What Causes Alcoholism?

Nearly 17 million Americans (or 6.4% of the total population) meet the criteria for an alcohol use disorder, which is associated with numerous risks, including health complications, occupational and academic impairments, and damaged relationships.1 It is essential that everyone—those with the disorder and their loved ones—understands the risk factors and potential causes of alcoholism.

The Role of Genetics

Various causes for alcoholism.Many researchers and clinicians are exploring the role genetics play in the evolution of alcoholism. For example, the disorder tends to run in families, with children of alcoholics having a 2–4 times higher risk for developing it, though to date, it has proven challenging to pinpoint the specific genes that influence this increased risk.2

However, one large study examining nearly 14,000 interviewees found some link between genetics in families with alcoholism across at least 3 relatives. The most prominent results indicated that the gene GABRA2 is associated with alcoholism. Other associated genes may include:2

  • ADH genes.
  • NFKB1.
  • SNCA.
  • TACR3.
  • NPY2R.

In another study examining same-sex pairs of twins, researchers found higher rates of alcoholism in identical twins compared with fraternal twins.3 Additionally, the dopamine D2 receptor was found to be more prevalent in those who have alcoholism compared with those who don’t.3

Gender may also play a role, with statistics indicating that males have higher rates of alcohol use disorders. However, females are likely to develop higher blood alcohol levels per drink than males, resulting in faster intoxication. Women are also more vulnerable to some of the physical effects associated with alcoholism, such as liver disease.4

It is important to note that neither genetics nor family dynamics completely determine whether or not someone will develop an alcohol use disorder. Research supports a combination of genetics and specific environment factors as playing a more influential role in who has it and who doesn’t.

What Are the Psychological Factors?

While we know there is no singular cause for alcohol addiction, medical professionals have researched several psychological factors associated with increased risk. For instance, cultural attitudes and acceptance of drinking and intoxication may be associated with an elevated risk for addiction. Furthermore, prevalent peer substance use and the propagation of exaggerated positive experiences with alcohol may contribute to problematic drinking.4

The Connection to Depression

Having a mental health and an addiction to a substance.Alcoholism and depression often coexist, and there are likely different reasons for this. It is possible that people struggling with depression drink as an attempt to self-medicate or numb their intense feelings of sadness or hopelessness. Conversely, people already struggling with alcohol addiction may feel depressed about their compulsive use of the substance, which lead them to drinking more—a vicious endless cycle.

A study conducted by the University of Buffalo Research Institute on Addictions found that people with an alcohol use disorder were 3.7 times more likely to experience a major depressive disorder than those without an alcohol use disorder.5 The research also suggested that when people experience co-occurring disorders (alcoholism and depression simultaneously), both conditions tend to be more severe.5 In 2014, the National Institute of Mental Health estimated that out of the 20.2 million people struggling with a substance use disorder, 7.9 million of them also had another mental illness, with depression being one of the most common of them.6

Unfortunately, as addiction progresses, the person’s mental health may worsen due to the consequences associated with chronic drinking—which can exacerbate a stronger desire to continue numbing one’s feelings.

Underage drinking remains a serious public health concern in America, with a third of teenagers having their first drink by age 15 and about 60% of teenagers having their first one by age 18.7 Currently, alcohol kills more teenagers than all other drugs combined.8 In fact, it is a prime contributor to the three things that kill 15 to 24-year-olds the most: accidents, homicides, and suicides.

Statistics about the relationship between alcohol experimentation and polydrug use are also alarming. Young people who drink alcohol are 7.5 times more likely to use other illicit drugs and 50 times more likely to try cocaine than young people who do not drink.9

Research shows that people ages 12–20 drink as much as 11% of all alcohol consumed in America.7 Even if they drink less frequently than their adult counterparts, they are more likely to engage in binge drinking which, by one definition, refers to drinking more than 4-5 drinks within a few hours. In fact, teenagers consume more than 90% of their alcohol through binge drinking.7 The data between 2006 and 2010 revealed that alcohol was associated with more than 4,000 deaths each year in automobile crashes, homicides, alcohol poisoning, suicides, and accidents such as falls, burns, and drowning.7

Teenagers drink for many reasons including:7–9

  • Susceptibility to peer pressure.
  • Stress.
  • Easy access (95% of 12 to 14-year-olds who drank alcohol reported they got it for free and usually from a family member).
  • Increased independence.
  • Desire to take risks.

