THE ADDICTIVE PERSONALITY: MYTH OR CORNERSTONE OF PREVENTION AND TREATMENT?

Abstract

The concept of an addictive personality offers an attractive and intuitive construct for defining the parameters of prevention, diagnosis and treatment of substance abuse and addictive disorders. However, despite the intellectual and practical appeal, it remains controversial, with researchers and practitioners heavily debating its fundamental validity. In a seminal research study, Alan R. Lang, in conjunction with the US National Academy of Science, found that while there was no single identifiable personality type that could be used to exclusively determine susceptibility to addiction or constitute an “addictive personality,” there are, however, significant personality factors that tend to underlie addictive behavior. Specifically, these included, impulsivity, sensation seeking, nonconformity, social alienation, tolerance for deviance, and heightened stress coupled with lack of coping skills. Proponents of the addictive personality paradigm argue that these common characteristics represent critical information for intervention and treatment, as well as in the realm of development and prevention. Conversely, opponents contend that not only does empirical research not support the conclusion, but neither does the theoretical framework of addiction as disease. They contend that this view is deterministic and undermines the complex and multifaceted nature of addiction, thus limiting the approaches to treatment and potentially increasing the stigma associated with addictive disorders. Currently, most researchers and practitioners would argue against the notion of a deterministic addictive personality, but consider the potential of individual personality factors to influence behavior in both positive and negative ways and thus, incorporate relevant strategies into a comprehensive treatment plan. As we now face a global epidemic of opioid abuse that surpasses previous waves of drug use in both magnitude and severity, perhaps it is time to reevaluate the role of personality as a contributor in both the development and rehabilitation of addiction and how such information, taken in context with other relevant factors, can best serve to combat the widespread epidemic.