5th Edition of Addiction World Conference 2026

Abstract

The approach to substance use has traditionally focused on observable behavior, neurobiological effects, and associated social factors. However, through practical experience and fieldwork with vulnerable populations, it becomes evident that these approaches, while necessary, are not sufficient to fully explain the persistence of substance use and the recurrence of relapse. This presentation offers an expanded understanding of the phenomenon by introducing the concept of “invisible factors of substance use”: underlying internal processes that are not directly observable, including implicit memories, unregulated emotional experiences, and unmet psychological needs that operate beyond conscious awareness and significantly influence behavior. Drawing on more than 12 years of experience working with families, individuals experiencing homelessness, people struggling with substance dependence, and adolescents involved in judicial processes, this perspective frames substance use not merely as a behavioral problem, but as an emotional regulation strategy in response to internal states that are difficult to manage. From this perspective, the presentation integrates elements of emotional regulation, experiential learning, and neuropsychological systems involved in survival and stress response. It emphasizes that many substance-related behaviors are not primarily driven by rational processes, but by more automatic systems linked to emotional memory and the need to relieve internal distress. A practical approach is included, allowing participants to identify the regulatory function of substance use, understand the emotional cycle that sustains it, and recognize the importance of working beyond behavior. The focus is placed on supporting the development of new selfregulation strategies. Finally, it is proposed that transformation does not occur solely through cognitive understanding, but through meaningful experiences that allow individuals to reprocess emotional distress and expand their internal resources, leading to more sustainable and lasting change.