Lack of wholeness. Substances fill the void left by any number of influences: genetics, upbringing/environment, emotional pain, failed relationships/hopes. David miller md has demonstrated that spiritual counseling makes no difference in alcoholic recovery. However, spiritual experience changes a persons entire value system and motivation. "12 steps" right, spiritual awakening [wholeness] is the basis of recovery.
Effect of abuse. Psychological, physiological, social and economic.
Family disease. Addiction is a family disease.