Personality & gender
Personality & substance use
Personality may influence vulnerability to certain patterns of substance use, but personality does not determine a person's future.
How to read this page
Group-level patterns, not individual predictions
Research on personality and substance use describes averages across large groups. Averages cannot tell you anything reliable about one person — including yourself, a patient or a relative.
Effects are modest
Where associations are found, they are usually small to moderate, and they overlap heavily between people who develop dependence and people who do not.
Direction is unclear
Some traits may precede substance use; some appear to be affected by prolonged use. Much of the research cannot separate the two.
Context does the heavy lifting
Trauma, mental health, availability, poverty and social norms consistently matter, and they shape whether a trait becomes a risk at all.
Six traits
What the research examines
Open each trait for what it means, how it may relate to substance use, and why the relationship is not deterministic.
Impulsivity
What the trait means
A tendency to act quickly on urges, with less weight given to delayed consequences. It is measured as several distinct components rather than one thing.
How it may relate to substance use
Higher impulsivity has been studied both as something that may precede problematic substance use and as something affected by prolonged use, particularly for stimulants and alcohol (Verdejo-García, Lawrence & Clark, 2008).
Why it is not deterministic
Direction of effect is genuinely difficult to establish. Many people with high impulsivity never develop dependence, and impulsivity can be expressed in ways unrelated to substances.
Sensation seeking
What the trait means
A preference for novelty, intensity and varied experience, and a willingness to take risks to get it.
How it may relate to substance use
Sensation seeking has been associated in research with earlier experimentation and with heavier episodic use in some groups, especially during adolescence and early adulthood.
Why it is not deterministic
It is also associated with sport, travel, performance and enterprise. Whether it becomes a risk depends heavily on what is available and what is normalised in someone's environment.
Neuroticism / emotional instability
What the trait means
A tendency towards more frequent and more intense negative emotion, including anxiety, low mood and stress reactivity.
How it may relate to substance use
A meta-analysis linking broad personality traits to psychiatric and substance use disorders found higher neuroticism across many disorder groups, including substance use disorders (Kotov et al., 2010).
Why it is not deterministic
This overlaps strongly with mental health and with trauma. Neuroticism is not specific to substance use, and treating distress is often more useful than describing personality.
Conscientiousness
What the trait means
Planning, persistence, organisation and follow-through on intentions.
How it may relate to substance use
Lower conscientiousness has been reported alongside substance use disorders in meta-analytic work (Kotov et al., 2010), and is thought to relate to how consequences are weighted.
Why it is not deterministic
Conscientiousness is not fixed, and it is also reduced by chaotic circumstances, poverty, sleep loss and untreated illness — cause and consequence are hard to separate.
Agreeableness
What the trait means
Trust, cooperation, warmth and consideration in dealings with others.
How it may relate to substance use
Findings are mixed and generally weaker than for other traits; some studies report lower agreeableness in groups with substance use disorders, others find little relationship.
Why it is not deterministic
Evidence here is limited and inconsistent. It should not be used to make judgements about an individual, and it can easily slide into character judgement.
Extraversion
What the trait means
Sociability, assertiveness and positive emotion in company.
How it may relate to substance use
Extraversion has been linked with social and situational drinking in some populations, but the relationship depends on setting and social norms more than on the trait alone.
Why it is not deterministic
The evidence is mixed and context-dependent. Sociability describes where use may happen, not whether dependence will develop.
No personality trait, and no combination of traits, makes substance dependence inevitable — and no trait protects against it. Personality is one possible influence among many, and the others are often more changeable and more useful to act on.
Interactive
One factor among many
Select any factor to see how it can contribute. Substance use sits at the centre because it is the result of these influences interacting — not the product of any single one.
At the centre
Substance use
Personality would be one more button on this diagram — no larger than the others.
Factor
Biology
Genetics, tolerance, physical health, how a substance is metabolised.
No single factor on its own explains a person's substance use. They interact, and they change over time.
References & further reading
Personality research in this area is genuinely mixed. Findings for agreeableness and extraversion are weaker and less consistent than for impulsivity and neuroticism, and we have said so on the page rather than smoothing it over.
Personality research
Kotov, R. et al. (2010). Linking "big" personality traits to anxiety, depressive, and substance use disorders: a meta-analysis. Psychological Bulletin, 136(5), 768–821.
Meta-analysis of trait associations across disorder groups; effects are group-level and modest.
Verdejo-García, A., Lawrence, A.J. & Clark, L. (2008). Impulsivity as a vulnerability marker for substance-use disorders. Neuroscience & Biobehavioral Reviews, 32(4), 777–810.
Review of impulsivity as both a possible precursor and a possible consequence of substance use.
Zuckerman, M. Research programme on sensation seeking and risk behaviour.
Origin of the sensation-seeking construct referred to on this page.
UK guidance and policy
Drug misuse and dependence: UK guidelines on clinical management (the "Orange Book")
Department of Health and Social Care and devolved administrations, 2017. Treatment and prescribing practice for drug dependence in the UK.
Open source ↗NICE guidance on alcohol-use disorders and drug misuse
Includes CG115 (alcohol dependence and harmful drinking), CG100 (alcohol-related physical complications) and CG51 (psychosocial interventions for drug misuse).
Open source ↗Office for Health Improvement and Disparities — alcohol, drugs and tobacco collections
UK Government guidance, commissioning support and data on treatment and recovery in England.
Open source ↗Independent review of drugs (Dame Carol Black)
GOV.UK, 2020–2021. Examines treatment capacity, funding and system barriers in England.
Open source ↗Rights, respect and recovery: alcohol and drug treatment strategy
Scottish Government, 2018. Sets out a rights-based, stigma-aware approach to alcohol and drug support.
Open source ↗Medication Assisted Treatment (MAT) standards
Scottish Government / Public Health Scotland. Standards on same-day access, choice, harm reduction and retention in treatment.
Open source ↗Public Health Scotland — substance use and stigma resources
Population health information and work on reducing stigma in services.
Open source ↗NHS inform and NHS.uk
Public-facing health information and service finders for drug and alcohol support.
Open source ↗World Health Organization — alcohol, drugs and addictive behaviours
International guidance, including WHO/UNODC International Standards for the Treatment of Drug Use Disorders (2020).
Open source ↗
This website provides educational information and is not a substitute for individual medical assessment, diagnosis or treatment. Information should be interpreted alongside current clinical guidance and evidence.