What drives alcoholics to drink? Recently, a team from The Mayo Clinic considered this question, and found that the answer is like a lot of relationship statuses: it's complicated. Everything from gender to current mood can play a role in a drinker’s motivation to abuse alcohol. In response, the team suggest that alcoholism treatment should be as varied as the backgrounds of those it aims to help.

Alcoholism is a complicated disease, so it makes sense that alcoholics’ reasons to drink are equally complex. The study found that immediate mood, history of depression and mental health problems, and gender all influenced an individual's reason to drink.

"This work once again shows that alcoholism is not a one-size-fits-all condition," said lead researcher Victor Karpyak in a recent statement. "So the answer to the question of why alcoholics drink is probably that there is no single answer; this will probably have implications for how we diagnose and treat alcoholism."

For example, alcohol consumption among abusers is closely linked to immediate feelings of either high “ups” or low “downs” on the day of the binge. The study also dispelled the idea that people drink due to anxiety or depression; for the majority of alcoholics, a personal history of these conditions had little to do with their urge to drink. However, there was one exception: Men with a history of major depression drank less often and less heavily than men without major depression. Gender also affected an individual’s drive to drink; alcohol-dependent men tend to drink more alcohol per day than alcohol-dependent women.

“There are a lot of sex-specific (biological) and gender-specific (psychosocial) differences between men and women in terms of reasons for drinking and its consequences, etc,” Karpyak told Medical Daily in an email.

The need to find an effective treatment for alcoholism is especially pressing, as The World Health Organization reports alcohol as a contributor in a quarter of deaths and disabilities among individuals aged 20 to 39. In addition, alcohol consumption is a causal factor in more than 200 diseases and injury conditions. According to the Centers for Disease Control and Prevention, long-term effects of excessive alcohol consumption include high blood pressure, heart disease, learning and memory problems, mental health problems such as depression and anxiety, as well as a number of cancers.

Ultimately, the study was not designed to explain why people have different reasons for their drinking, but rather to show that these differences exist, and may affect current drinking patterns. The researchers' ultimate goal is to call attention to the need for personally-tailored alcohol abuse treatment, urging that cookie-cutter treatments simply don’t work.

“One-size-fits-all approach is not working in other areas of medicine,” wrote Karpyak in the email. “It is clearly not able to work for such a complex problem as alcoholism, which includes very complex interaction between biological and psychosocial circumstances and is constantly developing.”

Source: Karpyak V, Geske DK, Hall-Flavin DK, et al. The impact of positive and negative emotional states vs. comorbid depression or anxiety diagnoses on alcohol consumption in male and female alcoholics. European College of Neuropsychopharmacology . 2017