What Causes Alcoholism?
What causes alcoholism?
At its essence, alcoholism is caused by drinking to the point of intoxication over and over again to the point that the body begins to crave alcohol when the person is not actively drinking, and withdrawal occurs when blood-alcohol levels drop below a certain point (or after alcohol has been out of the body for long enough). Exactly when this craving and withdrawal process occurs differs from person to person - for some it may have a relatively quick onset within a matter of weeks, whereas others it may take months.
The biological process that occurs is called down-regulation. The brain has a balance of chemicals it likes to keep, which we call "homeostasis." When the brain is constantly flooded with more chemicals due to frequent alcohol consumption, it tries to return to homeostasis by producing less of those chemicals itself. As a result, someone has to keep drinking more and more to feel the same level of intoxication, and also experiences withdrawal when they stop drinking.
What is the difference between a biological and psychological addiction?
Alcoholism is caused by a combination of biological and psychological dependencies that form around alcohol use. On the biological side, when your brain becomes used to the changes caused by alcohol, it starts producing fewer natural neurotransmitters to compensate for these changes. This is the cause of alcohol tolerance, and eventually withdrawal. After a certain amount of time the brain and body start to crave alcohol, and, in addition, also makes subtle changes to how reward pathways work - lowering the feeling of pleasure from anything that is not alcohol.
On the psychological side, alcohol becomes the primary way that someone copes with problems or stressors in their life, related to something either internal (anxiety, depression, trauma, etc.) or external (work stress, marriage, social anxiety, etc.). A person begins to feel subjectively like they "need" alcohol to make it through their day, which, combined with the biological hooks, can be very challenging for someone to break on their own.
Who is at higher risk of developing alcoholism?
Statistically speaking, men are at greater risk of developing alcoholism than women, as well as those with peer groups (coworkers, family, friends, etc.) who are heavy drinkers. People who struggle with mental health concerns are at higher risk to develop alcoholism. Past traumatic experiences are also highly correlated - both in terms of childhood abuse and traumas experienced as an adult. Additionally, there are genetic factors related to developing alcoholism that are heritable, as well as behavioral modeling - if you look at one or both of your parents and see them coping with stress by drinking, you are more likely to do it yourself.
What genetic factors have been implicated in alcoholism?
About 50% of the chances of developing alcoholism are related to genetics, with studies showing that if you have a blood relative with alcoholism, you are 3-4x more likely to develop alcoholism yourself. These strong associates have also been found in twin studies, when the twins are raised in separate households. In terms of specific genes, there have been several associated with enhanced risk for alcoholism (such as GABRA2 and CHRM2) and some that provide protective factors against alcoholism (such as ADH1B and ALDH2).
If you need help, more information is available on my website related to working with me for online addiction counseling for alcoholism – in addition to my concierge therapy practice, I also have a small in-network practice with Equipoise Teletherapy in Chicago. I also provide non-clinical parent coaching services upon request. For any other questions, please feel free to reach out to me directly!