Skip to content

How To Tell If You Have A Narcissistic Drug Problem

ME words in red under a magnifying glass

The title sounds very grand and I am sure many of you are now rushing to Google to see more about this new disorder but let me save you some time – it doesn’t exist. Over my 20 plus years in working in the field of substance use and mental health I have lost count at the number of individuals that come through the door with problematic alcohol or drug use problems and an attitude of self-importance the size of the empire state building. Described by psychologist Tom Cunningham in the 80s as “King Baby” or “Queen Baby” syndrome, these narcissistic individuals have to be right all the time and blame everyone else for failures or unpleasant events. They expect everyone to love them, take care of them and are typically selfish, reject criticism and are huge complainers. King and Queen babies don’t necessarily think they’re better than other people though; they just don’t think of anyone else at all. They behave as if the world exists primarily for their gratification and that things revolve around them.

More often than not they do not come willingly through the front door, and why would they, for they can see no wrong in their behaviour. More often than not there is an external motivating force, a husband or wife threatening divorce or they have been kicked out of their home and it is the getting back of their “castle” or avoiding huge financial loses of divorce that is their priority as opposed to really addressing their alcohol and drug use. So what are narcissistic traits?

Narcissist Self-Test

The following self-test was published in Psychology Today a few years ago but holds true to this day. It suggests six dimensions for assessing narcissist traits. Score each sign from 0 to 5. (0 is not at all, 5 is all the time). Scores of 10 or less indicates a healthy to average range, 10 -17 indicate traits that need to be worked on but probably are not impacting too much, 18 and above means there are big things to address. Have a go for yourself or score it with someone you have in mind and then read on in terms of how this plays out with problematic alcohol and drug use.

N.B. It is important to note that having a little bit of “self-love” is not a bad thing. It’s one of the elements that gives people confidence and magnetism, and it’s the sort of personality attribute that can make a person seem attractive or even powerful. But humility is also vitally important, as it allows people to respect others and balance the needs of the self against the needs of society as a whole.

Sign #1: Unilateral listening. 

What I want and what I have to say are all that matters when we talk together. When we make decisions, what you want, your concerns, your feelings—these are mere whispers, inconveniences, and irrelevancies. When we discuss issues, my opinions are right. Yours are wrong, or else of minimal importance. If you expect to have input, you are undermining me.                                           

Narcissistic listening rejects, refutes, ignores, minimizes, belittles, or otherwise renders irrelevant other people’s concerns and comments. It is very common for those with high narcistic traits to talk down to people and with a tone of disdain. Another narcissistic indicator is consistently responding to what others say by beginning with the word “But….” Using “but” pretty much is negating whatever came before i.e. Whatever you have just said to me has no value.

Sign #2: It’s all about me.

I know more. I know better. I’m more interesting. When we talk, it’s mostly about me. In conversations, I take up most of the airtime. Almost all of my conversations are about what I have done, or what I am thinking about. If you begin to talk about yourself, I link it back to something in my life so that the focus of the discussion again turns onto me.

When I want something, I need to have it. Never mind how you feel about it; it’s all about me. I’m big and important and your role is mostly to do things for me and meet my needs, a bit like a servant.

Sign #3: The rules don’t apply to me. 

I can have affairs, barge into queues, park in other people’s spaces, and ignore rules that get in the way of me doing what I want. Rules are for other people to follow.

Narcissists experience themselves as above others, so in general rules don’t apply to them.

Sign #4: Your concerns are really criticisms of me, and I hate being criticised.

I can criticise others, which I will do often—but if you criticise me, you’re hurting my feelings, so I’ll hurt you back. If you say you are at all unhappy, that’s a way of indirectly criticising me. Since “it’s all about me” your feelings must be about what I have been doing.

Narcissists ironically demonstrate both an inflated idea of their own self-importance and quickness to feel deflated by any negative feedback. Criticism hurts—and because narcissists think everything is about them, they hear others’ attempts to talk about personal feelings as veiled criticisms of themselves i.e. “I’m feeling alone,” gets heard by someone who is narcissistic as an accusation: “You don’t spend enough time with me.”

Sign #5: I’m right. You’re wrong. So when things go wrong between us, it’s always your fault.

I can’t be expected to apologise or to admit blame. I’m above others and above reproach. If you expect me to say how I’ve contributed to a problem, I’m not going accept that and will get angry with you

Whatever the source of the sensitivity to criticism and difficulty admitting mistakes, narcissists will, overall, blame others when anything goes wrong. Blaming and fault-finding in others feel safer to narcissists than looking into their own part in difficulties. 

Much of this is based in the narcissist own relationship with shame. For many this goes back to childhood. Shame is designed to cause children to curtail behaviour through negative thoughts and feelings about themselves. It involves a comment – direct or indirect – about what the child is. Shaming operates by giving children a negative image about their selves – rather than about the impact of their behaviour.

Shaming can take many forms; for example: The put-down: “You’re acting like a spoiled child!”, “You selfish brat!”, “You cry-baby!”. Moralizing: “Good little boys/girls don’t act that way”. The age-based expectation: “Grow up!”, “Stop acting like a baby!”, “Big boys don’t cry”, The gender-based expectation: “Toughen-up!”, “Don’t be a sissy!”, The competency-based expectation: “You’re useless!”. The comparison: “Why can’t you be more like so-and-so?”, “None of the other children are acting like you are”.

