Addiction is bigger than the substance – why we need to understand the person, not just the drug
Trying to understand addiction by focusing only on the substances is like analyzing gasoline to understand how an engine works. It says something, but far from everything. To really understand, we need to look at the engine itself – how it’s built, what makes it stutter, overrev or stall. Addiction is not just about what we we put into our bodies, but why we need it in the first place.
The substance is a symptom, not the cause
For a long time, society’s view of addiction has been dominated by the substance: alcohol, cocaine, opioids, cannabis. We prohibit, control, punish – in the hope that if we just get rid of the ‘drug’, addiction will go away. But research shows otherwise.
“Addiction is not about substance – it’s about the user’s relationship to it.”
– Dr. Gabor Maté
He and many other researchers point out that trauma, attachment, stress and existential emptiness is what often lies behind addiction. The substance becomes a way to regulate pain – not the cause of suffering.
And therefore the most relevant question we can ask is not:
“What’s wrong with you?”
Without:
“What happened to you?”
It is a shift in perspective. From guilt to understanding. From judgment to curiosity.
Scientific support: Addiction as a coping strategy
In the groundbreaking Adverse Childhood Experiences (ACE) Study, Felitti and colleagues showed that people with a high burden of childhood trauma are at dramatically increased risk of alcoholism, drug addiction, depression and self-harm. It is not a choice – it is often a survival strategy.
“Trauma survivors may use substances not to seek pleasure, but to avoid pain.”
– Dr. Judith Herman
Many people with addiction have never been taught other ways to cope with their emotions, anxiety or shame. The substance becomes a way of coping with life – until they can’t anymore.
Rat Park – a paradigm shift in understanding
In the 1970s, scientist Bruce Alexander the prevailing view of addiction with his famous Rat Park study. He showed that rats in a stimulating, social environment rarely developed dependence on morphine, while rats in isolation did so almost immediately. The conclusion? It’s not just the substance – it’s the environment, the community, and the psychology of use that make the difference.
This is also consistent with the WHO definition, which recognizes addiction as a complex disease with biological, psychological, social and spiritual factors.
The addiction brain: not weak, but vulnerable
Modern neuroscience shows that people with addiction often have altered functioning of the brain’s regulatory systems: impulse control, emotion regulation and the reward system. The brain seeks balance sheet, not euphoria. The substances have a function – not to create joy, but to escape pain.
It reinforces the picture: addiction is not moral weakness – it is often a wounded brain’s attempt to heal itself.
Behavioral addiction – without drugs
The fact that addiction is bigger than the substance is also reflected in the fact that people can become addicted to gambling, sex, food, work or screens. These serve the same purpose – to numb, distract or subdue. This shows that addiction does not require a chemical substance – it requires a psychological hole to fill.
“The opposite of addiction is not sobriety. It’s connection.”
– Johann Hari
What does this mean for treatment?
If we really want to help people, we need to understand that they are not just trying to escape something – they are also trying to find something. peace of mind Safety and security. Coherence. Seeing addiction as an expression of human desire – rather than a self-imposed decline – is key to both empathy and effective care.
Treatment should therefore not only be withdrawal-focused, but also:
- Trauma Awareness
- Relationally based
- Neuroscientifically informed
- And existentially open: What are you looking for in the rush? What is missing in your life?
Final words: From control to understanding
Substances can destroy lives – but they don’t explain why people get caught up in them. For that, we must dare to look beneath the surface. Dare to ask: “What happened to you?”
Because that’s where we find real change. Not in the bottle. Not in the pill. But in the story behind it.
