AIM: The study reported in this paper investigated factors that led to the initial use and abuse of drugs in 237 addicts receiving treatment at the Psychological Medicine Hospital, Kuwait. METHOD: A self-administered questionnaire was designed to elicit information regarding socio-demographic data and initiation patterns. Questions about initiation patterns were related to personal, familial and social variables in addition to accessibility to drugs. RESULTS: Almost all the sample were male (99.2%) and 42.6% were married. The findings were grouped into (1) factors associated with drug abuse and (2) initial/ significant factors for drug abuse. One way ANOVA showed that there was a significant statistical association between current age and source of drug. Also, there was a significant statistical association between the age of the addict when first started on drugs, and the source of drugs. Multiple regression analysis was also computed for initial significant factors. One factor 'excessive unsupervised free time' was statistically significant. RECOMMENDATIONS: Strategies for primary, secondary and tertiary interventions in addition to recommendation for further studies are suggested