What Causes Addiction?

Elizabeth Michael
Last updated:
Erin L. George, MFT
Erin L. George, MFT
Medical editor

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Biological Perspectives

When it comes to what causes addiction, the answer may not be as straightforward as some people think. While many people believe that addiction is a personal choice rather than a disease, researchers have determined that addiction may have a significant relationship with the brain and biology. Experts believe drugs and alcohol change the way the brain functions, and these changes can increase in tandem with the amount of drugs or alcohol an individual consumes. 


The decision-making area of the brain, or the prefrontal cortex, normally helps individuals recognize when the body may be in danger. It also aids in the decision-making process that comes with weighing "the good and the bad." For example, a person following a strict weight-loss diet plan may be tempted to eat sweets after dinner, or they may crave sweets. A healthy, normal-functioning prefrontal cortex helps the individual determine if the consequence of going off their diet is worth the reward. 

The brain also rewards people with "good feelings" when it recognizes healthy, positive behaviors, such as eating delicious foods or expressing feelings of love. When people use alcohol or drugs, the brain reacts in the same way, releasing "good feelings" due to the effects of the chemicals. These feelings are what motivate people to repeat the behaviors for which they were rewarded. 

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As addiction sets in, the pleasure/reward system in the brain essentially "tricks" the individual into believing that continued use of alcohol or drugs will keep the high going and ensure the "good feelings" keep coming. This is when the cycle of addiction can really start to take hold and substance use becomes more about biology than choices.

Also, continuous use of alcohol, drugs, or other mind-altering chemicals can damage the prefrontal cortex and affect decision-making abilities. Changes to the prefrontal cortex can lead to feelings of stress and anxiety, causing the individual to turn to drugs and/or alcohol to neutralize these sensations and emotions. (1) 

Psychological Perspectives

Psychological addiction refers to how drugs, alcohol, and other mind-altering substances affect the mind and emotions. When a person takes a drug or consumes alcohol and they feel "buzzed," high, or relaxed, these feelings also affect their moods and emotions.

For example, someone who's shy or uncomfortable in social situations may have increased confidence after a few drinks or after using recreational drugs. If the person believes they can only feel confident when drunk or high, their mind may become addicted in the same way their physical body becomes addicted. (2)

Some common signs of psychological addiction to drugs and alcohol include:

  • Feelings of depression when not using alcohol or drugs
  • Mood swings when withdrawing or after the "happy" effects of drugs or alcohol have worn off
  • Obsessive thoughts and behaviors about obtaining alcohol or drugs
  • Trouble concentrating 
  • Cravings to experience the emotional state caused by drugs and alcohol
  • Irritability when attempting to abstain from alcohol or drugs

While alcohol and drugs can lead to psychological dependence and addiction, certain substances may cause stronger symptoms due to the "high" they produce. (3) Some substances associated with psychological addiction include: 

Physical Dependence Versus Psychological Dependence

Physical dependence and psychological dependence tend to go hand-in-hand, but the two types of addiction also have distinct differences. Physical dependence pertains to actual chemicals, such as nicotine in cigarettes and alcohol. People experience physical reactions when ingesting and withdrawing from these substances. Physical symptoms of withdrawal from addictive chemicals can include pain, tremors, and seizures.

Environmental Perspectives

Many medical professionals believe a strong link exists between an individual's environment and addiction. A person's environment can include immediate and extended family, peer and social groups, and the community in which they live and socialize. "Peer pressure" is a common term that refers to younger people feeling pressured to "fit in" socially, which can lead to using drugs or consuming alcohol. On the other side of the spectrum, some kids and teens turn to substance use as a way to cope with feelings of anxiety caused by bullying and loneliness.

Family environments in which drinking and substance use are common may make it easier for children and teens to develop the same habits as their parents. Plus, some researchers believe genetics may play a role in whether an individual is more prone to addictive behaviors. For example, if a parent has a substance use problem, their child may have a genetic predisposition to addictive behaviors. (4)

Abusive environments in which a child, teen, or young adult experiences trauma, such as physical or sexual abuse, are also linked to addiction and chemical dependency. In fact, studies have shown that children and teens with histories of trauma, abuse, or neglect are likely to develop some sort of chemical dependency before age 18. Sadly, individuals who experience abuse at a young age are at risk of carrying the traumatic memories into adulthood, which can lead to post-traumatic stress disorder (PTSD) and other mental health conditions. (5)

Moral and Spiritual Perspectives

Some people believe that substance use issues and behavioral addictions are a direct result of a disconnect from God or another higher power. For individuals with deep spiritual beliefs, having strong values and a sense of morality is extremely important. If they become addicted to drugs or alcohol or struggle with substance use, they may feel their issues are due to "straying" from the moral codes established by the value systems within their cultures. 

The moral and spiritual model of substance use issues suggests that simply strengthening an individual's willpower can free them from addiction. In some cases, those with strong religious beliefs are encouraged to undergo Moral Reconation Therapy (MRT). This type of therapy program teaches individuals struggling with substance use how to raise their morals so that they make better decisions surrounding substance use. (6)

While MRT therapy may work for some, causes of addiction include a variety of factors that range from childhood trauma to a history of substance use within a community. Many types of therapy treat addiction, and individuals who don't believe in a higher power have the same chances of successful recovery as those who follow specific religions or spiritual practices. 

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12-Step Perspectives

Individuals who participate in 12-step programs to treat or manage their substance use issues believe that a "power greater than themselves" can aid in a successful recovery. The program consists of 12 steps an individual must follow while abstaining from drugs, alcohol, and addictive behaviors, such as gambling. The steps are outlined in a book titled "12 Steps and 12 Traditions," also referred to as "The Big Book." When following the 12 steps, an individual must:

  1. Admit they're powerless over alcohol, drugs, or addictive behaviors
  2. Believe a higher power can help those struggling with addiction can help restore their sanity
  3. Make the conscious decision to turn their will and life over to God or a higher power they believe in
  4. Create a morals "inventory" of their addictive behaviors
  5. Admit the exact nature of their behaviors to God or a higher power, themselves, and another human being
  6. Decide they're ready for God or a higher power to remove their defects of character 
  7. Ask God or a higher power to help remove their shortcomings
  8. Create a list of all individuals they may have harmed while using alcohol or drugs or engaging in addictive behaviors 
  9. Make amends whenever possible to individuals they may have harmed while under the influence of drugs or alcohol or when engaging in addictive behaviors
  10. Commit to taking personal inventories throughout the course of their recovery
  11. Use prayer and meditation to directly communicate with God or a higher power and ask for knowledge and the power to carry out that knowledge 
  12. Share the 12-step message with other individuals struggling with addiction and practice the 12 steps in all areas of their lives (7)

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