How Does Alcohol Use Disorder Happen?

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When someone has uncontrolled drinking due to a physical and emotional dependence on alcohol, it is called alcohol use disorder (AUD). AUD is a health condition in which people struggle to stop drinking, despite its negative impact on their relationships, finances, career, health and more.

But why do people become alcoholics? Alcoholism is a complex disease that does not discriminate. Most commonly, it develops from a combination of environmental, genetic, and psychological factors, which vary from person to person. This is one reason AUD can be so challenging to treat. 

Here are some of the most common reasons that people become addicted to alcohol.

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Genetics/Family History

A family history of alcoholism does not mean you’re sure to develop AUD yourself. Still, there is significant evidence that alcohol use disorder can be passed down from generation to generation. People with an alcoholic parent are about four times more likely to have issues with alcohol.1

But is this connection because of genetics or home environment? Research says it’s a bit of both. Studies of children of alcoholics adopted by other families show that these children still have a higher likelihood of developing AUD.2 And scientists have identified specific genes that they believe contribute to alcohol addiction.3

However, parental alcohol use itself plays a role too. Children are influenced by their environment, and children of alcoholics often struggle with low self-esteem, depression, and anxiety, which are all additional risk factors for alcoholism.

Read more: Is Alcoholism Genetic?

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Self-medication is another frequent answer to the question, “Why do people turn to alcohol?” Many people attempt to manage symptoms of physical or mental pain, childhood trauma, or mental health disorders like depression with alcohol. Unfortunately, self-medication is often a slippery slope to alcoholism.

Alcohol can numb difficult feelings, but only temporarily. That’s because alcohol slows the central nervous system and releases the “feel-good” chemical dopamine. But when these temporarily pleasant feelings fade, the stress, pain, anxiety, or depression returns, often even worse than before.

In response, people who use alcohol to self-medicate may feel the need to drink even more. Increased drinking leads to increased tolerance, and people must drink more and more to experience the same feeling of relief. The resulting cycle often leads to physical dependence and AUD, ultimately worsening existing issues and creating new problems.

Read more: What Is Self-Medication?

Changes in Brain Chemistry From Frequent Drinking

Heavy drinking is another common cause of AUD. Drinking to excess can change your brain chemistry, even if you don’t have a genetic history and don’t self-medicate.4 Brain changes related to the dopamine system, GABA, and the prefrontal cortex can lead to addiction.

  • Alcohol activates the dopamine system, also called the reward system. When someone drinks, the brain experiences a powerful surge of dopamine, causing it to associate alcohol with pleasure. This “teaches” the brain to seek alcohol and leads to cravings. Over time, a person’s ability to experience pleasure from healthy, naturally rewarding activities is reduced, and the amount of alcohol needed to experience pleasure continuously increases. 
  • GABA and glutamate calm and ramp up your nervous system respectively. As a central nervous system depressant, alcohol throws these off balance. If you drink frequently and heavily, your body can begin to require alcohol to keep your nervous system in check. Without it, symptoms of anxiety and depression can appear, even where there were none before.
  • The prefrontal cortex is involved in impulse control, problem solving, and decision making. Alcohol damages this essential area of the brain, making it more difficult to control one’s drinking urges.

Environment/Social Pressure

Social pressure to drink can also play a role in alcohol abuse. From teen drinking to college alcohol culture and even adult peer pressure, our environments may influence us to drink more than is healthy or safe. 

In many cultures and contexts, alcohol is considered socially acceptable. Alcohol is a part of nearly every social gathering for some families and friend groups. It’s also widely accepted and even encouraged through stereotypes like “wine moms,” or high-powered executives who drink away the stress. 

When drinking in large amounts isn’t frowned upon, it can lead to the impression that heavy drinking isn’t particularly dangerous. People who don’t drink, or who drink very little, may even feel like outcasts.

In fact, numerous studies have shown that drinking with peers increases personal alcohol consumption.5 In a UK study, 35% of drinkers said they drink more than intended because of encouragement from others.6 Perceived peer pressure has also been shown to increase involvement in risky drinking practices, like drinking games. When our culture, peers, or environment encourage frequent heavy drinking, it can ultimately lead to AUD.

Drinking at an Early Age

Drinking at an early age is closely linked to becoming addicted to alcohol in the future. For example, children who begin drinking by age 13 have a 38% higher risk of developing alcohol dependence later in life.7

A survey of 36,000 U.S. adults found that those who began drinking earlier in life were not only more likely to eventually develop AUD, but also to develop it more quickly and at younger ages, independent of other risk factors.8 However, the risk is even higher for children who drink at an early age and have a family history of alcoholism.

Read more: Talking To Your Kids About Alcohol

Preventing Alcohol Use Disorder

The question, “Why do people become alcoholics?” doesn’t have a simple answer. We are always learning more about AUD, and this is not an exclusive list. None of these risk factors mean you are doomed to become addicted either.

But if these sound familiar and you’re concerned about your drinking, getting support can help. Ria Health offers an evidence-based, fully virtual solution for problem drinking. Members receive expert medical support, recovery coaching, FDA-approved medication, and powerful digital tools. Whether you want to cut back on drinking or quit altogether, we’re here for you. 

If you’re ready to take the first step, learn more about how Ria Health works, or set up an account today to start your journey.

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