The Genetics of Alcoholism




Alcohol consumption is probably as old as human civilization, and so is its abuse. The social and physiological ill effects of alcoholism are well known. What is less clear is why certain individuals are more predisposed to it. Alcohol addiction is a multifactorial phenomenon where personality traits, individual and social influences interact with neurobiology, creating varied clinical results and manifestations. The effect of alcohol on the central nervous system has been established but the exact mechanisms of action remain obscure. Alcoholism has different facets, from habitual intake, to problematic abuse, to addiction resulting in severe physiological damage.

Research now supports the idea that along with other social factors, genetics has an important and critical contribution in the progression of alcoholism.

The comparison of monozygotic and dizygotic twins in different studies has shown a significant correlation between hereditary and alcohol abuse. Children of alcoholic biological parents who were adopted at birth develop alcohol addiction more frequently compared to adopted children with no alcoholic parent. There is a lower genetic risk for alcohol dependence among women.

Candidate gene studies have implicated the genes encoding alcohol metabolising enzymes in the liver like alcohol dehydrogenase (ADH), the microsomal oxidation system (MEOS) and the aldehyde dehydrogenase (ALDH) in the development of alcohol addiction. Genetic studies conducted in various ethnic groups have confirmed that certain allele variations of ADH and ALDH are linked either in development of or in protection from alcohol addiction through a mechanism that is not yet known. The alleles influence the various alcohol addiction syndromes, such as tolerance, sensitivity and dependence. In addition to these genes, neurotransmitter genes have been associated with increased risk for alcohol dependence. Alcohol modifies the neurochemical milieu and acts on many different neuroreceptors although there is no known receptor for alcohol in the brain.

Although the theory that a distinct type of personality leads to alcohol dependency has been rejected, some traits such as low self-esteem and antisocial behavior have been found to be positively correlated to alcoholism. Social modeling and conditioning seem to be significant psychological factors in the development of alcohol addiction. Thus, a complex web of genetic and environmental factors contributes to alcoholism.

Alcoholism is a major economic burden and public health issue. Delineating the genetic components can not only offer information about the risk factors, but also form the theoretical basis for development of therapeutic and educative regimes for its prevention.

References

Moussas, G., Christodoulou, C., & Douzenis, A. (2009). A short review on the aetiology and pathophysiology of alcoholism Annals of General Psychiatry, 8 (1) DOI: 10.1186/1744-859X-8-10

  • Azkyroth

    This is interesting, since I’m married to a tentatively recovering alcoholic. Do you know of any studies on alcoholism genetics and risk factors (perhaps something analogous to the CHARGE study for autism?) that our family might be able to participate in?

  • Dear Azkyroth,

    I’m glad that you enjoyed the article. There are at least 179 open clinical trials on alcoholism, many in the fields that you inquired. Please visit ClinicalTrials.gov by the NIH for a full listing. Thank you.

    Sincerely,
    Shaheen

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  • I’m a witness to alcoholism being hereditary. I’m a published author and wrote about my seventeen years living in an alcoholic marriage. I watched a wonderful husband lose everything and die in 1985 at forty-five years of age. I wrote about it in Someone Stop This Merry-Go-Round; An Alcoholic Family in Crisis (June 2009 by Infinity Publishing).

    His mother, sister and brother were alcoholics. My niece on my husband’s side is fifty-two and is battling the disease.

    My precious daughter, Lori, died November 22, 2006 at the young age of thirty-nine from the same demon. She had been in rehabilitation three times and couldn’t fight this illness. She wanted to become a counselor for substance abuse.

    I’m completing the sequel about her life in Please, God, Not Two; This Killer Called Alcoholism.

    Now I’ve become the “Demon Fighter” talking in rehabilitation centers, halfway homes and any location wanting to hear my story. This is a worldwide, incurable disease.

    If I can help one person, it will be worth it. It’s not the abuser we hate, it’s the disease. After all, this is a family disease and every member is mentally and physically affected by it.

  • Nicolas Cage

    It really is an interesting subject, and indicates that the times have changed dramatically, and now the depression is much stronger than before, is also the lifestyle that we lived for two generations, very different indeed, as to the antidepressants should be very careful as they can be very dangerous if not performed adequately, because we have many cases where people have come to impair their lives by these drugs (as findrxonline, trusted source, and there are more than thousand cases in United States) it is required to be very careful and take an appropriate and prescribed by the doctor, never self that is much more dangerous still.

  • The self-esteem and antisocial issues raise a chicken/egg question: are they the results of living in a dysfunctional family, or themselves of partially genetic origin, or both? It’s too bad the research establishment isn’t well-enough organized to pursue these question logically, as they arise.

