Why are some people alcoholics, while others are just occasional social drinkers? Why does one person smoke marijuana a few times and becomes prone to daily use, while another person just uses it occasionally? Why can some people take pain medication for the prescribed course only, while others seek out that same feeling from illicit substances?
While the phrase “addictive personality” is not an official diagnosis, it points to something very real. For example, when someone asks whether they have an addictive personality, what they typically mean is:
“Is there something in my current state (physical, mental, emotional) that is predisposing me to addiction?”
The answer is “Yes, there could be.”
We in the psychological field can sometimes be picky about terminology. There is no denying, however, that there are life events, genetic tendencies, and mental conditions that can influence whether a person will ultimately develop addition. And, yes, studies have shown that personality traits can be linked to a higher likelihood of addiction as well.
So, in this sense, having an addictive personality is a true phenomenon.
Here are the factors and traits that have been shown to indicate a higher risk of developing addiction:
Do you come from a family of addicts? If so, your chances of developing an addiction are greater.
It is generally accepted that genes account for roughly 50% of the probability of developing addiction. Environmental factors account for the other half.
Genes can influence whether you develop addiction in a myriad of ways.
They can result in: 1
- Greater impulsivity
- A tendency to experience anxiety
- Altered function of receptors in the brain
- Differences in the way the brain handles stress and emotions
- Differences in how the brain’s reward system operates
- Differences in the way the brain metabolizes drugs or alcohol
You can also have a propensity to develop addiction to a particular substance. For instance, there are specific alcohol and nicotine metabolism gene variants.2
Also, different drugs have a stronger relationship to genetics. In one study, the hereditability for hallucinogens was found to be nearly 40% – the low end of the spectrum – while it was a whopping 72% for cocaine.3
Interestingly, your genes also influence whether you begin using substances in the first place.
One caveat here is that we only know what we know. In fact, it has been estimated that we have only identified five percent of the genetic variances involved in a tendency toward substance abuse.4 That leaves a vast terrain of genetic research yet to be discovered.
Mental Health Disorders
Addiction and mental illness tend to co-occur. Nearly half (45%) of people with addiction also have a mental health disorder, according to the National Survey on Drug Use and Health. Some studies have found the percentage to be even greater. In one, as many as 80% of addiction treatment clients in surveyed treatment centers had at least one co-occurring anxiety disorder.5
Correspondingly, certain mental disorders are more strongly associated with addiction, including anxiety disorders, depression, schizophrenia and personality disorders. A two-wave survey of a representative sample of the U.S. population conducted 10 years apart found that:6
- Only some types of anxiety disorders were associated with addiction development. Those included social phobia, panic disorder, PTSD, specific phobia and separation anxiety – but not generalized anxiety disorder and agoraphobia.
- Most of the disruptive behavioral disorders measured were associated with later development of drug addiction, but not all.
- The only increased risk for alcohol addiction was among those with oppositional defiant disorder, intermittent explosive disorder or an existing nicotine addiction.
The study also found that bipolar disorder carried the highest risk of developing addiction.
It has also been demonstrated that the more pre-existing mental conditions you have, the greater your risk of addiction.7 Also, the more severe the mental illness, the greater the likelihood of becoming addicted.8
It is important to note that mental health disorders ultimately boil down to genetics, environmental factors and/or the complicated interplay of genetics and your environment.
Whatever the cause, though, you should know that not all hope is lost. Seeking treatment for any sign of a mental health issue can not only help you deal with it, but also ward off addiction. In fact, it has been estimated that successful treatment for mental health issues could reduce alcohol addiction by 54% and illicit drug addiction by 90%.9
Adverse Childhood Experiences
A higher rate of adverse childhood experiences (ACEs) has a well-established connection to substance use disorders. It is so common, in fact, that the number of ACEs could outstrip genetics as the most accurate predictor of addiction.
