Addiction is an outcome associated with pre-existing conditions or more accurately “distal factors”, namely attachment disruptions, attachment here referring to early bonding experiences that determine what genes are expressed as traits, how we relate to other people and importantly, the capacity to regulate emotional states. For any who are interested in its scientific basis, the following is largely informed by Dr. Allan Schore’s Regulation Theory of Attachment and Dr. Edward Khantzian’s Self-Medication Hypothesis of Addiction.
Attachment security can be disrupted through early childhood experiences or later trauma. Insecure attachment styles are present in roughly 50% of the American population and constitute vulnerability to all manner of disorders of self-regulation including ADHD, PTSD, Personality disorders, impulse control disorders and the Substance Use Disorders commonly referred to as addiction.
Addiction isn’t caused, solely by drug use. Addiction is caused by a person’s particular response to drug use and the factors associated with drug use (e.g. genetically determined susceptibility to peer influence, the ameliorating effect that drug use has on pre-existing negative affect states, unmet social needs that are satisfied through group affiliation, etc.). Similarly PTSD isn’t caused by trauma in and of itself, rather it is a person’s particular response to trauma. These responses could be determined by various factors, but one factor that stand out from any other is the individuals capacity to self-regulate (this covers functions such as willpower, impulse control, susceptibility to social influence, self-awareness etc.), a function which is developmentally determined during the first 1000 days following conception; a time when the right hemisphere of the brain that is responsible for the processing of emotional information, is undergoing development through attachment with the primary caregiver. This development precedes left hemisphere development, where analytical functions such as choice making, are coming online. People do make choices that have lasting outcomes, but the neural circuitry that determine the choices that people make are a product of right brain development, cultivated through early attachment experiences.