What Causes Substance Use Disorders? A Look at Spiritual Factors

What Causes Substance Use Disorders? 

A Look at Spiritual Factors

In previous blogs I have explored the physiological, psychological, social, and environmental factors contributing to substance use disorders.  Today, I will be writing about spiritual factors.  It’s not a coincidence that I write this blog just after returning from a vacation to my favorite place for reconnecting spiritually—a tiny island in the West Indies called Anguilla, a place of such natural beauty and loving people that it’s hard for me not to feel connected to something much larger.  On these trips, I also read spiritually based books that enhance my appreciation of being there or, more accurately, being here.

 It’s important that we feel a sense of purpose or meaning in our lives.  Without that, we feel a sense of emptiness—what is often termed a “hole in the soul.” In order to fill this hole, we often seek behavioral distractions, such as substance use, sex, work, food, or gambling, to fill this void. These behaviors, however, seem to help only temporarily at best.  We still feel empty, despite these distractions. I describe this state as having a spiritual deficit—the inability to feel purpose, meaning, or connection to something larger than ourselves.  This spiritual deficit is characterized by feeling alone, appearing depressed or apathetic, being involved in a variety of compulsive behaviors, having difficulty connecting to others, and suffering a variety of physical ailments.

Eckhart Tolle, in his classic book The Power of Now, succinctly depicts what it’s like to feel disconnected.  He writes, “The inability to feel this connectedness gives rise to the illusion of separation, from yourself and from the world around you. You then perceive yourself, consciously or unconsciously, as an isolated fragment.  Fear arises and conflict within and without becomes the norm.”  According to Tolle, feeling disconnected leads to a general sense of fear or dread.  It’s not surprising, then, that individuals with this spiritual deficit turn to drugs and alcohol to medicate the fear. 

How do we find purpose or meaning in our lives?  The simple answer is by finding passion for something.  This may include finding passion in our jobs, or through our roles, such as being a good parent.  However, many of us have not been able to find passion for anything.

One of the books that I took with me on vacation was The Art of Happiness.  A classic, it integrates our understanding of happiness from the perspective of the Dalai Lama’s Buddhism and that of Western science.  The Dalai Lama believes that our ultimate purpose in life is to simply find happiness.  He believes that the ways many of us seek happiness are often misguided.  He believes that the key to finding happiness and avoiding suffering is our state of mind.  He writes, “The greater the level of calmness of our mind, the greater our peace of mind, the greater our ability to enjoy a happy and joyful life.”  The way we develop this peace of mind is based upon the way we interpret the events in our life.  Cognitive therapy is a Western form of psychotherapy that challenges our irrational beliefs and helps us form new ways of thinking about situations in our lives.  The Dalai Lama believes that a systematic retraining of the mind by deliberately selecting and focusing on positive mental states (e.g., compassion, kindness) and challenging negative mental states (e.g., hatred, anger, greed, jealousy) can lead to happiness and the avoidance of suffering.

In my lecture with patients entitled “Spirituality: The Neglected Dimension,” I review common character weaknesses that foster unhappiness, including self-centeredness, irresponsibility, hatred, and resentment, and suggest ways to replace those responses with ones that lead to happiness and fulfillment.  For example, compassion can replace self-centeredness, discipline can replace irresponsibility, and compassion can replace hatred and resentment.

I truly believe that many individuals seeking treatment for substance use disorders are suffering from spiritual deficits and seeking something to replace their sense of isolation and lack of purpose.  It is our responsibility as practitioners to guide individuals toward greater fulfillment in their lives.


Nicholas Lessa is the Clinical Director of Chat2Recovery, an online substance abuse treatment program, and Inter-Care, a leading substance abuse treatment program in New York City.  He has been in the field of substance abuse treatment for over 30 years.  He is the lead author of two books, Wiley’s Concise Guide to Mental Health: Substance Use Disorders and Living with Alcoholism and Drug Addiction.

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