The notion that someone chooses to become addicted has long been a source of stigma and misunderstanding. However, scientific advancements and increased awareness show that this brain disease is a multifaceted condition shaped by biological, psychological, environmental, and social factors. It’s not simply a matter of willpower or moral failing. By examining these influences, we have a better understanding of when a loved one needs treatment—or when we need treatment ourselves. 

The Biological Basis of Addiction

For some individuals, genetic factors increase susceptibility to addiction. Studies suggest that up to 50% of a person’s risk for developing addiction is hereditary. Genes influence how people metabolize substances, their sensitivity to drugs, and their likelihood of developing dependency. For example, based on advances in genetic addiction risk severity tests, variations in the DRD2 gene, which affects dopamine receptors, have been linked to a heightened risk of addiction.

The American Psychological Association defines addiction as “a state of psychological and/or physical dependence on the use of drugs or other substances, such as alcohol, or on activities or behaviors, such as sex, exercise, and gambling.”

The human brain is wired for reward, and substances like alcohol, opioids, and stimulants exploit this system by releasing large amounts of dopamine, a neurotransmitter associated with pleasure and motivation. Over time, according to the National Institute on Drug Abuse (NIDA), “our brains are wired to increase the odds that we will repeat pleasurable activities. The neurotransmitter dopamine is central to this. Whenever the reward circuit is activated by a healthy, pleasurable experience, a burst of dopamine signals that something important is happening that needs to be remembered.” This is one reason why people develop compulsive drug or alcohol use. 

Additionally, structural and functional abnormalities in the prefrontal cortex, the area responsible for decision-making and impulse control, can predispose individuals to addiction. When these systems are compromised—whether due to genetics, trauma, or early exposure to substances—self-regulation becomes significantly more challenging.

Contributing Psychological Factors

Early childhood plays a crucial role in our psychological vulnerability. Adverse childhood experiences (ACEs), such as neglect, abuse, or parental substance use, are strongly correlated with the development of addiction later in life. Without proper preventative care or focused therapy, a person may resort to dysregulated stress responses and have difficulty managing emotions, increasing the likelihood of turning to substances for escape or control.

Mental health conditions such as anxiety, depression, post-traumatic stress disorder, and trauma are closely linked to addiction as well. People often use substances to self-medicate, seeking relief from overwhelming emotions or intrusive thoughts. While this coping mechanism may provide temporary solace, it often leads to dependency as tolerance builds and the brain begins to rely on the substance to function. Mental Health America offers these screening tools to help assess connections between mental health, SUD, and AUD. 

Environmental, Social, and Cultural Influences

Socioeconomic status, exposure to drug use, and access to education and healthcare all play critical roles in whether someone develops AUD or SUD. In communities where substance use is normalized or easily accessible, people are more likely to experiment with and subsequently become dependent on substances.

Peer pressure and social environments also contribute. Adolescents and young adults are particularly vulnerable as they navigate identity and belonging. Experimentation can escalate into dependency when reinforced by social acceptance or a lack of alternative coping mechanisms.

When we experience chronic stress—whether from financial hardship, unsafe living conditions, or workplace pressures—it’s easy to think alcohol or drugs might be a means of relief. Stress-induced drug use has been well-documented in both human and animal studies, illustrating how external pressures can override rational decision-making.

Stigma also plays a dual role. It can deter individuals from seeking help, exacerbating the problem. Societal judgment can reinforce feelings of shame and isolation, driving people further into substance use as a coping mechanism. The National Council for Mental Wellbeing reports that “81% of U.S. adults who received substance use care had trouble getting care.”

Sobriety Centers of New Hampshire: Removing the Barriers to Health

Viewing addiction as a multifaceted disease rather than a choice emphasizes the importance of proper medical care rather than punishment. Our primary goal at Sobriety Centers of New Hampshire is to deliver high-quality, evidence-based treatment. We have three locations to serve you: 

• The Antrim House in Antrim, a detox and residential treatment facility for adults.
• Recovery Mountain in Tilton, a residence for Veterans and first responders as part of outpatient programming.
• The Lakes Addiction Treatment Center in Laconia, which offers inpatient, outpatient, partial hospitalization, and intensive outpatient rehabilitation programs for men and women.

If you or a loved one recognizes a need to focus on whole-person health and is eager to recover, please reach out to our admissions team today to learn how we can help.