How Addiction Works

Why is Alcohol Addictive?

Alcohol is addictive by nature and there are a variety of reasons why people become addicted. Some start drinking because their friends or colleagues drink and they want to be socially accepted. Some find that the more they drink, the more relaxed they feel and more fun their friends seem to think they are. Others turn to binge drinking as a way of relieving pain and loneliness, or to wash away bad memories.
Most people know that alcohol affects the brain by releasing the naturally occurring feel-good opioids, known as endorphins, in regions of the brain associated with reward processing. But there’s more to it.The brain must maintain a careful balance of chemicals called neurotransmitters to function normally. Neurotransmitters are small molecules involved in the brain’s communication system that ultimately help regulate the body’s function and behavior.

Chemical Dependence

Just as a heavy weight can tip a scale, alcohol can alter the delicate balance of neurotransmitter chemicals in the brain. Such imbalances can lead to drowsiness, loss of coordination, and euphoria—markers of alcohol intoxication. But then the brain begins to adapt to these chemical changes...
With long-term heavy drinking, alcohol is present in the brain for long periods and the brain seeks to compensate for its effects. To restore the brain’s balanced state, the function of certain neurotransmitters begins to change so that the brain can perform more normally in the presence of alcohol. These long-term chemical changes are believed to be responsible for the harmful effects of alcohol, such as alcohol dependence.

How Alcohol Affects You

As the brain adapts to alcohol’s presence over time, a heavy drinker may begin to respond to alcohol differently than someone who drinks only moderately. Consequences such as alcohol tolerance and alcohol withdrawal symptoms may be caused by these changes. When exposed to alcohol, the brain may become tolerant—or insensitive— to alcohol’s effects. Even as the brain becomes tolerant to alcohol, the desire for alcohol may transition into a pathological craving for its effects.Thus, as a person continues to drink heavily, he or she may need more alcohol than before to feel the effects of being intoxicated. A rise in alcohol tolerance also increases the amount of alcohol consumed, putting an already heavy drinker at a higher risk for a number of health problems.
Other changes in the brain increase a heavy drinker’s risk for experiencing alcohol withdrawal—a collection of symptoms that can appear when a person with alcohol dependence suddenly stops drinking. Withdrawal symptoms can be severe, especially during the 48 hours immediately following a bout of drinking. Typical symptoms include profuse sweating, racing heart rate, and feelings of restlessness and anxiety.