There is a theory that substances such as drugs and ultra-processed foods call to us with a siren’s song that mere mortals cannot resist. Once these substances take hold of us, we become slaves to their consumption and can think about little else.

That is one story about how addiction happens. Here’s another angle: There’s an accident and a person is treated at the hospital and given a pain prescription. When the leg hurts, the patient treats it with painkillers. Even when the pain is gone, however, the patient fears it will return and eventually becomes a slave to the painkillers.

The first theory starts with the properties of the substance being consumed. The second theory starts with pain and the use of painkillers. Statistics show that more than half the people in treatment for substance use disorders (SUD) in the U.S. were victims of abuse as children. Adverse Childhood Experiences (ACEs) have a stronger correlation with substance abuse than genetics.

It is possible that substances only become irresistible when they are used to treat either physical or emotional pain. That’s a combination of the substance theory of addiction and the pain theory of addiction. 

But there’s another theory of addiction — the behavioral theory — that what we become addicted to is the performance more than the substance. The substance gradually loses its ability to ease the pains of withdrawal. However, the performance never loses its ability to soothe.

There is a behavioral addiction to the motions of the rituals of consumption, whether that’s drinking, eating, smoking, praying, playing, exercising, or having sex. It includes anticipation and cues, leading to a briefly satisfying moment. Stress can be displaced, with or without substances, by engaging in displacement activities that divert attention from pain, such as crying, eating, and solving puzzles.

Here’s Belgian researcher, Patrick Anselme, explaining how behavioral addiction works:

[A]bnormal patterns of displacement activities result from attentional interference caused by a thwarting experience or conflicting motivations.

The displacement patterns are considered “abnormal” because they are more intense than called for, often incomplete, and of short duration. Dr. Anselme explains these abnormalities as the result of “attentional interference” induced by thwarted motivation or conflicting motivations.

Dr. Anselme writes, “[M]oderate exposure to a drug reward makes natural rewards increasingly attractive to organisms, whereas prolonged exposure to the same drug reward has the opposite effect.” What people get hooked on is the anticipation of the drug, and the ritual of its use, rather than the substance.

So, what we’re doing when we do drugs is a dance that starts with pain, and pain relief, and becomes a ritual of displacement sustained due to habit more than relief.

Written by Steve O’Keefe. First published August 18, 2026.

Sources:

“Crying: Why We Cry and How It Works,” Cleveland Clinic, January 9, 2025.

“Abnormal patterns of displacement activities: A review and reinterpretation,” Behavioural Processes, September 2008.

“The effect of exposure to drugs on the processing of natural rewards,” Neuroscience & Biobehavioral Reviews, March 2009.

Choice, Behavioral Economics, and Addiction, by Rudy E. Vuchinich and Nick Heather, Elsevier, 2003.

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