Why Addiction Isn't Really About Drugs
When people hear the word addiction, they usually think about the substance.
Alcohol.
Cocaine.
Crystal meth.
GHB.
Heroin.
Or perhaps gambling, pornography, shopping or compulsive sexual behaviour.
It’s understandable why. Those are the things we can see, and they’re usually the things we judge. But after more than a decade working in addiction services, and nearly three decades in recovery myself, I’ve become much more interested in what comes before the substance. Addiction may eventually become about the drink, the drugs or the behaviour. It rarely starts there.
Nobody Chooses Addiction
Nobody grows up wanting to become addicted. Nobody dreams of spending their life trying to stop drinking or imagines losing relationships because of cocaine. Nobody says: "When I grow up, I want to become an addict."
Addiction is not what anyone wanted. It is where something that once helped eventually led them.
That’s why I’ve never found it useful to ask “Why the addiction?” I want to explore what was happening before it. What was hurting? What did you stop feeling, or what became easier, after the first drink, line, bet or sexual encounter?
Addiction almost always begins because something works. For a while, anyway. Alcohol might quieten anxiety. Cocaine might create confidence that has always felt out of reach. Crystal meth might make someone feel connected, desirable or alive. Gambling might offer temporary escape from grief. Pornography might provide comfort without the vulnerability that real intimacy demands.
Different behaviours meet different needs, but they often offer some form of relief: an escape from something unbearable, or access to something that has felt impossible to find elsewhere.
For a while, that relief that the drink, drugs or behaviour bring can feel like an answer. The tragedy is that the answer slowly becomes another, bigger problem.
Recovery Begins With a Different Question
One of the biggest myths about addiction is that it’s simply a failure of willpower. If that were true, people would decide to stop and that would be the end of it. Addiction is rarely that straightforward.
Stopping isn't usually the hardest part. It’s the staying stopped—because once the substance or behaviour has gone, the anxiety, shame, loneliness or memories it helped someone avoid are still there.
Anyone who's experienced addiction will probably recognise that relentless internal voice.
"This time will be different."
"I’ll just have one."
"You've had a great day!"
"You've had a fucking shit day."
"Nobody will know."
The substance may change. The voice is pretty much the same.
That’s why a phrase such as “Stay strong!” isn’t helpful, in my book. It completely misunderstands the nature of addiction, and assumes the problem is a lack of strength. In my experience, it rarely is.
Over the years, I've become less interested in the substance itself and more interested in what it allows someone to do or not feel. What does it make possible? What does it make easier? What feelings disappear when someone drinks? What fears become quieter when they use drugs? What loneliness disappears, even briefly? Every addictive behaviour serves a purpose.
Understanding its purpose is not the same as excusing the harm. It gives us somewhere more useful to work. Unless something changes underneath, people will often find themselves searching for another way to cope: another substance, another behaviour or another relationship. When the need underneath isn’t addressed, the search for relief continues.
Recovery isn't just about stopping something. It's about understanding why you needed it in the first place. Otherwise all you’ll do is remove the plaster and ignore the wound.
The Hidden Role of Shame
If there is one emotional experience I've encountered more consistently than any other in addiction, it's shame. Shame whispers in our ear: “There’s something wrong with me.”
When someone believes they are the problem, rather than simply having a problem, asking for help can feel exposing. So many people living with addiction carry a deep fear that, if others really knew them, they would be rejected. And being rejected cuts like a knife.
So they hide. They wear masks, tell people they're fine and become experts at looking okay while quietly falling apart inside.
In that context, it’s hardly surprising that something capable of numbing the pain, even for a few hours, can become so compelling.
Why LGBTQ+ People Can Be More Vulnerable to Addiction
Not every LGBTQ+ person experiences addiction, and not everyone struggling with addiction identifies as LGBTQ+. But many of the gay, bi and queer men I've worked with describe growing up believing that some part of them wasn't acceptable.
Those messages may have come from family, school, religion or society itself. Sometimes nobody said the words out loud. They didn't have to. Children are remarkably good at working out what feels safe and what doesn't, and many learn to hide: to monitor how they speak, how they walk, who they look at and what they say.
