As much shame as symptoms may trigger, drinking problems are an understandable human predicament. But these may be easier for concerned family members and friends to ask, since they may hesitate to ask direct questions about quantity. As a screening test, the single question about drinking patterns is as good as slightly more detailed ones, such as the CAGE questions. Therefore, primary care physicians often make a point of use time during a visit to provide education about drinking and its dangers. The limits are different for women and men because of known differences in how alcohol is absorbed, distributed and eliminated from the body. Therefore, screening is very important, whether primary care physicians or friends and family do it.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) was founded 40 years ago to help elucidate the biological underpinnings of alcohol dependence, including the potential contribution of genetic factors. Research shows that genetics can play a significant role in determining a person’s risk for developing alcoholism. It is a complex disorder influenced by a variety of factors, including genetics, environment, mental health, and social pressures.

Variants in the gene speed the conversion to acetaldehyde — a compound linked to unpleasant side effects from drinking — and that compound has a protective effect, making people less likely to drink heavily or become alcoholics. “As we analyze additional alcohol-dependent individuals, we should be able to find additional genomic regions affecting risk for alcohol dependence,” said first author Raymond Walters, of the Broad Institute of MIT and Harvard. The goal of the research was to better understand how genes may contribute to alcohol problems as a way to develop improved and more personalized treatments. The effects of other genes weren’t big enough to reach statistical significance individually — even though this study involved more than 50,000 people — but their combined effects were significant. “Those biological insights are critical to potentially developing better strategies for prevention and treatment of alcoholism and related psychiatric disorders,” he said. “We identify genetic factors that may be specific to problem drinking.”

How can I prevent alcohol use disorder?

The first two are considered “normal” drinking and the last two are viewed as “typical” alcoholic drinking. Johnson (1980) proposed that the emotional progression of the addicted people’s response to alcohol has four phases. The WHO calls alcoholism “a term of long-standing use and variable meaning”, and use of the term was disfavored by a 1979 WHO expert committee. Despite the imprecision inherent in the term, there have been attempts to define how the word alcoholism should be interpreted when encountered.

Measured genotype studies to detect G x E effects have used a range of alcohol consumption and diagnostic phenotypes and stressors ranging from early life to adulthood past year life events . G x E interactive effects are likely for stress and anxiety related genes including HPA axis genes, GABAergic pathway genes and genes with a glucocorticoid response element located within their regulatory region such as MAOA, COMT and SLC6A4. Likewise, another group was able to identify genotype combinations across SLC6A4, HTR3A and HTR3B that increased risk for AUD and predicted the response of alcoholics to the 5-HT3 antagonist ondansetron .

However, variants in ADH1B are uncommon (~3–5%) in European Americans (EAs) and African Americans (AAs) . The AUDIT, a 10-item, self-reported test was developed by the World Health Organization as a screen for hazardous and harmful drinking and can be used as a total (AUDIT-T), AUDIT-Consumption (AUDIT-C) and AUDIT-Problems (AUDIT-P) sub-scores. It is also important to remember that availability of alcohol is the most important factor that influences the outcome of AUD1, 10. Worldwide, an estimated 20–30% cases of esophageal cancer, liver cancer, cirrhosis of the liver, homicide, epilepsy, and motor vehicle accidents can be attributed to excessive consumption of alcohol.

Alcohol-induced DNA damage, when not properly repaired, may have a key role in the neurotoxicity induced by alcohol. The protein β-Klotho is an essential element in cell surface receptors for hormones involved in modulation of appetites for simple sugars and alcohol. They are found at different frequencies in people from different parts of the world. Beer alone is the world’s most widely consumed alcoholic beverage; it is the third-most popular drink overall, after water and tea. There is evidence that with abstinence, there is a reversal of at least some of the alcohol induced central nervous system damage. There are decision tools and questionnaires that help guide physicians in evaluating alcohol withdrawal.

For example, there is growing interest in studying epigenetic factors—that is, factors which alter certain phenotypes by modifying regulation of gene expression, without, however, changing the gene’s DNA sequence. The investigators found that the genetically “enriched” rats were more sensitive than the control animals to the effects of environmental stress on reinstatement of previously extinguished alcohol drinking (i.e., the alcohol-preferring rats resumed alcohol drinking more easily after being exposed to a stressor). In fact, alcohol preference in these animals is even more replicable across studies (and therefore, across environments) than brain weight (Wahlsten et al. 2006), suggesting that it is strongly influenced by genetic effects. One of the challenges is how to define the environment, which may include family, peer, and societal influences; other exposures; personality or psychiatric factors (which also have genetic components); and many more, most of which change over time. In contrast, our understanding of the critical environmental factors influencing alcohol use disorders remains inadequate and is an area of active research.

