Alcoholism Causes and Risk Factors

A guide to most of the risk factors (and the studies behind them) that can lead to the development of a drinking problem.

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ARTICLE OVERVIEW: Many risk factors contribute to a drinking problem. We review the major ones, starting with psychological and then looking at genetic and cultural factors.



Causes of Alcoholism

Alcoholism is also known as “alcohol use disorder” (AUD). It is a chronic brain disease that can impact anyone no matter the gender, age, ethnicity, personality, nor body type. Everyone is at risk. But how does alcoholism begin?

A drinking problem doesn’t usually happen over night. Most cases develop gradually over a period of time. While it can sometimes develop quickly and aggressively, an AUD usually takes a longer period to develop. According to SAMHSA’s national survey on drug use and health,over 15 million Americans aged 12 or older had an alcohol use disorder in 2016. What are the causes for this difficult disease?

There is no fixed formula for the onset of an AUD. Many studies has shown that alcoholism is influenced by a variety of factors. These factors interact differently in each person causing alcohol disorder in some, and not in others. The risk factors can be divided into two categories:

External factors:

  • Age
  • Cultural norms
  • Education
  • Employment status
  • Environment
  • Family
  • Social norms
  • Religion

Internal factors:

  • Drinking history
  • Genetics
  • Personality
  • Personal choice
  • Psychological conditions

The numerous risk factors make it impossible to predict whether any person will develop alcohol use disorder. They just increase the chance that a person will develop this disorder. Even if you have some of the risks factors it doesn’t mean that you will become an alcoholic.

But, regardless of when the drinking problems start or what caused them, there are many options for treatment that can help you get back your life on track. Do not waste time, reach out for help as soon as possible.

Psychological Factors

People with certain psychological conditions are at higher risk of developing alcohol use disorder. Many people with psychological disorders turn to alcohol as a coping mechanism for their disorder. For instance, individuals with depression claim that alcohol elevates their mood, while those with schizophrenia claim that drinking quiets down the voice in their head. One study published in the journal BioMed Central estimated that:

  • More than 40% of people with bipolar disorder can develop a drinking problem.
  • More than 45% of people diagnosed with schizophrenia can develop a drinking problem.
  • More than 25% of people with major depression can develop a drinking problem.
  • More than 80% of people with anti-social personality disorder can develop a drinking problem.

Personality Factors

Person’s personality is clearly associated with drinking patterns. There are many theoretical models showing connection between effects of personality on alcohol use and its problems.

Indeed, some personalities are more prone to developing alcohol use disorder than others. Numerous studies show links between specific personality traits and alcohol abuse. Some of the most common traits related to alcohol abuse include a person’s impulsiveness/ disinhibition and these five traits:

  • Agreeableness.
  • Conscientiousness.
  • Extraversion.
  • Neuroticism.
  • Openness to experience.

Still, a recent meta-analysis suggests that among the five-factor traits only low conscientiousness, low agreeableness, and high neuroticism are significantly linked to alcohol use disorder.

In sum, there are numerous theoretical models with varying degrees of empirical support whose goal is to answer the question how and why certain personality develop drinking problems. Keep in mind that these models are neither all-inclusive nor mutually exclusive. Check out this illustration of multiple pathways related to personality that show alcohol use disorder might develop:

Personal Choice Factors

The personal choice to start drinking is a risk factor of developing alcohol dependence. For example, an individual who has decided that they will never have a drink, can obviously not develop an AUD. Also, people who choose to avoid social situations where drinking occurs heavily, are less likely to develop dependence.

On the contrary, people who love to socialize with few drinks, are more prone to developing alcoholism.

Whether you are at risk of developing alcohol use disorder or not, the choice to try alcohol is yours. You make the decision to try it or not.

Drinking History Factors

An individual’s drinking history plays an important part of developing alcohol use disorder. People who started drinking at early age, and continue into their adulthood are at high risk of becoming alcohol dependent.

