Is alcoholism hereditary? It’s a question many families ask when they see patterns of drinking passed down from one generation to the next. While it may seem that addiction “runs in the family,” the truth is more complex. 

Understanding how genes and environment interact can help explain why some people are more at risk, and how awareness, prevention, and early support can change the outcome for future generations.

How Alcoholism Develops

Alcoholism, also called alcohol use disorder (AUD), happens when someone loses control over their drinking. What may start as casual drinking can slowly turn into a powerful physical and emotional dependence that disrupts health, behavior, and quality of life.

Common signs of alcohol addiction include:

• Strong cravings or urges to drink
  
• Drinking even when it causes problems at work, school, or home
  
• Struggling to stop once drinking starts
  
• Needing more alcohol to feel the same effect (tolerance)
  
• Feeling unwell or anxious when not drinking (withdrawal)

When alcohol enters the body, it changes how the brain’s reward system works. It releases dopamine, a chemical that creates feelings of pleasure and relaxation. The brain begins to connect alcohol with feeling good, which encourages repeated use. This leads to tolerance; the body and brain need more alcohol to reach the same level of satisfaction.

When someone tries to stop, withdrawal symptoms such as sweating, shaking, nausea, or anxiety can appear. These symptoms make quitting difficult and can trap a person in a cycle of dependence.

Over time, those changes go beyond behavior. Alcohol starts to alter how the brain and body work together.

How Alcoholism Affects the Brain and Body

Below are key ways that can reshape how your brain and body work:

1. Disrupted Brain Communication & Neuron Damage

• Alcohol interferes with how brain cells (neurons) communicate. It alters neurotransmitters like GABA (which slows things down) and glutamate (which excites) so that balance is lost.
  
• Chronic drinking can cause the shrinkage of brain cells and a reduction in the size of brain regions, including both gray matter and white matter.¹
  
• Heavy drinkers often show worse structural brain changes compared to moderate or non-drinkers, even when controlling for other risks.²

2. Impaired Memory, Judgment, and Emotion

• Alcohol damages areas of the brain responsible for memory, decision-making, and emotional control, including the hippocampus and prefrontal cortex.³
  
• In research on animals, even after months of abstaining, rats exposed to heavy alcohol use still showed poor decision-making, indicating lasting changes to brain circuits.⁴
  
• Emotional processing also changes: people with alcohol dependence may misinterpret facial expressions (e.g., seeing anger when it’s not there) and feel more negative moods.⁵

3. Thiamine Deficiency & Neurotoxicity

• Long-term alcohol use often causes poor nutrition or blocks the absorption of thiamine (vitamin B1). Thiamine is critical for brain health. Its deficiency can lead to serious conditions like Wernicke–Korsakoff syndrome, which causes memory loss and brain damage.⁵

• Alcohol and its byproducts also cause oxidative stress and inflammation in brain tissue, which further harms neurons.⁶

4. Effects on the Body & Other Systems

• Alcohol passes through the blood–brain barrier, so its toxic effects can reach deep into the brain.⁶
• It also harms the nervous system outside the brain, causing neuropathy (nerve damage) that can lead to pain, tingling, or weakness, especially in legs and arms.⁷
• Because alcohol affects many organs (liver, heart, pancreas), damage in one organ can trigger indirect harm in others, including the brain.⁷

While these physical effects show what alcohol can do to the body, genetics can also influence who is more likely to develop alcohol dependence in the first place.

Genetic Risk Factors for Alcoholism

Here is a clear look at inherited risk, key studies, and how genes influence, but don’t control, outcomes.

1. How Much Do Genes Matter?

Twin and family studies estimate that 40%–60% of the risk for AUD is attributed to inherited genetic factors.⁸

• In adoption studies, children of biological parents with alcoholism are more likely to develop AUD, even when raised apart, compared to those without such a biological history.⁹
  
• But genetic influence is not a guarantee. Many people with a family history never develop AUD, and many with no family history do.

