If you were trying to find something to blame alcoholism on, genetics would be a good place to start: As much as 50-60% of the risk of becoming an alcoholic is determined by a person’s genes (1). We’ve discussed the genetics of addiction in general as they relate to other condition like ADHD, depression, and anxiety, but the risk that a person may become an alcoholic also depends on their sensitivity to alcohol’s effects, development of tolerance, susceptibility to withdrawal symptoms and alcohol-related organ damage, among others.
Alcohol related genes and alcoholism
The genetic causes of alcoholism are not always simple and straight-forward, especially because genes interact with one another (and the environment) in ways that can create unexpected results. However, some aspects of the genetics of alcoholism are clear, like the case of the genes that affect the speed with which liver enzymes will break down (metabolize) alcohol and its byproducts. Some people have a gene variation which produces liver enzymes that have trouble breaking down acetaldehyde (ALDH2-2, very common among Asians), a basic breakdown product of alcohol. As the levels of acetaldehyde increase, people experience flushing, nausea and rapid heartbeat which makes them less likely to consume alcohol and therefore less likely to become alcoholics. Not surprisingly, alcoholism rates have been historically low in Asian populations. However, recent increasing trends of alcoholism in Japan show that if you work at it hard enough, even a genetic predisposition that is supposed to protect you from alcoholism is no match for good old social pressures to drink.
Researchers have identified one neuropeptide (called NPY) that is located near known alcohol-related traits and indicates an alcohol preference in rats, consequently increasing response to alcohol (1). The effects of alcohol are increased with certain forms of NPY and that gene has been linked to addiction-related, and anxiety, behaviors (2). It is also generally accepted that genes that affect the activity of serotonin and GABA (one of alcohol’s main targets in the brain and body) are likely to be involved in alcoholism risk.
It is important for everyone to remember that there is a predisposition to becoming an alcoholic and that alcoholism is a disease, not simply an outcome of poor behavior . There are ways to treat both the physical symptoms and the underlying addiction in alcoholics.
We’ve barely scraped the surface of the numerous influences on alcohol’s effects, and the predisposition to alcoholism, but hopefully this post leaves you with a slightly better appreciation of the complexity of the matter…
Co-authored by: Jamie Felzer
Citations:
1. Alcohol Alert-National Institute on Alcohol Abuse and Alcoholism. No.60. July 2003
2. Anxiety and alcohol abuse disorders: a common role for CREB and its target, the neuropeptide Y gene. Trends in Pharmacological Sciences, Volume 24, Issue 9, September 2003, Pages 456-460.
8 responses to “The alcoholism gene? That’s quite a long story!”
This is very important information — especially for families with alcohol abuse or addiction. Hopefully, as this and similar information is more widely understood, the more accurate view of alcoholism as a disease will generate the necessary funding resources for research, diagnosis, treatment and prevention – similar to what’s occurred with other diseases such as cancer, heart disease or diabetes.
Nice summary of alcohol genetics. I always thought the anti-disease,”it’s a matter of will power”camp would crumble in the face of irrefutable evidence that alcoholism has a genetic substrate. But no.
Yeah, the world doesn’t seem to run according to my plans… Alas, I’ll stick to studying the evidence, discovering more, and getting the word out.
I hope that more resources go into researching the effectiveness of 12 step programs and the recovery industry as we know it today. It seems like the disease concept drives a very complex problem into a single solution.
As it stands, our recovery industry is broken. Inpatient and Outpatient facilities must prove they are affiliated with the 12 step program methodology in order to get reimbursed by insurance companies. Insurance companies pay for the treatment because it is a disease.
Insurance companies pay for treatment that isn’t 12-step based, though their current standards are ridiculous and will hopefully be changed by the MHPAE act that says all mental health and addiction issues must be covered equally with physical health if they’re covered at all.
I do understand the genetic predisposition to becoming an addict or alcoholic. My concern with this being an excuse for overindulgence of a chemical, is the fact that everyone has a choice not to indulge in the first place. Most treatment facilities who use CBT, 12-step Facilitation, or Motivational Interviewing say not to use. Relapse prevention starts with identifying triggers. This leads me to believe the one using has a choice. I am not denying the existence of a disease. When we look at the definition of the term “disease,” it is clear that alcoholism is one. Just because your genetic make-up is vulnerable to compulsivity does not mean you have to drink. Exposure to the chemical will trigger the compulsiveness. Don’t do it. Education and prevention at an early age must be the solution to fighting addiction.
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