A man takes a pill as a form of self-medication

Over the years, various models and hypotheses have been formulated to try and explain the causes and origins of addiction. One of these theories, known as the self-medication hypothesis, has gained traction over the past few decades as a plausible explanation for why addiction occurs.

Here we take a look at the self-medication hypothesis.

What is the self-medication hypothesis?

The self-medication hypothesis (SMH for short) argues that an individual’s choice in a particular drug as being their favorite is not an accident or coincidence. Instead, the hypothesis states that an individual’s choice in drugs is based on relief that the drug provides for certain psychological conditions they have (real or imagined). In other words, A human head standing next to a series of pillsusers prefer certain drugs because the effects produced by that drug relieve them of certain conditions they may have, such as anxiety, fear, depression, etc. (1)

What are some examples of the self-medication hypothesis?

Each different class of drugs produces different effects in users. Thus, according to the SMH theory, each drug class might be associated with a certain physiological condition. Here we take a look at some examples.


Includes: Cocaine, amphetamines, caffeine, and nicotine

Stimulants tend to increase energy and heighten mental focus. Individuals who are dealing with the following psychological issues are believed to prefer stimulants (2) (3):

  • Depression
  • Social Anxiety
  • Low self-esteem
  • Lack of motivation

Opiates and Opioids

Includes: Heroin, morphine, and oxycodone

Opioids are commonly used as painkillers and for their ability to produce euphoria. Individuals who are dealing with the following psychological issues are believed to prefer opioids (2) (4) (5):

  • Physical pain
  • Aggression and rage issues
  • Depression and anxiety

Central nervous system depressants

Includes: Alcohol, benzodiazepines, and barbiturates

Central nervous stimulant depressants produce relaxation and sedation by decreasing anxiety and lowering inhibitions. Individuals who are dealing with the following psychological issues are believed to prefer CNS depressants (2) (5) (6) (7):

  • Social anxiety
  • Anxiety
  • Depression
  • Aggression issues

Final Note

This article is intended for those considering a new way of life, free of the pain of drug and alcohol addiction. For more information on recovery and anyone seeking help with addiction and substance abuse problems, please call True Recovery at (844) 744-8783 or visit us online.


  1. https://www.ncbi.nlm.nih.gov/pubmed/9385000
  2. Khantzian E.J. (2003). “The self-medication hypothesis revisited: The dually diagnosed patient”. Primary Psychiatry. 10: 47–48, 53–54.
  3. Khantzian, E.J., Halliday, K.S., & McAuliffe, W.E. (1990). Addiction and the vulnerable self: Modified dynamic group therapy for drug abusers. New York: Guilford Press.
  4. https://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.142.11.1259
  5. Khantzian, E.J. (1999). Treating addiction as a human process. Northvale, NJ: Jason Aronson.
  6. https://www.ncbi.nlm.nih.gov/pubmed/9385000
  7. https://pubs.niaaa.nih.gov/publications/arh26-2/130-135.htm