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5 Risk Factors that Contribute to Substance Abuse

Over the past few decades, researchers have tried to determine why some people are more likely to abuse substances than others. And they’ve noted several risk factors that increase a person’s chance of drug or alcohol abuse as well as addiction.1

However, many people who are at risk for substance abuse don’t begin using substances or develop an addiction. Plus, what may be a risk factor for one person may not be for another. This is because we are complex people influenced by biological, psychological, and social factors. Either way, knowing the five factors that contribute to substance abuse can help you seek help before your substance abuse progresses to a full-blown drug or alcohol addiction.  

Untreated Mental Health Disorders

An untreated mental illness, such as depression, anxiety, and bipolar disorder, can increase a person’s likelihood of engaging in substance abuse. This could be for two reasons, including:2

  • Mental health conditions and substance addictions share similar risk factors
  • People with mental health conditions often self-medicate their symptoms with drugs or alcohol

Having a substance addiction and co-occurring mental illness is referred to as a dual diagnosis, and dual diagnoses are extremely common in the United States. In fact, about 38% of people with substance use disorders also have mental illnesses. And over 18% of people with psychiatric conditions also have substance addictions. Co-occurring conditions require integrated, comprehensive care, and yet, of these individuals, only about 9% get the dual diagnosis treatment they need to adequately address both mental health and substance addiction.3

Some common mental illnesses that may increase the risk for addiction include:4

  • Eating disorders, such as anorexia nervosa
  • Anxiety disorders, such as panic disorder, generalized anxiety disorder
  • Attention deficit hyperactivity disorder (ADHD)
  • Bipolar disorder
  • Depressive disorders, such as major depressive disorder
  • Personality disorders, such as borderline personality disorder and narcissistic personality disorder
  • Posttraumatic stress disorder (PTSD)
  • Schizophrenia

A History of Trauma

People who have gone through trauma have a significantly higher risk of developing a substance use disorder, and those with PTSD may abuse drugs or alcohol to:2

  • Decrease their anxiety
  • Avoid flashbacks or unwanted feelings
  • Improve sleep
  • Avoid dealing with the traumatic event or events

The connection between PTSD and drug or alcohol addiction is especially troubling for service members returning home from tours in Afghanistan and Iraq. Between 2004 and 2010, about 16% of veterans had an untreated addiction, and 8% needed treatment for serious psychological distress. Moreover, about 20% of veterans with PTSD have a co-occurring addiction.2

While veterans are a particularly vulnerable population when it comes to trauma and substance abuse, it’s important to remember that there are so many different types of trauma, including:5

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Neglect
  • Witnessing violence, including domestic violence

All of the above adverse childhood experiences (ACE) increase the risk of substance addiction by 2-3 times.5 That said, it’s never too late to seek help. Receiving professional trauma-informed care and substance abuse treatment can help people recover and heal.

Chronic Stress

Chronic stress is a major risk factor for substance abuse and addiction, as well as relapse to drug use after a period of sobriety. This is because high levels of stress can decrease activity in various parts of the brain that are responsible for impulse and behavioral control. By reducing the activity, people may be more impulsive, leading them to try drugs or alcohol.

Life stress during at a young age and chronic stress can cause long-term adaptations to areas in the brain related to:2

  • Adaptation
  • Learning
  • Motivation

These neuronal changes can cause impairment in these areas, increasing the risk for substance abuse. Furthermore, stress can increase vulnerability to addiction by changing dopamine pathways in the brain, thereby increasing the rewarding effects of certain drugs. After substance abuse has been initiated, these substances can alter neurotransmitter systems that modulate stress response, which can lead to an escalation of drug or alcohol use.2

Genetics and Family History

It is estimated that between 40% and 60% of a person’s risk of addiction can be attributed to genetics. Most of this vulnerability is due to interactions between several genes, as well as how a person’s genes interact with environmental risk factors.2

Moreover, drug likability is largely genetic. Some people may try a drug like cocaine and dislike how it feels so they don’t wind up using it ever again, whereas someone else may use cocaine and enjoy the effects, making them more likely to use cocaine again in the future.2

Genes can also have an indirect influence on a person’s substance abuse by changing how a person reacts to stress or by increasing the chance of engaging in novelty-seeking or risk-taking behaviors—these behaviors could then lead to substance abuse and addiction.2

Epigenetic Influence

Epigenetics refers to the environmental impact on gene expression and activity. This means that the environment can actually change which genes are active or silent, and these adaptations can even be passed down for the next generation to inherit.2

Being a Member of the LGBTQ+ Population

People who identify as lesbian, gay, bisexual, transgender, or queer or questioning deal with discrimination, stigma, and systemic oppression, as well as a higher risk of violence and hate crimes. Many LGBTQ+ individuals also lack support, have been disowned by their families, or experience internalized homophobia. These challenges and stressors can increase the risk of substance abuse and addiction.6

Nearly 38% of adults in the LGBTQ+ community report marijuana use whereas only about 16% of cisgender heterosexual people have. Meanwhile, LGBTQ+ individuals are nearly three times more likely to abuse heroin and prescription opioids than the overall adult population.6 As for all illicit drugs, LGBTQ+ individuals are more likely to use illegal drugs, smoke cigarettes, and drink alcohol than their sexual majority counterparts. And lastly, sexual minorities are more likely to have a substance addiction and to require addiction treatment than sexual majorities.7

Sexual minorities seeking recovery may want to look for a specialty rehab that has experience treating the unique challenges those in the LGBTQ+ population face. Plus, sexual minorities may feel more comfortable recovering in a space reserved for LGBTQ-identified members.

Finding Help for a Drug or Alcohol Abuse

It’s never too early or too late to seek a drug or alcohol rehab program. In fact, attending substance abuse treatment early can help stop the progression from substance abuse to addiction. Call our confidential helpline at 1-800-429-7690 to find the best rehab program for your needs.

Substance Abuse Resources

  1. National Institute on Drug Abuse. (2011). What are risk factors and protective factors?
  2. National Institute on Drug Abuse. (2021, April 13). Why is there comorbidity between substance use disorders and mental illnesses?
  3. National Institute on Drug Abuse. (2021, April 6). Comorbidity: Substance use and other mental disorders.
  4. Substance Abuse and Mental Health Service Administration. (2020). Substance Use Disorder Treatment for People with Co-Occurring Disorders.
  5. Whitesell, M., Bachand, A., Peel, J., & Brown, M. (2013). Familial, social, and individual factors contributing to risk for adolescent substance useJournal of addiction2013, 579310.
  6. National Institute on Drug Abuse. (n.d.). Substance Use and SUDs in LGBTQ Populations.
  7. Substance Abuse and Mental Health Services Administration. (2016). Sexual Orientation and Estimates of Adult Substance Use and Mental Health: Results from the 2015 National Survey on Drug Use and Health.

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