Why People with Use Disorders Manipulate: What Every CASAC, CADC, or CAC Should Understand

If you’re a CASAC, CADC, or CAC, you may have asked yourself why people with substance use disorders manipulate those who are trying to help them. This behavior can be perplexing and frustrating for substance use counselors. It’s essential to recognize that manipulation often stems from intense cravings and a deep-seated need for control in a situation that feels overwhelming. Understanding manipulation in substance use treatment is crucial. Clients may engage in these behaviors not out of malice, but as a response to fear and vulnerability during their recovery process.

Manipulation during addiction recovery can manifest in various ways, including lying, shifting blame, or evoking emotional reactions. Recognizing the underlying causes of these actions allows substance use counselors to respond more effectively. Instead of viewing manipulation as a personal attack, consider it an opportunity for growth and understanding. By learning how to respond to client manipulation with compassion and clarity, counselors can help clients navigate their recovery journey more effectively, fostering a supportive environment that encourages honesty and accountability.

You’ve seen it. The lying. The guilt trips. The charm. The chaos.

Clients promise they’ll show up next time. They swear they’re sober. They borrow from everyone, disappear, and then reappear as if nothing had happened.

And yeah, you’ve probably thought, Why all the manipulation?”

If you’re a CASAC, CADC, or CAC, you’ve been in that chair wondering whether this is addiction, survival, or just straight-up deception. Spoiler: it’s all three. But it’s not random. And it’s not personal.

Let’s break this down so you can help your clients without losing your patience or your mind in your substance use counselor role.

It’s Not Just Lying. It’s Survival.

Individuals with substance use disorders do not manipulate others for enjoyment; instead, they do so out of desperation. They often feel trapped by their circumstances, and the intense need to satisfy their cravings can lead to extreme behaviors. In these critical moments, their brains are urging them to survive, which means acquiring their next drink, pill, or hit. This manipulation can arise from various factors, including fear of withdrawal, feelings of shame, or the desperate need to maintain their habit at all costs.

Does this behavior make it acceptable? No. However, it makes it more understandable by highlighting the intense struggle that individuals with substance use disorders face daily.

They Need to Feel in Control (Because Internally, They’re Not)

Most clients with SUDs don’t feel like they run the show.

They feel hijacked by their cravings, memories, shame, trauma, and the daily chaos they can’t escape.

So what do they do?

They try to control you. Or the system. Or the schedule.

Because controlling anything outside them feels safer than facing the mess inside.

Control becomes the illusion of safety.

If you’re a counselor walking into that power struggle without realizing it, you’ll get played—or you’ll push them away—neither works.

So the job? Don’t engage in the tug-of-war.

Get underneath it.

Ask: What are they afraid to lose if they give up control?

Cravings Feel Like Emergencies

When a person’s in withdrawal or locked into craving mode, logic is off the table.

They’re not weighing pros and cons—they’re chasing oxygen.

Have you ever gone two days without eating?

Now imagine every cell in your body screaming for one specific thing: heroin. Or liquor. Or anything that numbs the pain.

In that state, manipulation becomes a means to an end.

For example, I once had a client who traded a pair of sneakers and a busted DVD player for a bag of heroin, then lied to his mom about why his shoes were gone. Not because he didn’t love her, but because the obsession had already taken the wheel.

Counselors must recognize the manipulation that often masks deeper issues, such as a nervous system stuck in survival mode. Individuals with substance use disorders may manipulate to protect themselves from vulnerability, to escape painful emotions, or to avoid facing brutal truths. This behavior often stems from fear and an overwhelming sense of powerlessness. Understanding these underlying motivations is crucial for effective counseling and support, allowing counselors to address root issues and guide clients toward healing and healthier coping strategies.

Thinking Clearly? Not in the Cards

Let’s talk about brains.

Substance use disorders alter the prefrontal cortex—the part of the brain that handles decision-making, impulse control, and logic.

So while a client might want to stop lying, stealing, cheating, or dodging…

They often don’t have the mental bandwidth to stop themselves once the cycle begins.

How to respond to client manipulation means we never let it slide. It means we build in support, scaffolding, and structure before expecting significant behavior change. It also means we stop taking their manipulation personally. It’s not about us. It’s about their brain being rewired for short-term relief over long-term repair.

Desperation Trumps Morality

You might think your client doesn’t care who they hurt.

However, I promise you, most of them genuinely care.

They care later, after the damage is done.

When someone’s in active use, desperation overrides everything.

The obsession takes over. The guilt comes later. And when does it hit? It’s often too overwhelming to face.

So they keep using.

Because using feels safer than looking you in the eye and saying, “I f***ed up again.”

Guilt Fuels the Cycle

Here’s the kicker: guilt isn’t what gets people sober.

Guilt keeps people stuck.

When clients feel like garbage, they often double down on the lies. They can’t ask for help because they don’t think they deserve it. They feel like the damage is too deep, the bridge already burned.

So they continue to manipulate because honesty feels too risky.

