接上篇《成瘾》，这篇同样转摘于Psychology Today.这篇文章细数了成瘾的各种可能理由，文章有点长，请耐心看完。

Causes of Addiction

成瘾的原因

There are many theories about the causes of addiction, the use and abuse of legal and illegal psychoactive substances. Biology, psychology, and social and cultural elements all play a role in the enormously complex causal bouquet that results in addiction, and different theories weight the elements differently. Together they reflect the fact that there is no one path to addiction, and no one factor makes addiction an inevitable outcome. Addiction can’t happen without exposure to agents, but that is hardly the determining factor. Addiction is not a property of the substance ingested or activity engaged in.

关于成瘾的原因有很多的流派。精神刺激类药物的非法使用和滥用，生物学，心理学，和社会文化因素都是引起成瘾极其复杂的因素之一。不同的流派对不同因素的看重程度不一样。他们一起反映出了一个事实：没有那条路是确定通向上瘾的，也没有任何一个因素使成瘾成为必然。没有一些中间因素，成瘾是不可能发生的。但那个中间因素几乎就是成瘾的决定性因素。成瘾不是所摄入物质的特性或者所从事的活动。

Instead, research indicates that it is more related to what else is, or isn’t, going on in a person’s life that makes the sensation a substance induces so attractive. Among the many factors that have been shown to influence the development of an addiction are feelings about oneself, emotional state, quality of family relationships, social ties, community attributes, employment status, stress reactivity and coping skills, physical or emotional pain, personality traits, educational opportunities, compelling goals and progress toward them, opportunities for and access to rewards in life, as well as physiological responses. While no factor predominates, each exerts some degree of influence.

相反，研究表明，成瘾更多的与其他事情有关。或者说，不是一种物质在一个人的生命中引起如此吸引人的感觉。已经表明影响成瘾发展的众多因素包括自我感觉，情绪状态，家庭关系质量，社会纽带，社区属性，受雇状态，应激反应，应对技巧，身体或精神上的痛苦，个人魅力，受教育机会，令人信服的目标和朝这些目标所取得的进展，通向或者到达人生奖赏的机会，也包括人的生理反应。这些因素没有哪个占主导地位，每个都在一定程度上发挥作用。

What are the most common causes of addiction?

什么是成瘾的最普遍的原因。

There are no substances (or activities) that universally or uniformly cause people to become addicted. And the vast majority of people exposed to most substances (or activities) considered addictive do not in fact develop addiction to them. Rather, a very complex array of cultural factors, social factors, and situational factors mingle with psychological factors, biological factors, and even personal values to influence the possibility of addiction.

没有一个普遍的或统一的物质或活动会使人成瘾。绝大多数人表现出的大部分物质或活动事实上并不能导致他们成瘾。反而，很多复杂多样的文化因素，社会因素和情境因素与心理因素，生理因素甚至个人价值观交织在一起，共同影响了成瘾的可能性。

Many different theories of addiction exist because they weight the role of contributing factors differently. Some current models of addiction emphasize the causative role of individual variations in biology or genes that make a substance or experience feel more or less pleasurable. Many models of addiction highlight the causative role of individual psychological factors, whether personality factors such as impulsiveness or sensation-seeking, or psychopathology such as the negative effects of early trauma. Other models of addiction emphasize the role that social and economic factors play in shaping behavior, such as the strength of family and peer relationships and the presence of absence of educational and employment opportunities.

对构成成瘾因素的权重不同发展出了许多不同的成瘾流派。一些当代的成瘾理论把原因归结为个体在生物学或基因上的差异使得个体对物质或经验体验到快乐的多少。许多的成瘾流派强调个人的心理因素在成瘾形成过程中的作用，像冲动或感性等人格因素或者像早期创伤所带来的负面影响等精神病理学因素。其他的流派强调家庭的力量，同伴关系，失学和失业等社会和经济因素在塑造个体行为时所起的作用。

What are the most common substances of abuse?

