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What Causes Addiction?

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Not everyone who uses drugs and alcohol will develop addiction. What causes addiction is typically a blend of environmental and biological factors. Addiction is a complex disease that may involve a number of underlying issues, not just one. Environmental factors can feed off biological components of addiction and vice versa. For instance, you may have depression, experienced unhealthy relationships with caregivers as a child, and also have a close relative with a substance use disorder. These are examples of some of the factors that can contribute to drug and alcohol abuse.

What Causes Addiction?

Self-Assessment: Am I Addicted?

Environmental Factors of Addiction

The age-old question of nature versus nurture comes into play here. As it relates to addiction, the answer is usually that both play a role.

Family Dynamics

Maladaptive family dynamics can contribute to substance abuse. Unhealthy attachment styles and dysfunctional family roles are often underlying addiction factors. For instance, one or both of your parents may have been overly enmeshed, ambivalent, or avoidant in the way they related to you. Your early relationships can have a long-lasting impact on your psyche and how you relate to others throughout your life. Trying to cope with resulting emotional turmoil and behaviors through drugs and alcohol is common.


The link between trauma and substance abuse is strong. Types of trauma that can contribute to alcohol abuse and drug addiction include:

  • Assault
  • Rape
  • Military combat
  • Physical or sexual abuse
  • Natural disasters
  • Witnessing traumatic events

Emotional trauma from childhood like abuse and neglect can also trigger drug and alcoholism and alcohol abuse later in life.

Substance Use by Caregivers

Growing up in an environment where drinking was common can predict problem drinking later in life. For example, some research shows that if your parents regularly drank alcohol and had permissive attitudes around alcohol, you’re more likely to drink.

Peer Pressure

Researchers found that being asked to drink or smoke by friends is one of the strongest predictors of substance use in adolescents — even outweighing parenting styles or parental drinking behaviors.

Adolescents aren’t the only ones that fall prey to peer pressure. Even middle-aged drinkers face peer pressure when it comes to alcohol use. One study by the Medical Research Council found many middle-aged people admit to making excuses such as dieting and driving to avoid feeling pressured into drinking.

How Environmental Factors Can Fuel Addiction

Drugs and alcohol can provide a temporary escape from painful feelings and stress in the moment. The problem is that it’s temporary. Substance abuse ultimately makes these issues worse. When you use addictive substances, your brain changes. Its chemistry is altered.

Because they are mind-altering substances, drugs and alcohol can cause surges of dopamine, which is one of the brain’s chemical messengers that regulates emotions and signals feelings of pleasure. Repeated use of drugs or alcohol can actually change the way your brain responds to pleasure. It can impact your reward processing pathways. This can lead to addiction, as your brain becomes dependent on substances to produce feel-good chemicals. You can then experience cravings and difficult withdrawal symptoms without drugs.

The seeds of addiction can also be planted early on. Children and teenagers have a less fully formed prefrontal cortex than adults. This means they are more apt to be impulsive and not think through consequences as much, making them more likely to experiment with drugs and alcohol. Peer pressure and a lack of parental oversight can add to this challenge. Some research suggests close to 80 percent of teens report using alcohol or drugs at some point before reaching adulthood. This can be a predictor for addiction down the line. Teen drug and alcohol use can make you two to three times more likely to struggle with addiction as an adult.

Not every teenager who tries substances will become addicted to drugs or alcohol. Some risk factors include:

  • A high stress environment
  • A social group that encourages drug or alcohol use
  • Parents not involved and/or relaxed parental attitude toward drug and alcohol use
  • An unstable home life, often from a young age

Genetic Factors of Addiction

The link between genetics and addiction is strong. Studies show heritability of the disease at 30% to 70% based on the substance abused. If your parent or an immediate family member struggles with addiction, you may be twice as likely to abuse drugs and alcohol than someone who doesn’t have the same genetic link.

While scientists haven’t found one specific “addiction gene,” a large body of research points to genetic influences in people who abuse alcohol and drugs. By comparing DNA of family members with substance abuse, scientists have pinpointed groups of similar genes and similar ways proteins bind to genes in relatives, not found in people without substance abuse issues.

