Different Drugs Attract People With Different Attachment Styles

Heroin users were predominantly fearful-avoidant, ecstasy users showed mixed insecure patterns, and cannabis users were mainly dismissing and secure, suggesting different drugs may serve different emotional needs.

Schindler, Andreas et al.·Attachment & human development·2009·Preliminary EvidenceCross-Sectional
RTHC-00390Cross SectionalPreliminary Evidence2009RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Preliminary Evidence
Sample
N=22

What This Study Found

Researchers compared attachment representations across four groups: 22 heroin users, 31 ecstasy users, 19 cannabis users, and 22 non-clinical controls.

Heroin users were primarily fearful-avoidant in their attachment style. Ecstasy users showed a mix of insecure styles (preoccupied, fearful-avoidant, and dismissing-avoidant). Cannabis users were mainly dismissing and secure. Controls were mainly secure.

The groups also differed in psychosocial functioning (cannabis users > ecstasy users > heroin users), but attachment differences remained even after controlling for this.

The authors interpreted these patterns through the self-medication hypothesis: heroin may serve as an emotional substitute for people lacking coping strategies, while cannabis may support existing emotional distancing strategies.

Key Numbers

22 heroin users, 31 ecstasy users, 19 cannabis users, 22 controls. Cannabis users had highest psychosocial functioning among substance groups. Attachment differences persisted after controlling for functioning.

How They Did This

Cross-sectional comparison using the Family Attachment Interview and Bartholomew & Horowitz attachment measure. Four groups compared: heroin users (n=22), ecstasy users (n=31), cannabis users (n=19), and non-clinical controls (n=22). Global Assessment of Functioning (GAF) was controlled.

Why This Research Matters

Understanding why people gravitate toward specific substances could improve treatment by addressing the underlying emotional needs rather than just the substance use.

The Bigger Picture

The self-medication hypothesis suggests people use specific substances to manage specific emotional difficulties. This study provided empirical support by showing that different attachment patterns, which reflect different emotional regulation strategies, cluster with different substance preferences.

What This Study Doesn't Tell Us

Small sample sizes in each group. Cross-sectional design cannot determine whether attachment patterns preceded substance choice. Cannabis users may represent a less severe population. The groups may differ in other unmeasured ways.

Questions This Raises

  • ?Could attachment-informed therapy improve substance abuse treatment outcomes?
  • ?Do attachment patterns predict which substances people try first?
  • ?Would changing attachment patterns reduce substance use motivation?

Trust & Context

Key Stat:
Cannabis users were mainly secure or dismissing; heroin users were fearful-avoidant
Evidence Grade:
Small cross-sectional comparison (n=94 total) using validated attachment measures but unable to establish causal direction.
Study Age:
Published in 2009. The self-medication hypothesis and attachment-based approaches to addiction treatment have continued to develop.
Original Title:
Heroin as an attachment substitute? Differences in attachment representations between opioid, ecstasy and cannabis abusers.
Published In:
Attachment & human development, 11(3), 307-30 (2009)
Database ID:
RTHC-00390

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

What is the self-medication hypothesis?

The self-medication hypothesis proposes that people use specific substances to manage specific emotional difficulties. For example, someone with anxiety might use a depressant, while someone who feels emotionally numb might use a stimulant.

Why were cannabis users the healthiest substance group?

Cannabis users had the highest psychosocial functioning and the most secure attachment patterns among the three substance groups. This may reflect that cannabis is often used recreationally by relatively well-functioning individuals, or that its pharmacological effects are less disruptive to daily functioning than heroin or ecstasy.

Read More on RethinkTHC

Cite This Study

RTHC-00390·https://rethinkthc.com/research/RTHC-00390

APA

Schindler, Andreas; Thomasius, Rainer; Petersen, Kay; Sack, Peter-Michael. (2009). Heroin as an attachment substitute? Differences in attachment representations between opioid, ecstasy and cannabis abusers.. Attachment & human development, 11(3), 307-30. https://doi.org/10.1080/14616730902815009

MLA

Schindler, Andreas, et al. "Heroin as an attachment substitute? Differences in attachment representations between opioid, ecstasy and cannabis abusers.." Attachment & human development, 2009. https://doi.org/10.1080/14616730902815009

RethinkTHC

RethinkTHC Research Database. "Heroin as an attachment substitute? Differences in attachmen..." RTHC-00390. Retrieved from https://rethinkthc.com/research/schindler-2009-heroin-as-an-attachment

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.