Denial: Why Alcoholics and Drug Addicts Think it is OK to Drink and Use Drugs

Denial is a defense mechanism that allows a person – despite overwhelming evidence to the contrary – to deny that something is true, when in fact, it is true.  It is one of the most powerful and difficult problems that Alcoholics and Drug Addicts face before, during, and after treatment, because it is always the thinking that precedes the act of picking up a drink or a drug.

Physical components of Denial

Over the course of time, drinking and using drugs can cause changes in the brain that affect thought processes and emotions.  For example, when the hippocampus, which controls memory and judgment, is damaged, the Alcoholic or Addict has great difficulty remembering the bad things that happen when they drink or use.  This coupled with impaired judgment allows them to actually believe that drinking or using drugs is ok.

Poor judgment is further compounded by the over stimulation or inhibition of two important neurotransmitters: Serotonin and Dopamine.  Serotonin affects thinking and emotions, while Dopamine affects the pleasure and reward center of the brain.  When a person drinks or uses drugs excessively, these neurotransmitters are over stimulated, and the body develops a tolerance to them.  This causes the individual to need more and more of the substance while they get less and less of an effect.

Non-addicted people find it very difficult to understand the thinking and actions of the addict or alcoholic.  They just don’t “get it” because their brains have not been damaged so their thinking is not organically impaired and they have the capacity to differentiate between truth and falsehood.

Thought patterns of Denial

The essential and most basic of all Denial thinking is this:  “I don’t have a problem with alcohol or drugs, and the things that are wrong in my life don’t have anything to do with my drinking or using.”  This erroneous belief gives rise to all sorts of strange twists and turns of thought that are common in Addicts and Alcoholics.

Substance Abusers blame others for the negative things that happen in their lives and lie about where they have been and what they have been doing.  They live in a fantasy world where they have convinced themselves that their lives are “not so bad” despite the loss of jobs, marriages, family and friends.  They say that if only they had more money or if the people in their lives would understand them, that everything would be ok.

They do not acknowledge, nor do they connect the fact that drinking and using drugs have become the root cause of their current problems; this is Denial.

Emotions and Denial

Alcoholics and Addicts vacillate between feelings of superiority and inferiority, mania and depression, and typically suffer from tremendous anxiety and fear.  They use drugs and alcohol to cope with these strong and painful emotions, but this only provides temporary relief and is counterproductive because when the effect wears off the feelings are still there, and are compounded by shame, guilt, and remorse.  For the alcoholic/addict, the usual response to these new emotions is to drink or use again. The fact that it did not solve anything does not register with them.

In addition, substance abusers almost always have low self-esteem and deep seated emotional issues that are rooted in childhood.  They often say things like “I never felt like I fit in” or “I never felt good enough.”  They do not know how to deal with negative emotions.  When they had their first drink or drug that changed.  Instantly, they had relief from the painful feelings; they felt like they fit in, and didn’t feel bad about themselves anymore.  This is where emotional denial begins.  While under the influence, problems and painful emotions don’t exist; it seemed to be a real solution, because it worked.  What they did not know, is that instead of being the solution, it was the road to self-destruction via the highway of Denial.

Behavior Patterns of Denial

Family, friends and employers notice changes in the behavior of an alcoholic or addict long before the person with the disease does.  This is the first indicator that someone is in denial about their disease.  Tragically, as it progresses, the individual barely notices the changes and deterioration because they happen gradually, day after day and seem normal to the sufferer.

Typical behaviors include, but are not limited to: being late to work, inability to hold a job, getting arrested, ending relationships when people criticize their drinking or using, spending rent money on drugs or alcohol, not keeping commitments, driving under the influence, poor personal hygiene, frequenting dangerous neighborhoods, and living on the street.

Again, the alcoholic or addict does not notice or pretends not to notice that these behaviors are related to their substance abuse, when clearly they are.


Denial is one of the biggest roadblocks to recovery.  It is an elusive and dangerous pattern of thinking that is extremely difficult to break because it has so many different causes and manifestations.  The first clue that someone is in denial is that their behavior and dialog changes dramatically and they develop a litany of excuses for this that do not include drinking or using drugs.

This is further compounded by physical damage to the brain and its chemistry, which exacerbates poor judgment, increases tolerance, and enhances denial.  The fundamental problem of denial is that the alcoholic/addict actually sees substance abuse as the cure not the cause.

It is only when a person has a moment of clarity; where they see through the fog of denial and connect their problems to their drinking or using drugs that they will seek help.  When this happens, recovery is possible. Denial: Why Alcoholics and Drug Addicts Think it is OK to Drink and Use Drugs

Recovery First offers several levels of substance abuse treatment and rehabilitation. Our most intensive level of treatment is the Inpatient Substance Abuse Program, but we also have other treatment options for drug addiction and alcoholism like our Day/Night Program or Sober Living.

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Editorial Staff
Editorial Staff, American Addiction Centers
The editorial staff of Recovery First is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed thousands... Read More