From my book "Malignant Self-love - Narcissism Revisited":

"Pathological narcissism is an addiction to Narcissistic Supply, the narcissist's drug of choice. It is, therefore, not surprising that other addictive and reckless behaviours – workaholism, alcoholism, drug abuse, pathological gambling, compulsory shopping, or reckless driving – piggyback on this primary dependence.

The narcissist – like other types of addicts – derives pleasure from these exploits. But they also sustain and enhance his grandiose fantasies as "unique", "superior", "entitled", and "chosen". They place him above the laws and pressures of the mundane and away from the humiliating and sobering demands of reality. They render him the centre of attention – but also place him in "splendid isolation" from the madding and inferior crowd.

Such compulsory and wild pursuits provide a psychological exoskeleton. They are a substitute to quotidian existence. They afford the narcissist with an agenda, with timetables, goals, and faux achievements. The narcissist – the adrenaline junkie – feels that he is in control, alert, excited, and vital. He does not regard his condition as dependence. The narcissist firmly believes that he is in charge of his addiction, that he can quit at will and on short notice."
 

Read a lot more about Narcissism, Substance Abuse, and Reckless Behaviors

Read more about the Adrenaline Junkie

Addiction and Narcissism as Organizing Principles

In our attempt to decipher the human psyche (in itself a mere construct, not an ontological entity), we have come up with two answers:

I. That behaviors, moods, emotions, and cognitions are wholly reducible to biochemical reactions and neural pathways in the brain. This medicalization of what it is to be human is inevitably hotly contested.

II. That behaviors, moods, emotions, and cognitions can be explained and predicted by the introduction of "scientific" theories based on primary concepts. Psychoanalysis is an early - and now widely disregarded - example of such an approach to human affairs.

The concepts of "addiction" and "(pathological) narcissism" were introduced to account for oft-recurring amalgams of behaviors, moods, emotions, and cognitions. Both are organizing, exegetic principles with some predictive powers. Both hark back to Calvinist and Puritan strands of Protestantism where excess and compulsion (inner demons) were important topics.

Yet, though clearly umbilically connected, as I have demonstrated elsewhere, addictive behaviors and narcissistic defenses also differ in critical ways.

When addicts engage in addictive behaviors, they seek to change their perception of their environment. As the alcoholic Inspector Morse says, once he had consumed his single Malts, "the world looks a happier place". Drugs make the things look varicolored, brighter, more hopeful, and fun-filled.

In contrast, the narcissist needs narcissistic supply to regulate his inner universe. Narcissists care little about the world out there, except as an ensemble of potential and actual sources of narcissistic supply. The narcissist's drug of choice - attention - is geared to sustain his grandiose fantasies and senses of omnipotence and omniscience.

Classical addiction - to drugs, alcohol, gambling, or to other compulsive behaviors - provides the addict with an exoskeleton: boundaries, rituals, timetables, and order in an otherwise chaotically disintegrating universe.

Not so for the narcissist.

Admittedly, like the addict's search for gratification, the narcissist's pursuit of narcissistic supply is frenetic and compulsive and ever-present. Yet, unlike the addict's, it is not structured, rigid, or ritualistic. On the contrary, it is flexible and inventive. Narcissism, in other words, is an adaptive behavior, albeit one that has outlived its usefulness. Addiction is merely self-destructive and has no adaptive value or reason.

Finally, at heart, all addicts are self-destructive, self-defeating, self-loathing, and even suicidal. In other words: addicts are predominantly masochists. Narcissists, in contrast, are sadists and paranoids. They lapse into masochism only when their narcissistic supply runs hopelessly dry. The narcissist's masochism is aimed at restoring his sense of (moral) superiority (as a self-sacrificial victim) and to prod him into a renewed effort to reassert himself and hunt for new sources of narcissistic supply.

Thus, while the addict's brand of masochism is nihilistic and suicidal  - the narcissist's masochism is about self-preservation.

Addiction masquerades. When we mentally conjure up an image of a junkie, it is usually that of an unkempt, devious, and disintegrating misfit. But the overwhelming majority of addicts are nothing like that.

Someone with an addictive personality interacts with his environment - social and physical or even internal - via his addiction, by getting addicted. Narcissists are addicted to narcissistic supply. Obsessive-compulsive are addicted to their anxiety-reducing rituals. Borderlines and codependents are addicted to the presence of other people in their lives.