Case in point: A 2018 study found that 43% of adults undergoing inpatient addiction treatment had a family history of substance use disorder, while a whopping 93% had experienced an ACE.10
The landmark Adverse Childhood Experiences Study conducted by the Centers Disease Control and Prevention and Kaiser Permanente surveyed 17,000 patients from 1995 to 1997 and again 15 years later. The findings were groundbreaking: As the number of ACEs rose, so did the percentage of those compulsively using alcohol or injected street drugs. With every added ACE, the likelihood increased sharply.11
ACEs studied included the following broad categories of experiences:
- Growing up in a household with someone addicted to drugs or alcohol (25% reported this)
- Sexual abuse (22%)
- Absence of both biological parents (22%)
- A household member who had a mental condition or was institutionalized (19%)
- Mother treated violently (12%)
- Recurrent, severe physical abuse (11%)
- Recurrent, severe emotional abuse (11%)
- An imprisoned member of the household (3%)
Each category was graded as one ACE, and the results were astounding. As compared to those with no ACEs:
- Having just one ACE doubled the risk of becoming alcoholic
- Two ACEs tripled the risk
- Three ACEs quadrupled the risk, and
- Those with four or more ACEs had over five times the risk
As you can see, each category of ACE experiences raised the risk of becoming an alcoholic by tenfold.
The sharply increased risk of multiple ACEs was even more pronounced when it came to intravenous drug use. As compared to those with no ACEs:
- Having just one ACE doubled the chance of later intravenous drug use
- Those with two ACEs had six times the chance
- Those with three had nine times the chance
- Those with four or more ACEs had roughly 13 times the chance
The type of ACE experienced is also telling, as it can be associated with the abuse of specific substances, as demonstrated by other studies on the subject. For example, emotional abuse has been associated with sedative use, while physical abuse significantly predicted cannabis use in a 2018 study. It also found that five or more ACEs predicted a higher risk of sedative use.12
ACEs have also been implicated as a factor in the development of mental health disorders such as borderline personality disorder, anxiety disorders, antisocial personality disorder, conduct disorder and more. This, in turn, also increases the likelihood of developing addiction.
Not everyone who has experienced an ACE will also develop a mental illness or drug and alcohol addiction, though, because individuals vary in their levels of resiliency.13
Your level of resiliency in the face of stress also has a genetic basis, however, resiliency can be learned. Treatment for both addiction and mental illness focuses on the development of coping skills so that resiliency can be developed.
Post-Traumatic Stress Disorder
The American Psychological Association defines trauma as “an emotional response to a terrible event like an accident, rape, or natural disaster.”
In the immediate aftermath of such an event, you may feel a sense of shock or even denial. However, trauma can continue to affect you long-term. You can experience flashbacks, a roller coaster of emotions, headaches, stomachaches, nausea and more. Trauma can also affect your relationships with others.14
PTSD, or post-traumatic stress disorder, can develop after an ACE or in adulthood as well. The most obvious example of adult trauma is the development of PTSD in military combat personnel. Veterans Administration studies estimate that 35 to 75% of veterans with PTSD also have substance use disorder.15
PTSD is not limited to combat veterans, however.
Studies have shown that PTSD is a “highly prevalent disorder” in the American public, even though it has only been an official diagnosis since 1980.
The key here is: Will you develop PTSD in response to a traumatic event?
Some people experience trauma, yet, because of their greater resiliency and coping skills, they do not go on to experience PTSD, which puts them at risk of addiction.
There is some evidence to suggest that, as we continue to experience and process traumatic events, the increasingly distant past becomes less impactful in our present lives. One study of those 65 and over showed that adulthood trauma had a greater effect on older adults’ current physical health than did events from their childhood. It is not too far of a leap to hypothesize that it would be the same for mental health.16
Examples of adulthood traumatic events include a divorce, a child having a near-fatal accident or illness, the death of a child or a spouse, having a partner or spouse addicted to drugs or alcohol, physical abuse by a spouse or partner, and loss of a job, among others.
Data clearly shows that, when trauma occurs earlier in life, there is a stronger connection between it and addictive behavior. Why? Because trauma can damage both the structure and function of children’s developing brains.
