Are certain personality disorders predisposed to developing problematic substance use?
Patients with Cluster B types are particularly vulnerable to the positively reinforcing effects produced by taking medications that provide immediate positive psychoactive effects (euphoria). This is especially true of opiates and benzodiazepines. These patients do not tolerate the strong negative emotions produced by pain, and therefore, they are primed for the negative reinforcement of pain relief. As a result, even when the negative consequences of substance abuse begin to mount, these patients have difficulty discontinuing their use because of powerful reinforcements already established.