    We have so much to learn.

  • Carol

    It is so refreshing to know that studies have know proven that gentics plays a role with this disease. The field of chemical depenency has always known this.

  • What’s amazing, Carol, is that one child becomes alcoholic while the others have no trait of it. Lori couldn’t understand why her only sister could drink, and she couldn’t. But, we do have to watch in the future with their children.

  • John

    Have been clean and sober for 15 yr.s now. Am from a family ,where all the men were highly functioning alcoholics. No one lost jobs ,families or were in jail. We all drank , thats just the way it was. We are an Irish Catholic family, and in my yr.s of meetings in AA, have found that to be a common factor with a large number of drunks. So I do believe that it is an inhereted genetic trait , buy in combination with family upbringing and family social interaction.

  • melford

    I am so much happy that there is place to discuss such a thing like alcohol,here in Africa it is never a thing to be serious about.Well I grew up in a Family that dadd drinks rarely.Have seen many friends that lost one thing or the through that poison,well it will be a very good thing to have another international organisation campaigning the effect of alcohol in our lives.Am a Nursing Student ,hope this should be taking cognizance.

    iwugo_m@yahoo.com

    All AIESEC’ers greetings from Awka LC.

  • Anonymous

    There are two creative, artistic works that say a lot about alcohol abuse. One is the painting by Diego Velasquez called, in English, ‘the Tipplers.’ Another is the early 1960s song recorded by Peggy Lee. ‘Is That All There Is?’ with the famous lines: “If that’s all there is, my friends,/ Then let’s keep dancing…’ /Let’s break out the booze and have a ball..” I think both works tell us a lot about the appeal and the culture of the drug.

  • fred

    sorry, forgot to add my address – alcohol is not to blame…

  • madeleine

    I understand that based upon adoption and twin studies we can establish that genes play an important role in alchoholism, but how can people know that it is genes and not the environment that contributed to the alchoholism in family members if they all are alchoholics and have been brought up in the same environment? I am studying Health Psychology in Oslo, and am currently writing an assigment on the social, biological and psychological factors that contribute to alchoholism. In my book (by Shelley Taylor) it says that genetic factors appear to be implicated, and that men have traditionally been at greater risk for becoming alchoholics, but now that the norms are changing, also more women are becoming alchoholics. This means that it is more the environment than genes, does it not?

    Thank you. – M.

  • Anonymous

    Dear Madeleine,
    genetics is a susceptibilty factor for alcoholism, that means it works only when certain other factors also contribute to its manfestation which are mostly as you pointed out environmental.
    adoption studies-an adopted child of alcoholic biological parents, and non alcoholic adopted parents would have higher susceptibilty for alcoholism, and vice a versa. In twin studies-twins that have been separated at birth into different environments are studied, so it is basically a nature vs nurture study.
    but primarily genetics of alcoholism only provides an additional risk factor for alcoholism and it does not follow a mendelian inheritance like some other diseases such as haemophilia.
    Dr Divya Mathur

  • I’m truly starting to think we need to find out why a person drinks more than the affect of it on the abuser. So many reason play into substance abuse; child having been abused, divorce, broken homes, teens trying to fit into the “popular” crowds, coming from an alcoholic family, sexual abuse, depression or people too afraid to solve a serious problem. The reasons could go on forever.

    My daughter could not open up to me about her past before her death because it was so painful. That is so hard to live with.

    I also believe strongly that the Patient Privacy Act should change. I had to listen to counselors tell me that Lori was very emotionally sick and I wasn’t allowed in her counseling because my daughter wouldn’t agree to it. There was no fighting or hostile feeling between us. She feared talking about it. I feel she could have had a 70% change of surviving if we could have talked.

    Professional counselors are wonderful opening the door to the alcoholic for hope, but Lori was looking for answers from her past. I had those answers. When the patient is so confused with alcohol taking over their thinking, I think the Privacy Act stops the alcoholic from recovering.

    I might not have saved her but I would have lived better with myself knowing I tried to reach her. She hinted to me that something happened with her father. She refused to talk about it. Maybe she feared hurting me or felt guilty. She died at thirty-nine thinking I knew all about the event.

    I think we need to look at the emotions more deeply with the sick.

  • Theodore A, Hoppe

    Why single out alcohol when talking about addictions?