However, experiencing trauma as an adult still puts you at a higher risk for addiction than adults who haven’t experienced a traumatic event.17
An intriguing study on personality and addiction published in BMC Psychiatry in 2008 compared personality profiles to the use of illicit substances as well as tobacco.18
Using the Five Factor Model (also called the OCEAN model), researchers rated participants’ personalities on a scale for five basic traits:19
- Openness to Experience – Willing to Try New Experiences, Intellectually Curious, Inventive, Appreciative of Art and Beauty, Lover of Art and Culture, Creative, Emotionally Aware, Open to Unconventional Ideas
- Conscientiousness – Responsible, Aware of Consequences of Actions, Organized, Efficient, Always Prepared, Ambitious, Goal-Oriented, Motivated
- Extraversion – Energetic, Talkative, Confident in Social Situations, Outgoing, Attention Seeking
- Agreeableness – Friendly, Compassionate toward Others, Co-Operative, Altruistic, Team Player, Peace Maker
- Neuroticism – Fearful, Nervous, Anxious, Full of Worry, Sensitive, Emotionally Unstable, Over-Thinker, Less Adaptable, Overreacts to Stress
Each of these five broad categories (or factors) also has a myriad of facets which are individually measured and, taken together, make up the category score.
For example, facets of conscientiousness include: competency, orderliness, dutifulness, achievement striving, self-discipline, and cautiousness, among others, while extraversion measures friendliness, gregariousness, assertiveness, activity level, excitement seeking, cheerfulness, etc.
Overall, drug users were found in the 2008 study to be low on conscientiousness. Also, while extraversion overall wasn’t associated with drug use, one particular facet of it was – excitement seeking. Researchers theorized that excitement seeking is an aspect of impulsivity, which has been associated with drug use in previous studies.20
There were also differences in the personality profiles for users of specific substances.
With cocaine and heroin users, the scores for neuroticism were very high. Looking at facets of personality, current users scored especially high on excitement seeking and low on trust, straightforwardness and compliance. They were also very low on conscientiousness, especially competence, achievement striving and deliberation.
For marijuana users, neuroticism scores were average overall, but they had high scores on openness to experience and low scores on agreeableness. Current users were particularly higher on certain aspects of openness to experience, including values and ideas. They were also lower on conscientiousness, especially dutifulness and deliberation. Marijuana users were also high on certain facets of neuroticism (anger, hostility and vulnerability) and extraversion (activity and excitement seeking) as well as low on compliance.
The study concluded that, as a whole, low levels of conscientiousness and high levels of neuroticism and impulsivity traits were correlated with drug use.21
A five-year study begun in 2011 at the University of Leicester also found traits that corresponded with drug use and added two more measurements of personality to their study (impulsivity and sensation seeking). In addition to the higher neuroticism and lower conscientiousness traits found in the 2008 study, researchers found that higher openness to experience and lower agreeableness were associated with the use of drugs.22
This study also confirmed that there were differences in the profiles of those using different drugs. Heroin users were significantly higher in neuroticism and impulsivity as well as lower on extraversion, openness to new experience and agreeableness than were ecstasy users.
Other evidence for the addictive personality theory includes the fact that those who have one addiction are likely to have another. Also, individuals who are able to give up one addiction commonly replace it with another. Perhaps after giving up alcohol or opioids, they become addicted to cigarettes or vaping, for example.
Again, personality also arises partially from your genes and partially from your environment, situation and circumstances. Personality traits (and their intensity) can change over time, and they can also shift due to drug use. The 2008 study, for instance, found measurable personality differences between current and past users of drugs.23 So, just because you may fit the profile of an addictive personality now, that doesn’t mean you always will.
Get the Help You Need
When you get down to it, it doesn’t matter whether you were born with the tendency to develop addiction, experienced multiple ACEs resulting in PTSD, or that your personality may be wired for drug use… the result is the same. Addiction can have devastating consequences on your life – from wrecked relationships to criminal records and even death by overdose.
If you are struggling with substance abuse, it is urgent you reach out for help before it is too late.
Thousands of people before you have been able to stop the damage and rebuild their lives in recovery. With evidence-based treatment delivered by highly qualified addiction counselors, you, too, can be one of them.