Also, the National Institute on Alcohol Abuse and Alcoholism lists few drinking patterns that show drinking problems:

For women, problem drinking is:

  • Drinking more that 1 standard drink daily.
  • Drinking more than 7 drinks weekly.
  • Drinking more than 3 drinks on any single day.

For men, problem drinking is:

  • Drinking more than 2 drinks daily.
  • Drinking more than 14 drinks weekly.
  • Drinking more than 4 drinks on any single day.

Binge drinking, by definition is a drinking pattern that builds up the blood alcohol concentration (BAC) to 0.8 g/dL or more. This usually happens after 4 drinks for women, and 5 for men in one drinking session. Heavy drinking is a binge drinking on 5+ days in a period of one month.

Even though a person may have a genetic predisposition to developing alcohol use disorder, it doesn’t mean that they will become alcoholic.

Genetic Factors

NIAAA’s genetic research shows that genetic factors account for 50 to 60 percent of the variance in risk for developing alcohol use disorder. Moreover, children of alcoholic parents have an approximately four times greater risk of becoming alcoholic themselves.

Still, there is no empirical data that identifies what genes are responsible for increasing the risk of becoming alcohol dependent.  However, there are many genes in person’s DNA that can increase the risk of becoming alcohol dependent. A combination of these genes with personality traits, and various environmental factors may have the key of alcoholism. Check out this diagram to help you see the relationship between genes and environment of developing AUD:

Familial Factors

If alcoholism runs in your family, the risk of developing alcohol use disorder is higher that for someone who does not have a family history of AUD. Growing up around a parent who struggles with alcohol problems may change your perspective: you may see drinking as normal, and fall victim to bad habits, or learn the negative effects of alcohol, and never touch it.

Even though genetics and familial (heredity) are closely linked, there is a difference when discussing genetic versus familial diseases:

  • A person with genetic disease has abnormality in their genome.
  • A person with a familial disease has received a genetic mutation from their parents’ DNA.

Environmental Factors

Environment has a huge impact on becoming alcohol dependent. How? For example, if a person cannot cope with stress, they might choose drinking as a way to deal with the stress. Moreover, if an individual has experienced a traumatic event, the chances to turn to drinking are enormous.

Some of the many environmental factors related to alcoholism include:

  • Attitudes.
  • Bad parenting.
  • Beliefs.
  • Culture.
  • Financial power.
  • Lifestyle.
  • Physical abuse.
  • Peer pressure.
  • Sexual abuse.

Religious Factors

Every religion has a different view towards alcohol use. Islam promotes total abstinence, while Catholicism have integrated alcohol use into some religious ceremonies. One study published in the journal Drug and Alcohol Dependency showed that individuals who viewed their religion as promoting abstinence were less likely to develop alcohol dependence. Also, drinking was highly associated with person’s religious commitment: if the religion promoted abstinence the percentage of reduced drinking was higher.

Moreover, the U.S. National Alcohol Survey showed diverse patterns of abstention and drinking that shows that religion is important for drinking behaviors.

Social and Cultural Factors

Alcohol use varies across gender and ethnicity. Worldwide, men drink more than women. According to the 2013 National Survey on Drug Use and Health, American men drink more than women:

  • Regular drinking: 56% vs. 47%
  • Binge drinking: 30% vs. 16%
  • Heavy drinking: 9% vs. 3%.

Among ethnic and racial groups, Caucasians report the highest rate of alcohol use among people aged 12+, while American Indian/Alaska Natives report the highest rate of binge drinking. Moreover, this SAMHSA’s report shows the following rate on demographics and addiction rates:

  • American Indian/Alaska Native: 14.9%
  • Native Hawaiian and Other Pacific Islander: 11.3%
  • Hispanic: 8.6%
  • Caucasian: 8.4%
  • African American: 7.4%
  • Asian: 4.6%

Additionally, this analysis show that there are many underlying social and cultural factors contributing to the numbers above. For instance, people with high socioeconomic status tend to drink more frequently than others, while people with low socioeconomic status tend to drink in larger quantities of alcohol.

