Different Drugs Attract People With Different Attachment Styles

What the researchers 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.

Why it matters

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

The numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

Small cross-sectional comparison (n=94 total) using validated attachment measures but unable to establish causal direction.

When this study was published

Published in 2009. The self-medication hypothesis and attachment-based approaches to addiction treatment have continued to develop.

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.

Questions still open

• 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?

Common questions

Read the original research

Heroin as an attachment substitute? Differences in attachment representations between opioid, ecstasy and cannabis abusers.

Attachment & human development, 11(3), 307-30

Citation

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

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