Attachment and substance abuse

Attachment and Substance Use Disorders—Theoretical Models, Empirical Evidence, and Implications for Treatment

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How Attachment Style can Impact Addiction

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Those who think addiction is a choice or merely a behavioral defect may be unaware of how early development can significantly influence someone’s susceptibility to addiction, or other behavior health issues, later on in life. Attachment styles are the different kinds of emotional bonds infants form with their caregivers from the time they are born. The interactions they have with their parents during these earliest stages, as well as later into adolescence and early adulthood, all affect psychological, physical and emotional behaviors. The way people learn to connect to their caregivers also gives them a preview of other relationships they will have in the future, along with mechanisms to deal with positive and negative aspects of life.

4 Styles of Adult Attachment

People’s perceptions of emotional intimacy, communication style, response to conflict and expectations of relationships are dependent on their attachment style experience in early life. Attachment styles all have three primary dimensions with which they can be characterized by:

Dependence/Avoidance: How people feel having others dependent on them or depending on others.

Anxiety: How worried people are about their partner or others abandoning or rejecting them.

Closeness: How comfortable someone is feeling emotionally connected and close to others.

These factors all differ when looking at the different attachment styles below:

  • Secure: Low avoidance, low anxiety. Autonomous yet comfortable with intimacy and not concerned with abandonment or rejection. Has the ability to depend on others and have others rely on them. Trusting, empathetic, forgiving, and tolerant of differences. Open communication style while being able to pick up on nonverbal context clues. Parents with this type of attachment are sensitive, warm, and in-tune with their child’s emotions and needs.
  • Avoidant: High avoidance, low anxiety. Dismissive and uncomfortable with intimacy. Emotionally distant and prioritizes freedom and independence over togetherness. Aloof communication style with a focus on logic and intelligence without touching on emotions. Stoic, self-sufficient, but will hold off on confronting conflict until they erupt with anger. Parents of this type are emotionally unavailable and often disengaged from their child’s cues, causing them to adopt avoidant attachments as well.
  • Anxious: Low avoidance, high anxiety. Preoccupied with the desire to be close with others or in a relationship but too anxious and insecure. Often needy and concerned with rejection and abandonment. Holds grudges and is very sensitive to a partner’s mood or actions. Highly emotional, combative, and has few boundaries. Communication style is deflective and has a hard time accepting blame. Parents with this style are inconsistent with the attention they give their children, causing them to feel anxiously attached, unsure of what the day’s mood will bring.
  • Disorganized: High avoidance, high anxiety. Uncomfortable with intimacy and untrusting of others in a relationship. Unresolved emotions make them frightened by past experiences and traumas that have not been mourned or dealt with. Difficulty with emotional intimacy and can be argumentative and often abusive to partners or loved ones. Antisocial tendencies and can be aggressive, unremorseful, and often suffers from depression and PTSD. Parents with this type of attachment often mistreat their children, withhold attention and love, and lead them to have a disorganized attachment to others, often making them susceptible to becoming the victim of abusers.

It’s important to note that most adults have a combination of traits from various types; rarely do people fall precisely into one style exactly. These classifications are passed down from generation to generation and are the way that children learn how to connect with their caregivers, others, and eventually their own children.

Effects of Insecure Attachment Styles

Healthy attachments are essential for the development of many key characteristics of someone’s personality, like having empathy, resilience, adaptability and the ability to trust others. It impacts a person’s ability to manage stress and emotions, as well as communicate both verbally and non-verbally and maintain functioning inter- and intrapersonal skills. The key factor that relates to addiction is problems with stress management. Security attachment helps people manage independence and take control of their lives and their environment.

Insecure attachment styles can lead people to have abnormal responses or unhealthy coping mechanisms to deal with stress or conditions like depression, anxiety and PTSD. There are long-term consequences that correlate with these attachment styles that can include risky behavior, substance use, homelessness, anger management issues and problems with interpersonal relationships. The issues that come along with these situations and behaviors add to the inability to handle stress, usually pushing the person to seek out some form of release or pleasure in other ways.

Addiction as an Attachment Disorder

Research has shown that those with insecure attachment who greatly fear intimacy frequently use substances as an escape technique rather than facing their emotional distress, especially avoidant types. Not having any close friends or partners can lead to isolation and dysfunctional view of self. Those who aren’t entirely avoidant but feel distrust in romantic relationships also show an increased rate of drug use, as well as those who have attachment anxiety. Overall, each of these insecure attachment styles ultimately lead to heightened stress-motivated behaviors that have negative consequences. These results add to the multidimensional core of the addiction connection because avoidant types are more likely to turn to drugs or alcohol rather than confide in a friend or loved one or communicate their concerns in a romantic relationship.

Treatment for Addiction and Attachment Style

If someone with substance use disorder is looking to treat their illness effectively, it’s helpful to become aware of attachment styles and reflect on their upbringing. Successful recovery can be achieved when underlying trauma like problematic family affairs are dealt with as they may have lead a patient to substance use as a coping mechanism. Cognitive-behavioral therapy can help rewire the brain to overcome the adverse effects that unhealthy attachment styles have impressed into the brain’s pathways and teach patients how to deal with their feelings more productively.

