No one ever plans to have a substance use disorder. It is a process, which generally begins with social use and progresses along a continuum from mild, moderate and to severe.

There are many social, psychological and biological factors involved in the progression from social use to severe use disorder or addiction.

Learning about the risk factors of substance use disorders and the progression of addiction can help us protect and prevent a substance use disorder from occurring.

Biological Risk

It is true that a person who has alcohol or drug problems in their family is at a higher biological risk for developing a substance use disorder.

It is also true that an individual who is at a higher biological risk can make different choices to prevent alcohol or other drug problems from occurring.

Genetics of Alcohol Use Disorder

Genetics and Epigenetics of Addiction


We are all born with an initial tolerance level. Using alcohol or other drugs in high-risk ways will increase tolerance. Increasing tolerance is how an individual increases their risk for problems.

To gain more information on tolerance:

The Neurobiology of Drug Addiction

Alcohol and the Brain: An Overview by NIH


Many individuals believe that substance misuse begins as a way to self-medicate an underlying mental health condition. Research has shown that many mental health and substance use conditions co-occur. Some mental health conditions precede substance use and some mental health conditions follow the use of substances.

According to National Institute on Drug Abuse, “The high prevalence of comorbidity between substance use disorders and other mental illnesses does not necessarily mean that one caused the other, even if one appeared first. Establishing causality or directionality is difficult for several reasons. For example, behavioral or emotional problems may not be severe enough for a diagnosis (called subclinical symptoms), but subclinical mental health issues may prompt drug use. [In addition], people’s recollections of when drug use or addiction started may be imperfect, making it difficult to determine whether the substance use or mental health issues came first. Three main pathways can contribute to the comorbidity between substance use disorders and mental illnesses:

  1. Common risk factors can contribute to both mental illness and substance use and addiction.
  2. Mental illness may contribute to substance use and addiction.
  3. Substance use and addiction can contribute to the development of mental illness.”

(Online: National Institute on Drug Abuse-   Common Comorbidities With Substance Use Disorders )

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