The Many Faces (and Potential Dangers) of Self-Medication as an Explanatory Concept for Substance Use

Abstract

The self-medication hypothesis of addictive disorders maintains that individuals use substances to cope with dysphoric affect, and that painful emotional states are etiologically relevant to the development of a substance use disorder. While this hypothesis may be relevant for some, this paper proposes that self-medication understood in this fashion is an over-used concept. Furthermore, viewing substance use as being caused by some underlying emotional issue will affect how counselling is conducted and it is suggested that intervention may often be misguided. In this paper, other ways that substance use and mental suffering can become related that have nothing to do with emotional anguish being the causal agent for substance use will be elucidated. The implications that this has on counselling intervention will then be highlighted. Broadening of our understanding of self-medication and the many ways that substance use and psychological distress can become linked will help counselors to offer optimal care to this vulnerable population.