什么是最容易滥用的物质？

Around the world and in the U.S., nicotine is the most widely used addictive substance; tobacco causes a reported 40 million deaths worldwide. According to the National Institute of Drug Abuse, smoking kills more than 1,000 Americans every day, and although tobacco use is generally declining in the U.S. its use is increasing among some groups of young people, especially in the form of vaping, or inhaling nicotine vapors.

在美国和全世界，尼古丁是最广泛使用的上瘾物质。据报道，全球范围内，烟草导致了4千万人口的死亡。据国家药物滥用研究所的研究表明，每天有1000美国人因吸烟而死。虽然烟草使用在全美呈下降趋势，但在某些年轻群体中却呈上升趋势。特别是以电子烟或者以吸食尼古丁蒸汽的方式吸烟更是呈上升趋势。

Alcohol in some form is widely used for pleasurable purposes and is an important part of the social fabric worldwide, today as in ancient times. Nevertheless, according to the National Institute on Alcohol Abuse and Alcoholism, 14.6 million U.S. adults over the age of 18 have alcohol use disorder, marked by uncontrolled drinking. Around the world, 240 million people are reportedly dependent on alcohol; alcohol abuse is most prevalent in Eastern Europe and least prevalent among Asians.

尽管无论是古代还是现代，酒精都被广泛运用于助兴，它是全球社会结构的重要组成部分。根据国立酒精滥用和酗酒研究所的研究表明，一千四百六十万美国18岁以上成年人存在以酗酒为标准的酒精使用障碍。全世界范围内有24亿人被报道说存在酒精依赖。东欧酗酒的人最多，亚洲酗酒的人最少。

Painkillers including prescription opiates such as oxycodone and fentanyl and the illegal drug heroin account for more than 10 percent of all addictions in the U.S, affecting more than 2.5 million people, according to the American Society of Addiction Medicine.

美国成瘾医学会显示，在美国，对含有像羟考酮，芬太尼以及非法药物海洛因等鸦片成分的止痛药上瘾的人占所有成瘾者的十分之一以上，涉及到250万人。

Cocaine is a stimulant that is often taken intranasally (snorted) or injected intravenously but is considered to have the most potential for addiction because of the fast, intense high when smoked in the form of “crack.” Other stimulants that are subject to abuse are amphetamines, widely prescribed to combat attention deficit hyperactivity disorder and to foster alertness and energy.

可卡因是一种兴奋剂，它经常是被吸食或者通过静脉注射，它被认为是最容易上瘾的一种物质。因为吸粉时，它能使人体很快的到达强烈的快感。其他容易被滥用的兴奋剂是苯丙胺，一种被广泛用来对抗注意缺陷多动症和提高人的警觉性和能量的处方药。

Depressive agents such as sedatives and tranquilizers are widely used medically to combat stress, anxiety, and sleep disorders, but NIDA reports that 3.5 to 5 percent of the population uses tranquilizers and sleeping pills nonmedically.

引起抑郁的物质，像镇静剂，镇痛剂被广泛用来对抗压力，焦虑和睡眠障碍，但NIDA的报告显示，有百分之3.5到百分之5的在非医学使用镇痛剂和安眠药。

Are some substances more addictive than others?

有些东西比别的东西更容易上瘾吗？

The synthetic stimulant methamphetamine is widely considered one of the most addictive agents. Often inhaled, it directly affects the dopamine and other neurotransmitter systems system to produce an extremely fast and intense—but short-lived—high, with an altered sense of energy and power. Further, by changing the responsiveness of dopamine receptors, methamphetamine blunts the experience of reward from normal sources of pleasure.

合成兴奋剂甲基苯丙胺是一种被最多人认为的最容易上瘾的物品。它经常被吸食，它直接影响多巴胺和其他神经递质系统。它让神经系统在及短时间内产生激烈的短瞬即逝的力量改变的感觉。另外，通过改变多巴胺感受器的反应能力，甲基苯丙胺削弱了对正常事物快乐的感受能力。

Crack cocaine is also considered highly addictive. Cocaine processed so that it can be smoked, it enters the blood stream rapidly and produces a rapid “rush” of a high; the immediate response becomes powerfully reinforcing, driving the motivation to repeat the experience.