Over time, hiding can become second nature, and we don't always stop once the danger has passed. We may continue hiding from other people and, eventually, even from ourselves. For many, this creates a painful sense of disconnection from themselves, from other people and from the feeling that they truly belong.
Alcohol or drugs can temporarily bridge that gap. Compulsive sex or chemsex may make confidence, connection or freedom from shame feel possible for a few hours, or days. For someone who has spent years monitoring and containing themselves, that relief can be enormously powerful.
The cost often only becomes clear later.
The Survival Strategies We Learn in Childhood
We don’t develop coping strategies for no reason. We learn them somewhere.
You may have grown up feeling you had to be the strong one, or learned that showing emotion wasn’t safe. Keeping other people happy may have been the best way to avoid conflict, while your own needs came second.
These adaptations often make perfect sense in the environments where we first learn them. The difficulty is that they don’t always serve us in adulthood. The child who learned to hide may become an adult who struggles to be emotionally honest. The child who never felt safe asking for comfort may insist they’re “fine” while quietly falling apart. The child who never felt enough may spend years searching for something outside themselves to fill that emptiness.
Sometimes that “something” becomes addiction.
As someone in recovery, and as a therapist who works in a trauma-informed manner, I’m convinced that trauma is at the root of addiction, as well as codependency. I’m not only talking about the obvious experiences of trauma that people tend to think of. I also mean the quieter ones: feeling unseen or emotionally alone, or growing up believing that love had to be earned. These experiences may not leave visible scars, but they can shape how we see ourselves and the world for decades. And the pain they leave us with is what drives us to self-medicate.
When addiction develops against that backdrop, it can begin to make sense as an attempt to solve a problem, even when it creates far more problems of its own.
Recovery Is About Much More Than Stopping
People often assume that recovery begins when someone puts down the drink or the drugs. In reality, that's often where the real work starts.
If addiction has become a way of coping with anxiety, shame, loneliness or emotional pain, simply removing it doesn't make those feelings disappear. They're still there and, without the thing that helped keep them at bay, they can feel even louder.
This is why stopping and staying stopped can be two very different things. Recovery isn't simply about taking something away; it's also about building something in its place.
That means learning how to ask for help, recognise and express emotions instead of numbing them, tolerate vulnerability, and discover that connection with other people may be safer than you've always believed.
None of this happens overnight. It develops gradually, through honest conversations, difficult days and repeated acts of courage.
Recovery isn't about becoming someone else. It's about becoming more able to live as yourself.
Why Chemsex Is Only Part of the Story
Chemsex deserves its own conversation because it brings particular risks and pressures, especially within some parts of the gay community. But it still needs to be understood within the wider context of addiction.
But I think it's important to say this. Chemsex isn't separate from addiction. It can be one expression of it. Just as alcohol may help one person escape unbearable feelings, chemsex may temporarily offer someone confidence, connection, intimacy or relief from shame.
Focusing only on stopping the drugs can leave the reasons for using them untouched. In therapy, I want to understand both the behaviour and the need it has been meeting.
What Therapy Can Offer
My role as a therapist isn’t to fix someone. It is to help them understand what has happened, what they have learned to do to survive, and what they may now want to change.
Many of us learned, for very understandable reasons, to hide how we were really feeling. We became the one who coped, the one who looked strong, the one who said, “I’m fine,” even when we weren’t.
Therapy can become somewhere those survival strategies are noticed and questioned rather than simply stripped away. They developed for a reason. The question is whether they still protect you, or whether they now keep you cut off from yourself and other people.
You don’t need to arrive with everything figured out. You don’t need the right words or even to know where to begin. Sometimes the first step is simply being able to say:
“Something isn’t working anymore.”
Written by Dan Lee
Therapist working with men and LGBTQ+ clients around addiction, shame, codependency and identity.
About Dan
If you’re ready to understand what your addiction has been doing for you and begin finding another way to live, get in touch and we can arrange a brief phone call to explore working together.