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Why Do Alcoholics Drink?

People who drink moderately may be able to say no to alcohol. They may go days, weeks, months, or even years between having a drink.

However, an individual who struggles with drinking may find it hard to avoid alcohol consumption. They may drink alcohol compulsively every day.

When someone suffers from alcohol addiction, drinking becomes a major part of their life, even if they want to stop drinking. This can lead some people to question why those with an alcohol use disorder drink.

There is no simple answer to why alcoholics drink. It varies depending on the individual, and there are many possible answers. 

Some people are more susceptible to addiction genetically. Others may experience mental health disorders and are more likely to self-medicate with alcohol. Some individuals may fall into bad habits easily.

Alcohol addiction is not a one-size-fits-all condition. Alcoholics begin drinking for various reasons. However, alcoholics generally continue to drink because they develop alcohol dependence and become physically addicted to it.

Physical Factors of Alcoholism

Here are some of the physical factors of alcoholism:

Intense Alcohol Cravings

As people develop alcohol dependence, it is normal to experience urges or cravings for alcohol. This refers to a wide range of thoughts, physical sensations, or emotions that push you to drink, even if you do not want to.

Those with intense cravings may experience an uncomfortable pull in two directions or sense a loss of control when it comes to alcohol.

Drinking to Prevent Alcohol Withdrawal Symptoms

Alcohol addiction is a diagnosable brain disease. It is characterized by a specific set of symptoms. It is also a chronic, relapsing disease.

This means that while recovery is possible, a recovering alcoholic must work hard to beat the disease.

Recovering alcoholics often experience challenging withdrawal symptoms that make it easy to relapse. In many cases, those suffering from alcoholism relapse to prevent alcohol withdrawal symptoms. 

Alcohol withdrawal symptoms include:

  • Anxiety or nervousness
  • Depression
  • Tiredness
  • Irritability
  • Jumpiness or shakiness
  • Mood swings
  • Nightmares
  • Sweating, clammy skin
  • Enlarged (dilated) pupils
  • Headache 
  • Insomnia 
  • Loss of appetite 
  • Nausea and vomiting
  • Rapid heart rate
  • Tremor of the hands or other body parts

A more severe form of alcohol withdrawal called delirium tremens can lead to:

  • Agitation
  • Hallucinations
  • Seizures
  • Severe confusion

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Neurological Factors of Alcoholism

Here are some of the neurological factors of alcoholism:

How Alcohol Changes Your Brain 

With time, consistent drinking can change the brain. The brain can end up responding differently to the outside world than it usually would. 

One of the parts of the brain known to adjust from long-term drinking is the prefrontal-striatal-limbic circuit. This area of the brain controls emotions, decision-making, and stress. It can be affected following long-term drinking.

Alcohol abuse can also adversely affect the ventral striatum part of the brain. The feel-good chemical dopamine stops working well in this part of the brain.

People with drinking problems also have fewer brain cells than usual in the prefrontal cortex and orbitofrontal cortex part of the brain. This is the area of the brain responsible for decision-making.

Specific Chemical Imbalances in the Brain

The neurotransmitters, or brain chemicals, of people struggling with heavy drinking, can differ from other peoples. Drinking alcohol causes a change in the way certain brain chemicals function, leading to imbalances.

Drinking particularly affects gamma-aminobutyric, otherwise known as GABA. Alcohol consumption depresses the central nervous system by increasing the levels of GABA.

Heavy drinking also affects the glutamate chemical. Alcohol consumption suppresses the levels of the chemical, which stimulates the central nervous system (CNS) under usual circumstances. As a result, the central nervous system is further depressed.

Dopamine is another chemical that is affected by heavy drinking patterns. This chemical is part of the brain’s reward system. It is triggered by alcohol consumption, leading to a feel-good state and a desire to continue drinking.

Drinking alcohol also increases the level of serotonin. This chemical links to a sense of well-being and a good mood. 

With consistent drinking, the brain becomes used to chemical imbalances. As a result, individuals need to consume larger amounts of alcohol more frequently to reach the same good mood and sense of well-being they once experienced.

With ongoing heavy drinking, the brain continues to adjust to alcohol. When someone has an alcohol tolerance, they can experience unpleasant withdrawal symptoms when they are not drinking because their brain chemistry has changed.

Emotional Factors of Alcoholism

Here are some of the emotional factors of alcoholism:

Drinking to Suppress Negative Emotions 

Some people turn to drink as a coping mechanism to help them deal with a difficult situation.

Unfortunately, drinking alcohol is a coping mechanism in which the long-term adverse effects significantly outweigh the temporary benefits.