被爆破的可卡因也被认为是高成瘾性的。经过加工的可卡因可以被吸食。它很快进入血液循环，让血流快速冲高。这即刻的反应使得人体力量显著提高，促使人们来重复这种体验。

Are there risk factors for addiction?

有哪些因素对成瘾者来说是危险的？

There are many risk factors for addiction, from individual factors such as stress tolerance and personality makeup to social factors such as friendships and educational and job opportunities. They interact in dynamic ways unique to each person. But what addiction may come down to for everyone is the emotional and physical appeal of a substance at a particular moment in a person’s life. The effects of drugs are pleasurable and rewarding only in relation to how a person feels emotionally and physically in the context of his or her relationships and social life and other opportunities for development and reward.

对成瘾者来说，从耐压性，人格特点等的个人方面，到友谊，求学和就业机会等社会方面，都存在着很多危险因素。他们以独有的动态的方式与不同的个体产生交互作用。但是成瘾对每个人来说，就是他生命中某个特殊时刻对某种物质的思想上或者身体上的诉求。只有当某个个体的人际关系，社会生活，以及其他的个人发展和所受回报和他情绪或身体感受相关时，药品才能带给他们的愉悦的有回报的感觉。

Do genes play a role in addiction?

基因在成瘾过程中起作用吗？

Some studies show that genes can account for as much as 50 percent of a person’s risk for addiction, although the degree of genetic influence shifts in importance over time. For example, environmental factors such as family and social relationships are more strongly tied to use of alcohol and nicotine in adolescence than later in life. Nevertheless, there is no single gene for addiction nor even a group of genes.

一些研究表明，基因在个人成瘾的风险中能占到多达50%的作用。尽管基因影响的程度随着时间的推移而变化。例如，家庭和社会关系等环境因素对青少年比对成人使用酒精和尼古丁的影响更大。尽管如此，没有哪个单独的甚或哪组基因能对成瘾起作用。

However, there are a number of personality traits, each of which is partly genetically influenced, that contribute to the risk of addiction. These include impulsiveness, frustration tolerance, and sensitivity to rejection. Impulsivity is thought to play its strongest role in the early stages of addiction, driving the motivation for seeking drugs.

然而，有许多的受到部分遗传影响的人格特质会导致成瘾的风险。这些特质包括有：冲动，抗挫力，对拒绝的敏感性。冲动被认为是成瘾早期最重要的因素，它会驱使个体寻找毒品。

What biological factors influence addiction?

影响成瘾的生物性因素有哪些？

Biology contributes to addiction in ways beyond genes. How the body metabolizes, or breaks down and eliminates, foreign substances such as drugs or alcohol is heavily dependent on the presence of various enzymes, and they may vary significantly between individuals and even between ethnic groups.

生物学对成瘾的影响是超越基因的。机体代谢，分解和消化像毒品和酒精类的外界物质严重依赖于不同种类的酶的存在。酶在不同个体甚至不同族裔群体之间有显著不同。

For example, research shows that the Japanese have unique variations of certain alcohol-metabolizing enzymes that are not present in other populations, deterring alcohol consumption— and alcoholism—because it quickly gives rise to uncomfortable body sensations. Biological factors such as enzyme profile can influence the amount of alcohol people ingest, the pleasantness of the experience, harmful effects on the body, and the development of disease.

例如，研究表明，日本人有一种其他人群中没有的某种酒精代谢酶的变种，它能快速地提升人体的不适感，从而使人不能喝酒，当然也不能酗酒。像酶的形状等生物学因素能影响酒量，快感，对机体的损害程度以及疾病的发展。

What environmental factors influence addiction?

影响成瘾的环境因素有哪些？

There are many factors that influence addiction beyond genes and biology. One of the most significant is the family milieu and early life experiences. Family interactions, parenting style, and levels of supervision all play a role in development of coping skills and susceptibility to mental health problems. Studies have linked authoritarian or neglectful parenting, family violence, and divorce to increased likelihood of substance use problems later in life. Growing up with strong ties to and a sense of belonging—to a family, to a belief tradition, to a culture—are known to be protective against addiction.

