The Root Causes of Addiction: How to Identify and Stop Possible Factors

Addiction can prevent someone from experiencing meaning in life, ruin relationships, and lead to serious health complications. When faced with your own or a loved one’s addiction, you may wonder what are the root causes of this crippling chemical dependency.

The truth is there is no single root cause of addiction. Factors like trauma, mental health conditions, genetics, environment, and changes in brain chemistry all raise the risk for addiction and can combine differently in every person.

We’ve covered nine factors that can help you understand the underlying cause of addiction and how you can help yourself or a loved one with this knowledge.

Is Addiction a Disease or a Choice?

Addiction is a “a treatable, chronic medical disease”, as defined by American Society of Addiction Medicine. While initial substance use is usually a choice, over time a substance user’s self-control can become impaired, which is the “hallmark of addiction”. By the time substance usage becomes chronic, the brain has gone through physical changes which can affect areas needed for decision making, learning, memory, judgement calls, and controlling one’s own behavior–which can make it more difficult to quit a substance.

Understanding Addiction

Addiction is the compulsive need to use drugs or alcohol, even if the usage is physically harming or preventing you from finding meaning in life. The key is that addiction is compulsive and nearly impossible to stop.

SAMHSA’s 2024 National Survey on Drug Use and Health estimates that 31.7 million adults aged 18 or older (or 12.2% of adults in the U.S.) have ever had a problem with their alcohol or drug usage. 
If you or your loved one are among that number, you are not an outlier and recovery is possible. Of those with past usage issues, 74.3% (or 23.5 million people) consider themselves to be in recovery or to have recovered. 

What is the difference between substance abuse and addiction?

Addiction is defined as a severe substance use disorder by the DSM-5. It’s different from substance abuse where someone uses an illegal substance but can stop. Substance abuse comes first, and the intense cravings of addiction can develop over time. Substance abuse is usually a choice, but once it develops into addiction, it’s no longer a choice.
Here is how clinicians separate the levels of substance use leading to addiction:

• Substance use is any use of alcohol or drugs, including use that causes no problems.
• Substance misuse is the use of alcohol or drugs in a way that is risky or outside how a medication was prescribed, such as drinking heavily on a weekend or taking someone else’s pain pills.
• Chemical dependency describes the body adapting to a substance, so that tolerance builds and stopping produces withdrawal. A person can be dependent on a prescribed medication without being addicted to it.
• Substance use disorder is the clinical diagnosis, ranging from mild to severe, based on criteria in the DSM-5.
• Addiction is a severe substance use disorder. NIDA defines addiction as “chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences”.

The process of using addictive substances, until it becomes an addiction, alters the brain function and structure in a way that’s extremely difficult to overcome without help. These changes affect how you act, and it can lead to behaviors you’d never considered doing before.

What Causes Addiction? Root Causes and Risk Factors

The root causes of addiction include trauma, mental health struggles, and genetic predisposition, environment, and chronic stress. However, it’s important to keep in mind that there is no one cause of addiction. No one can completely predict who will become addicted after substance abuse and who will not.

None of these factors necessarily cause addiction, having trauma, mental health struggles, or specific genetics doesn’t mean you’re bound to suffer from addiction. But these factors do have strong correlations with addiction following substance abuse. Here’s the 5 root causes of addiction with the most clinical evidence.

1. Trauma and Adverse Childhood Experiences

Trauma can include physical, psychological, and emotional experiences that overwhelm your ability to cope. Trauma correlates with addiction. It’s important to remember that not everyone who experiences trauma will develop an addiction, but many individuals who suffer from addiction have experienced trauma. A traumatic experience or ongoing condition can lead to despair and enduring pain, and some people will turn to substances to cope with or dull the pain.

Childhood trauma (also known as adverse childhood experiences or ACEs) in particular has a high correlation with developing an addiction later in life. ACEs are very common in the U.S. based on CDC data from 2011–2020: 63.9% of U.S. adults reported at least one ACE; 17.3% reported four or more ACEs. 

About 59% of young people who suffer from PTSD (as a result of childhood trauma) will suffer from substance abuse problems that could potentially lead to addiction. This trauma (especially at such a young age) can act as a catalyst for drug and alcohol addiction. Addiction from trauma is usually a way to try to return to feeling normal and to escape PTSD symptoms caused by trauma.

“In clinical populations (focusing on either disorder), about 25–50% have a lifetime dual diagnosis of posttraumatic stress disorder and substance-use disorder. Patients with both disorders have a more severe clinical profile than those with either disorder alone, lower functioning, poorer well being, and worse outcomes across a variety of measures.” 

• Schäfer, I., & Najavits, L. (2007). Clinical challenges in the treatment of patients with posttraumatic stress disorder and substance abuse. Current Opinion in Psychiatry, 20(6), 614–618. https://doi.org/10.1097/YCO.0b013e3282f0ffd9

This is why dual-diagnostic care is so important in addressing the root causes of addiction.

2. Mental Health Conditions

Mental health struggles are another underlying factor that can lead to addiction. 35% of U.S. adults who have two mental disorders also have a substance use disorder, according to the 2023 National Survey on Drug Use and Health (NSDUH).