All of this leaves children with this feeling of core shame. As the child gets older, it can become so unbearably painful that they feel driven to construct a false personality to cover it over. The narcissist doesn’t necessarily consciously know they are dealing with shame, as they are so defiantly defending against it. Also, a narcissist doesn’t often realise there is anything wrong with them, so they place blame elsewhere. As a consequence of this If they feel attacked, if they feel there’s any threat to their self-esteem, they’ll do everything they can to annihilate the source of the threat and defend their self-image.

Sign #6: I may be quick to anger—but when I get angry, it’s because of you.

You made me angry. You didn’t listen to me. You criticised me. You’re trying to control me. Your view is wrong. So you need to apologise, not me. If I’m angry it’s because I’m frustrated by what you are doing. I’m only angry because of you.

Many narcissists appear so charming they can be quite captivating to anyone they deploy this tactic with. However, the charm is manufactured and is another tactic the narcissist deploys to win over their new supply of worshipers – you. Narcissistic charm is part of their fake persona to hook you in. It’s a manufactured role they play when they first meet a new supply or when they are out in public. Hiding behind this charming facade allows them to hide who they really are, gain trust, and maintains the appearance of gentleness. The charming stage will last only as long as they need to hook you. Once they have you the charming person you knew will quickly disappear. However, by this time and more often than not, the charm has been imprinted on you and often individuals hold onto the narcissist far longer than they should because they believe that the charming person is still inside, and they can “love” them back into that charming person again.

It can be quite a shock when this charming person suddenly turns. The narcissistic rage may take the form of screaming and yelling. Selective silence and passive-aggressive avoidance can also happen with narcissistic rage. Most episodes of narcissistic rage exist on a behaviour continuum. On one end, a person may be aloof and withdrawn. Their goal may be to hurt another person by being absent. On the other end are outbursts and explosive actions. Here again, the goal may be to turn the “hurt” they feel into an attack on another person as a form of defense. Either way their behaviour will be your fault.

Narcissism and drug and alcohol use

For the most part the underlying traits of narcissism is built on shame and lack of self-esteem, a foundation component for many that turns them to drugs and alcohol. Furthermore, its very tiring to have to be the expert all the time, never to be wrong and always on the top of your game. And of course, life will through curveballs so more often than not those with high narcissistic traits will turn to drugs and alcohol as a coping mechanism to deal with their inner turmoil of failure.

Individuals who have high narcissistic traits also believe that they’re are stronger and better than everyone else. They believe that nothing negative can or will happen to them, simply because they’re extraordinary and capable of handling any challenge that might come along. Because of this it is not uncommon for them to take huge amounts of substances at once, and they don’t think that this behaviour is risky at all. In a group setting they will outdrink and out use all around them. Equally importantly, because they think they are invincible having a problem with alcohol or drugs couldn’t ever happen to them!

Similarly, they don’t spot the signs of problematic use. Really noticing a problem means admitting that something is wrong or that something didn’t play out in a way that they planned for. Narcissistic people just can’t admit these connections. Instead, they believe they have it all figured out.

As I mentioned it can be incredibly challenging to get a person with high narcissistic traits into treatment, especially because it is highly unlikely that they will admit they have a problem with drugs or alcohol. They often can’t relate to the idea of helplessness and any idea of some sort of higher power because they think they are the higher power, and they can’t understand why they simply can’t fix the problem alone.

Moreover, once they come into treatment it is not uncommon for their traits will play out by generating unrealistic demands on the therapists and other clients involved in the treatment programme. In many cases they will start dictating what the programme needs to look and portraying themselves as the expert. When their criterias of perfection are failed to be met, they usually quit treatment.

The good news is that there are many ways to crack a nut and through as range of therapy techniques the skilled practitioner can navigate the narcissistic traits and help invoke behaviour change.

Next Steps

New methods of drug and alcohol treatment are changing. If you or someone you care about is struggling with alcohol or drug use and you recognise some of the above traits there are options. Help Me Stop’s intensive non-residential Dayhab programme offers accessible aftercare and family support options to minimise the risk of relapse and to maximise the support of friends and loved ones that is so important to long-term success.

Our evening online drug and alcohol treatment programme is an excellent choice for adults who may have a smaller budget and are working and can’t access services in the day or get to our centres in London. Families can also access support online.

If you would like to know more then call us now on 0208 191 9191 or jump onto Live Chat or e-mail us via

Chris Cordell is Help Me Stop’s General Manager and is a senior associate member of the Royal Society of Medicine, Certified International Recovery Specialist, member of the International Society of Addiction Medicine and a member of the Federation of Drug and Alcohol Professionals.

Recent Articles

Building a Recovery Community

Having recently returned to Help Me Stop as Director of Treatment Services I want to share some thoughts on the importance of developing our recovery community further. I am honoured
Read More
university building

Drugs and University

University is an exciting time for young people but it also comes with a lot of risks. Peer pressure, new surroundings and often a new-found sense of freedom, can result
Read More
sober living word on green road sign with sunset in background

Sober Summer Nights

The beer gardens are open and summer is here, so how are you going to go about those sober summer nights spent socialising? Here is everything you need to know
Read More