Some women are addicted to male attention and would go to any self-degrading length to obtain it (most attention whores are female and have Histrionic or Borderline personality disorder). Many people are addicted to money and the freedom or power and control that it affords. They will accept any abuse and risk in order to gain access to it.

People get addicted to the most bizarre objects (hoarding), to emotions (love addicts), to activities (social media, sports), places, to circumstances, to periods in their lives. Addiction activates other mental health pathologies such as fixation and numerous defense mechanisms such as denial. Addiction is a response to emotional dysregulation, dysfunctionality, delusions (grandeur, persecution), a labile sense of self-worth, identity issues, impaired impulse control, and underlying mood disorders.

Observations on Alcoholism

The drunk person during an alcohol-induced blackout is FULLY AWARE of WHAT s/he is doing, WHO s/he is doing it with, whether what s/he is doing is WRONG, and if she is HURTING loved ones with her or his promiscuity, immoral, or antisocial or even criminal acts. During the entire episode, s/he makes multiple choices and decisions based on rational analyses and emotional states. S/he is 100% in control and should be held accountable for the misbehavior.

Throughout the blackout, orientation, reasoning, a moral sense, short-term memory, and decision making are NOT IMPAIRED. They are all intact. The only thing affected is long-term memory: the next morning, the recovering alcoholic has zero recall of what has happened during the blackout.

This is why it is difficult to tell a drunk in a blackout state from a merely inebriated person or social drinker. They appear to be fully present and cognizant throughout the blackout - and they are! Motor functions are affected and there is a tendency to repeat the same sentences over and over again - but that is it.

Like narcissists, people wasted to the point of a blackout just DON'T CARE about anything or anyone but themselves: behavioral inhibitions are down (alcohol disinhibits); empathy towards one's nearest and dearest is turned off (or redirected at strangers!); a sense of invulnerability, invincibility, omnipotence and impunity sets in; the drunkard experiences attraction or even infatuation with all and sundry; and the high and the buzz of the drink compensate for any frustration, depression, stress, or anxiety with a heightened sense of well-being and with aggression.

Ironically, alcohol being a depressant, all these effects are viciously reversed on sobering up.

People - women especially - get that drunk in order to feel better about themselves and their lives, legitimize their promiscuity and cheating ("the drink did it to me and I cannot remember a thing"), and trash themselves in a bout of self-destruction.
Alcoholism serves several psychological purposes effectively.

This is why alcoholism is so intractable (difficult to get rid of or treat) and why recidivism is as high as 60% within the first year after rehab.

1. Palliative

Helps the alcoholic to cope with dissonance, frustration, anxiety, anger, stress, sadness, panic, and other negative emotions or mood disorders

2. Restorative

Helps the alcoholic to restore his or her self-confidence and self-esteem, also as a man or a woman (especially when coupled with a body image issue)

3. Disinhibitory

By lowering inhibitions, alcohol legitimizes narcissistic traits and behaviors like: lack of empathy, extreme selfishness, a sense of entitlement.

Allows the alcoholic to express his or her repressed promiscuity and aggression: traits that s/he find ego-dystonic (traits that s/he dislikes or find denigrating or unacceptable)

Alcohol renders the alcoholic much more sociable, grandiose, and sociopathic: s/he becomes volubly defiant, hates authority figures, feels in control or in charge of others and of the situation, capable of anything s/he sets his/her mind to, irresistibly attractive, charming, or charismatic, and unfettered by rules or social mores: "I can do whatever the hell I want to, no one will tell me what to do"

As a result of these cognitive and emotional changes, the drunk person engages in reckless behaviors like unprotected sex with a stranger, or compulsive shopping or gambling.

4. Instrumental

Allows the alcoholic to accomplish goals (become goal-oriented) that s/he would never even try when sober.

Some people can have sex only when they are drunk.

There is a qualitative difference between drunk sex and sober sex.

Drunk sex is wild, forbidden, everything is allowed, everything can and does happen, exciting, arousing, out of control. It is surrealistic (dreamlike), a fantasy come true, freedom reified.

Alcohol disinhibits (removes behavioral inhibitions), renders sexual partners much more attractive than they are, suppresses empathy and long-term memory formation, and distorts cognition and judgment.

But perhaps as importantly, alcohol legitimizes immoral and socially unacceptable misconduct which often ends up hurting significant others: "It is not my fault that I misbehaved, I did not mean to or want to, it was the drink that made me do it!" The sexual alcoholic may be addicted not only to the alcohol - but also to drunk sex and that is why he or she inextricably links sexual arousal to alcohol.