Your job as a counselor isn’t to punish the manipulation.

It’s to create a space where truth feels safer than lies.

That doesn’t mean letting things slide.

It means confronting with compassion and holding boundaries with curiosity, while calling out the behavior and protecting the relationship.

What You Can Do About Manipulation in Recovery

As a substance use counselor, it’s essential to address cravings and manipulation openly. Understanding manipulation in recovery empowers clients to navigate their challenges and fosters a supportive environment for growth.

Case Example: Maria

Maria is currently in her second month of outpatient treatment. She claims to be sober, but her urine drug screen (UDS) shows positive results for benzodiazepines. She insists that it’s a mistake, but you know otherwise.

An old-school authoritarian approach would suggest discharging her for non-compliance. However, you recognize that there’s a better way to handle this situation.

You take a moment to sit down with her and ask, “What would it take for you to be fully honest with me today?”

In response, she begins to cry. She admits that she didn’t want to lose her spot in treatment and reveals that her boyfriend gave her something to help with her anxiety.

At that moment, you see a crack in her defenses. Now, you have a starting point for a productive conversation. This illustrates the difference between labeling someone as manipulative and providing them with genuine counseling.

Understanding manipulation in substance use treatment is crucial. Many individuals, like Maria, may use manipulation during addiction recovery as a defense mechanism or fear of abandonment. Recognizing these behaviors enables the building of trust and encourages honesty, which are essential for a successful recovery. By addressing manipulation in recovery, you foster a supportive environment that promotes healing and accountability.

Why This Matters for Every CASAC, CADC, or CAC

When working as a substance use counselor, understanding the dynamics of cravings and manipulation in recovery is crucial. Clients may use various tactics to manipulate situations or even the counselor’s responses. It’s essential to recognize these behaviors as signs of underlying struggles with their addiction rather than personal attacks. To effectively respond to client manipulation, maintain clear boundaries, reinforce the importance of accountability, and encourage open communication about their feelings. This approach not only helps them navigate their cravings but also fosters a therapeutic environment where they feel safe to confront their challenges honestly. Building trust can empower clients to embark on their recovery journey with genuine enthusiasm.

You’re not just a counselor.

You’re the first person in a long time who sees past the lies and calls out the fear underneath.

Clients aren’t manipulating because they’re bad.

They’re manipulating because they’re stuck. Scared. Wired to survive. And unsure how to trust anyone, including themselves.

You want to help?

Understand the behavior, name it without shame, and teach them an alternative approach.

Because when they learn, they can get their needs met without manipulation?

That’s the first authentic taste of freedom.

And that’s when the work gets good.

Introduction 

If you are a CASAC, CADC, or CAC working with clients who have substance use disorders, you understand the diversity of their personalities and backgrounds. Some clients may test limits daily, while others tend to withdraw under pressure. This variation exists because there is no single substance use disorder risk factor.

Instead, we recognize various traits that indicate a higher risk of developing substance use disorders, such as genetic predispositions, mental health challenges, impulsivity, emotional disconnection, poor self-regulation, and environmental factors like trauma or lack of support.

As a substance use counselor, your focus should not be on labeling clients, but rather on diagnosing their risk and developing tailored, client-centered counseling strategies. This process begins with evidence-informed screening and assessment, which should be grounded in facts rather than assumptions or stereotypes.

In this post, we will examine these risk factors for substance use disorders, discuss their significance in treatment, and demonstrate how to translate this understanding into practical actions using evidence-based counseling techniques. Recognizing these traits not only fosters empathy but also improves treatment outcomes.

Understanding traits of people with a high risk of developing substance use disorders isn’t guesswork.

Knowing the substance use disorder risk factors is the foundation for smarter, more compassionate substance use disorder care.

1. The “Addictive Personality” Is a Myth Worth Retiring

The media still loves to toss around the phrase “addictive personality.”

But substance use counselors know better. There is no one-size-fits-all psychological profile that guarantees a person will develop a substance use disorder. What we do have is data and a growing understanding of certain traits of people with a high risk of developing substance use disorder.

Substance use disorders (SUDs) represent a complex public health issue that affects individuals, families, and communities. Understanding substance use disorder risk factors that contribute to the development of these disorders is essential for early intervention and effective support. By recognizing the intricate interplay of predisposition, environment, and accessibility, professionals in the field, such as CASACs, CADCs, and CACs, can better serve their clients’ needs. The goal is not to stigmatize those at risk but to provide the necessary resources and support for a healthier, more fulfilling future.

2. Genetics Load the Gun, Environment Pulls the Trigger

People with first-degree relatives who have a substance use disorder are more likely to develop one themselves. But this isn’t a sentence, it’s a signal. Genetic susceptibility, particularly in dopamine regulation, can increase sensitivity to rewards and lead to risk-seeking behaviors.

As a substance use counselor, identifying this risk factor is essential for building rapport and developing personalized recovery plans.

