It is never just one thing. If you ask a doctor, a neuroscientist, and a person in recovery the same question—why are people alcoholics—you are going to get three very different, very intense answers.
One might talk about the GABA receptors in the brain. Another might point to a grandfather who couldn't put the bottle down in the 1950s. The person in the chair? They might just tell you it’s the only thing that makes the "noise" stop.
Alcoholism, or what clinicians now call Alcohol Use Disorder (AUD), is a massive, shifting target. It isn't a character flaw. It isn't a lack of "grit." It’s a biological and psychological hijack. Understanding why this happens requires us to look at the messy intersection of DNA, environment, and the way our brains are literally wired to seek rewards.
The Genetic Lottery: Is It in the Blood?
We’ve known for a long time that addiction runs in families. If you have a parent with AUD, you are roughly three to four times more likely to develop it yourself. That’s a scary statistic, but it isn’t a prophecy.
Genes account for about 40% to 60% of the risk.
Think of it like being born with a specific type of engine. Some people have a "high-tolerance" engine. They can drink their friends under the table and wake up feeling fine. This is actually a major risk factor. If your body doesn't give you the "stop" signal—the nausea, the spinning head, the immediate hangover—you are much more likely to keep going until your brain chemistry changes.
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Specific genes, like those affecting the enzymes alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), dictate how you metabolize booze. If your body breaks down acetaldehyde (a toxic byproduct) too slowly, you feel sick quickly. This is often seen in many people of East Asian descent, and it actually acts as a protective barrier against alcoholism. But for others, the "reward" of dopamine hits so hard and the "punishment" of the toxins is so low that the brain decides alcohol is more important than food or sleep.
The Brain Under Siege
When we talk about why are people alcoholics, we have to talk about dopamine.
Dopamine is the brain’s "do that again" chemical. Normally, it rewards us for things that keep us alive, like eating a good meal or having sex. Alcohol cheats the system. It forces a massive surge of dopamine in the nucleus accumbens, the brain’s pleasure center.
Over time, the brain gets tired of the overstimulation. It’s like someone screaming in your ear—eventually, you put on earmuffs. This is called downregulation. The brain produces less dopamine and pulls back its receptors.
Now, the person needs alcohol just to feel "normal." Without it, they plummet into a state of anhedonia—a total inability to feel pleasure. The world goes grey. This is the physiological trap. You aren't drinking to get high anymore; you’re drinking to stop the low.
The Prefrontal Cortex Betrayal
It gets worse. Chronic drinking erodes the prefrontal cortex. This is the part of your brain responsible for executive function, impulse control, and "thinking about the future."
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Imagine trying to drive a car where the accelerator is stuck to the floor (the craving) and the brakes have been cut (the prefrontal cortex). That is what's happening in the brain of someone with severe AUD. They know they shouldn't drink. They can see the wreck coming. But the "brakes" literally don't work.
Trauma and the "Self-Medication" Trap
Dr. Gabor Maté, a renowned expert on addiction and author of In the Realm of Hungry Ghosts, famously says that the question shouldn't be "why the addiction," but "why the pain."
For a huge percentage of people, alcoholism is an attempt to solve a problem.
- Adverse Childhood Experiences (ACEs): There is a direct, linear correlation between childhood trauma and adult substance abuse.
- Anxiety and Depression: People with untreated social anxiety often use alcohol as "liquid courage" until they can't socialize without it.
- PTSD: For veterans or survivors of violence, alcohol numbs the hyper-vigilance and the flashbacks.
If you use a substance to bridge a gap in your soul, the substance eventually becomes the gap.
The Environment We Live In
We live in a "booze-soaked" culture. We celebrate with champagne, mourn with whiskey, and "wine down" after a long Tuesday. Honestly, it’s everywhere. This environmental availability is a massive factor in why are people alcoholics.
If you are genetically predisposed to addiction but grow up in a dry household or a culture where drinking is frowned upon, you might never trigger that "switch." But if you grow up seeing your parents manage stress with a bottle, or if you work in an industry (like hospitality or high-finance) where heavy drinking is the norm, the risk skyrockets.
Peer groups matter. Proximity to liquor stores matters. Even the "Mommy Wine Culture" on social media matters. These things normalize high-risk consumption levels, making it harder for an individual to realize they’ve crossed the line from social drinking into dependency.
Why Do Some People Stop and Others Can't?
This is the million-dollar question. Why can one person have a "wild" college phase and then transition into a two-drinks-a-month adult, while another person loses their job, their house, and their family?
Neuroplasticity is a double-edged sword. Some brains are more "plastic" than others, meaning they form deep, rutted neural pathways more quickly. Once those paths are set, the "craving" becomes a survival instinct. To the brain of a person with AUD, alcohol feels as necessary as water.
There is also the "Kindling Effect" to consider. Every time a person goes through withdrawal and then starts drinking again, the brain becomes more sensitive. The withdrawals get more dangerous, and the cravings get more intense. It’s a downward spiral that becomes harder to exit the longer it continues.
Misconceptions We Need to Kill
- "It's about willpower." No. You can't "will" your way out of a broken insulin response if you're diabetic, and you can't "will" your way out of a hijacked reward system. You need treatment, not more "grit."
- "You have to hit rock bottom." This is dangerous advice. Rock bottom is often death. Intervention can happen at any stage.
- "Alcoholics drink every day." Many people with AUD are binge drinkers. They might go weeks without a drop, but once they start, they cannot stop until they are incapacitated. This is still alcoholism.
Actionable Steps: What to Do Next
If you are looking at your own habits or someone else's and wondering where things stand, the "Am I an alcoholic?" question is less helpful than "Is alcohol causing problems in my life?"
Assess the "C" Criteria:
Check for Loss of Control (drinking more than intended), Compulsion (spending a lot of time thinking about it), and Consequences (continuing despite physical or relationship harm).
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Consult a Medical Professional:
Do not quit "cold turkey" if you are a heavy daily drinker. Alcohol withdrawal is one of the few that can actually kill you due to seizures and Delirium Tremens (DTs). Seek a medically supervised detox.
Explore "The Sinclair Method" (TSM):
For those who have failed at total abstinence, TSM involves taking a medication called Naltrexone before drinking. It blocks the endorphin rush, eventually "un-learning" the addiction in the brain. It has a high success rate but is still underutilized in many traditional circles.
Find Community:
Whether it’s AA (Alcoholics Anonymous), SMART Recovery (a science-based alternative), or specialized therapy, recovery is rarely a solo sport. The brain needs new, healthy social connections to replace the dopamine it used to get from the bottle.
Understanding the "why" is the first step toward the "how" of getting better. It’s a medical condition, a psychological battle, and a social challenge all rolled into one. Treat it with the seriousness—and the science—it deserves.