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How Does Addiction Start?

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Medically Reviewed By: Diana Vo, LMFT

March 15, 2024

Table of Contents

Among the questions we are asked most frequently at Renaissance Recovery are “how does addiction start?”, or “how does drug addiction start?

Well, every person is different, and every addiction starts differently. Everyone will experience an individual journey into addiction just like they go through a personal recovery journey.

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Before we shine a light on how addiction begins, it’s vital to understand that addiction might be a chronic and relapsing condition, but it is treatable. Anyone suffering from substance use disorder or alcohol use disorder – the formal descriptors for drug addiction and alcoholism – has various treatment options and sober living homes when they are ready to commit to sustained sobriety.

What Causes Drug Addiction?

It is part of human nature to pursue things that make us feel good, from great food and drink to comfy environments and pleasurable activities. 

When you feel good, the brain releases dopamine. Dopamine is a neurotransmitter – a chemical messenger relaying information between neurons in the brain. 

As you develop from an infant into an adult, your brain stores the memory of good feelings, as well as the source of those feelings. In a healthy brain, memory is stored and associated with feeling good in the future.

When you consume drugs or abuse alcohol, though, the brain doesn’t function healthily. Instead, it starts releasing more dopamine than normal. Beyond this, drugs alter brain chemistry and block the efficient reabsorption of dopamine. Resultantly, you experience a prolonged sensation of happiness, an extended euphoria typically unattainable without using drugs. 

Humans are intrinsically hedonistic – pleasure-seeking – and the brain starts to ask for more of the good feeling induced by substance use. Over time, more and more of the substance is required to deliver the same effect. Tolerance starts building. 

Before long, nothing but substance use induces happiness. Routine matters may appear dull and pointless, with anything unrelated to substance use deprioritized. 

By this stage, the addiction cycle is in full swing, and nothing but substance use counts. 

While oversimplified, this typical journey from substance use to drug addiction shows the following: 

  • Brain chemistry is altered by drug use
  • Dopamine and the brain’s reward system slowly and continually mutate with ongoing substance use

How do people first get addicted to drugs, then?

How Does Drug Addiction Start?

While most people choose to use drugs for the first time, nobody chooses drug addiction.

Addiction does not occur through a lack of morals or a lack of willpower, either – more on that below. 

As outlined above, the chemical reactions taking place in the brain of someone with addiction differ significantly from those happening in the brains of those without addiction. 

The following certain risk factors can all impact your risk profile for addiction:

  • Genetics
  • Drug of choice
  • Dual diagnosis
  • Underlying medical conditions
  • Method of delivery
  • Environmental factors
  • Peer pressure
A man is looking out at California scenery to represent the question, "how does drug addiction start?".


Heredity is one of the most significant risk factors for drug addiction and alcoholism.

According to NIDA (the National Institute on Drug Abuse), roughly half of your risk of addiction to drugs, alcohol, or nicotine is due to genetics. If you have a family history of substance use, you are more likely to be impacted by drug addiction. 

The genetic risk for addiction is commonly described as an addictive personality. This is not a clinical descriptor but encapsulates the idea of someone genetically predisposed to addiction in one form or another.

Drug of choice

Some addictions slowly unfold over months or years, while others move much more rapidly. The substance in question can play a role in this.

Illicit drugs like meth, cocaine, and heroin can be more physically addictive than alcohol or marijuana. The withdrawal symptoms from meth, cocaine, and heroin is often physically painful, prompting further drug misuse to keep withdrawal symptoms at bay. 

Not only can this accelerate the process of drug abuse and drug addiction, but it can also heighten the risk of serious complications like an overdose.

Dual diagnosis

If you have an addictive disorder and a co-occurring mental health disorder, this is known as dual diagnosis or co-occurring disorder. 

Examples of dual diagnosis include:

  • Alcohol use disorder and depression
  • Substance use disorder and anxiety
  • PTSD and substance use disorder

Underlying mental health conditions raise your risk profile for addiction. Similarly, drug addictions can inflame the symptoms of mental health disorders. 

Often, people with mental health conditions and mental disorders – especially when undiagnosed – self-medicate these symptoms with drink or drugs. This does nothing to address the root cause of either condition. While potentially providing short-term relief, self-medicating will ultimately inflame both conditions.

Underlying medical conditions

Some medical conditions can increase your risk of addiction.

Many people prescribed opioid painkillers to alleviate post-surgery pain find themselves becoming tolerant to opioids, sometimes developing opioid-use disorder.

Sometimes, the knock-on effects of certain physical illnesses can encourage you to use drink or drugs as a coping mechanism.

Method of delivery

In the same way, as certain drugs can be more addictive than others, the method of using drugs can impact the risk of addiction. 

Broadly, when you smoke or inject substances, they tend to be more addictive than those you swallow. Smoking or injecting drugs means they enter the bloodstream rapidly. When you swallow drugs, they must first pass through your liver and other organs.

Environmental factors

Many environmental variables can impact your risk profile for addiction. 

Lack of parental involvement often leads children and teens to experiment more freely with alcohol or other drugs.

Ready access to drugs or prescription medications can also raise the risk of experimentation with substances. 

Neglect or abuse from parents can lead to some children and teens using drink or drugs as a coping mechanism.