Prevalence of teen drinking.Research on underage drinking shows that children who begin drinking at a very young age (before age 12) often share similar personality traits that may increase the likelihood for starting drinking. These characteristics include aggression, disruption, and hyperactivity (conduct problems), as well as mental health issues such as anxiety and depression.8 As previously mentioned, genetics may also play a role in the shaping of addiction, since children of alcoholics are between 4 and 10 times as likely to become alcoholics themselves compared to children who do not have close relatives with a substance use disorder.8

It is also possible that the media can influence young people’s perception of drinking. Today, a variety of mediums, ranging from the internet to television ads to billboards, advertise and glamorize alcohol. Teenagers consuming this media tend to develop a positive view of drinking, thus increasing their interest or desire to use alcohol.8

Typical Habits in Adults

Alcohol consumption is prevalent in America, with a 2015 National Survey on Drug Use and Health indicating that 86.4% of people age 18 or older have consumed alcohol at some point in their lifetime.10 The study also states that 56% of respondents reported having a drink within the last month, and 26% said they binge drank in the same time frame.10 Alcohol accounts for thousands of deaths every year, with estimates as high as 88,000 annually. It remains the third leading cause of preventable deaths in the United States.10 However, of the millions of American adults who have an alcohol use disorder, research shows that only 6.7% of people receive treatment.10

It can be difficult to distinguish the causes of alcoholism in a culture where social and binge drinking are normalized. However, generally recognized factors that can contribute to the development of alcoholism include co-occurring mental health disorders, a family history of addiction, drug abuse, and other environmental influences, including poverty.8

What Options for Treatment Are Available?

Alcoholism is a progressive disease that, when left untreated, can be fatal. When someone is addicted to alcohol, they often develop physiological alcohol dependence. When this dependence is significant, someone is likely to experience withdrawal symptoms when they try to stop using and—depending on the frequency, severity, and intensity of alcohol consumption—they can range from mildly uncomfortable to life-threatening.

The mere presence and experience of withdrawal symptoms can make it challenging for people to stop drinking on their own. Examples include:6,11

  • Insomnia.
  • Hand tremors (shakes).
  • Heightened levels of anxiety or depression.
  • Agitation.
  • Seizures.
  • Hallucinations or perceptual disturbances (known as delirium tremens).

Treatment options for alcohol addiction.Fortunately, professional treatment is available, and seeking medical detox is an important first step toward sobriety. In a detox setting, you receive 24/7 medical monitoring, support, and supervision as you transition from acute intoxication to medical stabilization. It’s important to note that detox alone is only the beginning of your recovery journey, and, in and of itself, is not a sufficient mode of treatment.

After successfully completing detox, most people benefit from formal clinical treatment, such as that offered in either an inpatient or outpatient setting, where they can learn relapse prevention strategies and effective coping skills.11 Reach out today for the help and support you need to achieve sustained recovery.


  1. Substance Abuse and Mental Health Services Administration. (2015). Alcohol.
  2. National Institute on Drug Abuse. (2011). Genetics of Alcoholism.
  3. National Institute on Alcohol Abuse and Alcoholism. (1992). The Genetics of Alcoholism.
  4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  5. University at Buffalo. (2016). Alcohol and Depression.
  6. National Institute of Mental Health. Substance Use and Mental Health.
  7. National Institute on Alcohol Abuse and Alcoholism. Underage Drinking.
  8. National Institute on Alcohol Abuse and Alcoholism. (2006). Alcohol Alert- Underage Drinking.
  9. Drug-Free World. (2015). The Truth About Alcohol.
  10. National Institute on Alcohol Abuse and Alcoholism. (2017). Alcohol Facts and Statistics.
  11. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment.
Last updated on November 15, 2018
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