    In recent years, Batwa pygmies from the Great Lakes region the Central Africa have been beset by a number of factors that are destroying their traditional social structures, culture, and hunter-gatherer existence. The result is a dramatic increase in alcohol abuse, (as well as domestic violence against women), since their traditional cultural mechanisms for dealing with tension and discord have eroded. They are, for lack of a better term “self medicating”. Wasn’t this observed in Native American groups as well?

    A Minneapolis VA Medical Center study reported that depression hinders attempts to quit drinking, but did not effect smoking cessation, suggesting that the depression might cause the using of alcohol for self medication.

    Dr Gene M Heyman, a research doctor at McLean Hospital, and Harvard lecturer, states in his new book,” Addition: A Disorder of Choice” that addicts respond to incentives. He sites surveys that say that over 70% of addicts quit be not seek clinical help. ” I do not mean to say that someone chooses to be an addict. Rather, they choose to have just one more drink or quit tomorrow. A long enough series of one-more-times makes an addict. Addicts tend to quit when the “hassles” of maintaining their habit become too great.” Asked if addictions have a strong hereditary component? “Yes. We are biological creatures, and even voluntary behavior has a biology, including a genetic background. The question is not whether addiction has a biological basis – it does – but whether its biological basis prevents drug use from coming under the influence of costs and benefits. As it turns out, incentives matter.”

    A similar perceptive was put forth in Scientific American Mind, August 2008, in an article titled, Do-It- Yourself Addiction Cures. “Psychologist Reginald Smart of the Center for Addiction and Mental Health in Toronto recently reviewed the findings on the prevalence of self-change efforts among problem drinkers. We draw the following conclusions from his review and from our reading of the literature:

    Most of those who change their problem drinking do so without treatment of any kind, including self-help groups.
    A significant percentage of self-changers maintain their recovery with follow-up periods of more than eight years, some studies show.
    Many problem drinkers can maintain a pattern of nonproblematic moderate use of alcohol without becoming readdicted.
    Those who do seek treatment have more severe alcohol and related problems than those who do not.”

    And one additional point; Can it be that the tens millions of dollars spent annually to advertise alcohol has some effect on how we relate to alcohol?

    The bottom line is there may be no one factor, no one answer. Like with most things, it’s never that easy and we sure stop pretending it is.

  • jack indusa

    hey these a very good forum have a brother who has been an addict for like ten years been on and off employment due to alcohol related cases and finding a rehabilitation center in Kenya is very expensive kudos to all who are fighting these demon.

  • Hi Jack,
    Have your brother read Someone Stop This Merry-Go-Round; An Alcoholic Family in Crisis at http://www.amazon.com

  • My 18 year old son and I had a discussion about this two days ago…for the umpteenth time. I’m so glad we started our talks many years ago. He gets it.

  • C

    I am sure that there is a heriditary aspect, although from the point of view of my own ongoing battle with drink, it is somewhat irrelevant. I have often wondered if I am an alcoholic because of the experiences, nature or nurture, but ultimately knowing why doesn’t help me figure out the ‘how’ of stopping.

    Unfortunately I just have to accept I cannot drink, whatever the reason is.

  • No matter how we go around it, everyone says the alcoholic has got to want to stop. How many have that desire and can’t. I watched my daughter, Lori, go deeper and deeper into the abuse. Then the pain of seeing her on a ventilator and turning it off, is beyond words. A useless death! A wonderful girl with everything to live for with two beautiful children she had adored, slipped away from her.

    Alcoholism is a family disease. It always will be. My strong feeling is that the abuser and family members have to be open up and be honest with each other about the abuse going on. I never knew until Lori’s last two years that she was an alcoholic. By then, her liver was beyond repair, and she couldn’t stop a year to receive another one.

    Family should be allowed into their counseling to help the abuser face the bad experiences within the family itself. It shouldn’t be decided up with the alcoholic who is too sick to make decisions for themselves. Lori would not talk about it. She “hinted” that something happened with her father, and yet, she adored him, and was lost after his death from the same abuse. I have to live with all the questions and no answers.

    We need to “listen” to each other when one is opening up with their pain. Abusers have to be honest first with themselves and then turn to the family for help and support.

    If emotional, physical, or sexual abuse happened to someone, they need to forgive. Move on. It doesn’t mean they have to socialize with that person again. Keeping the anger and hurt buried deep inside contaminates the soul. Recovery should cover getting all the “garbage” out of the memories and heart.

    Wouldn’t it be wonderful is “one” person could find the answer like Bill did with starting AA.

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Divya Mathur, PhD

Divya Mathur, PhD, holds a doctorate in molecular biology with several peer reviewed journal articles. She currently writes about medical research for the lay audience.
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