Addiction is often judged and misunderstood. Many people assume addiction happens due to personal failings or character flaws, but that is not the case. Addiction is a complex disease with no single cause. A variety of factors can come into play, influencing someone’s risk of developing an addiction during their lifetime. Our genetics, our surroundings, our health and our personality can all come into play.
The factors of addiction and each person’s experience with addiction are different, but everyone can ask for help. Understanding what leads to drug and alcohol addiction can help you understand your own condition or that of a loved one.
What’s an Addiction?
Before diving into the causes of addiction, take the time to consider what constitutes an addiction. Addiction, also referred to as substance use or substance misuse disorder, occurs when the use of a particular substance or substances affects a person’s ability to function in everyday life.
Despite damage to your health and your relationships, addiction will continue to push you to continue the same pattern of behavior. Addiction is characterized by an intense psychological and physical drive to continue using a substance, despite knowing its negative effects. Addiction can persist even when a person wants to stop using the substance.
Why do people start using substances that can potentially lead to addiction? Again, there is no simple answer to this question. Some substances, like alcohol, are legal. Alcohol is easy to obtain for adults of legal drinking age and often not difficult to obtain for people younger than 21. It is common to have drinks in a social setting and even expected in some situations. Drinking alcohol is socially acceptable, making it easy to forget its addictive nature.
Other potentially addictive substances can be legally obtained. For example, many prescription drugs are addictive by nature. Your doctor may prescribe you an opioid or a benzodiazepine for a legitimate medical reason, such as pain or anxiety. But, if not used correctly, these drugs can be addiction-forming. When people can no longer get these medications legally prescribed or cannot get the desired feeling from the regulated dosage, they may seek prescription medications illegally.
Many other addictive substances are only obtained illegally. Drugs, such as heroin and cocaine, are known to be addictive and potentially deadly. Yet many people use them. Factors like peer pressure, risk-taking, curiosity and desire to feel drugs’ various effects play a role in why people start and continue to use illicit drugs.
What Causes Drug and Alcohol Addictions?
Just as addiction impacts everyone differently, it also has unique causes. Explore the potential factors of addiction for a better understanding of why people use drugs and alcohol.
Genetic Factors in Addiction
Biology and the traits we inherit are outside of our control, but a variety of different genetic factors can make it more likely for someone to develop a substance misuse disorder.
1. Family History
Genetics and addiction is a tricky topic. Experts have not pinpointed one particular gene that can be considered directly responsible for the risk of addiction. But scientists estimate 40%-60% of a person’s risk of addiction can be tied to genetic factors. With genetics at play, the children of people who struggle with substance misuse and addiction can be at risk of developing the same challenges.
Though the exact relationship between genetics and addiction is murky, scientists continue to conduct research to make that link clearer. Researchers have found that a particular type of dopamine receptor, referred to as D2, can help predict a person’s chances of developing an addiction. To some extent, the number of these receptors in the brain is determined by genetics. People with more of these receptors are less likely to develop an addiction, while those with fewer D2 receptors are more likely to experience a substance misuse disorder.
We do not choose the heritability of traits, but gaining a clearer understanding of genetics and addiction can help individuals better understand their addiction. It can also help medical experts better understand the risk factors for addiction and develop more targeted treatments.
Addiction can happen to anyone, regardless of their genes. Some genetic factors in different races and ethnicities can play a role in the risk of addiction. For example, many people of East Asian descent have a gene that makes it more difficult to break down alcohol. As a result, some East Asian people may experience unpleasant physical sensations when drinking alcohol, meaning they may avoid drinking to excess or drinking in general. But this factor is not to say that East Asian people cannot become addicted to alcohol or other substances.
Research has also shown that the Native American population is disproportionately affected by substance misuse disorders. The rates of cigarette, marijuana and prescription drug use are higher in Native American youth than in the general population.
Anyone of any gender can struggle with addiction issues. Men are statistically more likely to use illicit drugs and are more likely to go to the hospital or overdose because of illicit drug use. Men are also more likely to develop a dependence on alcohol. Though the use of addictive substances may vary based on gender, individuals of any gender are equally at risk of developing some kind of substance misuse disorder. Gender is just one factor of many that can play a role in determining the risks and effects of addiction.
Environmental Factors in Addiction
People often consider the question of nature versus nurture when wondering what causes addiction. Does the key to addiction lie in our genes or our surroundings? The answer could be both. We have seen the role genetics can play, but the environment around us throughout childhood and beyond can also hold answers.
