Interconnection Between Alcohol, Drugs, and Aggression

Cardwell C. Nuckols, Ph.D. Alcohol, drugs, and aggression are all connected together, also, in several cases, addiction, rage, and violence are interconnected. According to the terminology of Alcoholics Anonymous, anger has been connected to relapse. For years, self-help services have served as a warning to addicts recovering from staying away from frustration, hunger, loneliness, and fatigue.  These thoughts can also be perplexing in cases where an addictive disorder co-occur with another psychiatric disorder. Rage and violent outbursts, for example, are signs of post-traumatic stress disorder, bipolar disorder, attention deficit disorder, delusional schizophrenia,  and personality disorders, including antisocial borderline and paranoid character disturbances.

From the studies carried out on alcohol, drugs, and aggression, it is seen that toxic effects from the stimulant drugs like cocaine and methamphetamine cause anxiety, hyperarousal, and, in some cases, abuse, with violence being the leading cause of death among stimulant drug addicts. Rage and anger can be perceived in a different light. They are feelings that helped the person cope with the turmoil and violence that he or she endured as a child. Rage can be seen in this light as a learned coping mechanism resulting from early life experiences.

In reference to alcohol, drugs, and aggression, the lack of a way to explain or define rage and violence in the DSM complicates the quest for answers.  This seems contradictory, given how much focus the manual puts on the other two main emotions – affective conditions and anxiety. While rage, agitation, and even violence are listed as signs of psychiatric disorders, there is no formal classification system in place.

This article will concentrate on two distinct but related sets of groups. The first segment will look at rage as a symptom of different mental illnesses. The emphasis for this will be on addictive disorders in this case. Anger and resentment are seen as acquired coping and survival skills in the second set of views when considering the link between alcohol, drugs, and addiction.  Rage and anger are represented as purposeful in this context, and they are used to establish power in circumstances where the person is afraid of losing control.

How Are Alcohol, Drugs, and Aggression Associated?

Alcohol and narcotics have long been associated with rage and violence(these puts alcohol, drugs, and addiction in a significant relationship). Alcohol, stimulants (methamphetamine and cocaine), marijuana, anabolic steroids, and other medications have all been linked to the alleviation of unpleasant emotional conditions or the precipitation of rage and hostility. Not only do several mood-altering substances affect cognition, but there is also evidence that alcohol and drugs change mood states by altering neurotransmitter levels.

For several years, direct pharmacologic actions of drugs like alcohol on the central nervous system have been promoted as the primary cause of violent activity in substance-abusing individuals. Alcohol, drugs, and aggression have always being connected trio. The facilitation of violence has been related to behavioural disinhibition triggered by alcohol consumption. However, as Blum points out, drugs merely alter the user’s judgment and self-control, causing him or her to become aggressive in a given situation. Blum’s explanation shows the relationship between alcohol, drugs, and aggression.


Alcohol has a disinhibiting impact which can be used as an excuse to justify one’s behavior. Alcohol may cause a decrease in the neurotransmitter serotonin in the later stages of addiction. The relationship between serotonin and depression, aggression, sleep control, and suicide is the most important from a psychiatric or psychological standpoint. Alcohol is the most frequently and seriously linked to a wide range of offensive and violent actions. Animals become more violent and impulsive when serotonin supply or delivery is hampered, according to studies of rodents and nonhuman primates. Serotonin-deficient rats can harass and kill other rodents. This indicates that the correlation between violence and alcoholism is more than just a matter of interpretation. 

Attempts to define pharmacologic parameters such as dose-response associations between alcohol intake and laboratory models of violence were the initial focus of experimental laboratory research. According to some studies, pharmacological causes may not be the primary cause of the violent behaviors observed. The type of alcoholic beverage consumed, for example, was discovered to be a significant factor in violent behavior. Despite comparable alcohol intake, vodka was found to have a more pronounced impact on violence than bourbon. While possessing comparable blood alcohol concentrations, male liquor drinkers were found to be more aggressive than male beer drinkers, while female beer drinkers were more aggressive than female liquor drinkers. 

