This is the six million dollar question! If there was a clear, concise answer those of us in the treatment arena could save individuals, families and communities a load of grief and unhappiness.
Various specialists have their own strongly held theories and beliefs.
Here is my attempt to throw some little light on the subject;
Addiction is mostly connected with, drugs, legal and prescribed, including nicotine and alcohol of course, gambling, gaming, food and pornography/sex.
The substance or behaviour itself is one strong causative factor. I know this is obvious but it still needs to be said. There would be very high rates of addiction amongst people who smoke or use heroin for example. Some clients know instinctively that they are not at risk for many addictions but have a specific ‘weakness’ around one or more substance or behaviour. In Ireland it has often been said that ‘our drug of choice’ is alcohol and it is hard to argue with that. As a nation we have a complicated relationship with alcohol and a predilection to drunkenness and binge drinking.
Hereditary factors are almost certainly important factors as are neurological hereditary factors. In simple terms this means that some people may be ‘hot wired’ to be dependent on a particular substance or behaviour due to genetic factors.
Life Circumstances play a part too. There are high rates of addiction in socially deprived areas. That said addiction is in every sector of society and does not respect gender, class or creed. People who worked in bars at a young age are more at risk to alcohol problems. Social isolation is also a probable cause while it is also a consequence of addiction.
We know, for sure, that depression and anxiety are important factors in the development of any addiction. Such a dual diagnosis, may result from addiction as well. Addiction can result from a lack of social confidence or a difficulty fitting in.
Trauma of any kind I believe is highly relevant too. An individual who endured sexual abuse as a child, for example, learns ‘denial’ at a young age and later on addictive substances/behaviours can serve to help to block out traumatic memories and feelings even if only in the relative short term. There are all sorts of other forms of trauma too and many of them are specific to the individual and highly contextual.
In my view and experience all or many of the above factors are at play before someone presents for help. There are many other causes too that I have not mentioned. To be very Irish, addiction is caused by a bit of this and a bit of that. The job of the therapist is to help the individual or family member to assess the level of the problem, and help the parties to come to terms with the reality of addiction in their lives and then to make appropriate changes over time. Sadly only a relatively small number of people who are suffering from addiction, including family members, get proper help and distressingly some are not even aware of to whom or where to reach out. Many are afraid of the process and do not know where to begin. Others are worried about labels, stigma and social humiliation.
The good news is that if you can identify that there is a problem, all sorts of help is available. Many people go on to make a full recovery.