What are the causes of alcoholism?

The phrase ‘alcoholism’ has been known over the years by a range of terms such as alcohol abuse, alcohol dependence and most recently as alcohol use disorder.

People suffering from alcoholism continue to drink without thinking about the negative consequences their actions are having. These negative consequences could include losing a job or relationships you value, or suffering financially.

Even though on a subconscious or conscious level they may know that their actions are causing negative consequences on both their life and the lives of the people they love; this is not enough for them to stop for good.

Whilst the consequences of alcoholism are known, the exact causes of alcohol use disorder are less well-known.

It’s well researched that once addicted, alcohol increases the ‘pleasure’ feeling in the brain. This ‘pleasure’ feeling makes you feel good, therefore making you want to drink more often even if it does cause harm.

Eventually, if consumed excessively, this pleasurable feeling associated with drinking alcohol does go away, leaving the individual with withdrawal symptoms.

However, the root causes of what might cause someone to start drinking excessively in the first place is yet known.

However, some research has been done into what could possibly cause someone to become dependent on alcohol.

Some causes may include gender, family history, comorbid psychiatric and pre-existing substance use disorders [1].

1. Gender

Data suggests that the rate of drinking and subsequent risks for alcohol-related addiction may be different for both men and women. Generally, men become addicted to alcohol at an earlier age than women do [2].

Although there is no definite reason why, studies suggest that the immediate, personal and professional costs to women may be greater if they were to become addicted to alcohol.

For example, data suggests that women report more psychiatric, medical and employment consequences from excessive drinking than men do [3].

2. Family History

It is well researched and documented that alcoholism runs in families [4].

There is some research that genetics play a large role in determining whether or not someone might become addicted to alcohol.

However, an individual is also much more likely to become addicted to alcohol if they are brought up in an environment where they’re exposed to alcoholism, and where alcoholism is normalised.

Whether it’s due to genetics or the environment in which you were brought up in, offspring of alcoholics are approximately four times more likely to develop an addiction to alcohol than someone whose family do not expose them to excessive drinking and addiction [5].

3. Psychiatric Comorbidity

Psychiatric Comorbidity is defined as having two or more psychiatric disorders, simultaneously at one time; one of which is a substance use disorder [10]. People with an alcohol use disorder are much more likely to become addicted to alcohol too [6].

Data from the National Institute of Mental Health and NESARC revealed that individuals suffering from alcohol dependency were nineteen times more likely to meet the criteria for drug dependence [7].

As there’s a high correlation between alcohol use disorder and other psychiatric disorders, an individual is much more likely to suffer from alcohol dependence if they are already suffering from another psychiatric disorder [7].

4. Age

Age is a large factor in determining whether or not someone is going to develop an addiction to alcohol.

Data suggests that if an individual engages in excessive drinking prior to the age of 15, then they are more likely than others to develop an alcohol use disorder.

Conversely, if an individual develops an alcohol addiction after the age of 60 then they are more likely to suffer from biomedical consequences rather than psychosocial. These biomedical consequences can often have detrimental effects on their health and wellbeing at this late age in life.

Who is at a Higher Risk of Alcoholism?

That being said, generally speaking, some people are at a greater risk of becoming addicted to others. The following risk factors can’t make you more likely to become addicted to alcohol [9]:

  • Genetics
  • Family history
  • Underage drinking
  • Frequent drinking
  • If you’re a male
  • If you’re suffering from other psychiatric disorders

However, these factors by no means dictate or ensure that you will become addicted to alcohol. It’s important to remember that even if you qualify for a number of the above factors, you are still able to avoid or seek help for any alcohol or substance abuse.

Stages of alcoholism

With any disorder, it’s important to know that it’s not created overnight. Alcohol addiction, along with other addictions, emerges over a long period of time.

The road to alcohol addiction has many stages, and knowing the signs and symptoms of each stage can help you to understand when and what kind of help you need.

Interventions in the early stages of alcohol addiction can help significantly reduce the severity, impact consequences the addiction can have on your life.

Stage 1 – Alpha Alcoholism [11]

Alpha alcoholism is the earliest stage of the disease and consists of purely psychological dependence on the effects that alcohol has on the body. This could be to reduce or relieve body pain or emotional trauma or suffering.

At this stage, the individual is often referred to as the ‘problem drinker’ and when they drink, their drinking causes social and personal awkwardness and issues.

Although they continue to drink, these individuals can indeed stop if they really want to. They haven’t lost total control at this stage, they are purely choosing to drink.

They often begin to experiment with binge drinking and start to test their limits. If they’re not at the stage of consuming incredibly frequently, they do start to drink exceptionally large amounts of alcohol at one time.

Binge drinking to this extent is incredibly dangerous and can on some occasions lead to coma or death.

Stage 2 – Beta Alcoholism [11]

Stage two is known as Beta alcoholism. This is where an individual’s drinking increases significantly as they start to drink almost every day.

Although at this stage an individual won’t be suffering from any withdrawal symptoms, people around them will start to notice they are drinking often and it will become incredibly hard to hide from friends and family.

At this stage, there generally becomes a higher emotional attachment to drinking as they begin to use alcohol as a crutch to feel better.

Stage 3 – Gamma Alcoholism [11]

Gamma Alcoholism involves a physical dependence and total loss of control. At this point, they’re suffering from addiction disease.

Their drinking becomes frequent and uncontrolled. Individuals at this stage of alcoholism become more depressed and anxious and they may start to develop sleeping problems.

Many drinkers in this stage are more likely to drink and drive, as they start to enjoy the effects of the alcohol more than the consequences of their actions.

At this stage, an individual might suffer from the following social changes:

  • Relationship problems
  • Lack of or change in a friendship group
  • Lack of healthy social activity
  • Financial issues
  • Struggles in work

Stage 4 – Delta Alcoholism [11]

Delta Alcoholism is where an individual suffers similar symptoms to those suffering from Gamma Alcoholism; but instead of a loss of control, they are now struggling to abstain.

At this stage, the individual has developed a tolerance to drinking but is still experiencing the negative consequences of doing so. The individual is aware of these negative consequences, but no longer has any control over their alcohol consumption.

At this stage, individuals start to develop withdrawal symptoms which involve experiencing:

  • Nausea
  • Body tremors
  • Sweating
  • Severe irritability
  • A racing heart
  • Trouble sleeping

Stage 5 – Epsilon Alcoholism [11]

This is the final and most advanced stage of the disease. This is historically and scientifically known as dipsomania (uncontrollable craving for alcohol) and requires harsh and professional help.

At this stage, you no longer want to drink for pleasure. It is now a physical and psychological need to drink.

Compulsive behaviours are now prominent and the individual may start to engage in other unhealthy habits such as taking drugs, avoiding responsibility and financial concerns.

If you are someone you know is concerned about the causes of alcohol addiction, or that they may be becoming addicted to alcohol, then it’s important to seek help from your GP or medical professional.

References

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860467/

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[10] Fridell, M., Bäckström, M., Hesse, M. et al. Prediction of psychiatric comorbidity on premature death in a cohort of patients with substance use disorders: a 42-year follow-up. BMC Psychiatry 19, 150 (2019). https://doi.org/10.1186/s12888-019-2098-3

[11] Jellinek, E. M. (1960). The disease concept of alcoholism. Hillhouse Press. https://doi.org/10.1037/14090-000