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Causes of Alcohol Addiction

Alcohol addiction stems from a complex interaction of biological, environmental, social, and psychological elements.[1] It occurs when alcohol use becomes unmanageable.  

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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

​​In the U.S., almost 30 million people (ages 12 and up) had an alcohol use disorder (AUD), according to the 2022 National Survey on Drug Use and Health.[33] This costs the U.S. economy nearly $250 billion annually in healthcare costs, lost productivity, criminal justice costs, and expenses related to collisions.[34]

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.

The gene ADH1B has been strongly linked to alcohol abuse, alcohol dependence, and alcohol-related diseases.[25-27]

Another gene, ALDH2, is associated with negative experiences related to alcohol consumption. As a result, people with this gene variation may be less likely to use and abuse alcohol since the experience isn’t as pleasurable for them.[28-30]  

Studies on both of these genes illustrate a strong genetic component related to the development of AUD. While the presence of certain genetic traits doesn’t guarantee that someone will develop AUD, it does put them at higher risk.

Neurochemical Imbalances

Neurochemical imbalances, including low dopamine levels and changes in serotonin 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.[31] As this use causes a surge in dopamine, they feel good, and this leads them to repeat the behavior, paving the path to addiction.

Regular use of substances can cause changes to the serotonergic (5-HT) system. This can result in increased impulsivity, which can deepen the cycle of substance abuse.[32]

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.


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. Studies show that negative peer pressure (to binge drink or use alcohol excessively) is linked to increased rates of drinking in adolescence and early adulthood.[34,35]

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. 

Updated May 7, 2024
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