This is a question commonly asked by family and friends of those who have a drinking problem. The answer to this is different with each person. A complex interaction of genetic and environmental factors influence the risk of a person developing Alcohol Use Disorder (AUD). Read on to learn more about the factors involved and the signs and stages of alcohol addiction.
The Addictive Nature of Alcohol
According to the National Institute on Alcohol Abuse and Alcoholism, alcohol addiction is a chronic relapsing disorder associated with compulsive alcohol drinking, the loss of control over intake, and the emergence of a negative emotional state when alcohol is no longer available. It can be mild, moderate or severe [1].
In simple terms, the cycle of alcohol addiction has these main effects, described in more detail below [2]:
- Alcohol produces pleasure
- Habit formation makes it hard to stop drinking
- Alcohol initially reduces, then promotes negative emotional states and pain
- In the misery of withdrawal, the brain becomes motivated to continue drinking
- Executive functions in the brain become dysregulated affecting impulse control, decision-making and emotional regulation. This makes it harder to withstand urges to drink and avoid repeating the negative behaviors in the addiction cycle.
Factors That Affect Development of Alcohol Addiction
Genetics
Scientists don’t yet fully understand why some people become addicted to alcohol and others don’t. But it is believed that 50-60% of the vulnerability to AUD is inherited [3]. There are a variety of genes which carry risk. These include genes which are related to:
- Addiction-related brain biology
- Physical responses to both alcohol and stress
- Co-occuring mental health conditions such as anxiety and depression
- Behavioral factors such as impulsiveness
Environment
Stress is one of the most important. People who experienced childhood trauma or many stressors as teens or adults, may be at risk for developing AUD. They may also be at risk for relapsing in response to stress during recovery. These, combined with a person’s genetic makeup and history of drinking strongly influence the stress response.
For those with moderate to severe AUD, the brain’s stress circuits become activated during withdrawal, leading to negative emotional states. These factors help to fuel the cycle of addiction and such states are the main cause of relapse.
Mental Health and Age
Those with mental health conditions such as anxiety, depression and PTSD have a greater risk for AUD. And those heavy drinkers who started drinking in their teen years are at greater risk of AUD because teen brains are not yet fully developed and their pleasure circuits are highly active making alcohol use even more rewarding and attractive for some..
So, How Easy Is It to Get Addicted to Alcohol?
There is no simple one-size-fits-all answer. Much depends on the impact of the risk factors described above. As well, given the brain changes that take place, especially in the prefrontal cortex, as described below, the length of time it takes for someone to progress from alcohol abuse to addiction depends largely on the brain’s ability to resist these changes.
Some may begin to develop an alcohol addiction during several weeks of heavy drinking. For others, it can take months or years.
Signs of Alcohol Addiction
There are many signs of alcohol addiction, including:
- Drinking more than intended
- Trying to cut down or quit, without success
- Spending a lot of time drinking, buying alcohol and recovering from drinking
- Having strong urges or cravings to drink
- Failing to do what is expected of you do to drinking
- Continuing to drink although it causes problems in your relationships
- No longer enjoying activities you used to because of your drinking
- Drinking in dangerous situations, like while driving
- Continuing to drink in spite of the negative side effects, either psychological or physical
- Needing to drink more than you used to just to get the same effect
- Experiencing withdrawal symptoms when you stopped drinking
- Used alcohol to manage withdrawal symptoms
Stages of Alcohol Addiction
The nature of alcohol abuse is understood to be a three stage model, as follows [1]:
Binge/intoxication stage
In this stage a person experiences the rewarding effects of alcohol such as euphoria, lowered anxiety and easier social interactions. The brain’s reward system in the basal ganglia reinforces the behavior of drinking alcohol. The basal ganglia plays a key role in motivation and habit formation. This increases the likelihood of repeating to drink. It reinforces cues to people, places and things associated with drinking that can trigger the compulsive urge to drink.
Withdrawal/Negative affect stage
When someone with AUD stops drinking they have symptoms of withdrawal which are the opposite of what they feel when drinking. These can be physical—sleep disturbances, pain, feeling ill—or emotional—unease, irritability, anxiety and emotional pain.
These arise from reduced activation of the brain’s reward systems in the basal ganglia, which makes it difficult to enjoy the normal pleasures of daily living. At the same time, there is increased activity of the brain’s stress systems in the amygdala which leads to anxiety, irritability and unease. Now the person no longer drinks to get high from alcohol, rather they are trying to avoid the low feelings of discomfort and emotional pain from alcohol abuse.
Preoccupation/Anticipation stage
After a period of abstinence, the person becomes preoccupied with seeking alcohol again. They look forward to the next time they can consume it. The executive functions in the prefrontal cortex of the brain are compromised. This is the ability to organize thoughts and activities, prioritize tasks and make decisions, including deciding to not consume alcohol due to its negative effects on their life.
Recovering from Alcohol Addiction in Los Angeles
If you or a loved one is seeking a way out of substance abuse, private, confidential help is just a call away. Reach out to our Admissions team at The Encino now.
At the Encino Recovery & Detox Center in Los Angeles we don’t just treat addiction. We nurture the spirit, heal the mind and help you to regain your life. All in a safe space.
We provide medically supervised detox. After detoxing, you may enter our residential treatment center. Trained staff are equipped to offer clinical care. They will provide the support, guidance and interventions necessary for you to reach your treatment goals. Participating in residential care greatly enhances your success rate at avoiding relapses.
Sources
[1] National Institute on Alcohol Abuse and Alcoholism. 2021. The Cycle of Alcohol Addiction.
[2] National Institute on Alcohol Abuse and Alcoholism. 2023. Neuroscience: The Brain in Addiction and Recovery
[3] National Institute on Alcohol Abuse and Alcoholism. 2024. Alcohol Use Disorder: From Risk to Diagnosis to Recovery
