Narcissistic Personality Disorder and Substance Abuse

Narcissistic personality disorder involves the need for other people’s approval and possession of an inflated sense of self-importance. Some may cope with drugs and alcohol.

Narcissistic personality disorder (NPD) and addiction frequently co-occur. The link between narcissism and addiction might be due to substances being used to cope with the negative feelings experienced by a person who has narcissistic personality disorder. Like an addiction, narcissistic personality disorder may lead to feelings of isolation. A person with NPD might be distrustful of, insecure about or feel superior to people around them to the point of failing to connect with their peers. One must treat both narcissism and addiction when the disorders co-occur.

Drug Abuse as a Hinderance to Narcissistic Personality Disorder Treatment

If untreated, drug use can prevent progress from being made in narcissistic personality disorder treatment. Narcissistic personality disorder and substance use disorders both are challenging to treat on their own. Combining narcissistic personality disorder with drug abuse can cause treatment adherence to drop even lower.

Effects of Substance Abuse on Narcissistic Personality Disorder Symptoms

Substance use can exaggerate some narcissistic personality disorder symptoms, including lack of empathy, feelings of superiority and invincibility, and a sense of grandiosity. Substance use while undergoing treatment for NPD may prevent treatment interventions from being effective. Narcissistic personality disorder treatment may involve slow progress and might require long-term treatment. Lessening the positive gains through using substances can cause development to slow and lengthen the treatment episode further.

Narcissistic Personality Disorder and Alcohol

At four times the rate of the general population, nearly 22 percent of people diagnosed with narcissistic personality disorder meet the criteria for an alcohol use disorder. Narcissistic personality disorder and alcohol abuse co-occur more frequently than other substance use disorders and narcissistic personality disorder. Narcissism and alcoholism may co-occur more often due to how easy alcohol can be accessed and the increased social acceptability of alcohol use versus other substances.

Narcissistic Personality Disorder and Marijuana

At three times the rate of the general population, approximately 9 percent of people diagnosed with narcissistic personality disorder meet the criteria for drug abuse. Marijuana is the most commonly used illicit substance and is considered more socially acceptable than other illegal drugs. The reduced concern about social judgment may make a person with narcissistic personality disorder more likely to use or abuse marijuana compared to other illicit substances.

Narcissistic Personality Disorder and Stimulants

Stimulants are another people with narcissistic personality disorder commonly use. A possible reason includes the potential of increased energy and confidence while initially using stimulants. A person with narcissistic personality disorder may feel the need to maintain a successful appearance and sociability. When this task becomes difficult due to NPD, stimulants can boost performance. Some commonly used stimulants by people with narcissistic personality disorder include Adderall, Ritalin, cocaine, methamphetamine and ecstasy.

Drug Abuse as a Cause of Narcissistic Personality Disorder

The large percentage of people with narcissistic personality disorder that also meet the criteria for a substance use disorder may lead many to question if drug addiction can cause narcissism. Substance use disorders may mimic the symptoms of narcissistic personality disorder during active addiction. The symptoms of narcissistic personality disorder may be present before the beginning of a substance use disorder, and substance abuse may worsen them. Substance use disorders may not cause narcissistic personality disorder.

If you or someone you know struggles with a substance use disorder in addition to narcissistic personality disorder, help is available at The Recovery Village. Resorting to drugs and alcohol to cope with the effects of NPD can be dangerous. Treatment is available to help people who have this mental health disorder.

Medically Reviewed By – Denise-Marie Griswold, LCAS

Denise-Marie Griswold is a Licensed Clinical Addictions Specialist. She earned her Master's Degree in Substance Abuse and Clinical Counseling from East Carolina University in 2014. Read more