Substance use and emotional regulation create destructive cycles where substances reduce inhibitions in anger-prone individuals, while chronic anger drives increased substance use, but evidence-based therapy and specialized coping strategies effectively break these interconnected patterns through professional therapeutic intervention.

Ever feel like you become someone else when drinking or using substances? Substance use can create a challenging cycle with anger and emotional regulation, but understanding this connection—and the therapeutic strategies to break free—can transform your relationship with both.

When Substance Use and Emotional Regulation Collide: Finding Balance

Many individuals turn to substances seeking relaxation and enjoyment. Yet for some, these substances can trigger unexpected emotional responses, particularly anger and aggression. This transformation can be so dramatic that it might appear as though an entirely different personality has emerged. What explains this connection between substance use and emotional dysregulation?

Can substances trigger anger?

According to the American Psychological Association, anger’s effects can potentially lead to substance use (formerly substance “abuse”) alongside impaired decision-making and various other mental and physical health concerns. People might begin using substances to self-medicate for anger, which may subsequently intensify their anger, creating a difficult cycle to break.

The phenomenon of substance-related angry behavior is widely recognized in our culture, particularly the stereotype of someone who becomes hostile after consumption. But do substances actually cause anger?

While this connection is commonly portrayed in media, researchers have not reached definitive conclusions. One study indicates “weak support for biased anger perception following acute substance consumption.” Scientists continue to investigate whether substances directly cause anger or if they simply amplify existing tendencies toward emotional dysregulation.

Substances, inhibition, and anger

Evidence suggests that pre-existing personality factors significantly influence how someone behaves when using substances—after all, not everyone becomes angry when consuming them. Research has found that individuals, particularly men, are more likely to become aggressive after substance use if they demonstrate a predisposition to anger on personality assessments.

Rather than creating anger, substances may reduce inhibitions in people already prone to anger, making them more likely to act on those feelings. This aligns with understanding that substance use diminishes behavioral control, leading people to engage in actions they would avoid when sober.

Substances and aggression

While they may overlap, anger and aggression represent distinct concepts. Simply put, anger is an emotion, while aggression is a behavior.

Substantial evidence shows that substances can affect brain function in ways that promote aggressive behavior. Research concludes that substance use decreases the ability to correctly process social cues, increasing the likelihood of perceiving hostility in others. Consequently, people under the influence may respond more readily with anger and aggression while being less able to recognize when someone is attempting to de-escalate a conflict.

These effects appear related to decreased functioning in the amygdala, a brain region involved in threat assessment, emotional processing, and social behavior regulation. Neurological studies also suggest that substance use can disrupt activity in frontal lobe areas associated with self-awareness and introspection. This means that while under the influence, you may struggle to reflect on your behavior and recognize abnormal aggression. You might also have difficulty identifying when your anger is unjustified.

The patterns described reflect potential effects of short-term substance use, but these may intensify in people who use excessively over extended periods. A 2021 review of existing research noted that long-term substance use results in structural changes to brain regions associated with:

• Self-control
• Impulsivity
• Emotional processing
• Decision-making

These changes suggest that heavy users may become progressively less capable of managing anger and more likely to act on it over time. Research consistently links substance consumption with violent crimes, including instances of aggravated assault, rape, and homicide. Consider these statistics:

• A 2013 study of New York establishments concluded that for every one-hour increase in weekly business hours, aggravated assaults and non-gun violence increased significantly, even after controlling for outlet density.
• 27% of all aggravated assaults are committed by individuals who have used substances. This percentage more than doubles in instances of domestic violence.
• On average, 48% of homicide offenders are reportedly under the influence at the time of the offense.

Other factors affecting substance-related aggression

Researchers have identified several additional factors that may increase the likelihood of post-consumption aggression. One is a mental orientation toward the present rather than the future. Though “living in the moment” is often considered positive, researchers found that individuals more focused on the present were also more likely to respond aggressively to irritations after consuming substances.

Your beliefs about substances may also play a role: A 2012 study stated that a person is more likely to become angry when using substances if that is what they expect to happen. People raised in environments where substance use frequently accompanies violence might be predisposed to hostility when they consume.

Another potentially important personality trait is rumination—the tendency to dwell on negative feelings and distressing experiences. Research reports that people who show high levels of rumination are more likely to act aggressively when using substances.

Can anger lead to increased substance use?

Individuals with strong tendencies toward anger may turn to substances attempting to improve their mood or distract themselves from their feelings. Substances are often used as self-management tools when other coping mechanisms are unavailable. When used excessively, this approach can lead to substance use disorder and comorbid mental and physical health conditions, such as depression, which is also a known risk factor for substance use disorders.

Evidence also suggests that people with higher baseline anger levels may face greater challenges recovering from substance use disorders. A study following 100 individuals in treatment found that those scoring higher on anger-related personality measures were more likely to relapse within a year.

These tendencies can create a loop where people use substances to avoid anger but instead deteriorate their mental health, leading them back to substances for temporary relief.

Managing substance use and anger

If chronic anger and substance use reinforce each other, how can someone break this cycle? Here are several coping strategies that might help. Please note that, especially in crisis situations, these coping mechanisms are not appropriate substitutes for professional help.

Avoid dwelling on anger triggers.

Since ruminating on unpleasant thoughts can fuel substance-related aggression, learning to let go may be key to improvement. If you catch yourself mentally replaying scenarios where others have hurt or angered you, try redirecting your thoughts to something more positive. Remember that dwelling on anger sources will likely cause unnecessary pain.

Practice self-compassion.

How often have you started a conflict with someone close only to realize you’re actually angry with yourself? Anger and aggressive behavior often stem from shame. You may defuse these feelings by deliberately forgiving yourself for past mistakes. If addressing yourself directly feels difficult, imagine you’re speaking to a close friend instead.

Document your substance use and emotional patterns.

Many find that keeping a daily journal provides a constructive outlet for negative emotions like anger. Recording your substance use may help you maintain accountability if you’re cutting back. Taking notes on patterns, amounts consumed, triggers, and emotional responses can help you gain better control.

Engage in meditation and relaxation practices.

Techniques like deep breathing and mindfulness meditation can help release anger and assist in identifying and redirecting unhelpful thought patterns. Studies suggest these methods may also reduce cravings for substances when practiced consistently.

As a person breaks this cycle, therapy can be a valuable, neutral support tool for addressing the psychological causes of anger and problematic substance use. Research demonstrates that therapy can decrease anger and aggression in patients with histories of both. For many, therapy plays a key role in recovery from substance use disorders.

Can telehealth therapy help with anger and substance use?

Not everyone finds it easy to attend in-person therapy sessions or anger management classes. This may be especially true for those facing legal and financial consequences resulting from excessive substance use. Telehealth therapy offers a convenient alternative. ReachLink connects you with licensed clinical social workers remotely using your computer or mobile device. The physical distance may make it easier to overcome feelings of anger and discuss tendencies transparently via video sessions or other communication options that suit your preferences.

For angry and aggressive behaviors and substance use disorders, telehealth therapy has demonstrated success. A 2017 paper concluded that online therapy led to reductions in trait anger and decreased substance use following treatment.

Takeaway

While the link between substances and anger requires further study, research clearly connects substance consumption with aggressive behavior. Research also indicates that persistent or repressed anger may lead people to increased substance use, which can elevate short-term and long-term aggression and comorbid disorders. Telehealth and in-person therapy provide effective treatment options for substance use disorders, anger management challenges, and aggressive behaviors.