Those who grow up with a healthy and secure attachment style with their caregivers are often very lucky but also somewhat rare. With addiction becoming more prevalent across the country and through all walks of life, it’s become evident that there are more underlying factors that can lead people to misuse substances. Being mindful of these risk factors that can predispose people to substance use disorder can aid in addiction recovery and also the upbringing of future generations.

Learn More About Treatment at BAART

Reach out to us today to get more details about BAART Programs and medication-assisted therapy (MAT) for opioid addiction at any of our centers near you.



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In 2004, the ROUPK was renamed into the state educational institution of additional professional education "Center for Advanced Training of Specialists with Secondary Medical and Pharmaceutical Education" of the Rostov Region, and in 2011 - into the state budgetary educational institution of additional professional education of the Rostov Region "Center for Advanced Training of Specialists with secondary medical and pharmaceutical education”

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  • A unified information environment of the center has been formed
  • Transition to multimedia technology 9 completed0057
Multimedia equipment for the lesson (using an interactive whiteboard, document camera, etc.) In the emergency medicine class, students work with the training computer program for cardiopulmonary resuscitation
Computational final testing of students is carried out Multimedia presentations are in the arsenal of every teacher. Example: developments of Garlikov N.N.

The achievement of our center is the introduction of the latest developments in the educational process:

  • In the field of safety of the professional environment of medical workers
Operation with needle destructor and portable autoclave New in laboratory diagnostics (work with express analyzers)
  • In training students in the section "Ambulance and emergency care"
Use of vacuum splints and heart massage with cardio pump Ambulance paramedics performing ventilation after tracheal intubation using a laryngoscope
  • Nursing Technology
Mastering the technology of blood sampling using vacuum systems Peripheral Catheter Training

Our contribution to the implementation of the Priority National Project "Health" goes in the following directions:

  • Formation of a healthy lifestyle

In order to achieve the best results in this area, a study room "Health" was opened

Demonstration of hardware and software complex "Health-Express" Tobacco control work organized

Competitions are held among students for the best creative work to promote a healthy lifestyle

The winner of the competition - the film "Radiant Smile" - the series "Dental Care for the Population"
  • Improving the provision of medical care to victims of road accidents

113 specialists trained to provide assistance to victims on the M-4 Federal Highway

  • Improving medical care for patients with cardiovascular diseases

422 specialists trained to work in new vascular centers for minimally invasive surgery and cardiac surgery departments

Particular attention is paid to cooperation with the International Committee of the Red Cross in the North Caucasus

74 medical workers have studied for five years of cooperation. The activities of the center in this direction were highly appreciated by the head of the International Committee of the Red Cross in the North Caucasus, Michel Masson.

The Center for Advanced Studies has ample opportunities to provide high-quality educational services for training specialists with secondary medical and pharmaceutical education in accordance with the ever-growing requirements of practical healthcare.

Development and support of the site - JSC "Regional intersectoral center of information and technology"

What is addiction and how does it differ from dependence?

The word "addiction" is used when they are ready to say "addiction", but they stumble for literally a second before calling someone addict out loud. It is used to distinguish between a person who is addicted to other people and a person who abuses alcohol. In fact, the meaning of this word is much more complex and deeper.

We tell you what it means and why it applies not only to alcoholics and smokers.

What was before - dependence or addiction?

At first, in the medical environment, as a term, there was only "addiction" and its other synonym - "drug addiction". For quite a long time, until enough research was done in the field of addictive and deviant behavior, any abuse was called addiction. However, as we study how human behavior changes with the formation of addiction at the physiological level, addiction has taken a separate niche in this process.

Addiction is a behavioral pattern that includes the abuse of psychoactive or dangerous substances (including nicotine, alcohol), as well as certain practices that are addictive (for example, watching pornography, and gambling or video games). However, at the stage of addiction, only psychological addiction is formed.

The subsequent physiological dependence, the construction of new neural connections and changes in the functioning of the limbic system of the brain are already considered the consequences of addiction.

How to look at life from the bright side and successfully deal with stress? Learn this in the Antifragility course.

The difference between addiction and dependence

Addiction usually begins before direct physiological dependence. However, it is rare to encounter a situation where there is a rigid separation of the episode, when a person loses psychological attachment, but retains a physical need to satisfy his need. But addiction without addiction can exist.

Addiction is formed by quickly getting a feeling of euphoria, security, or simply pleasure that a substance or repeated practice gives. It is strengthened due to several factors:

  • Additional rituals that the addict associates with the use or repetition of his addictive practices. For example, this connection is tracked in the phrases “I can’t wake up without a cup of espresso,” “I can’t survive a deadline without a smoke break,” or “Therapeutic shopping helps relieve stress.” All of these rituals include a system of motivation and reward that normally starts working (as the evolutionary mechanism intended) when a person escapes danger, finds food, a source of warmth, or a partner with whom it is not scary to raise offspring. The constant repetition of these rituals already turns addiction into a physiological dependence.

  • Support group. They are the same community (if we are talking about gambling addiction) or drinking buddies (if we are talking about more destructive practices). Belonging to a group makes a person more confident, gives a sense of security.

  • Acquired habits. For example, a person could learn them in childhood if, in front of his eyes, his parents nervously smoked, drank, or elevated addictive behavior to the level of tradition or norm.

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How to get rid of addiction?

Even if a strong physiological dependence has not yet formed, it can be difficult to give up an addiction or practice. In many ways, success depends on the individual characteristics of the person, but here are some tips that can help.

Learn more