On the other hand, cultural norms play a huge role in developing AUD. African Americans and Latinos report more conservative claims towards alcohol use compared with Whites. However, some studies have found out that drinking problems differ across Latino subgroups, such as higher rates of alcohol use disorder among Mexican-American and Puerto Rican men compared with Cuban Americans and Central and South Americans. As a cultural norm, machismo, which is a cultural influence for many generations of Latino male identity, suggest that Latino men attempt to appear strong and masculine because of cultural values, and drinking huge amounts of alcohol is one of the ways to show masculinity. On the contrary, Asians are believed to have higher abstention rates.

Also, alcohol consumption can be linked to a complex array of factors overlapping with each other, ranging from individual to cultural and societal factors. High social status suggest that social networks and connection influence overall health. For example, people who have higher levels of social support are thought to be healthier because they have better links and access to health services, and greater financial support.

Finally, this NIAAA pamphlet shows that the Native American population have a 60 percent lifetime prevalence rate for the development of alcohol use disorders and alcohol dependence.

Read this study Social and Cultural Contexts of Alcohol Use published in the journal Alcohol Research: Current Reviews to find more social and cultural risk factors including:

  • Discrimination factors.
  • Immigration factors.
  • Community factors.
  • Societal Influences (advertising, marketing, and social media).

Age Factors

One of the important risk factors for developing alcoholism is the age when you start drinking. The earlier a person starts to drink, the bigger the chances are they continue to drink in future. Also, regular drinking increases the risk of developing alcohol use disorder.

Even though it is illegal to drink before 21, many teenagers consume alcohol around 13 to 15 years old. According to this survey:

  • 26% of 8th graders reported drinking in the past month.
  • 40% of 10th graders reported drinking in the past month.
  • 51% of the 12th graders reported drinking in the past month.

Moreover, binge drinking is a popular pattern among youngsters.

Drinking at an early age increase the risk of alcohol abuse, but alcoholism as a disease doesn’t spare anyone. It can affect anyone at any age.

Educational Factors

According to this study, education levels affect your risk of a drinking problem. Individuals who dropped out from high school were about 6 times more to develop alcohol problems, while college dropouts were 3 times more to become alcohol dependent.

Career Factors

Careers can be exhausting, and many individuals seek coping mechanism in drinking. High levels of stress, long working hours, and strenuous tasks are only few factors that may produce negative effect on the person.

According to this CBHSQ Report, 8.7 % of full-time workers aged 18 to 64 drank heavily in the past month. The highest rate of drinking was noticed in mining (17.5%) and construction industry (16.5%).

How Alcoholism Risk Factors Affect Treatment and Relapse

All risk factors for developing alcohol dependence affect the treatment on many levels. For example,

  • This study published in the Journal of Ethnicity in Substance Abuse found that Spanish speaking individuals are less likely to perceive a need for treatment and seek treatment services than the general public. Also, women face more barriers to access substance abuse treatment, and are less likely to seek help.
  • According to NIAAA, women tend to seek help in mental health or primary care settings rather than in specialized programs.
  • People with stressful and high-end professions may consider addiction as shame and stigma, while people that are uninsured or have low income may have troubles finding treatment to their standard.
  • Moreover, depression is a major trigger for relapse. But, relapsing does not mean that you have failed. Relapse means that you need to reevaluate your treatment, and find the one that fits your needs. Also relapse makes you aware of the triggers around you.

However, treatment works!

Evidence-based treatment that is customized by the needs of the patient is overwlehmingly successful. NIAAA has found that about one-third of people who are treated for alcohol problems have no further symptoms a year later, while many others have reduced their drinking habits.

So, don’t put life on hold. Gelp help! Or, seek help for a loved one.

The time to act is now.

Reference sources: NCBI: The Multiple, Distinct Ways that Personality Contributes to Alcohol Use Disorders
NCBI: Genetic factors influencing alcohol dependence
NCBI: Religion and alcohol in the U.S. National Alcohol Survey
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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