Understanding Alcohol Use Disorder (Alcoholism): What Causes It?

What Is Alcohol Use Disorder (AUD)?

Alcohol use disorder (AUD) is a pattern of alcohol use that occurs when a person:

• Drinks heavily
• Cannot control their alcohol use
• Continues to drink despite its adverse effects on their life

Those with AUD also develop a high tolerance to alcohol and withdrawal symptoms after stopping drinking. 

Alcohol dependence is a growing problem worldwide. According to a 2023 study by the National Center for Drug Abuse Statistics, 10% of people over 12 in the United States have an AUD.¹

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What Causes Alcohol Use Disorder?

When it comes to substance abuse, every person is different. Some people become addicted to alcohol over time, while others are biologically prone to alcoholism.

Common causes of alcoholism include:

Biological Causes

According to the NIAAA, genetic factors account for about 50% of people developing an AUD.² Genetic factors and a family history of alcoholism can contribute to your risk of developing AUD.

There isn't just one "alcoholic gene" that increases a person's risk of developing alcoholism. Studies show that AUD is a complex genetic disease.

Hundreds of genes can impact the risk. However, certain gene combinations can make you more susceptible.

Two genes that have the most vital known link to alcoholism include:

• ADH1B: People with this gene metabolize alcohol slower, so they experience fewer adverse side effects.³
• GABRB1: This gene is associated with gamma-aminobutyric acid (GABA) production. Consuming alcohol alters the amount of GABA available to the brain, causing relaxation and anxiety relief.⁴

Certain gene variations, such as the beta-klotho gene, decrease your risk of developing alcoholism. People who don't have the beta-klotho gene may find it difficult to have just one or two drinks.

Psychological Causes

AUD may often co-occur with a mental illness (dual diagnosis), including: 

• Depression
• Anxiety
• Bipolar disorder
• Post-traumatic stress disorder (PTSD)
• Schizophrenia 

People with other mental health conditions often drink alcohol to relieve unpleasant symptoms.

A person’s poor coping skills regarding stress, negative feelings, and boredom can make them vulnerable to alcohol addiction. If they cannot handle stressors, alcohol can make dealing with it easier.

Some people also believe alcohol controls their mental health symptoms better than medications. However, using alcohol as a "crutch" to ease symptoms increases the risk of alcoholism.

Social and Environmental Causes

Even without a genetic component, you can still develop alcoholism when raised or immersed in a specific environment. Growing up around people with addiction predisposes someone to develop an AUD.⁵

Alcoholism can also develop in people who drink in social situations, such as college students. Binge drinking, which is common amongst college students, is a harmful drinking pattern that makes someone’s blood alcohol concentration (BAC) level rise to 0.08% or higher. While binge drinking in college may seem ordinary, it can lead to lasting AUD. 

Risk Factors of Alcohol Abuse

Some risk factors associated with alcohol addiction include:⁶

Early Drinking

Drinking from an early age increases the risk of developing an AUD later in life.

Peer Pressure

Environmental factors, like pressure from friends, family, and media, can contribute to excessive alcohol consumption and addiction. The media portrays alcohol as a way to wind down or deal with stress, encouraging people to drink.

High Levels of Stress 

High stress levels increase your risk of addiction. Whether your stress comes from your job, finances, or relationships, finding healthy coping mechanisms is essential to reduce the risk of turning to alcohol.

Family History 

Genetics plays a prominent role in problem drinking. Genetic mental illnesses also increase your likelihood of developing an addiction.

Previous Trauma

A history of emotional or physical trauma can increase the risk of AUD.

Co-Occurring Mental Health Disorders 

Alcohol can be a method of self-medication for those with mental health conditions, potentially leading to alcohol addiction.

Gender

AUD affects men more than women. Women’s bodies absorb more alcohol and reach a higher BAC even after drinking the same amount.

Regular Drinking Over a Long Period 

When you engage in frequent alcohol consumption, your body develops a tolerance, and a dependence forms over time. Because of this tolerance, your body needs more alcohol to feel the same effects. 

Drinking alcohol in moderation can be harmless, but over time, it can develop into abuse or addiction. 

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Symptoms of Alcohol Use Disorder (AUD)

The symptoms of alcoholism vary and can range from mild to severe.

