The developmental origin of drug abuse has long been known. Early in life a child develops the basic ego capacities governing human functioning: the ability to control their thinking and behavior; the ability to modulate their mood; the ability to distinguish reality from fantasy; and their development of the sense of who they are or, as it is termed, their "sense of self."
No one experiences perfect parenting but if it was greatly inadequate a weakness of one or more of these capacities develop. This can cause difficulty with paying attention in school, socializing, and enabling later success with the critical development tasks of adolescence: dating, gaining appropriate separation from parents, and constructing realistic educational and vocational goals. These failings cause distress and, with some youth, the attempt to alleviate it using alcohol or drugs.
Substance abuse occasionally begins earlier or later but mostly during adolescence. Treatment is difficult because undergoing psychotherapy to heal the underlying personality issues that cause the substance abuse takes time while using a drug lessens pain quickly. The need for many episodes of in-patient treatment to become "clean" begins their life-long struggle to remain so. Longevity is not associated with substance abuse.
This article was inspired by my reading in The Wall Street Journal ("The Dark Side of Addiction Recovery for the Rich"/Feb. 16, 2025).