Trauma? Self-medication for mental health issues? Isolation?Is there a root cause? My perspective

The debate about the origins of alcoholism often revolves around the idea of an underlying cause, such as unresolved trauma, that, once treated, would eliminate the dependence. However, my personal experience with alcohol use disorder, the loss of a partner to the same condition, and experience in the recovery field have led me to a different conclusion: this perspective does not reflect reality.

While many people with trauma develop dependencies, there are also those who, despite traumatic experiences, never become dependent. Likewise, some individuals with alcoholism have no significant history of trauma. Most people who undergo various therapies to address both trauma and alcoholism continue to experience relapses. Does this mean the therapy was ineffective? Not necessarily. The fundamental issue is that alcoholism causes structural and functional changes in the brain due to repeated alcohol exposure. These changes persist even after a period of sobriety, making abstinence a constant struggle. Without addressing these neurological alterations, the motivation to drink remains—and, in fact, intensifies over time—leading to nearly inevitable relapses when faced with internal and external triggers.

When we consume alcohol, chemical and hormonal processes are triggered in the brain, influencing our emotional state. Alcohol stimulates the release of endorphins, creating feelings of pleasure and relaxation. The human brain has a reward system designed to reinforce behaviours essential for survival, such as exercise, eating, sex, and social interaction. However, alcohol and other psychoactive substances generate an artificially intense reward compared to these natural behaviours With continued consumption, the neural pathways associated with pleasure become increasingly reinforced, embedding alcohol use as a deeply ingrained habit. Over time, these pathways become stronger and more easily activated—like a small side road transforming into a seven-lane highway. The result is a progressive increase in the motivation to drink, even when it leads to severe consequences for health and well-being. What starts as a simple habit can evolve into an uncontrollable compulsion, driven by strengthened neural circuits.

Additionally, research suggests a genetic predisposition to alcoholism. Individuals with a family history of the condition may have brain chemistry that makes them more vulnerable to dependence. These individuals may experience an exaggerated response to alcohol, feeling intense euphoria rather than just relaxation. This heightened effect strengthens the brain’s reward cycle, making drinking behaviour increasingly difficult to control. Over time, alcohol tolerance develops, requiring larger amounts to achieve the same effect, while other sources of pleasure become less satisfying.

The impact of alcohol extends beyond the reward system. Continuous consumption also affects brain regions responsible for decision-making, memory, and critical thinking. This results in a pattern of compulsive substance-seeking, driven more by automatic response than conscious choice. Alcohol consumption, therefore, ceases to be a rational decision and becomes a hard-to-resist impulse.

While trauma and mental health disorders can increase the risk of developing dependence, they are not the direct cause of alcoholism. People experiencing intense emotional pain or psychological distress may turn to alcohol for quick relief, increasing their exposure and, consequently, their risk of dependence. However, trauma alone is not the root cause of alcoholism. The issue is that, by repeatedly using alcohol for its calming effects, individuals expose themselves to the neurobiological processes that drive dependence.

In summary, alcoholism is a complex phenomenon involving genetic, neurochemical, and environmental factors. While issues such as trauma and mental health can influence the onset of excessive drinking, dependence is fundamentally a biological problem—rooted in brain changes that perpetuate the addiction cycle. Understanding these mechanisms is crucial for developing effective treatment and prevention strategies.

The Sinclair Method represents a true paradigm shift in the treatment of alcoholism. This approach is based on the pharmacological extinction of drinking behaviour through the targeted use of naltrexone, an opioid blocker. When taken before alcohol consumption, naltrexone reduces the release of endorphins and, consequently, the euphoric effects of drinking. Over time, as a person drinks without receiving the expected reward, the brain learns that alcohol no longer provides the same pleasure, leading to the extinction of compulsive drinking behaviour

This is the only treatment that reverses the motivation to drink to its original state—before dependence developed. Therefore, it makes sense to prioritize neurological stabilization before introducing conventional therapy. When cravings are reduced and the compulsion to drink is minimized, therapy has a much greater chance of being effective. The individual will be in a better mental state, more receptive, and able to process emotional and psychological issues without the interference of an overwhelming urge to drink.