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Therapists explain common causes of substance dependence

by Sarah Graham
Monday 09 February 2015
207 5024

Like alcohol dependence, substance dependence is an addiction to any substance that may initially, temporarily, have made you feel better. Substance dependence commonly refers to illegal, recreational drugs such as cocaine or heroin, but it's also possible to become addicted to prescription medication, nicotine, solvents and other inhalants. We asked RSCPP therapists to explain the common causes that can lead to developing a substance dependence.


Social and biological risk factors

No single factor can predict whether or not a person will become addicted to substance abuse. The risk of addiction is influenced by your biology, social environment, and age or stage of development. The more risk factors you have, the greater the chance that taking drugs can lead to addiction. The genes that you are born with - in combination with environmental influences - account for about half of your addiction vulnerability. Additionally, your gender, ethnicity, and the presence of other mental disorders may influence the risk of drug abuse and addiction. Your environment includes many different influences - from family and friends to economic status and quality of life, in general. Factors such as peer pressure, physical and sexual abuse, stress, and parental involvement (or lack of), can greatly influence the course of drug abuse and addiction in your life. Someone who has a family history of addiction, or addictive behaviours, is at higher risk. These genetic and environmental factors interact with critical developmental stages in your life to affect your addiction vulnerability, and adolescents experience a double challenge. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it is to progress to more serious abuse.


Trying to suppress your inhibitions

The use of substances, despite their negative long-term effects on your health and wellbeing, carry the potential to help you discover and express parts of yourself that you previously had denied. If, for example, you were punished as a child for being 'loud' or 'naughty', you may have learnt very early on to suppress experiences of excitement and playfulness. You may have adopted a quiet, reserved 'good girl/boy' persona, becoming shy and socially withdrawn, feeling flooded with shame whenever you find yourself in a situation that invites playfulness, such as going out with friends. Alcohol and drugs can temporarily suppress such painful feelings of awkwardness or inhibition and leave you feeling happy, relaxed and confident. The trap you fall into when you become addicted to alcohol and drugs, is that you think that this is the only way to experience such personal change.


Avoiding difficult feelings

Most people who use substances in an acute or ongoing way are trying to alter their emotional states in order to avoid having to deal with difficult feelings. You may become dependent on substances as it becomes the only way of coping with whatever underlying stressors you are experiencing. Unfortunately, this defence mechanism only works temporally, as you would need higher doses of whatever substances you use as the body becomes tolerant to it. Substances are also very harmful physically, as the body has to deal with breaking them down and eliminating them. This is why substance dependency is often linked with other serious physical comorbidities. Seeking therapy to deal with issues that triggers painful feelings may be useful as it allows you the time and space to work through whatever issues you are experiencing, as well as enabling you to find healthy ways of coping with painful states of mind.



Sometimes people want to escape from their life as they know it and use substances to "help" with this. Using substances can seem to temporarily help you with current difficulties, but soon you may find yourself chasing that same feeling of escapism, and find it harder and harder to get that same feeling. Talking things through with a therapist can help; they can help you to understand your attachments better, why you use substances, and why it may be difficult to stop.



In life, we all face issues such as a bereavement, trauma, perhaps a relationship breakdown, that trigger feelings and emotions that are difficult to deal with. You may sometimes use drugs (prescription drugs or other, illegal drugs, such as marijuana, heroine, cocaine, etc.) to 'medicate' or suppress your feelings. Short-term medication can be ok, however the addiction may creeps up on you, unawares, as your body gets more resistant to the effects and you need more and more of the drug to achieve the same effect. You will need to work on both the addiction and the underlying issues.

Finding support

If you are concerned about the issues raised in this article then you may like to read about finding the right therapist for you. If this route is not appropriate for you, your GP can assess you and direct you towards support.

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Updated 09 February 2015