Alcoholism, or alcohol use disorder (AUD), is a disease caused by a complex interplay of genetic, environmental, and psychological factors. There is no single cause for AUD, and no two cases are exactly the same.
While certain patterns exist, each person’s journey with alcohol use disorder is unique. Some may have a strong genetic predisposition, while others develop problematic drinking primarily through environmental influences. Some may even develop a drinking problem as a response to trauma or mental health challenges.
In this article, we’ll explore:
- The known causes of alcoholism
- Key risk factors that increase vulnerability
- How these risk factors, while significant, don’t predetermine your future
Our clinical team will also explain how to recognise the early warning signs of addiction.
We want you to know that these risk factors don’t mean you’re doomed to a life of addiction. With proper treatment, you can live an alcohol-free life that’s both fulfilling and enjoyable.
Read on to learn about the causes, risk factors, and treatment options for alcoholism and how you can get help for yourself or someone that you know who’s struggling with their alcohol consumption.
Key Takeaways
What is Alcoholism (Alcohol Use Disorder)?
Alcoholism is a chronic disease characterised by uncontrolled drinking and preoccupation with alcohol despite harmful consequences to the person’s physical health, mental health, and social life.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) defines AUD as “a problematic pattern of alcohol use leading to clinically significant impairment or distress.” It can be mild, moderate, or severe, and it’s typically described as a progressive or degenerative disease (meaning it gets worse as time goes on).
The most common symptoms of AUD include dependence on alcohol, an inability to limit drinking, and continued use despite the problems it causes. If you’ve noticed any of these signs in yourself or a loved one, that’s a clear indication that there is a problem.
When you have alcoholism, your relationship with alcohol fundamentally changes. You may need to drink more to achieve the same effects (known as tolerance), experience physical withdrawal symptoms when not drinking, and find yourself unable to cut down despite sincere attempts. When you have AUD, your daily life often revolves around drinking, obtaining alcohol, or recovering from its effects.
Now that you know what AUD is, let’s cover the causes.
What Are The Causes of Alcoholism?
The causes of alcoholism are complex, but they typically fall into three categories: genetic, environmental, and psychological. Some people are born with a predisposition to developing addiction (such as fewer dopamine receptors), while others are born “normal” but develop a substance use disorder (SUD) due to psychological factors such as trauma, depression, or other mental health issues.
Here’s more on the causes of alcoholism:
Genetic Factors
Science has proven that alcohol use disorder is at least partially genetic, with research showing that genetics account for approximately 40-60% of the risk for developing alcoholism. This includes having family members with an SUD, having certain gene types, and other heritable traits that predispose you to developing addiction.
In one fascinating study published in the National Library of Medicine entitled Genetics and Alcoholism by Edenberg, Howard J. and Foroud, Tatiana, the authors found that “twin studies in the US and Europe suggest that approximately 45-65% of the liability is due to genetic factors”.
The biggest genetic factor in the development of alcoholism is how your brain processes dopamine, the chemical responsible for feelings of pleasure and reward.
If you have fewer dopamine receptors or process rewards differently, this makes alcohol more appealing and makes it harder to stop drinking once you’ve started.
In a normal person’s brain, they will get a “normal” level of reward and then return to their stable baseline. But for someone with a different reward processing centre in their brain, the process is much more complex. Their baseline may be much lower, which makes them crave the dopamine hit from drinking alcohol. When they get that hit, it feels more euphoric to them than it does to someone with a “normal brain”. And worse, when they return to baseline, they feel low, and this intensifies withdrawal symptoms and cravings.
We want you to know that having these genetic risk factors doesn’t guarantee you’ll develop an addiction. Many people with family histories of alcoholism never develop problems with alcohol themselves. And even with these risk factors for AUD, you can still get help and live a happy, fulfilling life.
Environmental Factors
Your environment and social circles significantly impact your relationship with alcohol. Environmental risk factors include cultural views on alcohol, your job, where you live, and the current period you’re going through in life (for example, attending university vs. living at home with family).