Stress can be a major influence when it comes to developing an addiction. People can turn to substances to cope with intense feelings of stress. Research has also shown that stress can actually cause epigenetic changes that influence the development of addiction and mental health conditions. These reactions mean stress can trigger changes that affect how your genes are expressed. Stress like the loss of a job, the death of a loved one or a global pandemic can increase the risk of developing an addiction or relapsing.
Additionally, stress plays an integral role in the brain’s reward system. The reward system is a complex combination of electrical signals and chemicals, like dopamine, in the brain. The reward system can be triggered by a number of different things, like eating something delicious or talking with friends. The brain learns to seek pleasurable activities that trigger the reward system, which in turn floods your body with feel-good chemicals.
Drugs can trigger these same reward pathways, often resulting in a more powerful and long-lasting feeling of pleasure. When you are stressed, you can crave that feeling even more than you normally would. Over time, the reward threshold becomes higher — you need more of the same substance to produce the same feelings. Stress can trigger cravings, leading you to indulge in drinking or drugs. When you are unable to access that substance, you may go through withdrawal, triggering more stress and cravings.
2. Childhood Circumstances
While genetics shape our lives from birth, so does our environment. How children are raised, the relationships they form and the behaviors they model can affect their risk of developing a substance misuse disorder later in life.
For example, a lack of care and nurturing from parents can increase the risk of addiction. If a child’s parents themselves misuse drugs or alcohol, the child is at risk of that same behavior. If drugs and alcohol are readily available to a child, whether at home or through their peers, they are also at risk of developing an addiction.
Stress can affect adults and put them at risk of addiction, and this is also true of children. If they are not in a safe, loving home environment, they may seek unhealthy ways to cope, like using drugs or alcohol.
All children have a variety of addiction risk factors and factors that reduce that risk. Parents can help protect their children from the risk of addiction by fostering a strong bond. Active involvement in a child’s life can help parents discover other environmental risk factors and act accordingly. Regularly setting and enforcing healthy boundaries can also help children to develop helpful coping tools and self-regulation, which can also decrease the risk of developing a substance misuse disorder.
3. Your Peers
In many ways, the people around us help shape our behavior and who we are. Most people want to be liked and accepted by their family, friends and colleagues. In many situations, this can shape positive behaviors. We spend time with our family members, go out to socialize with our friends or go out of our way to help a coworker.
Not all influence is positive. Our peers can model and push for negative behaviors. Some social groups, family or friends, place drinking or drug use at the center of most activities. If you do not partake, you might be excluded from the next event. Rather than miss out on seeing these people, you might decide to drink or use substances to fit in with your peers.
Repeating this behavior can lead to addiction. It can also be challenging to recognize the signs of addiction when the use of a substance is so normalized by your peers. You may even struggle to get help, fearing what your social circle might think or say about you. Addiction can be difficult to beat if you do not have a strong, supportive network.
4. Socioeconomic Status
Addiction can be stereotyped as something that only happens to people living in poverty. But this stereotype is not true. People of any income level can fall prey to addiction, but people living in low-income situations do have a number of risk factors associated with addiction.
Higher levels of education are associated with a lower risk of addiction. People who are living in poverty have less access to educational resources, which can put them at greater risk of addiction. Unemployment and homelessness are also risk factors for addiction, and the rates of unemployment and homelessness are higher among people who live in poverty. People who do not have adequate financial resources are also less likely to be able to access necessary medical care to help with addiction.
Struggling to make ends meet has a significant influence on stress levels, another risk factor for addiction. Individuals with low incomes may use drugs and alcohol to help manage their stress levels. If children see their parents using drugs and alcohol to cope, they may repeat that behavior.
5. Surrounding Cultures and Cultural Changes
Surrounding cultures can also influence why people begin using drugs or drinking alcohol. Culture can be defined in many different ways. At a high level, culture is a set of values and beliefs shared by a group of people. In some cases, culture can lower the risk of alcohol or drug misuse. In other cases, the risk may be heightened. Addiction may be heightened among cultures that have experienced a history of oppression and sudden social change.
Acculturation can, in some ways, explain the link between culture and addiction. Acculturation refers to how change takes place when two cultural groups interact. That change can be voluntary or involuntary. Typically, acculturation involves a culture taking on the traits of the dominant group while leaving behind its own traditions. Research has found that in some cases, acculturation can play a role in a heightened risk of alcohol, marijuana and hard drug use.
