How do people get addicted to alcohol?

What causes alcohol addiction?

It's popular belief that people become addicted to alcohol use the longer they indulge. That is, they grow so resistant to the pleasurable effects of alcohol over time that they now need to take larger amounts for them to feel the stimulation significantly.

But new research has thrown doubt over that belief. People get addicted to alcohol because they are more sensitive to the pleasurable effects. So it's not about how long or how much they consume. If your brain's reward system gets high stimulation from alcohol, you may be at risk of alcohol use disorder. That's why two people can start drinking at the same time but only one becomes addicted.

This means that it isn't about becoming less sensitive to the effects over time that causes people to drink more. Instead, it is because these individuals were very sensitive to the pleasurable effects of alcohol right from the beginning. Knowing the significant rewarding effects they obtain from the substance, they tend to drink more to achieve more of that feeling.

The Study

The research, published in the American Journal of Psychiatry, studied 190 young adult drinkers over the course of 10 years. They were put under binge-drinking scenarios in the laboratory at three regular intervals throughout the period.

The participants' sensitivity to alcohol was tested at the beginning of the study and ten years later.

The results discovered that participants who developed alcohol use disorder experienced a stronger pleasurable response in the beginning. And at the end of 10 years, their responses, liking, and wanting were also at the highest levels, even higher than initially.

This goes against prior perceptions that response to alcohol wanes over time, causing the individual to drink more to maintain their desired reward level (pleasure). The study shows that it's, in fact, the opposite.

Why the Research is Important

Past studies about alcohol use disorder have focused more on the impairing effects of alcohol. "The thinking that alcoholics do not like the effects of alcohol over time is based on adhoc reports of patients entering treatment," says lead author Andrea King, Ph.D., professor of psychiatry and behavioral neuroscience at UChicago Medicine.

Of course, there are adverse effects of excessive drinking, including aggressive behavior and other social delinquencies. And some affected individuals seek treatment through therapy or medication.

But it's worthy to note that people battling with alcohol addiction seek treatment not because they do not like the drinking itself. In fact, these people actually enjoy drinking more, since they have higher sensitivity to the euphoric effects of alcohol.

And this explains why some people are only social drinkers -- only drinking a few bottles and stopping controllably -- while others just can't stop once they've started.

This knowledge will also help mental health experts put their AUD patients at ease. Rather than believing that they're addicts because they're weak, AUD patients undergoing therapy can feel better knowing it's because their brain just responds differently to alcohol.

This kind of information can empower patients to make better decisions.

For example, it's always been thought that people with AUD like alcohol but just can't stop using it. But they do like it, and that's what probably leads to relapse, as they long for the pleasurable effects once more.

If people know they are addicted to alcohol because they enjoy it and not because they can't help it, they can find healthier means to obtain pleasure and manage stress rather than indulging in drinking.

Author

Satu H. Woodland, PMHCNS-BC, APRN Satu Woodland is owner and clinician of Hope Mental Health, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.  Ms. Woodland with her background in nursing, prefers a holistic and integrative approach to mental health care that addresses the mind and body together. While Ms. Woodland provides medication management services in all her patients, she believes in long-lasting solutions that include a number of psychotherapies, namely cognitive behavioral therapy, exposure and response prevention therapy, attention to lifestyle, evidenced based alternative psychiatric care and spirituality. If you’d like to gain control over your mental health issues, call Hope Mental Health at 208-918-0958, or use the online scheduling tool to set up an initial consultation.