Is there a link between alcoholism and an ‘addictive personality’?
In 2022, 64% of all those in Britain who sought help for a problem with a substance were struggling with alcohol, but it’s possible to develop an addiction to almost anything. Many people put that down to an “addictive personality”: a certain set of traits that draw people into alcoholism or drug dependencies, compulsive porn use, obsessive online shopping, gambling or even gaming, while other people can drink or take drugs occasionally and go on unscathed.
People have asked Sharpe if she has an addictive personality, but “that isn’t it either”, she says. “There’s something in the brains of us alcoholics that gives us this propensity to not be able to stop,” she believes. “I’m not shy, or fearful, though I liked sitting at our bar with my parents and feeling like a grown-up. It’s how my brain is wired. Even today, with one sip that switch will come on again, and I’ll drink more and more.”
Some of the first references to personality as a cause of addiction come from scientific papers published in the 1920s. In 1925, one American researcher, Dr Lawrence Kolb, set out to understand why people of “good social standing” in the US were becoming addicted to alcohol.
Kolb determined the majority of alcoholics then were “care-free individuals, devoted to pleasure, seeking new excitements and sensations, and usually having some ill-defined instability of personality”, he wrote. He also believed that many middle-class Americans were “inebriates” – people who “go on [drinking] sprees at more or less regular periods, but who in the intervals drink little or not at all”.
Literature from the period makes alcoholism into a moral problem: Kolb also classed some addicts he interviewed as “habitual criminals, always psychopathic”. Today most people have more sympathy for those who fall into addiction. But the idea that personality is the main cause of addictive patterns of behaviour “is one of those myths that persists because it makes sense to people in their lived experiences”, says Antony Moss, professor of addictive behaviour science at London South Bank University.
“It’s not uncommon for people to have multiple addictions after they shake one, or to be using multiple things at once, like alcohol, cigarettes and cannabis,” Moss points out. “It makes intuitive sense to people that all this is down to someone’s personality.”
But a myth it is. “There’s no consistent, stable personality trait that you can measure that will give you an accurate prediction of whether someone will develop an addiction in the future,” he explains.
The things those struggling with addiction have in common
Some studies have attempted to draw a link between certain traits, like being more neurotic or emotional than the average person, with a predisposition to addiction. Research has linked high neuroticism to everything from drug dependence and alcoholism to addiction to social media, gaming and even studying in young people.
“But in reality all the evidence suggests that personality in a broad sense isn’t a cause for addiction,” Moss explains. No research has shown everyone with an addiction is highly neurotic – and even Kolb found in his early work around 14% of his interviewees “had a normal [emotional] make-up”.
Even someone’s level of impulsivity or thrill-seeking behaviour isn’t a good predictor of whether or not they might become addicted to something. “It’s chicken and egg,” Moss says. “One consequence of addiction is that the drugs involved can make you behave more impulsively even when you’re not using them, because those things stimulate those relevant parts of the brain.”
Today, modern theories about addictive behaviour tend to focus on a history of traumatic experiences, especially in childhood, which Moss says “is a strong predictor of whether someone will become an alcoholic”. It’s thought that as many as 60-80% of alcoholics experienced childhood abuse. The reasons behind that are complicated.
“One theory is that addiction is a kind of self-medication,” he explains. “People become addicted to things that are inherently fun, and often either relaxing or stimulating. Where someone who has been through trauma doesn’t have the right coping mechanisms, or access to support, they can start to lean on those things to get them through.”
Ultimately “addictive behaviour is serving a purpose for that person, no matter how destructive it might look from the outside”, Moss adds. “What I always say to family and friends is that it’s a symptom of something else.”
Does addiction run in families?
There is also the widely held belief addiction runs in families. It has been shown the children of alcoholics are around four times as likely to become alcoholics themselves than those with different backgrounds. But “teasing out whether that’s down to something genetic that science hasn’t proven yet, or to people mirroring their parents’ behaviour, or to the trauma that often comes with having a parent who has an addiction, is almost impossible”, Moss says.
But what about people like Alison Sharpe, who have no family history of addiction and no personal history of trauma? Sharpe herself is still convinced her own struggle with alcohol was prompted by a difference in her brain, and maintained by her body’s physical dependence on her drinking.
Scientists haven’t yet cracked whether there’s a brain difference in those of us who develop addiction, though it’s certain that “an alcohol addiction can creep up on you over time, unlike something like heroin addiction that can happen very rapidly”, Moss says.
The best understood cause of alcoholism in particular is strongly tied to family behaviour, Moss explains. But it isn’t necessarily about whether you have alcoholics in your family – which can just as often cause some to stay sober throughout their lives.
“People’s motivations for drinking are really important,” he explains. “Some people reach for a drink when they’ve had a bad day and they’re feeling stressed, while other people only drink to add to a positive situation, like a night out with friends or a big celebration. People who drink to cope with everyday stressors are much more likely to develop an addiction in the future, when something destabilising happens in their lives.”
More often than not, we learn our attitudes to alcohol from our parents, says Moss. “Children as young as 6 develop beliefs around alcohol based on what they see around them. If you ask those children why grown-ups drink, they’ll say the things that their parents would, and those beliefs crystallise as they age.”
Will we ever understand what causes addiction?
After many years as a peer mentor for her local alcohol and drug service in Hull, where she now lives, Sharpe will soon start work as a researcher for the University of Hull’s new £11 million addiction and mental health research centre. She will be helping to oversee new research into why people develop addictions to drugs and alcohol and how to help them through it.
The money has come from the National Institute for Health and Care Research, the UK government’s main funding body for public health research. It has been a long time coming, those in the field say.
“Despite the significant pressure on public health because of substance use, it has accounted for less than 3% of the overall mental health research activity in the last decade,” says Professor Thomas Phillips, who will lead the new centre at Hull. “We urgently need to identify how to improve the provision of treatments for those experiencing co-existing substance and mental health conditions.”
“There hasn’t been a huge amount of investment in research into addiction, so there’s still an awful lot to discover,” adds Moss. “For one, most research has been carried out with men, because women are less likely to enter formal treatment, and that’s where we go to find research participants.”
Sharpe first got on to the University of Hull’s radar as a participant in their earlier studies herself.
“When I first heard about this project, I was elated to think that it was going to put lived experience like mine right at the heart of the research,” she says. “Having had first-hand understanding of the current system for help with addiction for over 30 years, I am very much aware of the major shortfalls and lack of support for those seeking help.”
Will we ever crack the problem of why some people develop addictions? Sharpe isn’t sure. “The essence is that people don’t understand why you can’t just stop,” she says. “But maybe you can’t answer that question. To me, the important thing is to find a way to give people who have addictions clear pathways for treatment, and make sure that there’s someone in the room with them, like me, who really understands what it’s like.”
