Is Alcohol Addictive? Signs of Dependence & Finding Effective Treatment

What Is Alcohol Use Disorder?

Alcohol use disorder (AUD) is a chronic medical condition where someone cannot stop using alcohol or control the amount they consume despite negative consequences.[1] According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), approximately 29 million Americans meet the diagnostic criteria for AUD, which makes it one of the most prevalent substance use disorders in the United States.[2]

AUD is diagnosed on a spectrum from mild to severe based on the criteria present, including the inability to control drinking, continued use despite experiencing negative consequences, withdrawal symptoms when drinking stops, and building tolerance.[3]  Alcoholism, as many commonly refer to alcohol abuse and addiction, is at the most severe end of the spectrum.[4]

Is Alcohol Addictive?

Yes. Understanding why it is can also be helpful.

Alcohol is addictive because of the way it activates the brain’s reward and stress system. Drinking alcohol releases the neurotransmitter dopamine, which is associated with reward and pleasure; it’s this reward that reinforces repeated use.[5] Over time and with continued use, the brain makes adjustments to alcohol’s presence by reducing dopamine production and altering other neurotransmitter systems such as GABA and glutamate.[6] These adjustments cause the brain to become dependent on alcohol to function normally, and if drinking stops, it results in alcohol withdrawal symptoms, which vary in severity from anxiety and tremors to seizures and other complications.[7] 

It’s this physical dependence that causes many people to drink, not because it provides pleasure, but because stopping feels impossible or dangerous.

Not everyone who drinks alcohol will develop a disorder, however. There are several factors why some become addicted to alcohol, and some do not. Genetics plays a strong factor; a family history of AUD is one of the strongest risk factors, with genetic contributions estimated to account for around 50% of a person’s risk.[8] Environmental factors, including early exposure to drinking, chronic stress, and undiagnosed mental health issues, also play a role, especially if someone is already genetically predisposed to it.[9]

Signs of Alcohol Addiction

Recognizing the signs of alcohol use disorder is the first step in determining whether you or a loved one may need professional help. Common signs include:

• Drinking more or for longer periods than intended
• Repeatedly trying to stop or cut back without success
• Spending a significant amount of time drinking or recovering from drinking
• Strong cravings for alcohol
• Giving up or reducing activities previously enjoyed in favor of drinking
• Drinking in situations where it is dangerous, such as driving, operating machinery, or while caring for children
• Continuing to drink despite negative impacts on relationships or health
• Withdrawal symptoms when not drinking
• Increasing tolerance over time
• Neglecting responsibilities, obligations, or activities you once enjoyed

Not everyone with a drinking problem shows all of these signs, and AUD exists across a range of severity. The important thing to keep in mind is whether alcohol use is causing harm and whether or not you are able to control your drinking.

Alcohol and Mental Health

There has been a great deal of research done on alcohol abuse and mental health disorders, and there is a well-documented relationship between the two. Alcohol use disorder co-occurs with mental health conditions at a very high rate, and it runs both directions.

Mental health conditions can lead to alcohol abuse; depression, anxiety, PTSD, bipolar disorder, and other psychiatric disorders are all significant risk factors for developing an alcohol use disorder.[10] People struggling with these conditions often use alcohol to alleviate anxiety, numb emotional pain, manage flashbacks, fall asleep, or just to feel good until, over time, what starts as a way to get relief becomes a dependence. Without addressing both mental health and alcohol use, this cycle will continue and worsen

Conversely, alcohol use can cause or worsen mental health issues. Chronic alcohol use affects neurotransmitter function, which can worsen anxiety and depression, disrupt sleep, and contribute to the development or worsening of certain mental health conditions, including alcohol-induced mood disorders or, in severe cases, psychosis.[11] 

For many people with an alcohol use disorder, the alcohol use itself is a symptom of an untreated mental health disorder and not the primary problem.

When Alcohol Use Is a Symptom of a Deeper Issue

Many people who have a problem with alcohol have participated in various treatment programs, including detox, inpatient rehabilitation centers, Alcoholics Anonymous, and outpatient programs, only to see short-term success and then return to old habits. The mental health disorder underlying the alcohol use was never properly diagnosed and treated, and because of this, the cycle continues.

For people in this position, more treatment for their alcohol disorder is unlikely to be successful. An appropriate treatment plan must include diagnosis and treatment of the underlying mental health condition that drives its use, treating mental health as the primary diagnosis, and the alcohol use as a secondary. Because until the primary diagnosis is treated, the secondary diagnosis will continue.

Helios West Palm is not a detox or primary alcohol addiction treatment facility. Rather, we are a residential mental health facility. Our program is designed for adults whose alcohol use is secondary to the underlying and undertreated mental health condition, whether it’s depression, anxiety, or bipolar disorder. For these people specifically, we offer the kind of integrated, psychiatric-led care that addresses the real problem.

Anyone with a history of alcohol use disorder will receive an extensive psychiatric examination to evaluate drinking habits as well as identify any co-occurring mental health issues. The results of this psychiatric examination will help us develop a customized treatment plan for each patient.

If a patient needs detox before treatment can begin, we can provide a referral, since stopping alcohol use cold turkey can be dangerous, and medical supervision is required. Our team can help you with coordination.