除了基因和生物学因素之外，还有很多的因素会影响成瘾。其中最重要的是家庭环境和早期生活经验。家庭互动方式，父母类型和监管层级都对心理健康问题的应对方式和感受性的发展产生影响。研究表明，权威型或忽视型的养育方式，家暴，离婚都会提升个体后来物质滥用的可能性。强链接关系和有归属感的关系中，不管是归属于家庭，某种传统的信仰或是文化，都是已知的有助于防止成瘾的。

Peers play an enormous role in addiction susceptibility, especially among teens and young adults; most people use drugs for the first time as teenagers. Misuse of prescription drugs, for example, is highest among young adults aged 18 to 25, according to the National Institute of Drug Abuse. Alcohol is the most commonly abused drug among adolescents in the United States. The behavior patterns of friends influence everyone in the group. Further, psychological distress, especially depression and anxiety, has been shown to play an important role in such substance use.

易成瘾者尤其是青少年受同伴的影响很大，大部分第一次接触毒品的时间是十几岁。根据国家毒品滥用学院的报告表明，在18到25 岁的年轻人中间误食毒品的情况最为普遍。酒精是美国青少年最普遍的酗食物品。在那个群体中，每个人都说朋友的行为模式的影响。甚至，心理的苦闷，特别是抑郁和焦虑，对成瘾起到了重要的作用。

Does stress play a role in addiction?

压力在成瘾中起作用吗？

Stress is a risk factor for many kinds of nonadaptive behavior, and addiction is one. Researchers have long linked the effects of chronic stress to alcohol use. Stress relief may enhance the pleasurable effect of any substance. There is some research to support the view that adverse events in childhood and in adulthood change the responsiveness of brain systems. Adverse early life events and cumulative negative events in adulthood—especially those that are both unpredictable and emotionally distressing—alter reactivity of brain structures that govern learning, motivation, the control of distress and control of impulsiveness to increase susceptibility to addiction and to influence the risk of relapse. Stress also increases the risk of mood and anxiety disorders, which are linked to addiction.

压力是很多包括成瘾在内的不被社会认可的行为的危险因素。研究者早已把慢性压力和酒精使用联系起来了。压力的缓解可以增强任何物质的愉悦效果。有些研究支持了儿童期和成人期的不良事件可以改变大脑反应系统的观点。生命早期的不良事件和成人期累积的尤其是突如其来的让人情绪低落的事件会改变大脑控制学习，动机的结构，从而改变控制痛苦，冲动的能力，让人们更容易成瘾而且更容易复发。压力也使增加了情绪和焦虑症的风险，这也与成瘾有关。

What role does childhood trauma play in addiction?

童年创伤在成瘾中的作用？

Adverse childhood experiences (ACEs) such as trauma, especially combined with an unpredictable and chaotic childhood, pose a risk factor for many kinds of maladaptive behaviors and poor health outcomes. Studies show that having multiple ACEs puts children at risk of poor school performance, unemployment, and high-risk health behaviors including smoking and drug use.

童年的负面经验（ACEs)，比如创伤，特别是结合了始料未及和混乱的童年创伤是造成许多不适行为和不良健康结果的风险因素。研究表明，多重童年负面经验会把孩子推向学业糟糕，失业以及抽烟，毒品使用等危害健康的高风险行为。

Prolonged stress during childhood dysregulates the normal stress response and, through overproduction of cortisol, is especially harmful to the brain’s hippocampus, impairing memory and learning. Severe or sustained early life adversity shifts the course of brain development and can lastingly impair emotion regulation and cognitive development. What is more, it can sensitize the stress response system so that it overresponds to minimal levels of threat, making people feel easily overwhelmed by life’s normal difficulties. Research shows a strong link between ACEs and opioid drug abuse as well as alcoholism.

孩童时期的长期压力会使正常的压力系统失调，并且促使皮质醇大量产生，这对海马有特殊的伤害，也损害人的记忆和学习功能。一些或持续的早年困境会改变大脑的发展过程，持续损害人的情绪调节和认知发展。另外，它能使人的压力反应系统更敏感，以至于对于极小的事情反应过度，使人对生活中的困难不知所措。研究表明，童年负面经验和与鸦片类药物滥用和酗酒存在强相关。

Is there a brain malfunction that causes addiction?