Family history does not guarantee future outcomes, but it highlights the need for more client-centered counseling and comprehensive biopsychosocial assessments. This is particularly important when considering risk factors for substance use disorders, as individuals with a family history of addiction may be at greater risk. Understanding a client’s background can lead to more tailored interventions that address both genetic predispositions and environmental influences, ultimately fostering better therapeutic relationships and more effective treatment strategies. Engaging clients in this way helps uncover deeper issues and promotes a holistic approach to their well-being.

3. Co-Occurring Disorders: The Dual Burden

Mental health conditions such as anxiety, depression, PTSD, bipolar disorder, and schizophrenia often coexist with substance use disorders. The self-medication theory is not just a buzzword; it is a clinical reality.

Individuals experiencing intense internal distress frequently turn to substances not for pleasure, but for relief. When treating substance use disorder, it is crucial to help clients learn to cope without relying on the substances that have been their crutch.

This is why evidence-based counseling methods, like integrated dual diagnosis treatment, are essential. It is impossible to effectively address substance use without also tackling the underlying issues that contribute to it.

4. Risk-Taking, Thrill-Seeking, and Dopamine Hunger

Some individuals simply experience emotions less intensely, and this is not a philosophical issue—it’s a neurological phenomenon. Lower dopamine sensitivity often leads to a greater need for stimulation, which can manifest in pursuits like fast cars, risky sexual behavior, or substance use.

Clients with high-risk personalities are not inherently problematic; rather, they are individuals wired to seek out intense sensations. Alongside this tendency, certain risk factors for substance use disorder can include a family history of addiction, early exposure to substance use, trauma, mental health issues, and social environment influences.

As a CASAC, CADC, or CAC, your role is to help these clients discover healthier outlets that provide similar rewards. Possible approaches may include adventure therapy, exercise-based interventions, or developing plans centered around intense creative pursuits, ultimately helping them channel their need for stimulation in a positive direction.

5. Caution, Disconnection, and Quiet Despair

Not every client with a substance use disorder is wild and impulsive. Some are quiet, socially withdrawn, anxious, and depressed. These individuals often drink or use substances to soothe themselves, not to chase chaos, but to numb their pain.

As a substance use counselor, it’s essential to be aware of these factors. Loneliness, untreated trauma, and social anxiety are significant risk factors for substance use disorders.

In this context, client-centered counseling is crucial. You are not pushing clients to “open up”; instead, you are providing them the space to feel safe. This sense of safety fosters trust and creates the opportunity for change.

6. Self-Regulation: The Common Denominator 

What do thrill-seekers and socially anxious individuals have in common? They both struggle with poor self-regulation. One of the many traits of people with a high risk of developing substance use disorder is the inability to manage cravings, delay gratification, or sit with discomfort, which is at the core of many substance use disorder patterns.

Additionally, various risk factors contribute to these challenges, including genetic predispositions, environmental influences, and mental health issues. Often, these struggles stem from a history of trauma and neurochemical imbalances.

Substance use counselors’ evidence-based counseling interventions, such as Dialectical Behavior Therapy (DBT), Contingency Management, and Motivational Interviewing, can provide significant help.

Teaching self-regulation is not just about acquiring a skill set; it’s a vital lifeline that empowers individuals to navigate life’s challenges more effectively and reduces their risk of developing substance use disorders.

7. What This Means for Screening and Assessment

If you are a CASAC, CADC, or CAC conducting intake assessments, it’s essential to go beyond simple yes/no checklists. Begin to look for patterns, such as:

• – A family history of substance use disorders

• – A history of trauma

• Impulsivity or a tendency toward sensation-seeking behavior

• Chronic loneliness or feelings of disconnection

• Co-occurring mental health diagnoses

These indicators are not just red flags; they serve as valuable roadmaps for navigating the future. When using client-centered counseling, these insights should inform every aspect of the care plan.

8. Put It All Together: Client Voice, Counselor Strategy

Recognizing the traits of individuals at high risk for developing a substance use disorder is not about labeling; it’s about being attentive and listening. Risk factors for substance use disorder can include a family history of addiction, mental health issues, trauma, and socioeconomic challenges. Your client may not fully understand the reasons behind their substance use. Still, by employing a thoughtful, evidence-based counseling approach, you can reflect on what you observe without passing judgment. This is where Motivational Interviewing comes into play.

Help your client identify their patterns of behavior and the underlying risk factors that contribute to them. Allow them to express their pain, and then support them as they begin to make different choices. By doing so, you empower them to take control of their journey toward recovery.

Final Takeaway

In conclusion, understanding the complexities of substance use disorder involves recognizing the various risk factors associated with addiction. By exploring the traits of individuals facing these challenges, substance use counselors, not just their behaviors but also their emotional and psychological needs, can foster deeper connections and more effective therapeutic alliances. As counselors, it’s essential to remain vigilant about the addiction risk factors that influence our clients while maintaining a stance of curiosity and empathy. This approach not only empowers those we serve but also enhances our ability to support them on their journey toward recovery. Stay curious. Stay humble. Stay human.