Overview: Alcohol Use Disorder (AUD)

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If you or someone you love is struggling with an alcohol problem, you might be curious about the causes of alcohol addiction.

Alcohol use disorder (AUD), or alcohol addiction, occurs when a person is unable to control his or her drinking. Someone with alcoholism is preoccupied with alcohol and continues to use it despite the problems that occur after drinking. Withdrawal symptoms usually occur when not drinking. Over time, someone with alcohol use disorder must consume more to achieve the same effects.

Binge drinking is considered an alcohol use disorder. Most people who binge drink are not alcohol dependent. People who binge drink are more likely to develop dependency to alcohol.

A person’s addiction to alcohol can range from mild to severe, but mild disorders can escalate and cause long-term problems too.

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What Causes Alcohol Addiction?

Everyone is different and many believe that certain people tend to have a stronger reaction to alcohol than others. As a result, this makes them more susceptible to developing an addiction. Specific causes of alcohol addiction include genetic, psychological, social, and environmental factors in a person’s life.

It’s also important to note that drinking changes a person’s brain function. Excessive alcohol consumption can have long-lasting effects on neurotransmitters in the brain, decreasing their effectiveness or even mimicking them.

Alcohol also destroys brain cells and contracts brain tissue. Even if someone was not likely to develop an alcohol use disorder originally, binge drinking can change the brain to make addiction more likely.

Several risk factors are potential causes of alcohol addiction, including:

  • Drinking too much for an extended period or being a regular binge drinker. Heavy alcohol users are considered to be individuals who binge drink five or more times during the month.
  • Using alcohol at an early age, especially when binge drinking is involved
  • Family history of alcohol use disorder
  • History of emotional or other trauma
  • Depression and other mental health problems, including anxiety, schizophrenia, or bipolar disorder
  • Bariatric surgery, which is surgery performed to stimulate weight loss

Social and Cultural Causes of Alcohol Addiction

A person’s social life or environment alone is unlikely to cause an alcohol abuse disorder, but it can increase a person’s odds of developing a problem if he or she is already at risk.

People already at risk for alcohol use disorder are more likely to become alcoholics if they have a partner or close friends who drink regularly. Receiving the message, especially at a young age, that it is acceptable to drink too much also plays a role in a person’s likelihood to develop a problem.

Parents, peers, and role models influence young people and these peoples’ attitudes toward alcohol will increase or decrease someone’s risk of having an alcohol problem later in life.

Graphic of brain signifying brain trauma.

Trauma and Alcohol Addiction

Experiencing trauma increases a person’s risk of developing alcohol use disorder. This is especially true when the trauma involves violence or assault, including childhood physical and sexual abuse or rape. Those who experienced other types of traumatic events such as floods, fires, natural disasters, accidents, or witnessing harm to someone else also have a higher risk of developing a problem with alcohol.

According to a study conducted by researchers at Washington University School of Medicine in St. Louis and the Midwest Alcoholism Research Center (MARC), women with post traumatic stress disorder (PTSD) have an elevated rate of alcohol dependence.

Women who have experienced traumatic events are far more likely to develop an alcohol addiction. Some estimates show double the risk for these women.

A different study led by the same research team found genetic factors likely play a role and women with a family history of either PTSD or alcohol use disorder have a higher risk for developing both disorders.

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Is Weight Loss Surgery One of the Causes of Alcohol Addiction?

There is evidence that undergoing bariatric surgery could increase the risk of developing alcohol use disorder or relapsing if you’ve previously dealt with AUD.

According to a study published in the Journal of the American Medical Association, the risk is highest about two years after surgery. There was speculation based on anecdotal evidence of a connection between alcohol abuse and weight loss surgery.

Researchers found those undergoing Roux-en-Y procedures more than doubled their risk for alcohol problems. The Roux-en-Y procedure involves creating a small pouch from the stomach and connecting the pouch directly to the small intestine. After the procedure, food goes into the pouch and then directly into the small intestine, bypassing most of the stomach and part of the small intestine.

This study looked at 2000 obese people in the immediate, one- and two-year period after undergoing surgery. The percentage of people with alcohol abuse disorder before surgery remained the same immediately and one year after undergoing bariatric surgery.

Although, in the second year, the percentage of people abusing alcohol increased. The study revealed that 20.8 percent of RYGB patients went on to develop alcohol use disorder symptoms within 5 years of having the procedure. By contrast, only 11.3 percent of the laparoscopic gastric banding patients developed similar problems.

Researchers point out this does not prove the procedure is one of the causes of alcohol addiction. Still, because of how this specific procedure affects how the body metabolizes alcohol and allows it to reach the small intestine faster, there is likely a link. Another possibility is that RYGB increases tolerance by altering the genetic expression of the hormones that deal with reward circuits in the brain.

Researchers also found that instances of alcohol abuse disorder were higher among younger male study participants who were:

  • Cigarette smokers
  • Recreational drug users
  • Drank more than two drinks per week
  • Felt socially isolated

Researchers point out this information makes it easier to recommend the best possible weight -loss procedure for a specific patient. It also provides directives for after-care following a procedure.

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Resources +



Sartor CE, McCutcheon VV, Pommer NE, Nelson EC, Duncan AE, Waldron M, Bucholz KK, Madden PAF, Heath AC. Posttraumatic stress disorder and alcohol dependence in young women, Journal of Studies on Alcohol and Drugs, vol. 71(6), Nov., 2010. pp. 810-818, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2965479/

Sartor CE, McCutcheon VV, Pommer NE, Nelson EC, Grant JD, Duncan AE, Waldron M, Bucholz KK, Madden PAF, Heath AC. Common genetic and environmental contributions to post-traumatic stress disorder and alcohol dependence in young women, Psychological Medicine, published online in Nov., 2010. DOI:10.1017/S0033291710002072, https://pubmed.ncbi.nlm.nih.gov/21054919/

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