有脑部障碍会引起成瘾吗？

The common but mistaken view of addiction as a brain disease suggests that there is some malfunction in the brain that leads to addiction. But that is not the case. Studies show that repeated use of a substance (or an activity), encouraged by a surge in dopamine, creates changes in the wiring of the brain—and those changes are reversible after drug use stops.

大部分错误的观点认为，成瘾是脑部障碍导致的一种脑部疾病。但事实并非如此，研究表明，在多巴胺的刺激下，重复使用某种物质或者进行某种活动，会改变大脑的电路，但戒瘾之后这种改变是可逆的。

Neuroscience research supports the idea that addiction is a habit that becomes deeply entrenched and self-perpetuating, rewiring the circuitry of the brain as it is repeated. The repetition of a highly pleasurable experience—drugs, gambling—alters neurons; they adjust their wiring to become increasingly efficient at the experience. They prune away their capacity to respond to other inputs. It is a form of deeply engraved learning. As drug use stops, engaging in other rewarding activities rewires the brain to find interest and pleasure in non-drug pursuits.

神经科学的研究支持了成瘾是一种根深蒂固自我重复的习惯，当这个习惯重复时，它会重新布局大脑电路。毒品，游戏等高兴奋体验使神经元改变—他们调整他们的脑电路使得大脑对体验更高效。他们去除大脑对其他信息的反应。这是一种深度刻划的学习。戒毒然后从事其他事情之后，脑路会重新组织成对毒品之外的事情感兴趣并且享受其中。

If a family member was addicted, will I become addicted?

家里有人染瘾了，我也会吗？

The vast majority of children whose parents abuse alcohol or drugs do not grow up to do the same. However, they are at some increased risk for doing so, and there are a number of reasons why. For one, they are exposed to those substances, and exposure during early adolescence may especially influence substance use.

大部分父母酗酒或吸毒的孩子长大后不会沾染同样的毛病。然而，他们沾染这些毛病的风险会增加。有一些因素促成了这种风险，其中之哦一是因为他们被暴露在这些物质面前。特别是当他们在青少年早期被暴露在这种风险之中时，他们会被沾染的比例会提高。

For another, they may inherit whatever genetic or biological vulnerabilities laid the groundwork for a parental addiction. But they may also be more prone to addiction because they suffer from cognitive, emotional, or behavioral problems known to arise in children as a consequence of growing up in a home marked by substance use; for example, as children they are at increased risk of neglect, abuse, or a poor quality parent-child relationship.

另外一个因素是因为，他们可能继承了他们父母染瘾的基因或生物基础。但他们更容易染瘾的的原因是因为他们作为一个在有瘾君子标签的家庭里长大的孩子所受到的认知，情绪或者行为上的伤害。和比如说，这些孩子更容易会会被忽视，被虐待或者亲子关系很糟糕。

Is there an addictive personality?

有成瘾性人格存在吗？

It is a myth that there is some personality factor that is specific for the development of addiction and makes addiction likely. There are a number of personality traits widely shared in the population that contribute to the risk of developing an addiction, usually in indirect ways. For example, people prone to thrill-seeking may be more likely than others to find themselves in situations where drugs are used or to experiment with any number of activities—think: bungee jumping, base-jumping—or substances that provide outsize rewards.

很神奇的是，确实存在一些特殊的使人上瘾或更容易上瘾的人格因素。人群中广泛存在一感些通常以非直接的方式增加成瘾风险的人格特质。例如，喜欢寻求刺激的人比其他人更容易陷入吸毒或者例如蹦极，跳基等行为或者能提供超级刺激的物质当中。

Studies show that those who are high in the trait of neuroticism—they are prone to experiencing negative emotions—are overwhelmed by minor frustrations and interpret ordinary situations as stressful. Neuroticism is linked to a wide array of mental health problems, including anxiety, depression, and eating disorders as well as substance abuse. Neuroticism is also linked to a diminished quality of life, another factor that could increase the allure of substance use.