Personal Factors in Addiction
External factors aren’t the only potential causes of addiction. Other health conditions and specific personality traits can also heighten the risk of addiction.
1. Other Health Conditions
Addiction doesn’t always affect individuals on its own. Many people struggle with other health conditions and addiction simultaneously. When someone is struggling with a mental health condition and addiction, it is known as a dual diagnosis. Nearly 25% of people with a serious mental illness, including anxiety, depression, schizophrenia and PTSD, also have a substance use disorder.
Mental health and substance misuse have a complicated relationship. Some people may use drugs, alcohol or tobacco to self-medicate and try to manage the symptoms of mental illness. For example, someone who struggles with anxiety and depression may use alcohol as an attempt to cope and change how they feel.
Drugs and alcohol may also exacerbate the symptoms of a mental health condition. Abusing prescription opioids may actually increase the risk of depression. Some other drugs may heighten the risk of experiencing psychosis. Substance misuse and addiction can also worsen the symptoms of an existing mental health condition.
A dual diagnosis can be difficult to reach. The symptoms of one disorder may be masked and go unrecognized, leading to the treatment of just the mental health condition or just the addiction. The lack of a proper diagnosis can make it much more difficult to get the necessary treatment.
Once treatment for both mental illness and addiction begins, it takes a targeted approach. The treatment plan will likely integrate multiple different tools, such as medication, cognitive behavioral therapy and group therapy, to address both the mental illness and the addiction. Both conditions can be long-term challenges, but there is always hope for treatment.
There is no one personality associated with addiction. You may have heard the term “addictive personality,” but this is a broad, sweeping term, so much so that experts have dismissed its use. While there is not a single archetypal personality linked to addiction, there are certain personality traits that can come with a higher risk of addiction.
People who have a tendency to be obsessive-compulsive may be at higher risk of addiction. This personality trait often involves difficulty in regulating and managing impulses coupled with a high level of focus on specific behaviors and patterns. If someone with this personality trait begins using an addictive substance, it is possible they will make it a regular behavior and struggle to stop.
Some people tend to be risk-takers — you may hear a person like this referred to as “an adrenaline junkie.” They continuously look for different thrills despite the dangers involved. It is possible that experimenting with drugs may be one of the risks a person with this personality trait will take.
Similarly, people who tend to be impulsive may be susceptible to substance misuse. Driven by impulses and a tendency to struggle with self-control, this type of personality may try drugs on a whim.
How Addiction Develops
We know what causes substance use, the interplay of factors like hereditary traits, our environment and our health, but what actually happens to the brain and body when addiction develops?
Addiction is a chronic illness that actually changes the brain. Substances, like alcohol and various drugs, interact with the brain’s reward center. People often drink or use a drug because of the pleasurable feeling they associate with it. That decision to initially start drinking or using is usually voluntary. After you make that choice, you get that feeling caused by a surge of dopamine in the brain.
The brain is wired to encourage behavior that makes us feel good, regardless of whether or not that behavior is healthy. That is why many people crave sweets, even if they are making the conscious effort to eat healthier. The brain will also associate drinking and drug use with a pleasurable feeling, but it will adapt. Over time, you will need more of the substance to produce the same feeling.
You may also find that things that used to make you feel good, like socializing or eating a tasty meal, just don’t have the same effect they did in the past. Instead, your brain is trained to crave that addictive substance. This cycle of addiction continues, becoming difficult to break. When you try to stop drinking or use a drug, you will likely feel withdrawal and intense cravings again.
Get Help With Gateway Foundation
What causes addictive behavior varies from person to person. The cause can be traced back to multiple different factors, giving a complex answer to the question, “What are the underlying causes of addiction?” No matter what factors play a role in your addiction, or the addiction of a loved one, help is available.
At Gateway Foundation, we understand how difficult it is to battle addiction alone. We work with people to address substance misuse disorders involving alcohol, opioids, heroin, cocaine and other substances. We also work with people who are struggling with co-occurring disorders.
Our team takes an individual approach for each person who comes to us for help. Through therapy and other targeted addiction treatment approaches, we can help you understand how you developed an addiction and give you the tools to break free from that cycle and move forward with your life. Contact us to learn more about how we can help you or a loved one who is battling addiction.