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How Addictive is Alcohol Compared to Other Drugs?

By Gulnaz Khan
Learn why alcohol can be addictive, risks for developing alcoholism, and how to get help for problem drinking.

Alcohol can be addictive. There’s no single reason or timeline for developing an alcohol addiction. But things like your genes, environment, and psychological and social factors can all play a role, Mayo Clinic says. 

What Makes Alcohol Addictive? 

Over 14 million adults in the United States have an alcohol use disorder. This ongoing condition is characterized by the inability to stop or control your drinking, even though it’s interfering with your life. 

“The measure of a drug’s addictiveness is not how much pleasure (or reward) it causes but how reinforcing it is—that is, how much it leads people to keep using it,” writes Nora Volkow, MD, director of the National Institute on Drug Abuse. 

Both positive and negative reinforcement are thought to play a key role in alcohol addiction, according to the journal Science Advances. This means that people are motivated to drink alcohol for pleasure or euphoria, and to numb stress or other negative emotions. Over time, long-term alcohol use can cause physical changes to the brain, including an imbalance of neurotransmitters, or brain chemicals. Certain neurotransmitters may contribute to alcohol cravings, another hallmark of addiction. 

Once your body has developed a dependence on alcohol, you may experience alcohol withdrawal if you try to stop drinking. Symptoms include irritability, trouble sleeping, restlessness, sweating and vomiting. 

What Could Raise Your Risk?

Several things may might make you more likely to develop an alcohol use disorder (AUD), which can vary in severity. Mayo Clinic says the risk factors include:

  • Long-term heavy drinking.If you drink a lot of alcohol regularly, you’re at higher risk for getting an AUD. 

  • Binge drinking at an early age. You can develop an AUD at any age, but you’re risk goes up if you start binge drinking earlier in life. This typically involves having four or more drinks if you’re a woman and five or more drinks if you’re a man in about 2 hours. 

  • Mental health problems or trauma.“Substance use and alcohol is often used to self-medicate for both physical and mental health problems,” says Margie Skeer, ScD, associate professor of public health and community medicine at Tufts University School of Medicine. That’s why alcohol use disorder sometimes happens in people who also have a history of trauma, schizophrenia, anxiety, depression, or bipolar disorder. 

  • Other influences. If your family, social circle, or partner drink in excess, you may be at higher risk for developing an alcohol use disorder. 

Why It’s Important to Get Help 

Early treatment for problem drinking can make you less likely to get an alcohol use disorder, or prevent an existing AUD from getting worse, Skeer says. This is especially important for teens, because the earlier people start using alcohol, the greater their risk for developing problems with alcohol and other drugs as they get older, she says. 

If you’re having trouble stopping or controlling your drinking and need help, talk to your doctor about treatment options.

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