研究表明，更倾向于体验负面情绪的神经质者通吗常会被一些小挫折弄的不知所措。而且通常他们也更倾向于把一些日常的情形看作是压力。神经质质跟很多心理疾病相关，其中包括焦虑，抑郁，饮食失调，物质滥用。神经质也与生活质量下降相关，它是增加成瘾的另外一个因素。

Why do some people become addicted while others do not?

为什么一些人会上瘾而另外一些人不会？

There is some evidence that natural variation in genetic makeup of the dopamine system may influence who gets addicted. Dopamine is the neurotransmitter activated by rewarding activities as a way of increasing the likelihood of engaging in such activities in the future. Having a relationship, getting a promotion, doing something creative—those are normal ways of stimulating the reward system. Illicit drug use short-circuits that process and directly boosts dopamine levels.

一些证据表明，基因多巴胺构成的差给异能影响成瘾者。多巴胺是一种能促进未来同样行为的由奖励行为刺激的神经递质。发展了一段关系，得到了升迁，做了某些开创性的事情，这些都是正常的刺激奖赏系统的行为。非法毒品的使用加速了和直接提升了多巴胺的水平。

Some people may be more prone to addiction because they feel less pleasure through natural routes, such as from work, friendships, and romance. Their genetic makeup inclines them to develop such personality traits as thrill-seeking. Their craving for risk and novelty takes the fear out of drug use and the huge dopamine boost powerfully reinforces the motivation to seek the reward over and over again.

有的人更容易上瘾是因为他们比常人能难从像工作，友谊，浪漫关系等自然途径获得快乐。他们的基因构成使得他们更倾向于发展出寻求高刺激的人格特质。他们对新奇冒险事情的渴望使得他们忘记了毒品的危害，大量多巴胺的分泌强烈地一再的加强了他们一次又一次的寻求吸毒的快感。

Can someone get addicted by using a substance once?

一次沾上就会成瘾吗？

A person cannot get addicted to a substance without exposure to the substance, but exposure alone does not lead to addiction. Addiction develops only after repeated use of a substance. One use of a substance can produce a pleasurable effect that motivates interest in repeating the experience. But the experience of pleasure is relative; it hinges in part on biology and very much on what else there is going on in a persons life that is meaningful or rewarding.

不沾上毒品，人们不会成瘾。只沾过一次，也不会成瘾。只有在人们重复使用之后，他们才会上瘾。一次使用产生的快感可以让人重复体验这种乐趣。但是这种快乐体验是相对的，某种程度上，它是与生物性相关的，但大部分是与个体有意义的或者受奖赏的生活相关的。

Can drug addiction be prevented?

毒品成瘾能够预防吗？

In its simplest form, drug addiction can be seen as a way of hacking the brain—of finding a shortcut to feelings of emotional reward by bypassing the normal activities that stimulate such sensations and directly manipulating the neurochemicals responsible for them. To a very large degree, brain hacks become appealing when there are restricted opportunities for meaning and for pleasure other than the response to drugs.

最简单来说，毒瘾可以看作是一种黑客攻击脑部，为他们寻找通过忽略刺激感觉和直接操纵神经化学反应得到高兴奋的捷径。在很大程度上，大脑黑客出现于所做行为比吸毒更没有意义和乐趣时。

Just as recovery from addiction requires focusing on rewarding activities other than drug use, so does prevention. The definition of a meaningful life varies from person to person, but psychology has long identified its components—feelings of self-respect; meaningful relationships that create a sense of belonging; opportunities for growth and development; work that is engaging or rewarding; opportunities for enjoyment and pleasure.

就像要从毒瘾中恢复过来需要关注于奖赏行为而不是毒品使用一样，预防吸毒同样如此。于不同的人而言，有意义的生活是不一样的。但心理学上定义的“有意义的生活”包含了很多的东西：自尊，有归属感的有意义的人际关系，有成长和发展的机会，有趣且有回报的工作，开心和快乐的机会。