The issue of personality disorders (PDs) and substance abuse is quite intricate and can profoundly impact an individual’s life and relationships.

Today, about 1 in 4 people diagnosed with a type of personality disorder also have a substance use disorder. And according to the National Institute on Mental Health, about 9.1% of the U.S. population aged 18 and under has a personality disorder.

In this article, we will explore the connection between personality disorders and substance abuse, shedding light on these co-occurring diseases and treatment options. Ready? Let’s get started!

Link Between Personality Disorders and Substance Use

There has been growing interest in understanding the connection between these personality disorders and substance abuse and how to treat them. Today, there’s an integrated treatment called the Dual Diagnosis Treatment Plan. And you can get expert dual diagnosis care in LA.

Here are some known connections between personality disorders and substance abuse.

1.    Prevalence:

Research indicates that individuals with personality disorders, particularly those falling under Cluster B disorders such as Antisocial, Borderline, Histrionic, and Narcissistic, are more prone to experiencing substance abuse disorders (SUDs) compared to the population.

2.    Self-medication hypothesis:

One prevailing theory is that individuals with PDs may use drugs or alcohol as a way to cope with or alleviate their distressing symptoms or emotional pain. For instance:

Individuals with borderline personality disorder (BPD) might engage in substance use to manage intense emotional pain or feelings of emptiness. Those with antisocial personality disorder (ASPD) may use substances impulsively, reflecting their general disregard for rules and the consequences of their actions.

3.    Biological factors:

There might be shared underlying neurobiological factors that predispose an individual to both personality disorders and substance abuse. For example, alterations in the brain’s reward pathways or neurotransmitter systems might be involved in both conditions.

4.    Environmental factors:

Traumatic experiences, childhood neglect or abuse, and other adverse events can contribute to the development of both personality disorders and substance use disorders. Such experiences can shape coping mechanisms, attachment styles, and emotional regulation, which can influence both the emergence of PD and substance abuse.

5.    Reinforcement and negative consequences:

Substance use can sometimes reinforce the maladaptive behaviors or cognitive patterns associated with PDs. For instance, an individual with narcissistic personality disorder might use substances to enhance their feelings of grandiosity.

Conversely, the negative consequences of substance abuse, such as legal problems or interpersonal conflicts, might exacerbate symptoms of certain personality disorders.

6.    Treatment challenges:

The coexistence of a PD and an SUD can make treatment more challenging. The symptoms of the PD can interfere with the treatment of the SUD and vice versa.

For example, an individual with borderline personality disorder might have difficulties forming a therapeutic alliance due to fear of abandonment or frequent mood swings, which can hinder the treatment process for substance abuse.

7.    Prognosis:

Having both a personality and substance use disorder can make the prognosis more guarded. The relapse rate might be higher, and the individual might need more intensive or longer-term interventions.


The connection between personality disorders and substance abuse is intricate and bidirectional. While the presence of one does not necessarily predict the other, there is a higher prevalence of co-occurrence.

Understanding this link is crucial for clinicians to provide effective interventions and support for affected individuals. Integrated treatments that address both conditions simultaneously can offer the best chances for recovery and improved quality of life.

If you or a loved one living in LA is struggling and seeking professional help, adopting the best dual diagnosis care in LA is the first step towards a comprehensive recovery. So begin today!