What Causes Addiction? Factors That Increase Your Risk for a Substance Use Disorder

Substance misuse is a problem that affects millions of Americans. A 2021 survey found that nearly 30 million Americans aged 12 and over had an alcohol use disorder. Over 46 million Americans had a substance use disorder in the past year alone. 

While some people may use drugs and alcohol moderately, others can develop an addiction. Risk factors and protective factors explain why some people are more likely to develop problems with substances. 

Risk factors that can increase your risk for addiction

Risk factors are events, characteristics, or traits that increase the likelihood that a person can develop a condition. People who have one or more risk factors are more likely to become addicted to drugs or alcohol than people without these risk factors. 

There are many risk factors for substance use and addiction that typically fall into four categories. The four types of risk factors for addiction are:

1. Biological: related to a person’s physical body, such as hormones, diseases, or genetics 

2. Psychological: related to a person’s emotional experiences, including their exposure to stress and trauma

3. Social: involves the influence of others, like whether or not family and friends use substances 

4. Environmental: related to a person’s surroundings, such as how easily they can acquire substances

Below, we’ll discuss five specific risk factors for addiction.

1. Genetics

According to experts, genetics affect between 40% and 60% of a person’s risk of addiction. Having one or more biological family members with a substance use disorder increases the chance that you could develop one yourself. Based on current research, this is true for addictions to alcohol, nicotine, and opioids. 

2. Family environment

The family environment plays a critical role in a person’s risk of addiction. Children and teens exposed to drugs, alcohol, or criminal activity at home are at greater risk of developing a substance use disorder.

Even families who do not use drugs or alcohol may engage in behaviors that could increase a child’s risk of addiction. Other family risk factors for addiction include:

• Having a permissive parent (a lack of rules, expectations, and structure)

• Lack of warmth from parents

• Family conflict

• Harsh or inconsistent discipline 

• Child abuse or mistreatment

• Positive attitudes toward drugs and alcohol by parents

3. Peer influence

Peers are impactful in the lives of children and teens. Exposure to peers who use drugs and alcohol is another risk factor for developing a substance use disorder. Peers may encourage experimentation, which can lead to ongoing use and potentially addiction. 

Peer rejection and bullying are also risk factors for developing a substance use disorder. Both bullies and their victims are more likely than their counterparts to misuse alcohol, cigarettes, and cannabis. 

4. History of trauma

Experiencing trauma is another risk factor for addiction. Trauma is an emotional and physiological response to witnessing or experiencing a life-threatening or distressing event. All types of trauma can increase your risk of developing a substance use disorder. 

Indirect exposure to trauma, such as learning that a loved one experienced a traumatic event, also increases a person’s risk. People who experience post-traumatic stress disorder (PTSD), a mental health condition that develops after a traumatic event, are also more likely to have an alcohol or substance use disorder. In fact, teens with PTSD are four times more likely to develop an alcohol use disorder and nine times more likely to develop another type of substance use disorder. 

5. Mental health conditions

There is a strong link between addiction and certain mental health disorders. According to experts, substance use and mental health disorders have a bidirectional relationship. This means they can influence each other. In some cases, a person with a mental health disorder may turn to drugs and alcohol as a form of self-medication. For others, drug and alcohol misuse may contribute to developing a mental health condition. 

Mental health disorders that commonly occur alongside substance use disorders include:

• Major depression

• Bipolar disorder

• Anxiety disorders

• PTSD

• Attention-deficit hyperactivity disorder (ADHD)

• Borderline personality disorder (BPD)

• Antisocial personality disorder

Does being at risk mean you’ll definitely develop a drug addiction?

Having risk factors for an addiction does not necessarily mean that you will go on to develop an addiction. Instead, it means that you are at greater risk than someone who does not have these same risk factors. 

If you have one or more of the risk factors listed above, you may want to be cautious about how you use substances or avoid them altogether. In addition, protective factors can help reduce your risk of developing a substance use disorder.

Protective factors that can reduce your risk of addiction

Protective factors are positive experiences or events that reduce the chances of developing a condition such as addiction. The more protective factors a person has, the lower the chances they will become addicted to drugs or alcohol. 