The most common signs of alcohol use disorder include:⁷

• Not being able to limit or stop alcohol use
• Drinking more or for longer than intended
• Unsuccessful attempts to limit or quit drinking 
• Spending a lot of time obtaining, using, or recovering from alcohol
• Intense cravings for alcohol throughout the day
• Failure to fulfill responsibilities at work, school, or home due to alcohol consumption
• Continuing to drink alcohol even though it's causing physical, social, or interpersonal problems
• Giving up hobbies to drink
• Avoiding social settings that do not involve alcohol 
• Engaging in dangerous situations while under the influence of alcohol
• Developing a high alcohol tolerance 
• Experiencing withdrawal symptoms after you stop drinking 

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Alcohol Use Disorder and Withdrawal Symptoms

AUD typically involves alternating periods of alcohol intoxication and withdrawal symptoms. 

Alcohol withdrawal can occur when alcohol use has been heavy and prolonged but suddenly stopped or significantly reduced. It can occur within several hours to 4 to 5 days later. 

Signs and symptoms of alcohol withdrawal include:

• Sweating 
• Rapid heartbeat
• Hand tremors
• Troubles sleeping
• Nausea and vomiting 
• Hallucinations
• Restlessness and agitation
• Anxiety
• Seizures

Complications of Excessive Alcohol Use

Alcohol depresses your central nervous system (CNS), affecting your speech, muscle coordination, and brain health. Heavy drinking can even cause many life-threatening impacts on your safety and health.

Impact On Your Safety

Drinking excessive alcohol can reduce your judgment skills and lower your inhibitions. These lapses can lead to poor decision-making and dangerous situations or behaviors, including: 

• Motor vehicle accidents
• Accidental injury, such as drowning
• Relationship problems
• Poor performance at work or school
• Increased likelihood of committing violent crimes or being a victim of a violent crime
• Financial problems
• Development of other substance use disorders
• Engaging in risky, unprotected sex
• Increased risk of attempted or completed suicide.

Impact On Your Health 

Consuming too much alcohol, either on a single occasion or over time, can lead to serious health issues, including:

• Liver disease (hepatic steatosis, alcoholic hepatitis, and cirrhosis)
• Digestive problems (gastritis, ulcers, and pancreatitis)
• Heart problems (raised blood pressure, heart failure, and stroke)
• Diabetes complications (hypoglycemia or low blood sugar)
• Sexual dysfunction (erectile dysfunction or menstruation issues)
• Increased risk of cancer (mouth, throat, liver, esophagus, colon, and breast cancers)

The graphic displays only some health issues that heavy drinkers may develop. It is essential for anyone struggling with alcoholism to seek medical care to avoid serious health complications.

Treatment for Alcohol Use Disorder 

If you or a loved one struggles with AUD, help is available. Standard treatment options for AUD include:⁸

Inpatient Treatment

Inpatient treatment is an effective option for alcohol use disorder (AUD). This type of treatment takes place at a licensed residential treatment center. 

Patients receive 24-hour comprehensive and structured care. They also undergo medical detox, including medication-assisted treatment (MAT).

Outpatient Treatment

Outpatient treatment helps people with less severe alcohol use disorders. It works around a person's schedule and does not provide 24-hour medical supervision.

Support Groups

Support groups act as emotional support systems for people fighting AUD. In support groups for alcoholics, a person in recovery can relate to others with the same condition. Peers can positively help each other remain sober.

When Should I See a Doctor for Alcoholism?

Early treatment is critical. While AUD can range from mild to severe, even a mild disorder can lead to serious health issues. 

If you feel that you tend to drink too much alcohol, your drinking is causing problems, or your loved ones are concerned about your drinking, reach out to your healthcare provider. 

You may not recognize how much you drink or understand the connection between alcohol use and the problems in your life. Listen to your loved ones when they ask you to examine your drinking habits or seek help.

You may benefit from a rehabilitation program, a support group such as Alcoholics Anonymous, or a self-help group. 

Summary

Alcohol use disorder is characterized by excessive drinking, an inability to control alcohol consumption, and continued drinking despite the negative impacts of alcohol abuse on one’s life. 

Biological, psychological, and social factors can trigger an AUD. Certain risk factors, such as a family history of alcohol addiction or high stress levels, put somebody at a higher risk for developing AUD. 

Despite all the adverse effects of AUD, help is still available. There are various options for treatment, like inpatient and outpatient programs and support groups.