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What Causes Addiction?

picture of Joe Gilmore
Medically Reviewed By: Diana Vo, LMFT

January 24, 2024

Table of Contents

What causes addiction is a question with no universal answer, whether it’s what causes prescription drug addiction, alcoholism, or addiction to illicit drugs.

While drug use is often voluntary at first, full-blown addiction can develop for a variety of reasons. If you or someone you love is dealing with addiction, it is vital to find an addiction hotline and reach out to a treatment center like our Orange County rehab.

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Beyond this, we’ll also explore why some people can use substances without ever becoming addicted, while others find themselves with alcohol use disorder or substance use disorder following a period of recreational use.

What really causes addiction, then?

What is the Reason for Addiction?

If you abuse any addictive substance, your brain experiences structural and functional changes. This altered state can take some time to normalize.

If your brain circuitry has not been altered as a result of addiction, you will typically experience positive feelings related to normal rewarding behaviors like eating great food, relaxing with friends and family, or exercising. All of these activities should make you feel good. It is also likely you will repeat these behaviors to experience the positive feeling again.

If you abuse substances, by contrast, these substances trigger the release of large amounts of dopamine in the areas of your brain that govern reward. Dopamine is a chemical that occurs naturally in the body. As a neurotransmitter, dopamine is a chemical messenger. It carries, amplifies, and balances signals between the nerve cells and target cells of your body.

Addiction occurs when using a substance hijacks these circuits in your body, intensifying the urge to consume increasingly more of the substance to benefit from the same rewarding effects. When this manifests in the form of a substance use disorder, you’ll be faced with the following situation:

1. You will need more and more of the substance to feel the euphoric effects, but this feeling becomes increasingly elusive.

2. If you stop using the substance, you’ll experience withdrawal symptoms. These can be extremely uncomfortable and unpleasant.

By this point, you’ll need to use the substance simply to feel normal and also to prevent the acute discomfort of withdrawal.

Using alcohol or drugs to moderate your mood can impact the brain in three core areas:

1. Cerebral cortex: This area of the brain is responsible for executive functions like planning and decision making.

2. Brain stem: The brain stem controls heart rate, breathing, and sleeping.

3. Limbic system: This is your body’s emotional reward circuitry. Your limbic system controls your ability to experience pleasure, and it also governs motivation.

The type of substance is another contributor to addiction. Opioids, for instance, directly target brain receptors, which makes this class of drug highly addictive.

Where addiction was once viewed as a moral failing or a character weakness, most healthcare professionals now support the brain disease model of addiction.

While it is now widely accepted that addiction is a chronic and relapsing disease, some prefer to characterize it as a condition rather than a disease. What’s in a word, then?

Well, to describe addiction as “a chronic and relapsing condition” promotes the idea of treatment through behavioral change, and encourages the individual to feel more in control of the condition.

The disease model of addiction states that initial use may have been voluntary, but as neurobiological changes occur, these diminish behavioral choice over time.

Regardless of whether you prefer the descriptor “condition” or “disease”, the changes to brain function and structure triggered by substance abuse alter more than your initial response to the substance. Brain changes are also associated with:

  • Cravings
  • Distress during abstinent periods – also a key contributory factor to relapse
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Why Do Some People Become Addicted to Drugs While Others Don’t?

While the disease model of addiction is based on sound science – the brain undeniably undergoes changes as a result of substance abuse – the model is not without its limitations.

Why is it that some people become addicted to substances after exposure to them while others do not?

According to psychologist Bruce K. Alexander, the disease model makes both of the following claims:

1. Almost everyone who uses cocaine or heroin beyond a certain baseline becomes addicted.

2. Addiction is caused by exposure to the drug.

Alexander argues that data does not support these claims, citing widespread opiate use in both the United States and the United Kingdom during the nineteenth century, but with less than 1% of the population addicted or dependent. Even before laws were passed to restrict the use of opioids, use was already declining.