These negative effects include but are not limited to:

  • Health problems
  • Impacts on relationships with friends and family members
  • Poor decision-making under the influence of alcohol
  • Increased alcohol dependency
  • Financial issues

People may use alcohol to deal with:

  • Difficult emotions
  • Challenging life events such as a death of a loved one, a break-up, or an illness
  • Boredom
  • Stress
  • Insomnia
  • Trauma or PTSD symptoms
  • Social anxiety

Drinking to Cope with Stress

Many people deal with stress by turning to alcohol. Drinking alcohol may result in temporary positive feelings and relaxation. 

However, problems usually occur when stress is ongoing, and someone tries to deal with it by consuming more alcohol.

Drinking to Numb Mental Health Issues

Some people use alcohol to manage symptoms of a mental health issue. This is known as ‘self-medicating.’ Individuals may be aware that they have a mental health problem but do not know a healthier way to cope with it and turn to alcohol instead.

Someone may also have an undiagnosed mental health issue and use alcohol to try to deal with it. During the COVID-19 pandemic and the lockdowns and economic issues, many people ended up self-medicating mental health issues arising from the spread of the virus.

While self-medicating mental health issues may provide some relief in the short-term, it only worsens problems in the long-term. Regular self-medication can lead to alcohol addiction, a worsening of mental health disorders, and increased health problems.

Other Risk Factors of Alcoholism

Other risk factors may increase your risk for developing an alcohol substance abuse disorder. 

Some known risk factors include:

  • Consuming more than 15 drinks per week if you are male or more than 12 drinks per week if you are female
  • Consuming more than five drinks per day at least once a week (binge drinking)
  • Having a parent or close relative with an alcohol use disorder
  • Having a mental illness such as depression, anxiety, or schizophrenia
  • Being a young adult experiencing peer pressure
  • Having a low self-esteem
  • Experiencing a high level of stress
  • Living in a culture or family where alcohol consumption is common

Can Alcoholism Go Away on its Own?

In most cases, alcoholism does not go away on its own. However, though there is no easy ‘cure’ for an alcohol use disorder, the condition is treatable. 

Ongoing treatment from healthcare providers and continued recovery efforts can help manage an alcohol use disorder and prevent relapse.

Can Alcoholism be Prevented? 

Yes, alcoholism can be prevented. Preventing alcohol addiction starts with you. If you worry that you are becoming a problem drinker, there are some steps you can take to reduce the risk of alcohol addiction.

First, recognize your triggers. What triggers your alcohol consumption? 

Is it a specific time of day? Or do you desire a drink after a hard day at work? Understanding what actions, emotions, or people encourage you to drink helps you determine ways to limit your alcohol consumption or avoid drinking altogether.

It is also essential to surround yourself with a reliable, positive social network of friends and family where alcohol is not a significant factor. Spend time with positive people who make you feel good about yourself and do not pressure or encourage you to drink.

Discovering new hobbies, making new friends at social events, and finding people and activities that make you happy may help you limit your alcohol consumption and prevent addiction.

Getting Help for Alcoholics (Treatment Options)

If you or a loved one is struggling with alcohol abuse or addiction, there are various addiction treatment options available. Reaching sobriety is entirely possible, no matter how long or how much you have been drinking.

There are several initial first steps when it comes to recovering from substance use disorders like alcohol addiction. These include:

  • Medically monitored detox 
  • Inpatient rehab
  • Sober living

These steps must be taken for long-term sobriety. Recovering alcoholics may also find additional treatment options like support groups helpful.

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Resources

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Costardi, João Victor Vezali et al. “A review on alcohol: from the central action mechanism to chemical dependency.” Revista da Associacao Medica Brasileira (1992) vol. 61,4 (2015): 381-7, https://pubmed.ncbi.nlm.nih.gov/26466222/ 

Seo, Dongju, and Rajita Sinha. “Neuroplasticity and Predictors of Alcohol Recovery.” Alcohol research : current reviews vol. 37,1 (2015): 143-52, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476600/ 

Understanding Alcohol Use Disorder, National Institute on Alcohol Abuse and Alcoholism, December 2020, https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder 

Drinking Levels Defined, National Institute on Alcohol Abuse and Alcoholism, https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking 

Handling urges to drink, Rethinking Drinking, Alcohol and Your Health, U.S. Department of Health and Human Services, https://www.rethinkingdrinking.niaaa.nih.gov/tools/Interactive-worksheets-and-more/Stay-in-control/Coping-With-Urges-To-drink.aspx 

Anker, J J et al. “Drinking to cope with negative emotions moderates alcohol use disorder treatment response in patients with co-occurring anxiety disorder.” Drug and alcohol dependence vol. 159 (2016): 93-100, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782758/

The Link Between Stress and Alcohol, National Institute on Alcohol Abuse and Alcoholism, https://pubs.niaaa.nih.gov/publications/AA85/AA85.htm Alcohol withdrawal, MedlinePlus, February 2021, https://medlineplus.gov/ency/article/000764.htm

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