Do Drugs and Alcohol Cause Anger?

We’ve all seen someone grow aggressive or even violent when they’re drunk or perhaps high. Many times, these same people may blame their bad behavior on substances, saying something like, “I’m sorry, I was drunk.”

This raises the question of whether drugs and alcohol can truly make you aggressive. We know both definitely influence how somebody behaves, but does that excuse a violent or angry outburst? There is no easy answer to this question. What about other questions, such as asking, “what drugs make you aggressive?” However, there is a link, and it’s worth exploring the nuances.

Understanding Aggression and Substance Use

In the simplest terms, aggression is just a show of aggressive behavior, and it is not the same as anger. Anger is an emotion that we feel. We can feel anger and not be aggressive. On the other hand, aggression is an act. It’s something we do. It’s usually a behavior, such as a verbal or a physical attack ^[1].

There can be positive aggression, such as in defense from an attacker. But it can also be destructive aggression, like when one attacks others or oneself. Acts of self-harm or suicide are also a show of aggression, only toward oneself

Yes, anger can be the driving force behind aggression, but it isn’t always. There are two main kinds of aggression: reactive and proactive. Reactive aggression is impulsive and happens as a reaction to something external that is perceived as a threat or provoking. Anger is often at the root of reactive aggression, but fear, insecurity, pain, and a lot of other emotions can also cause this.

The other type of aggression, proactive aggression, is predatory or instrumental in nature. This is more controlled, and it has a goal. Think of a child bullying another child for lunch money, acts of gang violence, or even war.

Obviously, reactive aggression is the type of aggression where substances really come into play. Substances can affect our moods, the way we perceive something, and the way we behave.

Alcohol and Aggression

So, does alcohol make people behave aggressively or make them angry? The answer is that it definitely can. Let’s explore what happens in the brain when someone is drunk and how it could cause aggression.

Consider this scenario. A sober young man walks into a crowded room. As he does so, somebody pushes past him and bumps him. The man feels a flicker of annoyance. Perhaps he turns around and asks the person to be more careful, or perhaps he just lets it go.

With a fully sober brain, most people can usually work it out on their own that being bumped is rude, but not worth a fight.

Now, let’s imagine a drunk young man walking into the same room. Firstly, his prefrontal cortex (the part of his brain that makes decisions, regulates emotion, and dictates social behavior) is impaired ^[2][3]. So, he could perceive the bump as a direct insult. And, he has lost the inhibitions that would stop him from doing something rash.

His amygdala (the part of the brain that processes emotions and threats) is functioning more in overdrive from excess alcohol. So, his emotional reactions to the feelings of being threatened are more intense.

The other piece is that alcohol impacts the levels of neurotransmitters and brain activity in the ventral striatum ^[4]. Alcohol means that his brain is buzzing with dopamine, a neurotransmitter associated with reward and taking action.

The ventral striatum is also part of the brain that deals with reward processing. This means that reacting aggressively to being bumped in a crowd actually creates a sense of pleasure and reward in the alcohol-intoxicated state.

Now, it’s important to remember that not everybody is going to react aggressively in the same circumstances. A person’s specific brain chemistry, their past experiences, their relationship with substances, and their personality all play a role in this scenario. However, it does underline that alcohol does play a role in aggression.

Whether or not it excuses the behavior is another question altogether, and most people (including the law) would agree that it does not.

Stimulants and Violent Behavior

When we ask the question, “what drugs cause anger, aggression, or violence?” The first answer we get is usually stimulants like cocaine, methamphetamine, and amphetamines. ^[6] These are certainly not the only drugs that can cause it, but they are definitely at the top of the list.

The first factor here is that these drugs cause much larger surges of dopamine in the brain than even alcohol does ^[5]. Drugs also create a reward response for acting aggressively when provoked. Yet, somebody high on cocaine can feel a greater “rush” from acting aggressively when they feel threatened or insulted than someone intoxicated by alcohol.

Those on drugs are also often more impulsive and less able to appropriately assess a situation for risk. Another factor is that people on stimulants can be in such a state of hyperarousal that they feel anxious, jittery, and paranoid. This is a potent cocktail of brain chemistry that can definitely cause violence.

It’s also worth pointing out here that this doesn’t just happen when somebody is high on stimulants but also potentially in a state of withdrawal. A study in the Brazilian Journal of Psychiatry showed high levels of anger in people who are in drug withdrawal, drug treatment, and even after being abstinent for up to 95 days, regardless of age or sex.

There is also an ugly loop here: Anger can cause a relapse, with addicts choosing to use again to deal with the feeling ^[7].

We see it most in communities that are affected by epidemics of these drugs. An article in the Conversation creates a haunting image of rural communities in America struggling with high levels of meth addiction and domestic violence.

A major factor behind the violence is the sexual arousal associated with taking meth. Reports state the sexual factor behind meth led to more coercive control and abuse. Men would become violent as an intimidation, manipulation, and controlling tactic.

This touches on a difficult question. If drugs like meth can cause such intense levels of violence, is it really a victimless crime to take them? Is the only person getting hurt really just the user? Certainly, this problem rips apart both families and communities.

Opioids and Aggression

A lesser-known fact is that stimulants are far from the only drugs that have a strong connection with aggression ^{[8] [9]}. Opioids like morphine, fentanyl, and heroin might seem to keep people passive and “nodding off,” but once again, the problem is more complicated.

The first factor is the desperation that comes with withdrawal. Opioid withdrawal can start as soon as six hours after last use. A person who was once kind and peaceful can become angry and violent in an attempt to get their next fix.

