For a long time, alcoholism was treated like a moral failing or a bad habit. People might ask, “Why can’t you just stop drinking?” Today, we understand that addiction goes deeper than any average bad habit. We also understand real physiological changes are occurring in the brain of someone who’s struggling with alcoholism. But what causes someone to become physically addicted to alcohol, and is it possible to break that addiction?
Learn more about physical addiction and what causes it to happen in people who become alcohol-dependent.
What is Alcohol Dependence?
Alcohol addiction, more commonly called alcoholism, is a complicated disease that affects the brain. Though alcohol is legal, it is a psychoactive substance that can still have profound effects on the brain and nervous system. These effects can lead to chemical dependence and addiction. To understand physical alcohol addiction, it’s important to understand the difference between chemical dependency and addiction.
Chemical dependency, sometimes called physical addiction, is when your brain chemistry has adapted to the presence of alcohol in your system. Some drugs, like marijuana, don’t cause very potent chemical dependence, but people can still become psychologically dependent on the drug.
Alcohol’s psychoactive properties can lead to neurochemical consequences such as tolerance, when the body becomes used to alcohol, and dependence. If you binge drink or drink often, your brain will start to get used to alcohol. It may not trigger the same chemical response as it did when you first used it. It may require more alcohol to achieve the same effects.
If you continue to drink, you may start to become chemically dependent on alcohol. This means that your brain will start to integrate alcohol into your natural brain chemistry. It may adapt your brain chemistry around the foreign chemical, relying on it to maintain normal brain chemistry. If you stop drinking, you’ll experience the consequences of suddenly imbalanced neurochemistry in the form of withdrawal symptoms.
Addiction has been diagnosed as a severe substance use disorder. It’s usually identified by compulsive drug use despite harmful consequences. Addiction is related to physical dependence, but it’s actually a distinct condition that involves the brain’s reward center, which causes you to seek out drugs or alcohol like you would seek out life-sustaining things such as water and food.
How Alcoholism Works
Alcohol or, more formally ethanol, is a psychoactive substance that comes from the fermentation of certain plants and vegetables.
These chemical acts as a central nervous system depressant in the human brain, causing your nervous system to slow down. Alcohol achieves its effects by influencing a naturally occurring neurotransmitter in the brain called gamma-aminobutyric acid (GABA), and its respective receptor.
GABA is responsible for controlling central nervous system excitability in the brain.
When you are anxious, alert, or excited, GABA calms you down and allows you to relax and rest.
Alcohol binds to GABA receptors on a different binding site than the GABA neurotransmitter itself. Once alcohol is in position, it increases the effectiveness of GABA and the overall intensity of its effects. That’s why alcohol can make you feel tired, lethargic, foggy-headed, and unsteady. Intoxication can also cause slurred speech, loss of motor control, slowed breathing, and memory lapses.
Psychoactive drugs that disrupt, influence, or change the way your brain sends communication signals can potentially cause physical addiction. Since alcohol causes GABA to facilitate intense nervous system depression, your brain may stop producing inhibitory chemicals and start producing more excitatory chemicals as it tries to balance brain chemistry. As alcohol is incorporated into your brain chemistry, you will need more of it to feel intoxicating effects. You may also need it at odd hours, like in the morning, to avoid uncomfortable symptoms.
Addiction occurs when the reward center of your brain mistakes alcohol use for normal, life-sustaining activity. Your reward center can pick up on the things that help you to survive, like eating, drinking, and forming personal connections.
When you encounter these positive situations, your body releases one of several feel-good chemicals like dopamine, serotonin, oxytocin, and endorphins. Alcohol can affect some of these chemicals.
Most notably, it causes an increase in dopamine release, which contributes to alcohol’s rewarding effects. With repeated use, alcohol’s release of these feel-good chemicals may cause your reward center to take notice. It will then do what it’s designed to do and learn to encourage more alcohol use in the future.
You’ll start to feel intense alcohol cravings. Finally, addiction is characterized by a compulsion to drink that can get out of your control.
What is Involved in Alcohol Addiction Treatment?
Though dependence and addiction are very difficult to overcome, alcohol use disorders can be treated and successfully managed.
The first step in addressing alcohol addiction is to treat dependency and withdrawal. When you stop drinking, you may experience potentially dangerous withdrawal symptoms, especially if you stop abruptly.
Medical detox can help you to avoid dangerous symptoms such as seizures and delirium, and it can help treat uncomfortable symptoms. However, detox lasts for about a week to 10 days and may not be enough to facilitate a lasting change.
Instead, addiction treatment is a longer process that involves personalized treatment for biological, psychological, social, legal, and financial issues that are related to addiction.
Treatment may also include therapies based on your needs, including individual, group, and family therapy.
Causes of Alcoholism
It’s difficult to definitively pinpoint any one cause of alcoholism, and it’s more likely to be caused by multiple factors at once. According to the National Institute on Drug Abuse (NIDA), the more risk factors you have, the more likely you are to develop an addiction. However, risk factors seem to center around three areas: genetics, environment, and development. On the other hand, if you do have multiple risk factors in these areas, it doesn’t mean alcoholism is inevitable.
Studies have shown a strong link between a person’s genetic makeup and the likelihood that they will develop an addiction. Your family history, other genetic disorders, and your ethnicity may all be risk factors for addiction. If you have a parent or grandparent that struggled with alcoholism, it’s wise to be extremely careful with drugs and other substances.
Your surroundings can also influence your likelihood of becoming alcohol dependent. Social influences, family and friends, peer pressure, alcohol availability, and advertisements are all examples of environmental factors that can lead you to use and abuse alcohol. Stressful jobs, loss, trauma, and other challenging psychological and emotional circumstances can also be risk factors for addiction.
Development is where environmental and genetic factors meet. For instance, as you grow up, early exposure to alcohol can make it more likely for you to develop an alcohol use disorder later. If you are genetically predisposed to other mental health problems like depression, you may also have increased risk factors for substance use problems.