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Updated on September 22, 2021

Causes of Alcohol Use Disorder (AUD)

Overview: Alcohol Use Disorder (AUD)

If you or a loved one struggles 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 cannot control his or her drinking. Someone with alcoholism is preoccupied with alcohol and continues to use it despite the problems that occur after drinking. Alcohol withdrawal symptoms usually occur when not drinking. Over time, someone with alcohol use disorder must drink alcohol more to achieve the same effects.

Binge drinking is considered an alcohol use disorder. Many young adults especially may experience peer pressure to binge drink.

However, most people who binge drink are not alcohol dependent. People who binge drink are more likely to develop a dependency on alcohol.

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

What Causes Alcohol Addiction?

Everyone is different, and many believe that certain people tend to have a stronger reaction to drinking alcohol than others. As a result, this makes them more susceptible to developing an addiction. Specific causes of alcohol addiction and substance use disorders 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 and substance abuse 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 initially, heavy drinking could 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 members may have a history of an 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.

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What Are the Symptoms of Alcoholism?

The symptoms of alcohol abuse are based on the behaviors and physical outcomes that develop as a result of alcohol addiction. People with alcoholism may engage in the following behaviors:

  • Drinking alone
  • Drinking more to feel the effects of alcohol due to having a high tolerance
  • Becoming violent or aggressive when asked about their drinking habits
  • Not eating or eating poorly
  • Neglecting personal hygiene
  • Missing work or school due to drinking
  • Being unable to control drinking habits
  • Making excuses to drink
  • Continuing to drink despite the development of legal, social, or economic problems due to drinking
  • Giving up important social, work-related, or recreational activities due to drinking
  • Expressing that they may be suffering from a mental illness
  • Spending time with other heavy drinkers

People with alcoholism may also experience the following physical symptoms and side effects:

  • Alcohol cravings
  • Withdrawal symptoms when not drinking, like shaking, nausea, and vomiting
  • Tremors (involuntary shaking) the morning after drinking
  • Blackouts of lapses in memory after drinking
  • Illnesses, including alcoholic ketoacidosis, which includes dehydration-like symptoms, or cirrhosis

Do You Misuse Alcohol?

Sometimes it can be challenging to draw the line between safe alcohol consumption and the misuse of alcohol. If you answer yes to some of the following questions, you may misuse alcohol:

  • Do you need to drink more to feel the effects of alcohol?
  • Do you feel guilty about your alcohol consumption?
  • Do you become irritable or angry when you are drinking?
  • Do you have issues at school or work because of drinking?
  • Do you think you should reduce your alcohol intake?

How Does a Professional Diagnose Alcoholism?

Your doctor or healthcare provider can diagnose alcoholism. They will perform a physical exam and ask questions about your problem drinking habits.

Your doctor may ask if you:

  • Drive whilst drunk
  • Have missed work, school, or lost a job due to drinking
  • Require more alcohol to feel ‘drunk’
  • Have experienced blackouts resulting from your drinking
  • Have tried to cut back on alcohol but could not

Your doctor may also use a questionnaire that evaluates alcohol use disorder to help diagnose your condition. Usually, a diagnosis of alcohol use disorder does not involve any other type of diagnostic test.

There is a chance your doctor may order blood work to check your liver function if you display signs or symptoms of liver disease. Alcohol use disorder can lead to severe and lasting damage to your liver.

Your liver removes toxins from your blood. When you consume too much alcohol, your liver has a tougher time filtering the alcohol and other toxins from your bloodstream. This can result in liver disease and other complications.

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.

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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.

How Can You Prevent Alcohol Use Disorder?

You can prevent alcohol use disorder by limiting or reducing your alcohol intake. Women should not consume more than one drink per drink. Men should not drink more than two drinks per day.

If you are concerned, see your doctor to discuss addiction treatment options to stop drinking and to receive medical advice. Inpatient or outpatient treatment programs can help immensely. It would help if you also considered participating in support groups such as local AA meetings or attending self-help programs.

The National Institute on Alcohol Abuse and Alcoholism (NIAA) also has an online tool called NIAAA Alcohol Treatment Navigator, which allows you to find the right treatment.

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

There is evidence that undergoing bariatric surgery could lead to an increased 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.

Treatment Options for Alcohol Abuse & Addiction

  • Inpatient Programs — Inpatient treatment is the most intensive and effective option for alcohol addiction treatment. These prograInpatient treatment is the most intensive and effective option for alcohol addiction treatment. These programs usually last 30, 60, or 90 days. However, they may be longer in some instances. Throughout an inpatient program, you will live on-site in a safe, substance-free environment. You will go through medically supervised detoxification first, then behavioral therapy and other services will be added to your regimen. Many of these treatment programs will assist you with an aftercare program afterward.
  • Partial Hospitalization Programs (PHPs) PHPs are the second most intensive alcohol addiction programs. They are sometimes referred to as intensive outpatient programs (IOPs). Partial hospitalization programs provide comparable services to inpatient programs. These may include detoxification, medical services, behavioral therapy, support groups, and other holistic or custom treatments. The main difference between PHPs and inpatient programs is that you return home and sleep at your house during a partial hospitalization program. Some PHPs provide food and transportation. However, this varies by program. PHPs are ideal for new patients, as well as patients who have completed an inpatient program and still require intensive treatment.
  • Outpatient Programs Outpatient programs are less intensive than inpatient programs and PHPs. They are best for people who are highly motivated to achieve sobriety and have responsibilities at work, home, or school. Outpatient treatment programs customize your treatment sessions around your schedule. Outpatient programs can help new patients achieve success. They may also be a part of aftercare programs once a patient completes an inpatient program or PHP.
  • Medication-Assisted Therapy (MAT) Certain patients qualify for medication-assisted therapy. Some medications can assist you throughout detoxification and withdrawal. Others can reduce cravings and normalize your bodily functions. Disulfiram (Antabuse), acamprosate (Campral), and naltrexone (Revia and Vivitrol) are the most common medications used to treat AUD. MAT can help prevent relapse and increase your chance of recovery if combined with other therapies.
  • Support Groups Support groups are peer-led organizations made of people dedicated to helping each other stay sober. They can be the first step towards sobriety or a component of an aftercare plan. Many of these programs follow the 12-step approach.

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Alcohol use disorder, Mayo Clinic, July 2018,

Trauma increases risks for alcohol problems in women, Washington University in St. Louis, February 2011,

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,

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,

Treatment for Alcohol Problems: Finding and Getting Help, National Institute on Alcohol Abuse and Alcoholism (NIH), March 2021,

Gilbertson, Rebecca et al. “The role of selected factors in the development and consequences of alcohol dependence.” Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism vol. 31,4 (2008): 389-99,

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