Alcoholism refers to use of alcohol that results in an individual experiencing significant distress and or dysfunction in daily life. It is diagnosable through specific behavioral criteria. There are no laboratory tests, brain scans, or blood tests that can diagnose alcoholism.
Likewise, there is no single identified cause that leads to the development of alcoholism. Instead, researchers and clinicians refer to risk factors. Risk factors are conditions or experiences that can increase the chance or probability that an individual will develop a specific disease or disorder. Simply having a risk factor does not ensure that a person will develop the condition. Many people have significant risk factors for diseases or disorders and never develop them.
In addition, risk factors are cumulative, such that having more than one risk factor significantly increases the probability that one may develop a specific disease or disorder.
Risk Factors Associated with the Development of an Alcohol Use Disorder
There are several major risk factors that are associated with the development of any substance use disorder, including an alcohol use disorder. The major risk factors include:
- Family history: Having a family member with a diagnosis of a substance use disorder increases the risk that one will be diagnosed with an alcohol use disorder (or any substance use disorder). The closer the relation, the greater the risk. For instance, having a first-degree relative like a parent or sibling who has a diagnosis of an alcohol use disorder is a more salient risk factor than having a more distant relative, such as a cousin, diagnosed with the disorder.
Family history is often meant to designate a genetic component to some disease or disorder; however, in the case of mental health disorders, family history can represent genetic factors, learning factors, or a combination of both. Even though numerous genetic associations have been described for the development of substance use disorders, there is no singular genetic factor that can be designated as a cause to any substance use disorder.
- A diagnosis of some other mental health disorder: This interaction or comorbidity cannot be easily explained even though many try to use the notion of self-medication to explain the relationship between mental illness and substance abuse. As it turns out, many individuals develop alcohol use disorders before they develop certain types of mental disorders. The presence of a pre-existing substance use disorder is an increased risk factor to be diagnosed with another type of mental health disorder later.
- The experience of trauma and/or stress: People who experience some traumatic event, stress, etc., are at an increased risk to use substances like alcohol and develop substance use disorders. This may or may not be related to the self-medication hypothesis depending on the case. It appears that any type of traumatic or stress-related situation can increase the risk to abuse alcohol; however, certain types of experiences, such as physical or sexual abuse, the loss of a parent at a young age (even through divorce), being the victim of a violent crime, etc., can produce more salient effects.
- Subclinical levels of stress: Even individuals who experience levels of stress that are defined as being subclinical (not severe enough to be diagnosed as a formal psychiatric/psychological disorder or condition) may be at risk to abuse substances such as alcohol. Perceived stress can come from numerous sources.
- A lack of family supervision or involvement: Relationship issues within the family, particularly those that occur in the early stages of an individual’s development, are often considered to be significant risk factors for alcohol abuse. This can include poor supervision by family members, or parents who are cold and do not provide significant levels of nurturing.
- Peer pressure: Pressure from peer groups is a significant factor in directing one’s behavior, particularly at a younger age, but it can occur over all ages. In addition, societal pressure and influences, such as being given the impression through the media that alcohol use is a normal way to deal with stress can also increase the risk for individuals to abuse alcohol.
- Age of first use: The earlier a person begins drinking, the more likely it is that they will continue to drink. Continued or regular use of alcohol is associated with an increased risk to develop an alcohol use disorder in anyone.
- Other factors: There are numerous other risk factors that can interact to increase the risk that someone may develop an alcohol use disorder. For instance, men are more likely to develop substance use disorders, particularly alcohol use disorders, than women, so gender can be a significant risk factor. Social environment, such as living in an environment where alcohol use is acceptable and considered to be a standard approach to dealing with stress, can also increase the risk to develop an alcohol use disorder. These risk factors can all interact in ways that are not well understood.
Essentially, it can be boiled down to the understanding that the potential causes of alcoholism are not well understood. Instead, certain risk factors that represent both inherent (e.g., genetic) and environmental (experience) factors that interact in manners that researchers do not fully understand contribute to the development of any substance use disorder, including alcohol abuse issues.