Associations play a strong role. If heavy drinking is viewed as proof of being a “real man” or as “smart” and sophisticated, there is pressure to conform. Young men and women often are initiated into heavy drinking in this way and fall into a pattern of “telescoped” drinking​—periodically getting “high” at parties or Saturday-night drinking bouts. Gradually the drinking may spread over into more and more days of the week. The process may be deceitfully slow. Studies show that the making of an alcoholic takes an average of sixteen years in men, only eight in women.

The modern increase in alcoholism is especially strong among women. In the United States about half the women alcoholics have experienced broken marriages and a third are married to alcoholics. Some have well-paying jobs but have found life less than satisfying, lacking in meaning. Those who have the role of homemaker may experience boredom or find the responsibilities of caring for small children burdensome. A housewife’s greater privacy from public attention may enable her to develop and conceal a drinking habit for some time. Hormonal changes accompanying the menstrual cycle may be all that is needed to trigger a spell of very heavy drinking.