A personality disorder is characterized by rigid, long-term thought patterns and behaviors that impair personal, academic, social and occupational functioning. The effects of personality disorders can be particularly damaging when coupled with substance abuse. People with personality disorders tend to lack coping skills and may begin to abuse substances to deal with uncomfortable and powerful emotions. Co-occurring personality disorders and substance abuse conditions can be challenging to treat because the symptoms of each disorder tend to exacerbate both conditions. Fortunately, comprehensive treatment for both conditions can improve symptoms.

Effects of Substance Abuse on Personality Disorder Symptoms

About fifty percent of individuals diagnosed with a personality disorder also have substance abuse disorder. Substance abuse tends to worsen and intensify the symptoms of a personality disorder. As symptoms become more severe, people may begin to use an increased amount of substances to cope.

Narcissistic personality disorder and drug abuse is particularly common. Substance use can amplify the symptoms of this condition and undermine treatment by lengthening it and slowing down progress. Borderline personality disorder drug abuse is also prevalent. Studies estimate that between 50 and 70 percent of individuals with borderline personality disorder have a co-occurring substance use disorder.

Personality Disorders and Alcohol

Similar to substance abuse, alcoholism and personality disorders also frequently co-occur. There is a compelling linkage between alcohol and antisocial behavior in particular. People who exhibit antisocial tendencies are quick to engage in risky behaviors, lack shame and display high levels of impulsivity, which can make them more vulnerable to addictive behaviors. In these cases, alcohol use is driven more by an inclination toward rash and dangerous behavior than a desire to cope with negative emotions. Studies have shown that individuals diagnosed with antisocial personality disorder were 21 more times likely to develop alcohol dependence than members of the general population.

Personality Disorders and Marijuana

People with a personality disorder diagnosis are more likely to misuse marijuana, display signs of dependence. These individuals also tend to start using marijuana at a younger age. The motives for marijuana use may differ depending on the symptoms of each personality disorder. For example, some people may seek dissociation, while others look for an escape from painful emotions.

Personality Disorders and Stimulants

Personality disorders are often found in people who use stimulants. Stimulant use increases energy and attentiveness but can also worsen impulsiveness, mood control and anger. Meth can be particularly dangerous for people with personality disorders because of its potential to cause substance-induced psychosis, anxiety, paranoia and irritability.

Statistics on Personality Disorders and Addictions

Following are personality disorder and substance abuse statistics:

  • Addiction is diagnosed in roughly every second patient with a personality disorder
  • Approximately 50 percent of people with borderline personality disorder have a co-occurring substance abuse disorder
  • Antisocial, dependent, borderline and narcissistic personality disorder are the most common kinds of co-occurring diagnoses given to individuals with alcohol or substance dependence

Can Drug Abuse Lead to Personality Disorders?

Personality disorders are typically present before substance use disorders develop, meaning that drug abuse does not likely cause personality disorders. However, the symptoms of these conditions tend to make individuals with personality disorders more likely to experiment with, use and become dependent on substances.

Treating Personality Disorders with Co-Occurring Substance Abuse

Personality disorder treatment can be difficult, as many of the symptoms of personality disorders may make it harder for a person to acknowledge their condition in the first place. Substance abuse tends to increase this challenge.

Personality disorder treatment requires a specific, individualized approach with a comprehensive treatment plan. Treatment most often includes a psychotherapy component, such as cognitive behavioral therapy or dialectical behavioral therapy. Medication may also be prescribed when clinically warranted. Treatment for personality disorders and co-occurring substance abuse must be done simultaneously and address symptoms from both conditions to be effective.

Substance abuse can exacerbate the symptoms of a personality disorder, cause misdiagnosis and be an obstacle to treatment. Fortunately, treatment for co-occurring substance use and personality disorder can be successful with an evidence-based treatment plan. If you or a loved one lives with substance dependence and a personality disorder, consider contacting licensed mental health practitioners at The Recovery Village. Call a representative today to learn more or to get started.


Natural Drug Strategy. “8 Personality Disorders and Substance Abuse.” 2018. Accessed March 24, 2019.

National Institute on Alcohol Abuse and Alcoholism. “Antisocial Personality Disorder, Alcohol, and Aggression.”  December 22, 1998. Accessed March 24, 2019.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.