Let’s stay with cultural drinking norms.
Cultural attitudes toward drinking vary widely. What we consider normal in one setting may be viewed as excessive in another. These cultural norms shape your drinking behaviours, often without your conscious awareness. For example, drinking is widely accepted in the UK, whereas in some Middle Eastern cultures, it is considered taboo.
Another major environmental factor for AUD is your work environment, especially if you work in the military, hospitality, or finance. If you work in high-stress or dangerous industries, or if you work in an industry where after-work drinking is common, you face not just increased exposure but also implicit expectations about drinking.
Many careers intertwine alcohol with networking and team bonding, which puts intense pressure on the person to drink just to “fit in”.
The last environmental factor for alcoholism we want to cover is your current life situation. Are you in the midst of a major transition (divorce, moving, or going to uni?). This could have a serious effect on your risk of developing an SUD.
For example, the pressure to fit in during events like freshers’ week can establish drinking patterns that persist long after you graduate. And when you experience high-stress periods or major life changes, you may turn to alcohol, as it temporarily numbs difficult emotions.
Social And Personality Factors
We cannot overstate the power of peer influence on drinking habits.
When your friends, partner, or colleagues regularly drink and encourage your participation, it becomes nearly impossible to say no to a drink. If you are genetically predisposed to developing an addiction, this type of exposure can lead to AUD.
Psychological Factors and Co-occurring Conditions
Your mental health significantly increases your chance of developing AUD.
Science and our clinical experience have proven that if you live with conditions like PTSD, depression, anxiety, or bipolar disorder, you’re at substantially higher risk for developing alcoholism.
When you’re suffering from a co-occurring mental health condition, alcohol becomes a means of escape. People use it to “numb the pain” temporarily. Over time, they develop physical dependence, tolerance, intense cravings, and withdrawals. And to make matters worse, they don’t put in any work to improve their mental health condition.
The most common co-occurring mental health disorders are:
.
- Depression
- Anxiety disorders
- Post-traumatic stress disorder (PTSD)
- Bipolar disorder
- Attention-deficit/hyperactivity disorder (ADHD)
- Personality disorders (especially borderline and antisocial)
- Schizophrenia
- Social anxiety disorder
- Insomnia and sleep disorders
- Eating disorders
- Obsessive-compulsive disorder (OCD)
- Chronic stress
- Grief and bereavement issues
Post-traumatic stress disorder is the most common co-occurring disorder in our experience. This is a condition marked by intense flashbacks, hypervigilance, and avoidance in response to a traumatic event such as a natural disaster, violence, or other types of abuse.
People suffering from PTSD are at much higher risk of developing an SUD, mostly as a method to cope with the stress. Sometimes, the anxiety, intrusive thoughts, and mood swings are just too much to deal with. People suffering from this condition have no choice but to “self-medicate” with alcohol.
It’s extremely common among combat personnel and first responders.
To illustrate just how much trauma and mental health conditions affect the development of SUD, here’s a fascinating study:
A 2018 study from the National Library of Medicine entitled The Epidemiology of Post-Traumatic Stress Disorder and Alcohol Use Disorder followed 141 firefighters who had been exposed to a traumatic event. 42% developed AUD within a few years of experiencing the event.
We often see patients using alcohol as self-medication for undiagnosed conditions. You might not realise your drinking began as an attempt to manage symptoms you didn’t recognise as a treatable mental health issue. For example, if you experience social anxiety, you might find that a few drinks make social situations bearable, leading to a pattern where you can’t face gatherings without alcohol.
Are There Other Causes of Alcoholism?
Your risk for developing alcoholism involves several additional factors beyond genetics and environment:
- Drinking patterns: Binge drinking places you at high risk even without daily consumption by training your brain to associate alcohol with intense reward, potentially accelerating dependence.