Genes can influence the way drugs interact in your brain and body. This may make you more or less susceptible to addiction. For example, if you have lower levels of natural opioids in your brain and you try heroin, it may impact you more. You may feel more of a pull to continue using it because of the high it produces. Genes also influence how your brain regulates moods and impulse control. While environmental factors may be more influential for trying drugs as a teenager, genetic factors can impact repetitive drug misuse in adulthood. Drugs and alcohol can be a form of self-medication, and if you have problems regulating your mood and impulses on your own, substance abuse may provide temporary relief.

You may use drugs due to a stressful environment, but your biology may reinforce the behavior. Ultimately, genetics and environmental aspects are involved in most cases of addiction.

The Link Between Mental Health Disorders and Addiction

Substance abuse and mental health issues often go hand-in-hand. About half of people with mental health disorders will have substance use issues in their lifetime. Mental health issues can lead to drug abuse and alcohol abuse. On the other hand, substance abuse can cause mental disorder symptoms. Similar environmental and genetic factors play a role in both conditions. Around 9.5 million Americans experience substance use disorders and mental health disorders together. This is known as co-occurring disorders. Either issue can predate the other. For instance, you may suffer from depression and repetitively take drugs to try and feel better, which can lead to addiction. Conversely, you may use drugs for years and then try to stop, which can lead to depression and anxiety.

Many of the same parts of the brain are involved in the onset of mental health disorders and addiction. Both involve issues with:

  • Mood regulation
  • Impulse control
  • Reward processing

Environmental factors that impact drug use and addiction can also be similar, making you more vulnerable to mood and mental health disorders.

Regardless of which issue came first, addiction can complicate treatment for mental illness, and vice versa. The following mental health disorders commonly co-occur with addiction:

  • Post-traumatic stress disorder
  • Depression
  • Generalized anxiety disorder
  • Bipolar disorder
  • Borderline personality disorder
  • Panic disorder
  • Antisocial personality disorder
  • Schizophrenia
  • Attention-deficit hyperactivity disorder (ADHD)
  • Psychotic illness

Treating the Underlying Causes of Addiction

Addiction is always a symptom of a larger problem. Sometimes the symptom doesn’t always show as substance abuse. People may cope with underlying issues through a variety of unhealthy ways such as eating disorders, sex addiction, dissociative disorders, or gambling disorders. It’s important to address the root causes of substance abuse to help prevent relapse. It’s also important so that you don’t develop a cross addiction, meaning you replace substance abuse with other maladaptive coping mechanisms to self-soothe. If you detox from drugs and alcohol, but don’t understand the reasons why you’re coping with substances, you’ll likely turn to them again when you encounter the same triggers.

Treatment for addiction is individual, and it will be different for each person. If you struggle with both a mental health disorder and addiction at the same time, you will need treatment for co-occurring disorders. If you’re struggling with post-traumatic stress disorder (PTSD), it’s important to choose a trauma-focused addiction treatment program. While what’s needed for each person to get better is different for everyone, the common goals of addiction treatment programs are:

  • Rid your body of substances through medical detox.
  • Identify underlying causes of addiction like co-occurring disorders, trauma, relationship issues, and stress.
  • Engage in behavioral therapies that help you process these issues so that they lessen their hold on you.
  • Get appropriate medication for co-occurring mental health disorders if necessary.
  • Learn healthy coping skills to use in the face of triggers instead of substances.
  • Build a support system in recovery.

Approaches used in your treatment plan may include:

  • Individual behavioral therapy
  • Group therapy
  • Family therapy
  • Trauma-focused therapies like EMDR
  • Medication management
  • Alternative approaches
  • Aftercare

You Can Get Better. We Can Help.

Overcoming addiction is hard work, but it’s worth it. Footprints to Recovery provides evidence-based, trauma-focused addiction treatment programs. We’ll help you get to the root causes of addiction and learn to deal with your struggles in healthier ways. If you or a loved one is struggling, call us today for a free, confidential consultation.

Questions about treatment options?

Our admissions team is available 24/7 to listen to your story and help you get started with the next steps.

Medically Reviewed by Lindsay Hutchison, MS, LPC, LCADC
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