About 1 in 4 individuals with a serious mental illness (such as major depression, schizophrenia, or bipolar disorder) also struggle with substance abuse and addiction.

Just as with trauma, mental illness as a child can lead to an increased risk of addiction later in life. Some individuals with ADHD will rely on drugs to help them stay focused, which can lead to addiction. Mental illness and addiction can feed off of each other and worsen both. When mental illness occurs with addiction, it’s called co-occurring disorders, and it can be treated with dual diagnosis treatment.

Untreated mental illness can lead to feelings of being overwhelmed or in pain, and that’s part of what can lead to addiction. The key is to seek mental illness treatment and to rely on healthy practices that can provide meaning and hope without dependency. 

3. Genetics and Family History

Genetics can also affect addiction. Everybody’s DNA is identical except for 0.1%. But that minuscule difference can have effects on a variety of health conditions, including addiction. About 50% of your risk for drug or alcohol addiction comes from your genetic makeup. You also have a higher risk of predisposition to addiction if your parents currently or previously suffered from addiction.

4. Home, Family, and Peer Environment

Growing up in an environment surrounded by drug and alcohol use can lead to an increased risk of addiction later. When substance abuse is normal in a home, especially during the adolescent years, children may view drug and alcohol use as something that’s not a big deal and the risk of them developing a substance use disorder increases. Factors like lifestyle, diet, and stress can affect addiction as well. While genetics plays a role, the environment you live in can compound the effects.
Similarly, the earlier in life you begin using substances, the more likely you are to develop a substance use problem due to effects on the still-developing brain’s. This extends even into your 20s as your prefrontal cortex continues maturing until your mid-twenties on average.

5. Chronic Stress

Stress is often a reason people begin using drugs or alcohol in the first place; they often want to feel better by using substances, and will continue to return to it after recovery to reduce chronic stress.
For adults in high-stress work such as healthcare, construction, aviation, tech, and law enforcement, substance use can take the edge off during off-time. That’s why we partner with local businesses to provide streamlined Employee Assistance Program (EAP) referrals for working professionals.

Why Do People Get Addicted to Drugs or Alcohol During Substance Use?

While the 5 clinical risk factors–trauma, mental health disorders, genetics, environment, and stress–can increase your pre-disposed risk of getting addicted to a substance, what actually causes someone to progress from a substance user to having an addiction or severe substance use disorder?

1. The Dopamine Reward Circuit Adapts to Substance Use

Humans adapt to new situations, but some struggle and seek external ways to cope. Addicts often have a deficient brain-reward system, leading them to use substances for balance.

In non-addicts, natural neurotransmitters provide a “high” from everyday activities. In addicts, this system is faulty, driving them to drugs or alcohol for relief. For example, those with ADD might turn to illicit drugs like cocaine for focus when medication fails, creating a cycle of dependence.

No matter how you start, substance use can cause the brain’s reward system to be flooded with dopamine, which is critical for motivation and pleasure. Surges of dopamine from drug use reinforce substance use behaviors. 

Over time, the brain adapts to the excess dopamine by reducing the high the person feels, also known as tolerance to the substance. As the brain tries to stabilize their dopamine during chronic substance use, ordinary things stop feeling good: food, completing work, quality time spent with loved ones, etc. The substance becomes the only reliable source of dopamine and relief.

2. Negative Reinforcement

Addiction isn’t just about chasing a “high”; it’s also about avoiding the “low.” Withdrawal symptoms can be severe, leading individuals to use substances again to feel normal. This creates a vicious cycle of dependence. Research shows drugs like cocaine induce euphoria but also trigger stress and fear. These lingering negative feelings push users to seek relief through more drug use, perpetuating addiction.

This is also the point where stopping without medical support becomes dangerous, particularly with alcohol and benzodiazepines. Similarly, those chemically dependent on opioids can be helped with medication-assisted treatment (MAT), or a treatment program that uses medications with counseling to treat substance abuse, drug addiction, and prevent opioid overdose.

3. Smoking and Injecting Substances Increase Addictive Potential

How the drug is taken can affect the addictiveness significantly. Smoking a drug or injecting it into a vein increases its addictive potential. Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense high can fade within a few minutes. 

That’s why the slow delivery of substances you’re dependent on–like a nicotine patch used in place of smoking a cigarette–can be a long-term recovery strategy to slowly taper off substance use while reducing the risk of relapse.

Protect Factors to Reduce Addiction & Relapse Risk Long-Term

For every addiction risk factor, there is an equal and opposite protective factor you can focus on to reduce the risk of addiction in the first place or relapse in recovery.

Worried about a loved one? We’re here to help.

At The Phoenix Recovery Center, we don’t treat substance use in isolation. We’re a Joint Commission accredited, locally owned treatment center in South Jordan, Utah. Our integrated dual-diagnosis model means addiction and mental health are assessed and addressed together by master’s-level clinicians, with onsite psychiatric support for complex cases.

If you’re researching options for yourself or someone you love, we’re happy to answer your questions with a free consultation. No pressure and no obligation.