- Age of first use: Beginning to drink before age 15 makes your developing brain especially vulnerable, increasing your alcoholism risk fourfold compared to waiting until the legal drinking age. According to the National Institute on Alcohol Abuse and Alcoholism on their site Niaaa.nih.gov, in the article Alcohol’s Effects on Health, “research shows that people who start drinking before the age of 15 are at a higher risk for developing alcohol use disorder (AUD) later in life. For example, adults ages 26 and older who began drinking before age 15 are 3.6 times more likely to report having AUD in the past year than those who waited until age 21 or later to begin drinking.”
- Gender differences: While men show higher alcoholism rates historically, women develop alcohol-related health problems more quickly and at lower consumption levels due to physiological differences in alcohol processing.
- Economic factors: Alcohol pricing, your personal income level, and your exposure to alcohol marketing all subtly influence your relationship with alcohol.
- Metabolism genetics: Your unique genetic makeup, particularly variations in how efficiently your body processes alcohol, creates a personalised risk profile for developing alcoholism.
Risk Factors for Alcoholism
Several key factors can increase your likelihood of developing alcohol use disorder, though no single factor guarantees you’ll develop a drinking problem. Understanding these risk factors helps you assess your personal vulnerability and make informed choices about your drinking habits:
- Family history: Having a parent or sibling with alcoholism increases your risk by 3-4 times compared to the general population.
- Early onset drinking: Starting alcohol use before age 15 dramatically increases your chances of developing alcohol problems later in life.
- Mental health conditions: Conditions like depression, anxiety, and PTSD often lead to self-medication with alcohol to temporarily relieve symptoms.
- Trauma history: Experiencing childhood trauma, abuse, or significant adverse events increases vulnerability to using alcohol as a coping mechanism.
- Social environment: Regular exposure to heavy drinking through friends, partners, or work culture normalises excessive consumption patterns.
- High stress levels: Chronic stress from work, relationships, or financial problems can drive increased drinking as a form of stress relief.
- Impulsivity traits: Having difficulty with impulse control or sensation-seeking personality traits creates vulnerability to problematic drinking patterns.
- Low alcohol sensitivity: Requiring more alcohol to feel effects (high tolerance) paradoxically increases addiction risk rather than protecting against it.
What to Do if You Suspect You or Someone Else Has Alcohol Use Disorder?
If you suspect that you or someone you know is an alcoholic, you must get them help immediately. There is help for addiction everywhere in the form of detoxification, therapy, counselling, and even outpatient and inpatient rehabilitation. Sometimes, it can be free of charge depending on your location, situation, and income level.
Recovery happens every day. We’ve seen it over and over again at our clinic.
Effective treatment typically involves a personalised approach using these evidence-based methods:
- Medical detoxification: Safely managing withdrawal symptoms under professional supervision to ensure your comfort and safety during the initial phase.
- Therapy and counselling: Addressing underlying causes through approaches like cognitive-behavioural therapy, helping you develop healthier coping mechanisms.
- Ongoing support systems: Utilising support groups, family therapy, and aftercare programmes to maintain your recovery long-term
You don’t have to face this alone, and with proper support, a healthier relationship with alcohol is within reach.
How Can The Cabin Help Treat Alcoholism?
If you’re worried about your genetic predisposition to AUD or the underlying causes of your addiction, we want you to know that help is available no matter how or why you’ve developed addiction.
At The Cabin, we treat alcoholism no matter the cause, whether it’s trauma, stress, genetics, or mental health struggles.
Our experienced team takes a personalised approach to recovery, combining proven clinical therapies with the unique healing traditions of Thailand. Located in the peaceful mountains of Chiang Mai, our centre offers a calm, natural setting far from everyday triggers. Here, you’ll recover in peace and participate in one of the most unique alcohol rehabilitation programmes on Earth. Our holistic programme includes Thai Buddhist mindfulness, Muay Thai fitness, guided nature excursions, and evidence-based treatments like CBT and EMDR. This blend of Eastern and Western methods helps our clients heal fully, mind, body, and spirit.
Contact us today. Your evaluation call is 100% free. We want you to find help no matter your circumstances, and even if it’s not with us. We understand if going abroad for rehab is not possible. If that’s the case, we will connect you with a suitable treatment provider near you.