Stimulant Drugs 

Crime, accidents, and suicide are the leading causes of death for cocaine and methamphetamine users. Both of them are aggressive, and they may all be linked to toxic changes in the neurotransmitters dopamine and norepinephrine. Stimulant drugs can cause an increase in norepinephrine and dopamine during toxic episodes. Hyperarousal is caused by elevated norepinephrine levels. This is similar to the “fight or flight” response, which happens when a person is in danger, actual or perceived. When this is paired with continued dopamine elevations, a paranoid state is likely. The user experiences context-appropriate paranoia as dopamine levels in the brain begin to rise.

A good example is the belief that any sound outside your apartment is a drug agent, prompting the person to peek through the peephole in the door all the time. When dopamine levels increase as a result of continued stimulant usage, a symptom trend appears that resembles a psychotic (paranoid) condition. Other delusions such as persecutory, jealous, and some other forms may occur. After a night of heavy free base use, a man in a rehab facility explained a delusional paranoia that arose in the early morning hours. He was convinced that unmarked police cars were parked all along his driveway. He would step out of his house every fifteen minutes to look through his mailbox while checking the street for unmarked police cars to see if they were there. He believed that this was the only way he could search for signs of trouble in a non-obtrusive manner.


The words “mellow” and “let’s hang out” are used to explain the cannabis experience. These phrases tend to refer to the desired sensation that happens after inhalation. Most marijuana patients tend to be using the medication to relieve their frustration and/or anxiety.  Clinicians can search for these emotional expressions in patients and treat them as an underlying problem and a relapse concern if they do not go away quickly (do not forget that abstinence syndrome may manifest as irritability and anxiety for up to three days after cessation, and these symptoms may come back in an exacerbated manner in 3-6 weeks).

Anabolic Steroids

Anabolic steroids “stacking” and “pyramiding” can cause symptoms ranging from rage to psychosis. The term “stacking” refers to the use of more than one anabolic steroid at about the same time. An injectable, for example, can be used in addition to oral ingestion. The term “pyramiding” refers to the process of increasing the steroid dose. Rage and aggression can be symptoms of the drug experience as dose levels rise.

Learning Anger as A Mechanism for Coping

On alcohol, drugs, and aggression, many addicts and alcoholics come to recovery with histories of violence and neglect. As children, they made deliberate decisions never to let someone get close to them or harm them again as a way of coping with an unmanageable situation. In most cases, this decision is taken between the ages of 8 and 14. When a woman was questioned in a group about when she realized that she would never let someone hurt her again, she said she recalls her parents violently arguing and decided at the age of 11 that she will never put up with it any longer. Any time there was a fight at home, she decided to flee.

A man told a story about his drunken father thrashing him with a belt due to the established relationship between alcohol, drugs, and aggression. At the age of 12, he resolved that this will never happen to him again. He would hit his father whenever he saw him with the belt. These techniques are used frequently throughout their lives. In a group environment, for example, a violent patient may challenge the therapist to a confrontation. In contrast, a fleeing patient may move his or her chair a foot or more beyond the group circle.

Coping Mechanisms Adapted

These Learned Coping Mechanisms can appear in a variety of forms leading got the prevalence of alcohol, drugs, and aggression.

The Following Are Four Tactics that Can Be Seen:

  • Withdrawal Method: When a person feels weak or out of control in a situation, they may withdraw. This strategy was illustrated in the above story of the lady who wanted to run away from the crisis she faced as a child. Others can withdraw to avoid conflict by going into reactive depression.
  • Avoidance of Reality: Others would resort to drugs and alcohol to escape reality.  To prevent a clinician from getting too close to their heart, patients with antisocial and narcissistic disorders will use a narcissistic tactic. When the heat is turned up too high, or they do not get what they think they deserve, this patient will walk out of a session.
  • Attack on Self: When a real or perceived sense of abandonment occurs, clinicians may remember patients who injure themselves. Certain patients (for example, borderline personality disorder patients) may experience increased anxiety as a result of therapy termination, leading to impulsive actions such as sexual acting out, cutting, burning, or the use of food, drugs, and alcohol.
  • Attack on Others: Patients can put others down to improve their self-image in order to cope with a stressful situation. These insults can range from simple verbal defamation to sadistic acts.

All of these points explains the relationship between alcohol, drugs, and aggression.