Clinically Reviewed by Dr. Matin Hemmat LPCC, CADC.
Addiction is the great equalizer. Just like any natural disaster that comes your way, it does not care if you are rich or poor, brilliant or struggling, wild and carefree or profoundly lonely. It does not care if you’ve made promises to yourself never to be like your uncle or if you were raised in a home where no one even said the word “addiction” out loud. Addiction can come to any household, but what people often wonder is what causes addiction. The answer is pretty complex, but addiction typically gets in through a combination of three main doors: genetics, environment, and brain chemistry.
And it changes you. Not in a way that means you are ruined, but in a way that means you will have to work to get back to yourself.
What Causes Addiction: The Early Signs
When addiction arrives, it is not exactly a new face. Most likely, there is a history that may have started small, but eventually, the presence of drugs or alcohol in your life is as common as putting on shoes. But the disease of addiction does arrive quietly.
It happens in the small rewiring of the brain’s reward system. Maybe it’s the second glass of wine that turns into three, the pain pills you take even after the injury heals, or the heroin habit that started out as just something to try.
But then:
- You start thinking about it when you’re not using it.
- You find yourself needing more to get the same effect.
- You get irritable, anxious, or foggy when you go without it.
- You tell yourself stories about why it’s fine and why you could stop if you wanted to.
- You make small adjustments to accommodate it—socially, financially, emotionally.
By the time addiction is full-blown, the brain has changed. The pathways that were once about real and natural rewards—about laughing with friends, about taking a hike on a warm spring day, about music that makes you feel something deep in your bones—are now hijacked. The substance now has the authority over what makes you feel good. This is a big part of what causes addiction.
What Makes Someone More Likely to Become Addicted?
It is not just about willpower. If it were, we’d all just decide to be better, and addiction wouldn’t exist. The reality is more complicated. Let’s get back to those three doorways to addiction. Generally speaking, there is not a single thing we can point to that causes addiction. However, three things in your life (in everybody’s life) will contribute.
- Genetics – Addiction runs in families, and not because everyone was raised the same way. We now know that some people inherit a nervous system more prone to impulsivity, a reward system more vulnerable to chemical shortcuts, and a metabolism that processes substances differently.
- Environment – Trauma. Stress. Chaos. The absence of stable relationships. The presence of people who use. The way your parents talked (or didn’t talk) about their emotions. The neighborhood you grew up in. All these things shape the way the brain learns to cope.
- Mental Health – Depression, anxiety, ADHD, PTSD—when these exist in the background, addiction becomes more likely. Because here’s the thing: substances work. They soothe. They numb. They make the unbearable bearable. At first.
Does Genetics Determine Addiction?
Not entirely, but they do make a difference. If you have a family history of addiction, your risk goes up. Scientists estimate that about 40-60% of addiction risk is genetic. But genetics are not a prophecy that can’t be changed. They’re more like a road map. There are many options, and you can always choose a different route.
Does Environment Cause Addiction?
It doesn’t guarantee it, but it absolutely influences it. A person growing up in an environment where their best friend down the street and their parents make regular use of drugs affects things.
But that’s the obvious one. It also matters when emotional pain goes unacknowledged or where stress is constant—people living in these situations are more likely to turn to substances as a coping mechanism.
And once the brain learns that substances work—that they offer relief, even briefly—it will remember.
How Does Mental Health Impact Addiction?
The brain does not separate mental health from addiction. They are tangled up together like Christmas lights stuffed in a box and left in the attic for a decade. If you are living with untreated anxiety, depression, PTSD, or even chronic stress, your brain is already working overtime just to function.
Substances become a shortcut to peace. For people with mental health issues, drugs are a way to quiet the noise, even if it is only for a moment. The problem is that they make everything worse in the long run.
Is Addiction a Disease or a Choice?
This is where people tend to get stuck. They want something or someone to blame. They want it to be a moral failure. Or they want to remain a victim of a disease. It to be one or the other.
But addiction exists in the messy, complicated middle. It starts as a choice—no one is forced to take the first drink or the first pill. But once addiction takes hold, it is no longer just a matter of willpower. The brain is rewired, and stopping is no longer as simple as deciding to stop.
It is like telling someone with a broken leg to just “walk it off.” What causes addiction? Both a choice and a chilling disease.
Does Your Treatment Need to Address All Three Factors?
Yes. One hundred percent.
If treatment only focuses on stopping substance use, it fails. If it only focuses on past trauma, it fails. If it ignores mental health, it fails. Real recovery—the kind that lasts—means addressing all three:
- Healing the brain (through therapy, medication when appropriate, and time).
- Understanding personal risk factors (genetics, trauma, mental health).
- Building a life that feels worth staying sober for (community, purpose, connection).
Getting Help with the Causes of Addiction in the South Bay Area
Addiction is not a moral failing. It is not a character flaw. It is a brain issue, a coping mechanism, a tangled mess of biology, experience, and pain. And most importantly—it is treatable. No one has to do this alone. Real help exists. You are not beyond repair.
Peninsula Health Center in the South Bay area provides compassionate, evidence-based addiction treatment tailored to each individual’s needs. Through a combination of medical support, therapy, and holistic care, we help people break free from addiction and build a healthier, more fulfilling life.
Call. Ask questions. Get help. The road back to yourself is possible. Call today: 866-934-8228.