Withdrawal and cravings also lead to feelings of frustration, hopelessness, and irritability, which can also lead to violence when they become too intense. Many loved ones and healthcare workers who have tried to stop their addicted family from using can testify to the extreme levels of aggression they may face.

Finally, opioids also alter moods and cloud their ability to think clearly. This can make users erratic and unpredictable, even paranoid at times, about threats that don’t exist, which may lead to aggressive outbursts.

Synthetic Drugs and Their Effects

Synthetic drugs are an ever-emerging branch of drugs that are human-made and are meant to mimic the effects of natural drugs, like marijuana (synthetic cannabinoids). As a whole, they tend to have unpredictable and dangerous side effects ^[10].

The danger lies in the fact that synthetic cannabinoids like Spice and K2 affect different systems of the brain, causing mood swings, paranoia, and aggression.

These drugs are made in unregulated environments, so there is no control over what chemicals they contain or how strong they are. This means the effects are inherently unpredictable.

In the worst cases, they can cause psychotic episodes, including paranoia and hallucinations. This can trigger violent behavior as users react to imagined threats.

Prescription Drugs and Side Effects

Sadly, the drugs prescribed to us can be just as responsible for erratic behavior, angry outbursts, or even violence as illegal drugs can be ^{[11] [12] [13]}. The table below gives a quick overview of how some prescription drugs can cause anger or even violence.

Medication Type	Description
Antidepressants (SSRIs)	SSRIs can cause increased aggression and irritability, especially in children and adolescents. FDA warnings mention risks of suicidal ideation and aggression, too. Fluoxetine (Prozac) and bupropion are two of the most common examples.
Varenicline	This medication is meant to help stop smoking, but it can increase dopamine availability, which may lead to more aggressive thoughts and actions, similar to other stimulants.
Stimulants for ADHD	Medications like methylphenidate (Ritalin) can increase aggression in children, particularly with improper dosage.
Sedative/Hypnotics	Drugs like zolpidem (Ambien) may cause unusual behaviors, including aggression, during sleepwalking or other states of altered mentation.

The Risk of Mixing Drugs

Whether drinking or taking drugs, the risk for anger, aggression, and violence is clear. Particularly when mixing substances like alcohol and cocaine, users can feel much more irritable and jittery, be far more aggressive, and even show cognitive deficits ^[7].

The mixing of drugs essentially creates the same problem that comes with synthetic drugs. There is no control over how much of a substance a person may take and how the chemicals interact with each other in the brain, so the results can be unpredictable.

When taking multiple substances at once (called polydrug or polysubstance use), the joint interactions can be frightening. Alcohol affects judgment and lowers inhibitions, and cocaine or meth makes a person more impulsive. This is a dangerous cocktail.

Likewise, somebody drinking alcohol may feel invincible while also not having good decision-making skills. If this person mixes it with benzodiazepines (like Xanax), they may have even less impulse control. This can lead to unpredictable, violent actions.

Mixing drugs messes with neurotransmitters. Stimulants work on dopamine, which can cause a state of hyperarousal, but depressants affect the ability to think. And this is a dangerous combination.

Treatment for Substance-Induced Aggression

Treatment for somebody struggling with aggression while using substances is tricky. It’s not only an anger problem (which in itself is never simple), but also a substance use or abuse issue. It can be infinitely harder if the person in question does not want treatment or believe they have a problem.

Nevertheless, there are many concrete steps that one can take to address this issue head-on. And, since anger, violence, and aggression can be incredibly destructive not only to the person’s well-being but also to those around them and their loved ones, it is absolutely critical that this problem is properly managed and treated.

The following steps are vital to start effective treatment.

1. Safety Comes First

The most important thing is to ensure that anybody exposed to this kind of aggression is safe. This is especially true for children. If a person is in a situation where someone is aggressive, or you feel out of control, step away. Find a trusted person, call for help, or go somewhere safe. No one should deal with it alone. Nothing else matters before safety.

2. Getting Help for Substance Use

If substance use is part of what’s happening, it’s important to start there. Detox is a way to help the body get rid of substances and get through withdrawal safely. It’s not easy, but there is support every step of the way.

After that, rehab programs can help people understand why this is happening and supply the tools to feel more in control. There’s no shame in needing help. Loved ones care and want to see the individual get better.

3. Cognitive Behavior Therapy (CBT)

Sometimes, our thoughts can push us into places we don’t want to go. Cognitive behavior therapy (CBT) can help people figure out the thought patterns that trigger anger or stress and teach better ways to handle it.

It’s not about judgment. It’s about supplying real tools to calm down and feel like oneself again. Learning how to pause when things get tough and see a way through without losing control is a crucial skill.

4. Learning to Handle Anger

Anger can feel like an unstoppable storm, so it’s vital to learn to manage it. Anger management programs allow talking with others who are going through the same thing, helping people feel less alone. It shows that it’s okay to struggle and provides people to share the journey with.

5. Taking Care of Your Mental Health

Feelings of depression, anxiety, or unlike oneself, it’s really important to look at that too. These feelings can make everything harder, and it’s okay to get help for them. When you start to feel better emotionally, everything else gets a little easier.

Dealing with any underlying mental health problems is a big step towards avoiding substances that can lead to angry or aggressive outbursts.

6. Pay Attention to How You’re Feeling

Some days will feel better than others, and that’s okay. Check-ins matter to monitor your mental health and progress. If something feels harder again, small changes can help. Recovery isn’t perfect, and no one is expected to be perfect either. Every step forward matters, no matter how small.

7. Find People Who Care

Having trusted people makes this process easier. Whether it’s family, friends, or a support group, staying connected to those who care can help you feel stronger. They can listen, remind you that you’re not alone, and encourage you to keep going, even on the hard days.