What causes addiction?

Howard J. Shaffer, PhD
Addiction Medicine
Nobody starts out wanting to develop addiction, but people do gravitate toward certain substances or behaviors for specific reasons. Most of these objects of addiction offer people pleasure or, at the very least, the absence of displeasure. But often, the picture is more complex.

To a degree, people choose substances or activities that fill a real or perceived need. People who are anxious by nature, for example, sometimes turn to alcohol because it calms them and makes them feel more comfortable in social settings. Likewise, people who have persistent pain sometimes start taking opioids (among the most powerful painkilling drugs) to relieve their pain. People who are concerned about their finances sometimes gravitate toward gambling, particularly if they had a formative experience in which they won a lot of money.

In some cases, people discover the benefit of a certain substance or behavior in a social setting. Others go in search of a benefit they hope to find. The point is that objects of addiction offer people psychological, social, or biological rewards. Often those rewards are compelling, so the substance or behavior remains appealing, even if it also comes at a cost.

One key element in overcoming addiction involves recognizing the value it holds. Once you understand the value you derive from your addictive behavior, you can seek alternate—and less destructive—methods for filling that need.

Clearly, not every anxious person who tries alcohol becomes dependent on it; not every person who is in pain and tries opioids becomes opioid dependent; and not every financially challenged person who gambles becomes a compulsive gambler. Why, then, do some people develop addiction while others do not? Experts are still struggling with this question, but they do know that genes, the environment, and mental health all play a role.

Continue Learning about Substance Abuse and Addiction

Side Effects of Opioid Medication
Side Effects of Opioid Medication
Opioids—a class of drug that includes oxycodone, hydrocodone and codeine, as well as heroin, morphine and fentanyl—may knock out the pain, but they ca...
Read More
What services does the VA offer for substance abuse?
Challenge AmericaChallenge America
The VA offers treatment and care for the many veterans who have problems with use of alcohol, tobacc...
More Answers
How has addiction treatment evolved and how does that impact my options?
Arif A. Karim, MDArif A. Karim, MD
Addiction treatment has evolved over the years; there has been a shift from spiritual, community-bas...
More Answers
Do Young Adults Understand Risk?
Do Young Adults Understand Risk?

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.