This viewpoint challenges some aspects of the disease model of addiction, especially the claim that exposure to certain substances alone is what causes addiction in most people.

Many environmental and genetic factors account for the variation in susceptibility to addiction from person to person. Most research shows that genes are responsible for up to 50% of your risk of becoming addicted to substances.

Beyond genetics, your environment can also shape your behavior, as well as influence you when it comes to using substances.

What is the Cause of Alcohol Addiction?

Alcoholism has no single and universal cause.

There are dozens of risk factors at play when it comes to whether or not you develop alcohol use disorder after sustained alcohol use, misuse, or abuse. These risk factors will vary from person to person.

The risk factors in question are both internal and external, and the range and scope of the risk factors makes it almost impossible to predict with any accuracy whether or not an individual will go on to develop alcohol use disorder.

Even if alcohol use begins voluntarily, by the same dependence and addiction sets in, personal choice diminishes as the altered brain attempts to combat the onslaught of dopamine triggered by alcohol abuse.

The following factors all come into play as potential causes for alcoholism:

  • Genetics
  • Psychological factors
  • Personality
  • Drinking history
  • Environment


While the genetic component of addiction is complex and not fully understood, most research suggests anything up to half your potential for addiction is rooted in genetics.

This goes beyond the environment, too. The biological children of those with alcohol use disorder are substantially more likely to develop alcohol use disorder, whether or not they were raised by alcoholic parents.

Psychological factors

Some psychological conditions like depression, anxiety, PTSD, and bipolar disorder increase your risk of developing alcohol use disorder.

Many people use alcohol to self-medicate the symptoms of mental health conditions. Beyond short-term relief, this approach does nothing to address the issues at hand, and will only inflame symptoms over time.


People likely to disregard risk are more prone to developing alcoholism than risk-averse individuals.

Just like genetics, though, personality factors are complicated and nuanced, interacting in ways that are tough to parse.

Drinking history

People with a long history of alcohol abuse are more likely to develop alcohol use disorder.

Also, people who drink more alcohol are proportionally more likely to become an alcoholic than those who drink less alcohol.

The effects of alcohol rewiring your brain are cumulative.


If you are in an environment that normalizes, even celebrates, alcohol use – a college fraternity, for instance – you are more likely to parse that kind of alcohol abuse yourself, resultantly placing yourself at increased risk of developing a problem with drinking.

Result of Addiction

Ultimately, addiction brings with it the possibility of a battery of dangerous complications and adverse health outcomes.

Addiction not only impacts all areas of your life, but it also ripples outward and affects the whole family, and in many cases the community.

As well as the toxic, destructive physical effects – cardiovascular diseases like stroke and heart attack, for example – substance abuse can even end in overdose and death.

Drug addiction and alcoholism can also trigger a range of mental health conditions, from depression and anxiety to psychosis. Substance abuse can also increase suicidal ideation.

The best way to deal with addiction is to prevent it, and if it’s too late for that, you should consider engaging with professional treatment to streamline your recovery.

 people learning what causes addiction at Renaissance Recovery

Overcoming Addiction at Renaissance Recovery

Even if you’re still not certain about what causes drug addiction or alcoholism, the most important thing is recognizing that you have a problem with substances and taking action by getting the help you need to achieve sustained recovery.

At Renaissance Recovery’s rehabs in Florida and California, we offer a variety of personalized and evidence-based outpatient treatment programs, including intensive outpatient programs and PHPs (partial hospitalization programs).

With a combination of MAT (medication-assisted treatment), counseling – both individual and group – and talk therapies like cognitive behavioral therapy or dialectical behavior therapy. You should find the withdrawal symptoms and cravings you experience is less intense, and you’ll also have the chance to explore the root cause of your addiction. Addiction may not be curable, but it’s treatable, and we’re here to help you build a strong foundation for lifelong recovery with all the support and aftercare you need in place. To take advantage of this help, simply reach out to Renaissance 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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