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The Connection Between Addiction and Shame: Understanding the Risks


Substance use disorder (SUD) colloquially referred to as addiction, is a mental health disorder, and is classified as such in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Addiction is characterized by habitually engaging in rewarding stimuli regardless of the negative consequences. An individual that struggles with addiction issues will prioritize satisfying the needs associated with his or her addiction above all else in his or her life. The adverse effects of addiction reach far beyond the immediate physiological consequences and can seep into every area of one’s life. The development of substance use disorder does not occur immediately, nor will recovering from addiction be achieved instantaneously.

Shame, as explained by Verywell Mind, involves a “feeling of embarrassment or humiliation that arises from the perception of having done something dishonorable, immoral, or improper.” The relationship between shame and addiction is bidirectional, meaning that shame can contribute to the development and exacerbation of addiction, and addiction, in turn, can intensify feelings of shame. There is a multifaceted connection between addiction and shame, as empirical evidence highlights: 

  • Shame can trigger substance abuse. Surveys conducted among individuals in addiction treatment programs indicate that shame is a common and significant emotion experienced, often leading to further substance use as a coping mechanism.
  • Shame is a known predictor of relapse. Longitudinal studies reveal that individuals who experience shame and self-criticism are at a higher risk of relapse.
  • Research demonstrates that internalized stigma, or shame related to societal attitudes, is associated with poorer treatment outcomes and lower self-esteem among individuals with SUD.
  • Studies exploring neurotransmitter pathways suggest that substances of abuse can modulate neural circuits related to shame, creating a cycle where substance use both triggers and temporarily alleviates feelings of shame.
  • Neurobiological research indicates that shame is associated with specific brain activity patterns. Individuals with addiction often show unique neural responses related to shame, revealing the neurological basis of this connection. Further, studies show that higher rates of shame and guilt are linked to poor recovery outcomes.
  • Comparative studies show that treatment approaches integrating shame resilience techniques result in better retention rates and improved overall well-being in individuals with addiction.
  • Interventions addressing shame and self-esteem have been shown to reduce the likelihood of relapse, emphasizing the importance of addressing these emotions in treatment programs.

Understanding the risks associated with the connection between addiction and shame is crucial for developing effective intervention and support strategies. Addressing shame as a core component of therapy can improve treatment adherence, reduce the risk of relapse, and enhance overall quality of life for individuals struggling with addiction. This evidence-based understanding informs clinical practice and policy, promoting more effective and compassionate care for individuals affected by addiction and shame.

For Information and Support 

Substance abuse and addiction can be incredibly dangerous and can result in severe short and long-term consequences. If you or someone you know is suffering from substance abuse or addiction, please get help as soon as possible. The earlier you seek support, the sooner you and your loved ones can return to leading happy, healthy, and fulfilling lives. There is no reason to go through this alone, and we are here to help. Please feel free to reach out to us for further information or with any questions regarding substance abuse or addiction. We are available anytime via telephone at: 213-389-9964, or you can always email us at:

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