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What Makes Alcohol So Addictive? | Breaking Down the Science

Alcohol is an addictive substance, and misuse can lead to the development of alcohol use disorder (AUD).[1] No one sets out to have an addiction, but one can form relatively easily and quickly when certain factors are in place. 

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When you drink, alcohol prompts dopamine and endorphin release, so you feel good.[2] This causes you to want to keep drinking, and alcohol’s continued effects on the body pile up. 

Some people are more prone to addictive behaviors, either due to genetic, environmental, or other factors.[3] Once dependence on alcohol forms, which can develop after repeated abuse, an alcohol addiction is present.

Why Is Alcohol So Addictive?

Alcohol is so addictive in part because of the significant impact it has on the reward system in the brain.[4]

Alcohol binds to dopamine receptors in the brain, triggering a big release of the chemical while blocking the reuptake, or reabsorption that would cause that good feeling to balance out. This effect activates the pleasure and reward system, which causes the person to crave those good feelings. Since those good feelings were caused by substance use, this translates into craving alcohol.[2] 

The more someone drinks, the more this process occurs, and cravings grow stronger. The size, shape, and function of cells in the brain change over time to support this process.[5] The person is no longer thinking and acting the way they once did. Rather, they are now heavily focused on getting back to that good feeling.

A Spiraling Cycle of Abuse

The more someone drinks, the more they need to drink to get that feeling, which means that larger amounts of alcohol are needed over time. When combined with certain biological, environmental, social, and psychological factors, the scientific action of alcohol in the brain can quickly turn alcohol abuse into alcohol addiction.[6] 

Breaking the neurological mechanism of alcohol addiction requires professional assistance and support. Treatment strategies for alcohol addiction often involve consistent and long-term use of medication-assisted treatment, therapeutic intervention, support groups, and lifestyle modifications. 

How Does the Body Develop an Alcohol Dependency?

The physiological response to alcohol can be broken down by a handful of factors.

Dopamine Release

Alcohol consumption activates a large dopamine release in your brain’s reward pathway. Dopamine, an essential neurotransmitter linked with reward and reinforcement, produces a surge of pleasure that reinforces alcohol consumption behaviors.[7]

Tolerance Development

Alcohol abuse causes brain function adaptations that result in tolerance, making increasingly larger quantities of alcohol necessary to feel pleasurable effects.[8] This higher consumption of alcohol increases exposure to the toxin, which puts a strain on the liver, brain, and cardiovascular systems.

Neurochemical Imbalance

Long-term alcohol abuse disrupts the delicate balance between neurotransmitters in the brain, such as dopamine, serotonin, and other mood and reward-processing neurotransmitters.[9] This imbalance further fuels alcohol dependency.

Withdrawal

When alcohol dependence is present, a drop or cessation of use can trigger withdrawal symptoms that can range from mild discomfort to serious physical and psychological side effects, which can be life-threatening.[10] These motivate people to continue drinking in order to ease the discomfort.

Neuroadaptation

Continual exposure to alcohol and its effects can cause physical changes to brain structures, altering their function and response to stimuli.[11] This can result in personality changes, including increased compulsive behaviors and prioritization of alcohol use over relationships despite negative consequences.

Cravings

Over time, addiction erodes the ability to control alcohol consumption.[12] These cravings often persist after the physical dependence has been addressed in detox. Cravings are arguably one of the most difficult aspects of addiction to overcome in treatment, but medications can help to manage them.[13]

Reward System Malfunction

Alcohol essentially hijacks the brain’s reward system.[14] Over time and with long-term alcohol use, it may be harder to manage mood naturally, which means that people who are already struggling with mental health issues, such as anxiety or depression, need treatment to help them learn how to cope with those issues without alcohol.

Stopping the Cycle of Alcohol Addiction

Alcohol addiction is a cycle of use that is defined by cravings and alcohol withdrawal symptoms. As behaviors become focused on getting more alcohol and staying under its influence, it becomes harder for the individual to maintain positive relationships that may have helped them recognize their issues and get help. It’s easy for an alcohol abuse issue to spiral out of control.

For this reason, alcohol use disorder is a psychological, physical, and social disorder.[15] All of these areas must be addressed in treatment for recovery to be effective. 

Comprehensive treatment for alcohol use disorder offers an evidence-based approach to recovery. It often involves the use of medications, therapy, and complementary treatment approaches to ensure recovery on all fronts of life. Any co-occurring mental health issues are also addressed in treatment. 

The sooner you seek treatment for alcohol addiction, the better the long-term outcomes. Reach out for help today.

Updated January 11, 2024
Resources
  1. Understanding alcohol use disorder. National Institute on Alcohol Abuse and Alcoholism. Published 2020. Accessed December 14, 2023.
  2. The dopamine system and alcohol dependence. Ma H, Zhu G. Shanghai Archives of Psychiatry. 2014;26(2):61-68.
  3. The impact of gene–environment interaction on alcohol use disorders. Dick DM, Kendler KS. Alcohol Research: Current Reviews. 2012;34(3):318-324.
  4. The role of alcohol and the mechanisms involved in the reward pathway affecting the brain: A comprehensive review. Vadakedath S, Kandi V. American Journal of Medical Sciences and Medicine. 2022;10(1):34-39.
  5. Alcohol and the brain. Nutt D, Hayes A, Fonville L, et al. Nutrients. 2021;13(11):3938.
  6. Intersection of familial risk and environmental social control on high-risk drinking and alcohol dependence in a US national sample of adults. Karriker-Jaffe KJ, Chartier KG, Bares CB, Kendler KS, Greenfield TK. Addictive Behaviors. 2021;113:106668.
  7. Long-term alcohol consumption alters dorsal striatal dopamine release and regulation by D2 dopamine receptors in rhesus macaques. Salinas AG, Mateo Y, Carlson VCC, et al. Neuropsychopharmacology. 2021;46(8):1432-1441.
  8. 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.
  9. Serotonin in alcoholism. ClinicalTrials.gov. Accessed December 15, 2023.
  10. Alcohol withdrawal. Newman RK, Stobart MA, Gomez AE. National Institutes of Health. Published 2019. Accessed December 15, 2023.
  11. Alcohol’s effects on brain and behavior. Sullivan EV, Harris RA, Pfefferbaum A. Alcohol Research & Health: The Journal of the National Institute on Alcohol Abuse and Alcoholism. 2010;33(1-2):127-143.
  12. Identifying triggers of alcohol craving to develop effective virtual environments for cue exposure therapy. Ghiţă A, Teixidor L, Monras M, et al. Frontiers in Psychology. 2019;10.
  13. Pharmacological treatment of alcohol cravings. Marin D, Olívia M, Perrotte G, et al. Brain Sciences. 2023;13(8):1206-1206.
  14. The brain’s reward system in health and disease. Lewis RG, Florio E, Punzo D, Borrelli E. Advances in Experimental Medicine and Biology. 2021;1344:57-69.
  15. Alcohol use disorder. Nehring SM, Freeman AM. StatPearls. Published 2020. Accessed December 15, 2023.
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