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Buck Black, LCSWBuck Black, LCSW
A Blog about Anger and Other Uncomfortable Emotions

Anger May Stem from Alcohol and Other Drugs

Buck Black, LCSW Updated: Apr 28th 2009

There can be more to the anger iceberg than just feelings. Often people come to my office because of anger management issues and when I assess them for the reason behind the anger, they have extensive alcohol or other drug use. Others may have a brain injury.

drinkingIn cases where drinking or other drug use is present, anger is often the symptom of the drug’s attack on the brain. Often, the more and more a person uses drugs, the angrier he or she becomes. There are many reasons this results in anger, namely the withdrawal once a person runs out of drugs, the family problems stemming from the drug use, the drug user’s guilt, and the chemical attack on the brain as a direct result from the use.

I want to stress that anger management is usually ineffective for a person who is angry and frequently using alcohol or other drugs. You can do anger management with such a person until you are blue in the face—and it will not work! Believe me, I have tried this in my office during my younger days in my career. Yes, I even fell into the thinking that an anger management program was the answer for a drug user who was angry. Now that I know drugs are often the cause for anger, I refer this type of client to a substance abuse program. Once he/she has completed such a program, the anger is often gone. Occasionally, there is a need for anger management once the substance abuse program has been completed and the client has remained clean and sober. I am always glad to have such a client in my anger management program. A 12-step program, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) is an excellent long-term program that helps many to stay clean and sober and it does not cost a dime!

Another cause for anger can be a brain injury. The frontal lobes of the brain, located behind the forehead, are responsible for controlling impulses, such as anger. A simple injury, such as a car crash, falling and hitting your head, or other accident can turn a rather mellow person into someone full of rage. Actually, it is rather scary how easily one can damage his/her brain and become easily angered.

For cases where brain injuries are the primary cause for anger, I recommend seeing a neurologist before starting anger management. Often there are medical interventions that need to occur before an anger management program is appropriate. In these cases, there is often a need for psychiatric drugs in combination with anger management. Depending on the client, various other forms of other therapy can also be beneficial. Although many people believe brain injuries do not get better, there is often hope. I have personally seen many clients learn to control their anger in spite of having a brain injury. However, I will admit that it is difficult and takes a great deal of work. Remember, it is possible to calm yourself and lead a much better life.

Buck Black, LCSW

Buck Black offers psychotherapy for anger issues through his practice in the Lafayette Indiana area ( via phone, email, and office visits. He also provides anger and stress management for truckers via phone, webcam, and email at You can also follow Buck on Twitter at @TruckerTherapy or @BuckBlack.

Reader Comments
Discuss this issue below or in our forums.

You are correct - - Oct 12th 2014

Both alcohol and drugs effect the brain longer than the time they are high or intoxicated. Anger, and rage is directly related to the use of alcohol and drugs! For many, the anger doesnt necessarily occurr during the high, or while intoxicated. The day after using drugs and alcohol, irrational anger is very common for addicts and alcoholics. Each indiviudal responds differently, and not everyone responds this way. There are published studies supporting this. I also know personally as I have some in my life who unfortunately is one who gets extreme, irrational anger the day after. eg yelling at others because he is hungry. Feeling hungry is no reason to yell at another person, the normal response is to eat... My point is, to people disagreeing with this blog, think again! I personally know it to be true, and I have done research and found published studies.    

booze eqauls anger - - Jan 5th 2012

ive lost twice in 2011. both times came at the end of the nite after consuming more alcohol than a human has a right too, i beleive their is a defeatant coralation between alcohol and anger

anger from drugs - - Nov 5th 2010

anger cam stem from drug as drugs affect the brain for days after use and mental function is not crisp and this leads to abnormal behaviour including anger - i know from experience

sustance abuse anger - screw u - Jul 14th 2010

post tramanic disoders unresolved begins on more anger than alocolic or drugs ever will. 23yrs.clean and sober

Thankyou - - May 29th 2010

I just wanted to say I was very glad to come across this article regardless of how a couple others have felt. It all seems to make sense to me in my situation with a family member who is beginning to have anger issues at the same time that they are abusing drugs.Thankyou again.

Cobler, stick to thy last stich - Peter Stone, MA,CPT,CART,CAS - Feb 1st 2010

I am still shaking my head when I read what you wrote about substances causing anger.  Shame on you for making such a statement and presenting yourself as a professional.  Think before you act.  Do some research on the disinhibition, desensitization, and social reinforcement effects to substances.  Substances can no not cause anger than any more causing love.  Before you do harm, you should really do some research on cognitive neuroscience.  In fact, this is so disgusting, I am going to share your blog with my network:

the raging bull - vince manalac - Jan 31st 2010

I have a question : I know of a person who is easily roused to anger and then goes into a form of anger that looks like a RAGE . tHEN SUCH PERSON when he sees the person at whom he is angry looks at him with menacing looks and follows with her eyes . Is that a manifestation that the person is taking illegal drugs like shabu or cocaine ? But when not angry he is so sweet and nice like a normal person . Pls. comment on this . reply to my e mail ad .

Your wrong - Aaron - Nov 26th 2009

alcohol and drugs only bring out whats already inside the person.I know this from 16yrs of experience and from being true and honest.With all do respect you people have it all wrong.

Tragic Coping Mechanism - 2002to2009 - Apr 28th 2009

That's really fascinating...and tragic. What begins as a (destructive) coping mechanism winds up making the problems worse.

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