Kleptomania, which can be defined as an “impulse control disorder,” is a condition that involves recurrent impulses to steal objects. Usually, these are trivial items that are not needed or wanted by the individual.¹ This differs from simple theft, shoplifting, or delinquency, as behind the act of stealing lies a complex mental health condition. Researchers have discovered that kleptomania shares many overlapping features with substance use disorders (SUDs), biologically, physiologically and in treatment approaches.² They both share compulsive behaviours, a sense of impaired control, and often a cycle of shame or secrecy. 

This article explores the intersection between kleptomania, addiction, and substance abuse, focusing on how compulsive stealing can both mirror and coexist with substance use in its underlying neurobiology, motivations, and clinical challenges. As research into this connection continues to develop, new strategies for understanding and treating these overlapping conditions are emerging, several of which will be discussed in the sections that follow.¹

Understanding kleptomania

Kleptomania is a condition that is defined by “recurrent episodes of compulsive stealing,” usually in the form of shoplifting.³ Often, the items will hold little monetary value and serve no purpose to the individual.³ Importantly, the act is not committed out of anger, revenge, or delinquency. Rather, it is fuelled by an uncontrollable impulse. The act of stealing is often preceded by a rising sense of tension and may be followed by relief, gratification, or pleasure.¹

The diagnostic criteria, as defined by Talih (2011)³ and the American Psychiatric Association⁴ for Kleptomania are as follows:  

• The recurrent impulse to steal objects NOT in the interest of personal use or monetary value
• An increasing sense of tension or pressure leading up to the act
• A sense of relief, satisfaction, or pleasure, following the act. 
• The act is not driven by a sense of anger or revenge, and is not influenced by hallucinations or delusions
• The stealing is not a result of conduct disorder, manic episode, or antisocial personality disorder

The prevalence of the condition in the general population is approximately 0.6%, suggesting it is relatively rare.³ Kleptomania appears to be more prevalent among females, with research suggesting there is a 3:1 female-to-male ratio.⁵ However, it is important to note that often people with kleptomania suffer in silence due to the fear of shame and legal consequences. Resultantly, the prevalence may be higher in reality. 

It is important to understand that kleptomania is not a moral failing or a character flaw, and does not make you a bad person.³ The compulsion is usually completely out of your control, and the condition is classified as a mental health disorder. There is a range of treatment and support options if you are struggling with Kleptomania. 

Addiction and substance abuse: an overview 

Substance use disorders (SUD) are a mental disorder, characterised by an inability to control the use of substances, which may include illegal or legal drugs, medicine, or alcohol.⁶ The condition affects both one's brain and behaviour, and can have a range of consequences.¹  

Often, people suffering from an SUD will experience other mental health disorders.⁶ The causes and relationships between mental illness are complex, multidirectional, and it is often difficult to understand what caused each mental illness. However, there is an increasing body of research on the co-occurrence of mental disorders. This includes the parallels that exist between Kleptomania and SUD.^1,3,6

Kleptomania and addiction

At the centre of both kleptomania and substance abuse disorders lies a battle with impulsivity. Impulsivity is a psychopathological construct which often creates an overwhelming urge that cannot be resisted.⁷ The two conditions share common core features, which are thought to be characterised by low levels of the neurotransmitter (serotonin), and dysregulated brain signalling pathways, particularly a dysregulated opioid system, making impulses incredibly difficult to resist.² The neurobiological features of both conditions reaffirm that those suffering from kleptomania or SUD are not inherently bad people, nor is it simply a ‘bad habit,’ but rather a form of behavioural addiction and a mental condition. 

Given the strikingly similar features of kleptomania and addiction, it is not surprising that researchers have discovered that the rates of comorbidity amongst SUD patients with kleptomania were extremely high.⁷ 

Research also suggests it is common for an individual with kleptomania to develop a SUD as a means of coping with the distress caused by the intense urges they experience, or to deal with feelings of shame and guilt that may come following the act of stealing.² 

Treatment

Given the neurological and psychological overlap of both conditions, there are a number of treatments that are effective for SUD and kleptomania. This includes both pharmacological and psychotherapeutic approaches. 

Commonly prescribed medications include: 

• Naltrexone, an opioid antagonist which is commonly used to treat substance dependence, including alcohol and drugs, has shown great promise in alleviating symptoms among patients with kleptomania²
• Anticonvulsants and Selective Serotonin Reuptake Inhibitors (SSRIs), which are often used to treat depression, may be prescribed to regulate neurochemical imbalances which may drive both kleptomania and addiction⁸

Psychotherapy approaches include Cognitive-Behavioural Therapy (CBT), which may help individuals identify triggers, reframe thoughts, and develop healthier coping mechanisms. Additionally, often, impulse control and relapse prevention strategies adapted from addiction treatment models may be implemented. 

Treatment for co-existing kleptomania and SUD can, and should, be treated together.^2,4 Critically, your clinician should approach treatment in a confidential, non-judgmental manner. They must recognise the fear, stigma, and legal anxieties that often accompany both conditions, and should make you feel comfortable and listened to.^5,6 

A gap in research

Despite the growing body of evidence, the overlapping relationship with SUD and kleptomania in general remains poorly understood and under-researched.^1,3 There is an urgent need to undertake larger-scale, more rigorous studies into how and why kleptomania and addiction are so closely linked. An understanding of this relationship could allow for more effective and targeted treatment options. And, importantly, it may help to alleviate the stigma and shame associated with kleptomania. Given the condition is highly underreported, there could be a far higher burden than we realise. The conversation must shift from blame and uncertainty to one of empathy and understanding. 

Summary 

Kleptomania and SUD may appear to manifest differently, yet at their core, they share the same psychological, neurological, and behavioural traits. Compulsion, impulsion, impaired self-control and powerful behavioural urges override rational decision making. 

Treating kleptomania as a form of behavioural addiction and recognising this connection allows us to better understand the condition and support those who are suffering. As research continues to develop, clinicians, researchers, and the public must recognise kleptomania and SUD not as moral failings, but rather as a complex, yet treatable, mental health condition.