Is Alcoholism a Disease or a Choice?

In every era and every age, the word “Alcoholism” has always popped up in society. However, regardless of its recurring usage, the term is still surrounded by confusion, judgment, and stigma. For decades, society has argued about the cause of alcoholism and why it is so prevalent. Some attribute it to a lack of personal discipline, while others ascribe it to something more serious, as serious as a disease.

Here at Pride Detox, we understand the complexities that surround alcoholism and how different alcohol use can look on different people. We do not subscribe to the judgment or stigma that tends to surround alcoholism; instead, we pay attention to understanding how addiction works, what science says about it, and we use trauma-informed, LGBTQ-affirming care to manage alcoholism.

How Alcoholism Works

To better understand how alcoholism works, it helps to first understand how alcohol affects the human brain and body when ingested in excess; emphasis on excess because alcoholism doesn’t mean casual consumption of alcohol.

Alcoholism is a diminished ability to stop or control alcohol use even when the substance causes adverse social, occupational, or health consequences. Meaning that although the consumer knows that drinking is harmful to their health, they can’t help but continue drinking alcohol. Why is this so?

When alcohol enters the bloodstream and travels to the brain, it interacts with neurotransmitters (chemicals in the brain that control thoughts, emotions, and behavior). One of these chemicals is dopamine, which is responsible for emotion, pleasure, and reward regulation. In simple terms, alcohol increases dopamine levels, making people feel good, relaxed, or more social, which is not in itself harmful.

However, alcohol use starts teetering toward dangerous territory when it is continuously ingested in excess, making the brain rewire itself and its neurochemicals to accommodate the new pattern of chemical release. These changes cause the brain's natural ability to produce dopamine to decrease. Producing less dopamine makes our bodies rely on alcohol for emotional relief, stress management, or even daily functioning. Unfortunately, this makes quitting alcohol extremely difficult.

Although taking a first drink might involve choice, long-term alcohol use rewires the brain in ways that go beyond willpower. That is why alcoholism and other forms of addiction are not considered moral failings but chronic, treatable illnesses.

If a person tries to stop drinking, their rewired brain and body may react with withdrawal symptoms like shaking, sweating, anxiety, nausea, and even seizures. These symptoms can make quitting overwhelming, even when an individual wants to.

Where Choice Comes in Concerning Alcoholism

That said, choice still plays a role in alcoholism, but not in the same way people think. Initially, an individual can start drinking for social reasons, but unconsciously, other reasons motivate and prolong their alcohol use. Reasons include their environment, upbringing, stress, or unresolved trauma.

It is also important to remember that different people have different risk levels based on genetics, trauma, mental health, and access to support. For example, an LGBTQ person might start drinking just to fit in with their peer group, but unfortunately, it continues as an escape mechanism for conflict at home, anxiety about the future, and trauma. As alcohol becomes a way to cope, the brain strengthens the connection: Drink = relief. Over time, the line between choice and habit becomes blurred. The person might later recognize their drinking is hurting them and even choose to quit, but without support, they may relapse and risk their safety with potentially life-threatening withdrawal symptoms.

Why LGBTQ People May Experience Alcoholism Differently

LGBTQ people may have a different, more distressing relationship with alcohol because they often face interpersonal and systemic struggles that drive its use. Some of these may include:

• Discrimination and stigma: Facing rejection from family, school, work, or community can lead to isolation, anxiety, or depression.
• Minority stress: Constantly navigating safety, identity, and acceptance can create long-term emotional and mental strain.
• Bar-based social scenes: LGBTQ+ spaces, especially in cities, are often centered around nightlife, which can make alcohol a standard part of daily life.

These pressures may increase the risk of alcohol use as a coping mechanism. That doesn't mean all LGBTQ+ people are destined to become alcoholics, but it does mean that understanding someone's background and lived experience is key to offering the right kind of care.

Choose Healing Today with Pride Detox

Pride Detox believes that healing happens when people feel seen, safe, and supported, not judged or labeled. That's why our team is trained to provide trauma-informed care that honors and affirms all people.. Along with a supportive environment, we believe in meeting people where they are.

You don’t need to have everything figured out before reaching out. You do not need to prove that you deserve care.  We know that alcoholism is complex and the road to recovery is not linear. It starts with supervised, affirming alcohol detox, and we progress to may need therapy so you can address trauma, isolation, or habits formed over time. 

If you need support to recover from alcohol, please get in touch with us at 866-381-8221. We are here to help if you or someone you care about is struggling with alcoholism. Whether you need detox, residential treatment, or help figuring out where to start, we are always reachable.