They may star in Hollywood films or run Fortune 500 companies, but many of the world’s most successful people also have a secret: they struggle with a unique set of challenges that often lead them to require treatment for substance abuse.
Take Zac Efron. This Hollywood star, famous for his lead role in the High School Musical series, was on top of his game in the mid-2000s. He was on the cover of magazines, and the idol of millions of teenagers around the world. But as he shifted into adult roles, he also became part of a much more intense party scene—one that would eventually pull him away from his career. He soon found himself treating his anxiety and loneliness with substances.1 He reflects on that time:
“You spend a lot of time in your house going crazy. You know, pretty soon you need a social lubricant…It was getting to the point where I was caring less about the work and waiting for the weekend…But then when Monday and Tuesday were too difficult to get through, then I was like, ‘Oh, this is bad.’”
Efron pulled himself out of his substance abuse in 2013, when he sold his house in the Hollywood Hills and checked into a rehab program for cocaine and alcohol addiction. But Efron isn’t the only star who has battled substance abuse. Hundreds of CEOs, athletes, artists, and celebrities struggle with addiction. But why?
As it turns out, many of the same traits that make people high achievers, like risk-taking, a strong drive for success, and dedication to their work, also are traits that make them more likely to abuse drugs and alcohol. High achievement and substance abuse2 often go hand in hand—and neuroscientists and psychologists can help us uncover why.
The Science Behind Substance Abuse
To understand what drives CEOs, celebrities, artists, and other high achievers to substance abuse, we need to understand what neurological factors lead to substance abuse in the first place.
Addiction researcher and neuroscience professor David Linden, PhD, explains why the character traits that make someone a good CEO also make them a “good addict.” Simply put, the same brain chemicals that encourage us to achieve also push us toward substance abuse and other forms of addiction. Linden writes in his book The Compass of Pleasure: How Our Brains Make Fatty Foods, Orgasm, Exercise, Marijuana, Generosity, Vodka, Learning, and Gambling Feel So Good:3
“The pleasure derived from success, and in particular from risky or novel business ventures, is borne of the very same brain pathways that make substance use so irresistible to some. It’s all about pleasure-seeking and reward.”
But contrary to popular belief, people who struggle with substance abuse and addictive behavior don’t have a heightened desire for these substances. Instead, Linden’s research shows, many people with a history of substance abuse have “dampened” dopamine receptors. Dopamine is the chemical in our brains that allows us to feel pleasure—which means that to get the same rush of positive feelings, a person with dampened dopamine receptors needs to partake in significantly more of an activity or substance than the average person.
What does this have to do with achievement? The connection, Linden argues, is actually quite simple. Certain activities like drinking alcohol, eating fatty foods, and exercising give us a dopamine hit—and so does achieving a goal. When you set and achieve a goal for yourself, your brain releases dopamine, and you get a rush. So, the same mechanism that makes certain people more likely to crave substances like alcohol or drugs is also more likely to push them to work harder to achieve their goals.
“My strong, strong suspicion,” says Linden, “is that what makes some people more likely to rise to the top is the same thing that makes them more likely to be addicts.”
Anxiety, Trauma, and Alcoholism
Though dopamine receptors are responsible in part for substance abuse, they aren’t the only factor that can impact a person’s likelihood to struggle with addiction. While approximately half of someone’s addictive tendencies are thought to be genetic,4 the rest is based on factors having to do with life circumstances.
Constance Scharff, PhD, who works as an addiction researcher with Cliffside Malibu treatment center and co-authored the book Ending Addiction for Good5 reports that high achievers who struggle with addiction are also likely to have experienced a major stressor or trauma in their early lives that shape their behavior.
“There’s something, usually an early experience, that fuels that kind of drive, and oftentimes it’s the same thing that drives addiction. The vast majority didn’t have some sort of basic needs met as children, so they’re driven very, very hard to succeed. But the pain that goes with that is also what they’re self-medicating for.”
– Constance Scharff, Addiction Researcher, Cliffside Malibu
The rate of co-occurring disorders with substance abuse is very high—which is why more treatment centers are offering treatment for anxiety, depression, eating disorders, and other diagnoses. One study from 2010 showed that exposure to traumatic experiences as a child was linked to higher rates of substance use disorder (SUD),6 and many participants were living with both SUD and post-traumatic stress disorder (PTSD). A similar study on anxiety and substance use disorders7 shows that rates of SUD in patients with anxiety occur at a higher than average rate, suggesting that there is a correlation between the two conditions.
