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Updated on April 7, 2022

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 can't control their drinking. Someone with alcoholism is preoccupied with alcohol and continues to use it despite the problems it causes.

When not drinking, these people usually experience withdrawal symptoms. Due to tolerance and to avoid withdrawal, someone with AUD must drink more and more alcohol to achieve the same effects.

What Causes Alcohol Addiction?

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.

There are genetic, psychological, and environmental reasons for this. Risk factors include:

  • Using alcohol at an early age, especially when binge drinking is involved
  • Having family members who suffer from AUD
  • Trauma, depression, and other mental health problems
  • Previous history of substance abuse

While there are a variety of risk factors, the immediate cause of alcohol addiction is heavy drinking.

The NIAAA defines heavy drinking as follows:

  • For men: more than 4 drinks a day or more than 14 drinks per week
  • For women: more than 3 drinks a day or more than 7 drinks per week

Heavy drinking changes a person’s brain function. It can have long-lasting effects on neurotransmitters in the brain, decreasing their effectiveness. The brain then becomes dependent on alcohol.

Repeat alcohol exposure also destroys brain cells and contracts brain tissue. Even for someone not genetically predisposed to AUD, heavy drinking changes the brain to make addiction more likely.

Social and Cultural Causes of Alcohol Addiction

A person’s environment alone is unlikely to cause AUD, but it can increase their odds of developing a problem.

This environment ranges from laws regulating alcohol to advertisements for alcoholic beverages to school, work, and family life.

A good example of this can be seen in young adults of legal drinking age.

Young people are more susceptible to peer pressure and messages in advertising. In college, they're exposed to the additional risk factor of binge drinking.

This risk is further magnified by the fact brain development can last into one’s mid-twenties. Research shows that when the brain is exposed to alcohol while it's still developing, the risk for AUD goes up.5

According to the NIAA, 9 percent of college students meet the criteria for AUD.9

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Mental Health and Alcohol Addiction

Roughly 37 percent of alcohol abusers have at least one serious mental health condition.7

Mental health conditions associated with alcoholism include:

Post-traumatic Stress Disorder (PTSD)

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 PTSD have an elevated rate of alcohol dependence.2

Mood Disorders

Twenty to 60 percent of cases of drug and alcohol dependence involve mood disorders such as depression and bipolar disorder.6

Anxiety

Multiple studies show someone with an anxiety disorder is 2.1 to 3.3 times more likely to develop AUD.11

Other mental health conditions linked to alcoholism include:

  • Attention-deficit/hyperactivity disorder
  • Antisocial personality disorder
  • Obsessive-compulsive disorder
  • Schizophrenia

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 legal, social, or economic problems 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

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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 while 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.

How Can You Prevent Alcohol Use Disorder?

You can prevent alcohol use disorder by limiting or reducing your alcohol intake.

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.

Consider 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.

Treatment Options for Alcohol Abuse & Addiction

Here are some of the best treatments for AUD:

Inpatient Programs

Inpatient treatment is the most intensive and effective option for alcohol addiction treatment. These programs usually last 30, 60, or 90 days. They may be longer in some cases.

Throughout an inpatient program, you'll live on-site in a safe, substance-free environment. You'll go through medically supervised detox first, then behavioral therapy. Other services may be added to your regimen.

Many of these treatment programs assist you with an aftercare program afterward.

Partial Hospitalization Programs (PHPs)

PHPs are the second most intensive alcohol addiction programs. They're sometimes called intensive outpatient programs (IOPs). PHPs provide comparable services to inpatient programs.

These services may include:

  • Detox
  • Medical services
  • Behavioral therapy
  • Support groups
  • 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. This varies by program.

PHPs are ideal for new patients and those who have completed an inpatient program and still require intensive treatment.

Outpatient Programs

Outpatient programs are less intensive than inpatient programs and PHPs. They're best for people who are highly motivated to achieve sobriety. Patients usually have responsibilities at work, home, or school.

These programs customize your treatment sessions around your schedule.

Outpatient programs may be part of aftercare once a patient completes an inpatient program or PHP.

Medication-Assisted Therapy (MAT)

Certain people qualify for medication-assisted therapy. Some medications can assist you throughout detox and withdrawal. Others can reduce cravings and normalize your bodily functions.

The most common medications used to treat AUD are:

  • Disulfiram (Antabuse)
  • Acamprosate (Campral)
  • Naltrexone (Revia and Vivitrol)

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 part of an aftercare plan.

Many of these programs follow the 12-step approach.

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Resources

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  1. "Alcohol use disorder." Mayo Clinic, July 2018.
  2. Dryden, Jim. “Trauma Increases Risks for Alcohol Problems in Women - the Source - Washington University in St. Louis.” The Source, 13 Jan. 2016.
  3. Sartor, Carolyn E. “Posttraumatic Stress Disorder and Alcohol Dependence in Young Women*.” Journal of Studies on Alcohol and Drugs, vol. 71, no. 6, 2010, pp. 810–818.
  4. 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 : 389-99.
  5. Witt, Ellen D. “Research on Alcohol and Adolescent Brain Development: Opportunities and Future Directions.” Alcohol, vol. 44, no. 1, 2010, pp. 119–124.
  6. Quello, Susan. “Mood Disorders and Substance Use Disorder: A Complex Comorbidity.” Science & Practice Perspectives, vol. 3, no. 1, 2005, pp. 13–21.
  7. Dual Diagnosis: Substance Abuse and Mental Health.” HelpGuide.org, 8 Oct. 2021.
  8. "Drinking Levels Defined." National Institute on Alcohol Abuse and Alcoholism (NIH). www.niaaa.nih.gov.
  9. College Drinking.” National Institute on Alcohol Abuse and Alcoholism. (NIH) www.niaaa.nih.gov. "Treatment for Alcohol Problems: Finding and Getting Help." National Institute on Alcohol Abuse and Alcoholism (NIH) www.niaaa.nih.gov. Smith, Joshua P, and Carrie L Randall. “Anxiety and alcohol use disorders: comorbidity and treatment considerations.” Alcohol research : current reviews vol. 34,4 : 414-31.

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