Biological causes for alcohol dependence include genetic predispositions and neurochemical imbalances.[2] These issues can mean that someone begins to crave alcohol after use, either due to their genetic makeup or symptoms of a mental health disorder.
Environmental influences include peer pressure, family history, cultural norms, and accessibility of alcohol.[3] For many people, growing up in homes where alcohol abuse or heavy alcohol use is the norm and alcohol is easy to get, alcohol addiction develops more quickly.
Social and psychological aspects — including stress, trauma, and mental health disorders — can play a big part as well.[4,5] For some people, alcohol use doesn’t become a problem until they use the substance to manage uncomfortable feelings.
Though the existence of these risk factors does not guarantee the development of an addiction, recognizing that these issues are risks for addiction can help individuals, families, and communities to create effective prevention and intervention strategies. These efforts can limit the impact of alcohol addiction.
Causes of Alcohol Addiction
While there is no single cause of alcohol addiction, nor is there a guarantee that addiction will develop if risk factors are present, there are several correlative circumstances and factors that have been identified as common among people and families who struggle with addiction. These risk factors are biological, environmental, social, and psychological.
Some of the contributing factors that lead to the development of alcohol addiction include the following:
Biological Risk Factors
Certain risk factors for alcohol addiction can’t be controlled, such as genetic risk factors. Other types of biological risk factors develop. These are biological risk factors for alcohol addiction:[2,6-9]
Genetic Predisposition
In some families, there is a genetic susceptibility to the development of alcoholism due to variations in genes involved with its metabolism (ADH1B or ALDH2). When these genes are present and alcohol is used, there is an increased risk for dependence.
Neurochemical Imbalances
Low dopamine levels may also play a part in the development of alcohol abuse and addiction. People who routinely have low dopamine levels may turn to alcohol in an effort to trigger a release of “feel-good” chemicals in the brain and feel happier or more relaxed.
Altered Brain Structure & Function
Long-term alcohol abuse alters the structure and function of cells in the brain and shrinks the size of the prefrontal cortex. This hinders decision-making ability and increases the risk of addiction.
Tolerance & Dependence
Ongoing, regular use of alcohol can result in the development of tolerance to the substance. As tolerance develops, larger quantities may be needed in order to achieve the same level of effects.
Additionally, the body adjusts to the presence of alcohol, making changes to its function based on the assumption that there will be a certain amount of alcohol in the system. When the person abruptly stops drinking, withdrawal symptoms can develop, such as tremors, extreme anxiety, and seizures. Sudden cessation of drinking after dependence has formed can result in life-threatening symptoms.
Epigenetic Factors
Environmental influences, such as stress or trauma exposure, may lead to epigenetic modifications of genes related to alcohol addiction. Studies suggest that such traumatizing experiences alter gene expression, increasing risk for alcohol dependency as a coping mechanism.
Environmental Risk Factors
Environmental influences can contribute significantly to the development of substance abuse issues, including alcohol addiction. These are potential environmental risk factors:[10-12]
Home Life
Living in an environment in which alcohol abuse or addiction is common increases the likelihood of developing an addiction due to normalization of the behavior.
Availability
Proximity to liquor stores or continual exposure to advertising for alcohol may lead to higher consumption levels, which in turn can lead to addiction.
Peer Influences
Peer behaviors related to alcohol can greatly impact how young people perceive and use it, potentially increasing the risk of addiction.
Socioeconomic Influences
People experiencing financial insecurity, unemployment, or limited resources may experience higher stress levels and turn to alcohol as a form of relief, increasing their chances of addiction.
Social Risk Factors
Certain social settings encourage alcohol misuse and abuse. Here are some of the factors:[13-16]
Binge Drinking Culture
Within some social circles or on college campuses, binge drinking is seen as an accepted norm. In these situations, people may feel pressured into drinking more than they might otherwise, which may contribute to the development of alcohol dependence.
Social Isolation
Loneliness, lack of support from peers, or feeling isolated can push people toward drinking as a way to soothe social anxiety. When repeated, this habit can eventually lead to alcohol addiction.
Work-Related Drinking Culture
Certain professions or industries may promote an environment conducive to heavy drinking, such as after-work socializing or networking events or dinners that highlight alcohol. This can contribute to alcoholism among employees.
Interpersonal Conflicts
Difficulties within families, friendships, or romantic partnerships can be stressful, which may trigger drinking as an escape mechanism.
Media Influence
Celebrity endorsements, depictions in movies or TV shows, and media messages glorifying excessive alcohol use may potentially influence heavy drinking, especially among young people.
Cultural Rituals & Traditions
Certain ceremonies, celebrations or traditions within cultures that involve excessive alcohol consumption may lead people to develop alcohol dependency because it is considered socially acceptable to drink and, in some cases, unacceptable to not drink.
Psychological Risk Factors
Various psychological risk factors increase the likelihood of alcohol addiction:[17-22]
Stress & Trauma
People may turn to alcohol as a way to self-medicate the discomfort caused by overwhelming stress, trauma, or emotional pain. People with a history of trauma are more likely to have alcohol abuse and addiction issues.
Co-Occurring Mental Health Disorders
Depression, anxiety disorders, post-traumatic stress disorder (PTSD), and other mental health disorders may increase the risk of alcohol abuse for the same reason. Though self-medicating with alcohol may provide temporary relief from symptoms, it can increase the severity of the problem, leading to more drinking. An addiction can quickly develop as the cycle continues.
Low Self-Esteem
People struggling with low self-worth frequently turn to alcohol in an effort to increase confidence, soothe feelings of inadequacy, or to feel like they fit in better when in public situations. Over time, this belief that alcohol is necessary to feel confident can turn into a psychological dependency, which may evolve into addiction.