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1 Ducci F, Goldman D. The genetic basis of addictive disorders. Psychiatr Clin North Am. 2012;35(2):495‐519. doi:10.1016/j.psc.2012.03.010
5 Brady KT, Haynes LF, Hartwell KJ, Killeen TK. Substance use disorders and anxiety: a treatment challenge for social workers. Soc Work Public Health. 2013;28(3-4):407‐423. doi:10.1080/19371918.2013.774675
6 Swendsen J, Conway KP, Degenhardt L, et al. Mental disorders as risk factors for substance use, abuse and dependence: results from the 10-year follow-up of the National Comorbidity Survey. Addiction. 2010;105(6):1117‐1128. doi:10.1111/j.1360-0443.2010.02902.x
10 Kiburi SK, Molebatsi K, Obondo A, Kuria MW. Adverse childhood experiences among patients with substance use disorders at a referral psychiatric hospital in Kenya. BMC Psychiatry. 2018;18(1):197. Published 2018 Jun 18. doi:10.1186/s12888-018-1780-111
11 Felitti VJ. Ursprünge des Suchtverhaltens: Evidenzen aus einer Studie zu belastenden Kindheitserfahrungen [Origins of addictive behavior: evidence from a study of stressful chilhood experiences]. Prax Kinderpsychol Kinderpsychiatr. 2003;52(8):547‐559.
12 Kiburi SK, Molebatsi K, Obondo A, Kuria MW. Adverse childhood experiences among patients with substance use disorders at a referral psychiatric hospital in Kenya. BMC Psychiatry. 2018;18(1):197. Published 2018 Jun 18. doi:10.1186/s12888-018-1780-111
13 Ducci F, Goldman D. The genetic basis of addictive disorders. Psychiatr Clin North Am. 2012;35(2):495‐519. doi:10.1016/j.psc.2012.03.010
14 American Psychological Association. Trauma. American Psychological Association. https://www.apa.org/topics/trauma. Accessed June 8, 2020
15 Hackensack Meridian Carrier Clinic. Trauma and Addiction. https://carrierclinic.org/2019/08/06/trauma-and-addiction. Published August 6, 2019. Accessed June 8, 2020.
16 Krause N, Shaw BA, Cairney J. A descriptive epidemiology of lifetime trauma and the physical health status of older adults. Psychol Aging. 2004;19(4):637‐648. doi:10.1037/0882-7922.214.171.1247
17 Konkolÿ Thege B, Horwood L, Slater L, Tan MC, Hodgins DC, Wild TC. Relationship between interpersonal trauma exposure and addictive behaviors: a systematic review. BMC Psychiatry. 2017;17(1):164. Published 2017 May 4. doi:10.1186/s12888-017-1323-1
18 Terracciano, A., Löckenhoff, C. E., Crum, R. M., Bienvenu, O. J., & Costa, P. T., Jr. (2008). Five-Factor Model personality profiles of drug users. BMC Psychiatry, 8, Article 22. https://doi.org/10.1186/1471-244X-8-22] 19 Psychologist World. Five Factor Model of Personality. Psychologist World. https://www.psychologistworld.com/personality/five-factor-model-big-five-personality. Accessed June 8, 2020.
20 Terracciano, A., Löckenhoff, C. E., Crum, R. M., Bienvenu, O. J., & Costa, P. T., Jr. (2008). Five-Factor Model personality profiles of drug users. BMC Psychiatry, 8, Article 22. https://doi.org/10.1186/1471-244X-8-22
22 Neuroscience News. Personality traits of drug users. Neuroscience News. https://neurosciencenews.com/personality-substance-abuse-14209/. Published June 10, 2019. Accessed June 8, 2020.
23 Terracciano, A., Löckenhoff, C. E., Crum, R. M., Bienvenu, O. J., & Costa, P. T., Jr. (2008). Five-Factor Model personality profiles of drug users. BMC Psychiatry, 8, Article 22. https://doi.org/10.1186/1471-244X-8-22