Scharff and her team agree that exposure to adverse childhood experiences,8 also called ACEs, can increase the likelihood that a person will struggle with substance abuse later in their life. And ACEs can also lead to other traits, like perfectionism, that are associated with high achievement. As such, learning how to identify these behaviors, process childhood traumas, and cope with triggers is a pivotal part of treatment for many high achievers who struggle with addiction.
Substance Abuse and Everyday Stressors
There’s one final reason why many high achievers may be prone to addiction: the stress they experience in their daily lives.
Imagine, for a minute, what it’s like to run a global enterprise, or play in a Super Bowl Game. Not only are millions of people expecting you to succeed—your entire life is also often in the public eye. Even for people who aren’t navigating childhood trauma, the pressure to perform at a board meeting or on a movie set, along with the social pressures of being in the limelight, can be overwhelming. Facing anxiety and burnout, many high achievers self-medicate to cope.
Studies show that turning to potentially unhealthy coping mechanisms is surprisingly common among successful people. In the recent Executive Wellbeing Index from Bupa Global, 60% of executives who reported struggling with mental health issues during the pandemic said they turned to potentially unhealthy coping mechanisms, like alcohol or substances, to self-medicate9 those issues. Nearly 40% of those respondents said they used over-the-counter drugs and/or alcohol to treat their anxiety, depression, fatigue, or mood swings.
It’s also important to remember that though self-medication and stress is part of daily life for many high achievers, during the pandemic many people lost access to their old, healthier coping mechanisms. In the write-up on their survey, Bupa Global notes: “Many of the mechanisms people typically use to cope with such stress and anxieties such as seeing friends and family, going to the gym, going on holiday and even going to work have been diminished, and replaced for other, more addictive substitutes such as increased alcohol consumption, self-medication, substance abuse, and gambling.” In the absence of other outlets, people often turn to substance abuse.
Even for people who don’t typically struggle with anxiety or depression, periods of stress can lead to self-medication, which can devolve into a more serious substance use problem. Treating mental health struggles as they arise can help all people, including high-achievers, stay ahead of that spiral.
Celebrity Success Stories
For many celebrities, CEOs, and other highly successful people, a combination of childhood trauma, anxiety and stress from a demanding job or lifestyle, and genetics can lead to struggles with substance abuse. But those struggles don’t always end in pain and suffering. In fact, many celebrities with household names have overcome their substance abuse problems by seeking treatment.
Oprah Winfrey, talk show host, author, producer, and much more, was addicted to crack cocaine10 in her early 20s. She started using while in an unhealthy relationship and soon became addicted. In an episode where she interviewed recovering addicts, Oprah shocked her audience when she said to guest Kim Davis: “I did your drug.” Oprah sought treatment for her addiction and has since become one of the most influential women in the world.
Business mogul Steve Madden also struggled with addiction11 in the past. This high achiever, who started his shoe company from the trunk of his car, was tried in 2002 for money laundering and fraud. In a documentary from 2017, Madden admitted that he struggled with substance abuse since he dropped out of college, and his lawyers explained in court that his crimes were the direct result of his addiction. Madden spent 41 months in prison and was forced to resign from his role as CEO. Since then, however, Madden has returned12 as creative and design chief of the company he started back in 1990. The company did $1.5 billion in sales last year and now owns a dozen other well-known brands.
There are dozens of stories just like these. For many high achievers, especially those in the public eye, finding treatment can be challenging. But, it’s not impossible. A number of rehab centers specialize in co-occurring disorders, like Solice in Marbella, Spain, which offers a holistic approach to recovery and treats co-occurring disorders like anxiety and depression. Other facilities, like AToN Center in San Diego, specialize in helping executives and professionals heal from substance abuse. These centers and many more offer discreet, personalized treatment that takes into consideration the needs of high-performing individuals.
True Achievement: Healing Addiction and Underlying Trauma
As many people know, high achievement can be a double-edged sword. While it comes with motivation, hard work, creative thinking, and often, success, it also can also lead you down a path toward substance abuse and other addictive behaviors.
For many high achievers, substance abuse isn’t the problem—it’s simply a way to cope. Treating the underlying causes that can lead to addictive behavior, and learning about how your body handles substances, can be an invaluable way to find healing. The more you know about yourself, the more easily you can break old patterns, and discover a more successful, motivated, and capable version of yourself.
It’s important to remember that struggling with mental health is a normal part of life—particularly for certain groups of people. For many survivors of childhood trauma, those with a family history of substance abuse, and people in positions of power, treating mental health is part and parcel of living a successful life. Though it can be hard for high achievers to admit their own flaws, it’s okay to recognize that your brain has a unique way of navigating the world. And it’s entirely okay to ask for help when you need it.
You can start your healing journey and reduce your symptoms of anxiety and other co-occurring disorders at a treatment center near you.
