I think I would say that alcohol abuse is more a symptom of underlying problems than the immediate cause of problems. Of course, abuse of alcohol can in turn lead to other problems (such as drunk driving), but I suspect that significant problems precede alcohol abuse rather than vice versa.
Alcohol limits inhibitions. That is why people do things under the influence of alcohol that they may not otherwise do. However, I would also argue that passion limits inhibitions. In the heat of passion, people will do things even without the influence of alcohol.
The mental games seem possible with a sober Martha and George since they have created the myth of a son that perpetuates itself throughout their lives. However, some of the incidents, especially those of Martha's unrepressed sexuality seem to be ones that emerge under the influence of alcohol.
I can but concur with #2. If we look at the relationship as it is presented to us in the text, it is clear that alcohol is very definitely not the cause of the rather dysfunctional relationship we are presented with. There is no sense in which we could argue that if they didn't drink, they would be enjoying a happily-ever-after kind of relationship. Alcohol certainly in the way that it strips away our inhibitions plays a role in how it spurs George and Martha on in their various excesses, but it cannot be said to be the cause.
I certainly do see the role that alcohol plays as a depressant and as something that removes inhibitions between both George and Martha. However, I think that their relationship is fragmented and so unhealthy from a psychological point of view that even without alcohol, their absurd cruelty would be present. I agree that George's statement about the need to drink in light of the American Dream creates a belief that perhaps alcohol is to blame for the disenchantment and alienation present. Yet, I think that there is a hollowness, an emptiness in both George and Martha that lies at the core of their relationship.
In a parallel way, I think that Albee is suggesting that this is the same emptiness that lies in the pursuit of the American Dream. The connections between both George and Martha's relationship and that of the American consumer with the American Dream are similar. Both sets of relationships are, on the surface, well meaning and inspire people to look at them with a sense of awe. The person who pursues the American Dream is looked at with admiration, and George and Martha, college professor and socialite daughter of college president, are looked at as an ideal couple. Yet, further examination reveals something fundamentally wrong with both configurations. The American Dream is something whereby individuals become slaves to it, and the dream controls them and what they do. George and Martha are completely dysfunctional in their own relationship and nothing can seem to change that. At best, the ending of the play shows the only constant in their relationship is fear and a haunting nothingness. At best, silence emerges. In this light, both the American Dream and the couple have some similarities.
In the final analysis, alcohol is just a gateway, an accelerant, to these feelings that are probably already there. If not alcohol, then another drug of choice would be used to ease inhibitions and allow the full extent of their dysfunctionality take form. Alcohol does play a role in their destructive relationship, but I don't think its presence is causing them to display such unhealthiness. That, regrettably, is already there between both husband and wife.
I often wonder why it is that practically all of the great artist had or have a tragic event or psychological problem in their life and I wonder if their great accomplishments is through a release of the hurt they feel.
Yes, George and Martha's relationship is dysfunctional, but only seen under the influence of alcohol. Albee is influenced by Tennessee Williams - in "Streetcar" - Stanley, under the influence, beats Stella - is alcohol an excuse or alibi for his violent behaviour. "I was drunk" - tell it to a judge....