The role of personality in addiction is a major issue, with some believing in an 'addictive personality' and others suggesting different personality types might predispose to different aspects or forms of drug misuse. (26,27> In this highly controversial field a few facts are generally agreed. Predisposition to experiment with both licit and illicit drugs is more likely in those with sensation-seeking or impulsive behaviour traits, and in extroverts rather than introverts. However, once drug dependence is established, those with obsessional, dependent, or anxious characteristics find it hardest to stop. (2B)
The genetics of drug abuse are beginning to be unravelled and already these studies have thrown up some important insights in relation to personality. The best studied dependence is that on alcohol, where the Scandinavian adoption studies have found the risk of alcoholism in male children of male alcoholics is the same regardless of whether the child is reared with the alcoholic father or by a non-drinking adoptive family. Building on these data, Cloninger (27) has identified two main forms of alcoholism. Type I is the late-onset form that has low inheritance and is associated with anxiety and stress which drinking is used to relieve, often in binges. In contrast, type II alcoholism starts at a younger age with a heavy regular intake and is associated with antisocial personality traits and criminality. This form is male limited, is associated with impulsivity, and may be related to underfunctioning of brain 5-hydroxytryptamine systems, as genetic polymorphisms of 5-hydroxytryptamine receptors and enzymes have been found in these subjects. (29>
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