Why Someone’s “Drug of Choice” Matters
Why Someone’s “Drug of Choice” Matters
An individual's drug of choice can inform psychiatric diagnosis and even treatment
By Mark S Gold
Published by Psychology Today on October 7, 2025
Key points
• A person’s drug of choice reflects not only what feels good, but what temporarily makes a person feel normal.
• The late Harvard psychiatrist Edward J. Khantzian articulated the self-medication hypothesis of addiction.
• More than half of individuals with substance use disorders have other disorders and need treatment for both.
When people jokingly say they have a “drug of choice,” they’re implying a particular substance matches their emotional and psychological needs. They don’t realize they’re right: There are drugs of choice for individuals, and there’s a reason for preferring certain drugs. Clinicians and researchers have long recognized that drug preference isn’t random. The drug of choice may reveal how a person’s psychiatric vulnerabilities, life experiences, and personality style interact to affect self-medication and temporary equilibrium.