Three common protective factors against addiction are discussed below.

1. Family 

Family relationships and the home environment can serve as protective factors against addiction. Starting in early childhood, family plays a critical role in how a child’s behavior and personality develop. This continues to impact them throughout their life.

Family factors that help protect against addiction include:

• Having supportive family relationships

• Developing a secure attachment with caregivers

• Providing for a child’s basic needs

• Creating a safe environment for children

• Using language-based discipline, rather than physical punishment

• Disciplining consistently

• Setting clear and firm limits

• Resolving conflicts constructively

2. Positive experiences with peers

Peers can have a strong, positive influence on a young person’s likelihood of experimenting with substances and developing an addiction. Similarly, spending time with peers who discourage substance use decreases the risk of addiction.

3. School and community ties

Having positive experiences and connections at school and within the community can also protect against substance misuse and addiction. Children and teens who engage with school are less likely to develop an addiction. 

Other school and community factors that can protect against substance misuse include: 

• Positive expectations of students by their teachers

• Good classroom management

• Involvement in after-school activities

• Anti-bullying policies

How can you reduce my risk of a substance use disorder?

Most people have at least some risk factors for addiction. Having risk factors does not guarantee that you will become addicted to drugs and alcohol. However, you should be aware of them and make efforts to reduce your risk. 

To help reduce your risk of substance misuse and addiction, consider these tips.

Avoid or limit your use of substances

If you think you could be at risk for addiction, consider staying away from substances completely. Abstinence may be right for you because it takes away the need to have to self-monitor your use. 

If you do choose to drink, consider setting limits around your use. The current guidelines for moderate drinking include limiting your alcohol use to one drink or fewer per day for women and two drinks or fewer per day for men. A standard drink is: 

• 12 oz of beer

• 5 oz of wine

• 1.5 oz of distilled spirits (liquor)

Self-monitoring your alcohol use involves setting limits for yourself. Examples of limits include only having two drinks per occasion, only drinking socially, or avoiding alcohol during the weekdays. Taking a sober curious approach to alcohol, where you explore your reasons for drinking and try out periods of sobriety, can also be helpful in limiting your drinking. 

Find sober hobbies and activities

Exposure to drugs and alcohol can increase the likelihood of misusing substances. Participating in activities that do not involve drugs and alcohol can help you reduce your risk. Consider different activities and hobbies that might interest you. These can be: 

• Fitness-related: Joining a gym, exercise class, or competitive sports team

• Creative: Art, dance, or music

• Relaxing: Practicing meditation or yoga

Surround yourself with like-minded people

Connecting with other people who are sober or drink only in moderation is important in reducing your risk. If you would like to meet other people in recovery, consider attending peer support groups such as: 

• Alcoholics Anonymous

• Narcotics Anonymous

• SMART Recovery

Seek treatment if you have concerns

If you suspect that you may have a problem with drugs or alcohol, help is available. Some signs that you may have an addiction include:

• You have tried to cut down in the past but couldn’t.

• You use substances even though they cause problems in different areas of your life, such as at work, home, or in your relationships.

• Your substance use has been harmful to your physical and/or emotional health.

• You experience strong cravings for substances.

• You have tried to hide your use from others. 

• Over time, you have found that you need more drugs or alcohol to get the same effects.

There is a strong link between mental health disorders and addiction. If you have a mental health condition, getting treatment is important and can prevent you from turning to substances to cope.

If this sounds like you, speak with your healthcare provider about your concerns. For help finding an addiction or behavioral treatment program, call SAMHSA’s National Helpline at 1-800-662-HELP (4357). The helpline is free, confidential, and available 24 hours a day in English and Spanish. You can also search SAMHSA’s Behavioral Health Treatment Services Locator for a listing of local treatment facilities.

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Written by:

Emily Guarnotta, PsyD

Emily Guarnotta, PsyD, is a licensed clinical psychologist and certified perinatal mental health professional with over 10 years of clinical experience.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

Mona Bapat, PhD, HSPP

Mona Bapat, PhD, HSPP, has 15 years of clinical experience providing therapy. She is a licensed clinical psychologist in Indiana and Illinois with treatment experience in individual, couples, family, and group therapy modalities.

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