Most people have been educated that addiction is caused by drugs and alcohol. After all, we have decades of brain studies that show just how addictive certain substances are, and how they cause dependence. Let’s take a closer look at how addiction works.


It’s true that substances cause easily detectable changes in the brain, but that leaves out the full picture. The first thing to understand is that everything we do causes brain changes. If you practice a video game enough, your brain changes. If you use a certain computer program repeatedly, your brain changes. That’s Neurobiology 101, that we have wires in our head that are programmable.

As a psychiatrist, I’m all for teaching the science behind addiction. But that can falsely lead people to believe that consuming certain substances somehow takes over on its own - and that’s not how it works.


Addiction is the story of human suffering. We arrive at vices (however dangerous) out of a desire to escape how difficult and challenging life can get. Enjoying drugs and alcohol too much for recreational use is one thing. But when someone is truly trapped with an addictive substance, psychological pain is usually the underlying driver.

That hurt can come in several forms: a difficult childhood, sadness, anxiety, trauma, frustration… and even subtle things like resentments or boredom. The answer to addiction is right beneath our noses.

We all go through difficult times, but the question is: Why do some people turn to substances to cope, and others can endure hard times? Let’s explore that.


The ACEs study is one of the most important studies you can know about when it comes to emotional struggles. It was a large study that looked at how ten types of childhood trauma were correlated with long term health. Those traumas include: physical, emotional and sexual abuse; physical and emotional neglect; having a family that wasn’t loving or felt you were important; living with a family member who’s addicted to alcohol or other substances, or who’s depressed or has other mental illnesses; experiencing parental divorce or separation; having a family member who’s incarcerated, and witnessing a mother being abused. The results were simple and clear: the more adversity you have, the higher your chance of addiction. To be specific, a score of 4/10 equates to a 700% higher risk of becoming an alcoholic. Since the original study, we now see that other hardships like an unsafe environment, being teased, frequent moves, and poverty are also major factors in developing an addiction.


This matches up with what we see in population studies, where groups who suffer collectively have much higher rates of addiction. Native Americans are often cited as having some sort of genetic tendency to drink. But a closer look reveals that’s not the cause. Alcoholism only came about after their culture went through a series of multi-generational trauma. This is also the case with other groups of people with hardships, such as African Americans, veterans, people in poverty, being given up for adoption… you name it.


Don’t forget that we can suffer in much more minor ways too. These are the instances that can be the most frustrating for people because they feel even more faulty for having “no reason” to be addicted. But we forget just how much it hurts to be teased, or constantly criticized, to never feel like we’re enough, never belong, or not live up to certain standards, etc. If you don’t pay close enough attention to the subtle forms of suffering, you’ll miss it.


It’s too easy to pretend that we can control addiction by modifying some gene or removing every harmful substance from the planet. Sorry, it’s not that simple and it ain’t gonna work. Addiction is complex, ugly, and will never be some tidy illness you can cure with a silver bullet.


Addiction is actually a fairly expected adaptation to cope with the tough shit people go through. It might have been overt trauma like abuse, or more subtle like never feeling good enough - but there’s always some kind of hole there.

When I go through the ACEs study with patients, it’s amazing how much hope they feel when they understand (and eventually believe) that they aren’t defective, damaged, or broken.

Let’s stop taking the lazy, defensive role of blaming people for bad choices and start to meet them with respect and compassion for what they’ve gone through. I promise we’ll begin to see a whole lot of change when we can do that.

Most treatment options focus on the surface level behavior of addiction. I created Self Recovery as a new way for people to discover and then end the root cause of their addiction, privately and conveniently from home. You shouldn’t need to go away from home or spend a fortune to explore yourself and learn powerful strategies to change your ways. Whatever you do, please learn something new about yourself that gives you a new chance to move forward.

This opinion was written by Daniel Hochman, MD, the creator of Self Recovery.