2. What Research Says About Key Genes

The Collaborative Study on the Genetics of Alcoholism (COGA) has tracked families for decades to understand how genes, brain activity, and environment shape risk. Research shows there’s no single “alcoholism gene.”¹⁰

• Instead, many genes each contribute a small part, interacting with life experiences such as family environment, stress, and trauma.
• Genetic risk is more likely to appear when drinking starts early or during times of emotional or social stress.

3. Genes Shape Risk, They Don’t Control It

Genes may increase sensitivity to alcohol or cravings, but environment and choices often play a stronger role. Together, these factors determine whether genetic risk turns into addiction or stays under control.

• Alcoholism is polygenic, meaning many genes work together with lifestyle and environment.

• On the other hand, protective factors, such as good mental health, strong social support, and early intervention, can greatly reduce the risk, even for those with a genetic predisposition.¹¹

No matter where someone’s risk comes from, the path forward begins with reaching out for help and finding the right support system.

How to Get Help for Alcohol Addiction

Asking for help takes strength, and it’s the first step toward change. Alcohol addiction can make life feel overwhelming, but recovery is always possible with the right guidance and support.

Oceanrock Health and South Coast Counseling provide caring, judgment-free environments where individuals and families can heal together. 

• Personalized Treatment Plans: Specialists design care plans that fit each person’s situation by combining therapy, medical care, and group sessions as needed.
  
• Therapy and Counseling: Individual and family therapy help uncover the deeper reasons behind alcohol use and build healthier ways to manage stress and emotions.
  
• Group Support: Sharing experiences with others fosters understanding, accountability, and the sense that you’re not alone in recovery.
  
• Family Healing: Addiction affects relationships. Family programs rebuild trust, improve communication, and teach supportive ways to help a loved one recover.
  
• Ongoing Care: Recovery continues after treatment. Both centers offer follow-up care, relapse prevention tools, and continued emotional support to sustain progress.

If you or someone you love is struggling, reaching out today can open the door to healing. Oceanrock Health and South Coast Counseling are ready to help you take back control, one step, one day, and one choice at a time.

Sources:

1. Zahr, N. M., & Pfefferbaum, A. (2017). Alcohol’s Effects on the Brain: Neuroimaging Results in Humans and Animal Models. Alcohol Research: Current Reviews, 38(2), 183. Link
   
2. Welch, K. A. (2017). Alcohol consumption and brain health. BMJ, 357, j2645. Link
   
3. Oscar-Berman, M., & Marinkovic, K. (2024). Alcoholism and the Brain: An Overview. Alcohol Research & Health, 27(2), 125. Link
   
4. News Medical. (2025, April 3). Study reveals long-term decision-making deficits due to heavy alcohol use. Link
   
5. Nutt, D., Hayes, A., Fonville, L., Zafar, R., Palmer, E. O. C., Paterson, L., & Lingford-Hughes, A. (2021). Alcohol and the brain. Nutrients, 13(11), 3938. Link
   
6. Obad, A., Peeran, A., Little, J. I., Haddad, G. E., & Tarzami, S. T. (2018). Alcohol-Mediated Organ Damages: Heart and Brain. Frontiers in Pharmacology, 9. Link
   
7. Mosel, S. (2024). Neurological Effects of Alcohol: Impact of Alcohol on the Brain. American Addiction Centers. Link
   
8. Edenberg, H. J., & Foroud, T. (2013). Genetics and alcoholism. Nature Reviews Gastroenterology & Hepatology, 10(8), 487–494. Link
   
9. Heath, A. C. (2024). Genetic Influences on Alcoholism Risk: A Review of Adoption and Twin Studies. Alcohol Health and Research World, 19(3), 166. Link
   
10. Agrawal, A. et al. (2023). The Collaborative Study on the Genetics of Alcoholism: Overview. Genes, Brain and Behavior, 22(5). Link
    
11. ASU News. (2021, Sept 10). Social support reduces genetic risk factors linked to alcohol use problems. Link