Yeah, see, this is the problem with addiction treatment these days---the therapist, patients, textbooks do not recognize the difference between a positive and a negative system. in positive systems you add, in negative you take away. Addiction is compulsively going after the good stuff . Therapists shouldn t have the same bad thought processes. So, different people have different reasons for compulsive behaviors. It can be very mild in alcohol, but I doubt that is the case here. Both of my kids drank heavily in college a few times because, hey, college, alcohol. It didn t become a frequent occurrence. So, someone can have this from a totally unrelated problem: depression and/or bipolar disorder. You treat the depression, the drug abuse often goes away. It can be from escapism, it can be from liking a disrupted life, it can be from a learned response that doing something feels good, and having that associated with people, places, circumstances; it can be from the withdrawal from the drugs or alcohol feeling bad (in which case rehab is helpful; in the other instances it isn t). But in all of these cases it is identifying what cognitive pattern is messing up and working to damp it down (negative system; it isn t generally done or it isn t done well). 12 step programs are pretty good for a lot of these behavior patterns There are drugs that modify some of the internal chemicals involved in alcohol addiction. They are of small benefit (25% improvement in success).