Impulsivity & Sensation-Seeking Behavior
People who are prone to impulsivity may turn to excessive drinking as a form of thrill seeking. It provides quick gratification and can further lower inhibitions, increasing the potential for compulsive behaviors.
Dual Reinforcement
Alcohol addiction often stems from experiencing both positive and negative reinforcement simultaneously. Positive reinforcement occurs when alcohol produces pleasurable effects, while negative reinforcement occurs when stopping use triggers withdrawal symptoms. The combination of factors encourages continued use.
Maladaptive Coping Strategies
Individuals who lack healthy ways of dealing with stress, anxiety, or emotional difficulties may turn to alcohol as a coping mechanism. This only serves to worsen the underlying problem and adds to overall issues by fostering alcohol addiction.
Do Risk Factors Always Cause Alcohol Addiction?
No, risk factors for addiction do not necessarily mean that someone will automatically develop an alcohol abuse issue.[23] While the presence of risk factors makes the likelihood of alcohol addiction higher, it doesn’t mean it will develop.
Conversely, someone may not have any of the risk factors commonly seen among people living with alcohol addiction and can still develop the disorder if they drink regularly or misuse the substance. Plenty of people with no risk factors for alcoholism go on to develop alcohol abuse issues.
Early Intervention for Alcohol Addiction
Awareness is key. Knowing about the risk factors for alcohol addiction, and recognizing that you or a loved one may be prone to the development of an alcohol use disorder as a result, can help you to be more intentional with your drinking choices. You may also see the signs of a developing problem early in the process and be able to get treatment before it progresses.
If you believe that you or someone you care about is struggling with an alcohol use disorder, whether or not there are risk factors at play, early intervention and treatment are recommended.[24] The sooner you begin the process of healing, the better.
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- Genetics and alcoholism. Edenberg HJ, Foroud T. Nature Reviews Gastroenterology & Hepatology. 2013;10(8):487-494.
- Review: Environmental influences on alcohol use: Informing research on the joint effects of genes and the environment in diverse U.S. populations. Chartier KG, Karriker-Jaffe KJ, Cummings CR, Kendler KS. The American Journal on Addictions. 2018;26(5):446-460.
- Drinking together and drinking alone: A social-contextual framework for examining risk for alcohol use disorder. Creswell KG. Current Directions in Psychological Science. 2020;30(1):19-25.
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- Alcohol use disorder: Neurobiology and therapeutics. Yang W, Singla R, Maheshwari O, Fontaine CJ, Gil-Mohapel J. Biomedicines. 2022;10(5):1192.
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- Tolerance to alcohol: A critical yet understudied factor in alcohol addiction. Elvig SK, McGinn MA, Smith C, Arends MA, Koob GF, Vendruscolo LF. Pharmacology Biochemistry and Behavior. 2021;204:173155.
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- Access to alcohol outlets, alcohol consumption and mental health. Pereira G, Wood L, Foster S, Haggar F. Mazza M, ed. PLOS ONE. 2013;8(1):e53461.
- Peer influence in adolescent drinking behavior: A meta-analysis of stochastic actor-based modeling studies. Ivaniushina V, Titkova V. PLOS ONE. 2021;16(4):1-16
- Associations between socioeconomic factors and alcohol outcomes. Collins S. Alcohol Research: Current Reviews. 2016;38(1):83-94.
- The epidemiology of binge drinking among college-age individuals in the United States. Krieger H, Young CM, Anthenien AM, Neighbors C. Alcohol Research: Current Reviews. 2018;39(1):23-30.
- The neural processes interlinking social isolation, social support, and problem alcohol use. Le TM, Wang W, Zhornitsky S, et al. International Journal of Neuropsychopharmacology. 2020;24(4).
- Are workplace factors associated with employee alcohol use? Thørrisen MM, Skogen JC, Bonsaksen T, Skarpaas LS, Aas RW. The WIRUS cross-sectional study. BMJ Open. 2022;12(10):e064352.
- Alcohol in the media: Drinking portrayals, alcohol advertising, and alcohol consumption among youth. Bonnie RJ, Mary Ellen O'Connell, Council R. National Research Council (US) and Institute of Medicine (US) Committee on Developing a Strategy to Reduce and Prevent Underage Drinking. Published 2015.
- The role of stress, trauma, and negative affect in the development of alcohol misuse and alcohol use disorders in women. Guinle MIB. Alcohol Research: Current Reviews. 2020;40(2).
- Mental Health Issues: Alcohol use disorder and common co-occurring conditions. National Institute on Alcohol Abuse and Alcoholism (NIAAA). Published May 6, 2022. Accessed December 12, 2023.
- The factor structure of self-esteem and its association with alcohol use in American Indian (AI) adolescents. Schick MR, Nalven T, Spillane NS. American Journal of Orthopsychiatry. Published June 25, 2020.
- Personality and alcohol use: The role of impulsivity. Shin SH, Hong HG, Jeon SM. Addictive Behaviors. 2012;37(1):102-107.
- Interactions between adaptive coping and drinking to cope in predicting naturalistic drinking and drinking following a lab-based psychosocial stressor. Merrill JE, Thomas SE. Addictive Behaviors. 2013;38(3):1672-1678.
- Influence of sensation seeking on response to alcohol versus placebo: Implications for the acquired preparedness model. Scott C, Corbin WR. Journal of Studies on Alcohol and Drugs. 2014;75(1):136-144.
- Family history of alcoholism: Are you at risk? Los Angeles County Department of Mental Health. Published August 2005. Accessed December 12, 2023.
- Early intervention, treatment and management of substance use disorders. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Substance Abuse and Mental Health Services Administration. Published November 2016. Accessed December 12, 2023.
