Drug Addiction Leads to Loneliness but Does Loneliness Lead to Drug Addiction?

A recent article from the Times of India attempts to chart the path from loneliness to substance use disorders and makes some interesting observations along the way about what’s driving addiction in the world today.
The World Health Organization recognizes the problem of loneliness and estimates that 10% of global adolescents and 25% of “older people” are lonely. Those numbers sound fictional to this writer, as the experiences of adolescents vary widely around the world and what is “old” in one region or country is not considered old in others. No links to sources for these numbers were provided.
The article continues with a series of unsourced claims regarding loneliness and addiction:
Loneliness can alter the brain chemistry and affect the production of neurotransmitters, like dopamine and serotonin (also known as ‘feel-good hormones’), important for mood regulation and reward.
Really? A recent systematic review of the neurobiology of loneliness says nothing about dopamine or serotonin, and the only studies on neurotransmitters and loneliness are animal studies. It does, however, say there are structural differences in the brain that impact the response to social vs. nonsocial imagery. Let’s continue from the Times of India:
Deficiency in these neurotransmitters can thus lead to feelings of sadness, and anxiety, and can progress to even depression and addiction. It also disrupts sleep and increases suicidal thoughts, and risk of self-harm.
Here, the writer is making the case that deficiencies in neurotransmitters can cause sadness and anxiety and can progress to depression and addiction. That is quite a walk. Do we know which came first, the sadness or the drop in neurotransmitters? We don’t even have loneliness connected to neurotransmitters but suddenly we arrive at addiction:
People suffering from loneliness are more susceptible to substance abuse as drugs or alcohol can artificially boost the neurotransmitters and create a temporary sense of pleasure. Unfortunately, this often creates a harmful loop, and leads to a vicious cycle, as addiction can create a rift between the user and their family/loved ones, causing the feelings of loneliness to worsen.
There is a whole lot of bad science in that paragraph. Are lonely people more susceptible to drug abuse? I’ve not seen any science on that. It’s frustrating to have an interesting and serious subject handled without reference to peer-reviewed studies to support the sequence from loneliness to drug addiction.
The science does link loneliness to Alzheimer’s disease and mortality. Defining loneliness as the discrepancy between the desire for social relationships and the perceived number of social relationships, the systematic review of the neurobiology of loneliness found increased rates of dementia, anxiety, depression, and suicidal ideation. There is a correlation between anxiety/depression and substance use disorder, so there could very well be a correlation with loneliness, but it is not explicitly examined.
A fascinating study from the Drug and Alcohol Review in 2020 takes a backward look at loneliness, not attempting to show it causes substance abuse, by questioning those treated for substance use disorder about loneliness. The authors conducted a small study interviewing 20 participants from two residential treatment facilities in Australia.
The researchers found issues of loneliness intertwined with substance abuse in a way that is difficult to untangle. The recovering addicts had lost relationships due to mistrust, their behavior, and their drug addiction. They found the social aspect of group therapy helpful and discussed the need to substitute “authentic relationships and activities” in their quest to stay clean.
Many 12-step and other recovery programs include a social component to encourage recovering addicts to call on a close friend to help monitor their recovery, and rely on the community to keep the recovering addict from relapse. Whether loneliness leads to substance use disorder is unclear, but it’s pretty clear that substance use disorder leads to loneliness, as lying to, stealing from, and abusing friends, family, and partners is not a prescription for companionship. Certainly, reducing isolation is a necessary component of recovery.
Yes, there appears to be an epidemic of loneliness in the world. Social media has put everyone in touch with everyone, yet people feel more isolated and alone than ever. It’s unfair to say this loneliness leads to substance use disorder; there is no evidence for it. It is fair to say loneliness is caustic. Scientists estimate it reduces life expectancy by 30%. That sounds like another artificial statistic to me. However, we can certainly say that drug addicts often have few friends, and that hanging onto a good friend is a huge advantage in recovery.
Written by Steve O’Keefe. First published July 25, 2024.
Sources:
“From isolation to addiction: Understanding how loneliness can lead to drug abuse,” Times of India, July 22, 2024.
“Neurobiology of loneliness: a systematic review,” Neuropsychopharmacology, July 2021.
“Perceptions of loneliness among people accessing treatment for substance use disorders,” Drug and Alcohol Review, July 2020.
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