Traits of People with a High Risk of Developing Substance Use Disorder: A Guide for CASAC, CADC, and CAC Counselors

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.