Peer pressure

Peer pressure, whether explicit or less overt, often causes young people to experiment with alcohol or drugs.

When combined with ease of availability – large amounts of alcohol in college social settings, for instance – peer pressure can kickstart patterns of substance use that lead to addiction later down the line.

A man looks up at the sky to represent drug abuse as a complex brain disease.

How Does Addiction Work?

Addiction to drugs is termed substance use disorder (SUD), while the formal descriptor for alcoholism is alcohol use disorder (AUD). 

Addiction leads to structural and functional changes in the brain. Firstly, addiction interferes with the brain’s response to pleasure. Additionally, addiction impacts other areas of the brain, including those governing motivation and learning. 

There are three distinct ways in which addiction impacts the brain:

  1. Cravings for the substance
  2. Loss of control over substance use
  3. Continued substance use despite adverse outcomes

Researchers first started investigating the causes of addictive behaviors back in the 1930s. The prevailing contemporary belief was that addictions developed through a lack of willpower or a moral failing. To overcome addiction, a punitive approach was used.

Over time, the scientific consensus on addiction has shifted. Today, addiction is recognized as a chronic and relapsing disease that alters brain function and structure. 

How do these changes in the brain occur, then, and how does this drive compulsive behaviors further?

Brain’s Reward Center

Your brain registers all pleasures equally. 

Whether the source of pleasure is a meal, a monetary reward, a sexual encounter, or a psychoactive drug, pleasure registers a signature action in the brain: the neurotransmitter dopamine is released in the brain, specifically in the nucleus accumbens. 

The nucleus accumbens is a cluster of nerve cells located under the brain’s cerebral cortex. The release of dopamine in this area of the brain has led scientists to describe this pivotal region as the reward center of the brain. 

Every substance of abuse, from alcohol to nicotine to heroin causes a strong surge of dopamine to be released in the nucleus accumbens. The risk profile for a substance leading to addiction is linked directly to the following:

  • The speed at which the substance triggers dopamine release
  • The intensity of dopamine release
  • The reliability of dopamine release

Addictive drugs, then, flood the nucleus accumbens with dopamine. Not only does dopamine contribute strongly to the experience of pleasure, but it also plays a role in both memory and learning. Both these elements influence the transition from liking a substance to becoming addicted.  

Now for the good news: however addiction starts, you can get the help you need, and you don’t necessarily have to pack your bags and head to residential rehab either.

How to Start Addiction Recovery

If you are ready to commit to recovery and you want to nip addiction in the bud, follow this simple framework: 

If you are ready to commit to recovery and you want to nip addiction in the bud, follow this simple framework:

  • Reach out for help: Recovery is an ongoing process rather than an event. That said, the process cannot get underway until you admit you have a problem with drink or drugs. Once you reach this point, you should ask for the help you need. Only one in ten people with substance use disorder receive any form of treatment. Make sure you reach out for help and avoid falling into this huge treatment gap.
  • Learn about treatment and recovery: Start researching the various forms of inpatient and outpatient treatment for addiction. Speak with your healthcare provider and ask for recommendations for rehab. Assemble a shortlist of suitable treatment providers and commit to a course of addiction treatment.
  • Engage with treatment: Follow through with your chosen treatment program, whether at residential rehab or in an outpatient setting. Ensure you have the right aftercare in place when you complete your treatment.
  • Sober living: With the skills, you acquired in rehab and a solid relapse prevention plan in place, you are ready to pursue a life of sustained sobriety. And we can help you achieve all of this and more here at TDRC.

How Does Addiction Start?: FAQs

How does something become an addiction?

Addiction develops through a combination of biological, psychological, and environmental factors. Initial substance use provides pleasurable effects, leading to repeated use. Over time, the brain’s reward system is altered, resulting in a compulsion to seek and use the substance despite negative consequences.

How does the cycle of addiction begin?

The cycle of addiction typically begins when an individual engages in substance use that provides pleasurable effects or relieves negative emotions. Continued use leads to changes in the brain’s pleasure center, creating a compulsion to seek and use the substance. Over time, tolerance develops, requiring higher doses for the same effect, and withdrawal symptoms may emerge when substance use is reduced or stopped, reinforcing the cycle of addiction.

What is the first rule of addiction?

The first rule of addiction is acknowledging and accepting that you have a problem. Recognizing and admitting the presence of addiction is a critical step toward recovery. It requires honesty with oneself and the willingness to seek help and make necessary changes to avoid addictive substances.

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Addiction Treatment at Renaissance Recovery

Here at Renaissance Recovery, we can help you unchain yourself from addiction regardless of how your journey to substance abuse started. 

We specialize in the outpatient treatment of alcohol use disorder, substance use disorder, and co-occurring disorders. In addition to regular outpatient programs, we also offer more intensive treatment in the form of IOPs (intensive outpatient programs) and PHPs (partial hospitalization programs). 

Wherever you fall on the continuum of care, all our addiction treatment programs here at TDRC give you access to the following evidence-based therapies: 

We can also help you take a whole-body approach to your recovery with holistic therapies and adventure therapy to complement the above evidence-based treatments. 

Get started by reaching out to admissions today at 866.330.9449.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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