In an excellent guide to understanding substance use from a health promotion perspective, the authors write,
Human experience is complex. Helping people understand that complexity, and giving them skills to manage it, helps make them actors (rather than victims) in their own lives. That said, no one is completely autonomous. Our choices and behaviours are influenced by a variety of factors, including biology, physical and social environments and events throughout our life course (Here to Help, 2013, p. 2).
The diagram above shows how our social and physical environment, as well as our personal biology (including genetics), influence the opportunities and constraints of our lives. In turn, these opportunities and constraints affect our behaviour across our life course.
The full guide can be accessed here:
Understanding Substance Use: A Health Promotion Perspective
One important element of behaviour formation in relation to substances and potentially harmful behaviours (e.g., gambling, compulsive relationship with sex/porn, shopping) is the role of the brain reward system. Brain systems involved with feeling pleasure and reward help reinforce behaviours that feel good or primitively, that are needed to survive. This reward system helps us feel satisfaction when we eat, have social interactions, exercise, or have sex by releasing the chemical dopamine. When levels of dopamine are elevated, we feel a sense of pleasure and reward that help reinforce these behaviours. Many substances, gambling, pornography, binge eating, video games, and more, are associated with the release of dopamine (Avena & Bocarsly, 2012; Bello & Hajnal, 2010; Linnet, 2020; Love et al., 2015; Nutt et al., 2015).
This video provides an explanation of how the brain reward system works and changes when people use substances: How an Addicted Brain Works
If the frequency or intensity with which we pursue dopamine-releasing experiences increases, our brain’s dopamine receptors become less sensitive, and we develop tolerance to that stimulation. While this is certainly not the only process that contributes to behaviour formation, it is a very important one. Indeed, there is conflicting evidence on whether certain substances lead to significant increases in the release of dopamine (Nutt et al., 2015). Moreover, a person’s individual genetic and biological makeup, as well as their social and environmental contexts will mediate how the physiological experience of dopamine-release impacts behaviour, preferences, choices, and priorities.
Thus, it is important to understand from an individual’s perspective why they are engaging in a particular behaviour—beyond the potential ‘feel good’ experience of having elevated dopamine levels in their brain. The image below summarizes the reasons that people may engage in substance use. However, these reasons can apply to other potentially harmful behaviours as well.
