What Causes Addiction




Is that clear enough? Addiction is the story of human suffering. We simply do not cause harm to ourselves with our behavior unless there is some serious hurt to cope with. That hurt could come in a variety of forms (trauma, a difficult childhood, sadness, grief, worry, panic, fear, dread, anger, frustration…). People are far too focused on “biological causes” for addiction. But the answer to addiction is right beneath our noses.



The ACEs study is something everyone needs to know about. It was a large study that looked at how ten types of childhood trauma were correlated with long term health. Those traumas include: physical, emotional and sexual abuse; physical and emotional neglect; having a family that wasn’t loving or felt you were important; living with a family member who’s addicted to alcohol or other substances, or who’s depressed or has other mental illnesses; experiencing parental divorce or separation; having a family member who’s incarcerated, and witnessing a mother being abused. The more adversity someone has, the higher their chance of addiction. It is so clear. Having a score of 4/10 means a 700% higher risk of becoming an alcoholic, for example. Since the original study, we now see that other hardships like an unsafe environment, being teased, frequent moves, and poverty are also major factors in developing an addiction.



This matches up with what we see in population studies, where groups who suffer collectively have much higher rates of addiction. Native Americans are often cited as having some sort of genetic tendency to drink. But a closer look reveals that’s just not the case. Alcoholism only came about after their culture went through a series of multi-generational trauma. This is also the case with other groups of people with hardships, such as African Americans, veterans, people in poverty… you name it. And if you think about it, being adopted or fostered is a form of individual displacement (and sure enough, being adopted is highly correlated with substance use). We also see proof of this concept in the other direction. When Vietnam soldiers with heroin addiction returned home from the trauma of war, 95% of them were cured just by returning from displacement to a safe environment.



While the ACEs study looked at more clear forms of trauma, don’t forget that we can suffer in much more discrete ways. These are the instances that can be the most frustrating for people because they feel even more inept for having “no reason” to be addicted. But we forget just how much it hurts to be teased, or constantly criticized, to never feel like we’re enough, or never belong, or not live up to certain standards, etc. If you don’t pay close enough attention, or feel too guarded to explore it, or don’t appreciate all the forms of suffering, you’ll miss it. And who is more likely to miss it than the very person who has been trained to feel wrong all the time!



I can’t tell you how much of human behavior is driven by fear and protectionism. Just take a look at our politics and religious wars. We love making things other people’s problems, and hate taking the time and energy to deal with the reality of situations. It’s too easy for people to blame a certain population for their addiction instead of take responsibility as a community for the suffering they go through. And it’s too easy to pretend that we can control addiction by modifying some gene. Sorry, it’s not that simple and it ain’t gonna work. To anyone without addiction: the patients with addiction who I sit with absolutely hate when everyone makes them out to be the villain. Sure, they get that they’re responsible for themselves. But don’t make them feel like they did this to themselves. Addiction is complex, ugly, and will never be some tidy illness you can cure with a silver bullet.



When I go through the ACEs study with patients, it’s amazing how much hope they feel when they understand (and eventually believe) that they aren’t defective, damaged, or broken. They begin to see their compulsive and destructive behaviors as fairly expected adaptations to cope with the tough shit they’ve been through. It might have been overt trauma like abuse, or more microtraumas like teasing and lack of true affection – but there’s always some kind of suffering there. Let’s stop taking the lazy, defensive role of blaming people for bad choices and start to meet them with respect and compassion for the shit they’ve gone through. I promise we’ll begin to see a whole lot of change when we can do that.

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