, look at his parents, says Mark Willenbring,
director of treatment and recovery research at the National Institute
on Alcohol Abuse and Alcoholism.

If the parents are abusing drugs, chances are high that the child
will, too, Willenbring says. Having only one or no parent in the home
or a psychiatric illness also raises a child's risk of addiction, he says.

Clearly, addicts are born and made, their genes and their environment
inextricably linked, says NIAAA director Ting-Kai Li. Even people
genetically predisposed to becoming addicted won't unless exposed to
alcohol or illicit drugs.

"Children who drink early in their childhood are four times more
likely to become alcoholics" than those who don't, Li says. One
reason: Their main source of alcohol is the well-stocked fridge or
liquor cabinet of parents who drink.

Payne says he began "experimenting" with his father's beer when he
was about 10. He got marijuana from older kids. "In the neighborhood
that I grew up in, everybody was doing it," he recalls.

Masure, 39, says she started stealing her alcoholic dad's beers at
age 5 or 6, around when he split from her mother. Her mother worked
long hours at a coin laundry, leaving Masure and her brother, three
years older and also a recovering addict, to fend for themselves.

"I hung around with people who were pot-smoking," Masure says. "Acid,
pot and lots of alcohol. Alcohol was like not even a drug."

Scientists have known for decades that separating young laboratory
animals from their parents made them much more likely to take
alcohol. Such studies "didn't have the impact they should have had,
because we didn't understand why," Volkow says.

Molecular biology is beginning to provide answers. A rodent study
published this year found that contact between offspring and parent
is necessary to activate a gene involved in the animal's response to
stress, Volkow says. Environmental stressors in childhood, such as
abuse, probably have a longer-lasting effect than similar stressors
in adulthood, Volkow says.

Thanks to imaging studies, "we have come to realize that the brain is
changing significantly during childhood and adolescence," she says.
Li says the frontal lobe may not fully mature until age 25.

Research has shown that stress is a major contributor to addiction.
People who repeatedly take drugs may end up with an exaggerated
response to stress, so minor stressors become major ones, says Frank
Vocci, director of NIDA's Division of Pharmacotherapies and Medical
Consequences of Drug Abuse.

And even after an alcoholic has stopped drinking or a drug addict has
stopped using cocaine, Vocci says, "stress is thought to be a major
inducer of relapse."

While other 18-year-olds were applying to college, Masure, a
ninth-grade dropout, started using cocaine and heroin. Prescription
narcotics, like Percodan, came later.

Masure worked for nine years in the same coin laundry as her mother.
"It was a beautiful setup for what I had planned, which was to party
all the time," she says. "I had no clue that I had so many more
options to get my needs met."

Payne actually graduated in 1999 from the Virginia Military
Institute. Despite the school's strict anti-drug policy, Payne says,
as a senior he smoked marijuana daily and used cocaine three or four
times a week.

In March 2001, he was placed on probation for setting fire to a
vacant dorm room. According to an account in The Roanoke Times, Payne
told the judge that the "spontaneous acts of stupidity" leading to
the fire were fueled by 30 beers, five shots of liquor and his anger
at a friend's dismissal from VMI.

Finally, Masure and Payne were scared straight. They say they've
stayed that way with the help of counseling and 12-step programs.

Masure saw the father of her 13-year-old daughter take a fatal
methamphetamine overdose five years ago. He was in his early 40s. "It
hit home: Wow, I could be next," recalls Masure, who says she had
been using heroin for three or four years before her former lover
overdosed. "I've got numerous longtime friends who have sobriety,"
Masure says. "I just watched their life get better and better while
mine got worse and worse."

Today, Masure is co-coordinator of the Kingdom Recovery Center, a
drop-in center, and of the Aerie House, a transitional residence for
women addicts who have been released from prison.

Payne always figured drugs or alcohol or both would kill him by age
25. At 24, he says, he found himself alone in a Richmond hotel room
with a gun in his hand. The experience, he says, was "an awakening,"
and he hasn't used drugs since.

He left his job as a surveyor last year to become head of operations
for the McShin Foundation, a non-profit "recovery resource"
organization in Richmond that was established by his 12-step sponsor.

One of the foundation's main goals is to reduce the stigma associated
with addiction. Says Payne: "We do get better, and we do heal."
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