Stress, peer pressure, and easy access to alcohol can all influence whether a person develops an alcohol use disorder. Genetics play a role, influencing factors like brain chemistry and how alcohol is processed in the body, which may make some people more susceptible to addiction. However, addiction is influenced by a mix of genetic, environmental, and behavioral factors. Studies show that about 40-60% of the risk for alcoholism is inherited.

GENETICS DATA

Current evidence indicates that in both men and women, alcoholism is 50–60% genetically determined, leaving 40–50% for environmental influences. The most common dual dependence syndrome with alcohol dependence is benzodiazepine dependence, with studies showing 10–20% of alcohol-dependent individuals had problems of dependence and/or misuse problems of benzodiazepine drugs such as diazepam or clonazepam. Baclofen, a GABAB receptor agonist, is under study for the treatment of alcoholism. A 2008 review of the effectiveness of topiramate concluded that the results of published trials are promising, however as of 2008, data was insufficient to support using topiramate in conjunction with brief weekly compliance counseling as a first-line agent for alcohol dependence. A 2002 US study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) showed that 17.7% of individuals diagnosed as alcohol dependent more than one year prior returned to low-risk drinking. A 2021 meta-analysis and systematic review of interventions designed to promote moderate (controlled) drinking found that this treatment model demonstrated a non-inferior outcome compared to an abstinence-oriented approach for many people with alcohol problems.b

This sample included both African-American and European-American subjects, and the primary analysis sought to identify association with alcohol dependence using a case–control design. This technique, which is based on the assumption that common genetic variation contributes to disease risk, allows a comprehensive test of association across the genome, rather than testing only one gene at a time. These analyses detected significant evidence of association of alcoholism with 12 SNPs located in and around the ADH4 gene (Edenberg et al. 2006) and modest evidence of association with noncoding SNPs5 in ADH1A and ADH1B. These analyses detected linkage of alcoholism to a broad region on chromosome 4q that included the ADH gene cluster (Long et al. 1998; Prescott et al. 2006; Reich 1996; Reich et al. 1998; Williams et al. 1999). Finally, studies also have examined African-American alcohol-dependent families ascertained on the basis of cocaine or opioid dependence (Gelernter and Kranzler 2009).

• And if you have no genes for alcoholism whatsoever, you aren’t totally off the hook.
• Within psychiatry, the exploration of the alcoholic gene has intensified, aiming to understand its influence on a person’s risk of alcoholism.
• Children of alcoholics are about four times more likely than the general population to develop an alcohol problem.
• Studies continue to reveal other genes in which variants affect the risk of alcoholism or related traits, including GABRA2, CHRM2, KCNJ6 and AUTS2.
• Sanchez-Roige explained that variants, or alleles, of these particular SNPs are “protective” against a variety of alcohol behaviors, from excessive alcohol drinking to alcohol use disorder.
• Generally, children of alcoholics are more likely to abuse it themselves.
• As reported in the World Mental Health Surveys in 2020, 15% of all lifetime alcohol use disorder (AUD) cases occurred by the time the individual turned 18.

What Causes Alcohol Use Disorder?

The AUDIT questionnaire has a sensitivity of % for detecting unhealthy alcohol use, however the specificity is low. Online or written questionnaires have greater sensitivity for identifying unhealthy alcohol use compared to in-person questions asked by a healthcare worker. Another common theme is a score or tally that sums up the general severity of alcohol use.

• Many individuals with a family history of substance abuse can choose sobriety or moderate alcohol use with the right support.
• The research on epigenetics and alcohol is still developing, but some studies suggest there is a link.
• And to make things even more complicated, some research suggests your relationship with alcohol might actually affect your genes.
• With a goal to help predict if a person may develop this chronic illness, research in the field also aims to find new, effective approaches to treatment.
• Studies with the high- and low-drinking selected lines in particular have been a major focus of NIAAA-sponsored research efforts (for a review, see Crabbe et al. 2010; other reviews were published in a special issue of Addiction Biology, Vol. 113–4, 2006).
• In regions where alcohol is either prohibitively expensive or challenging to procure, there’s a noticeable reduction in alcohol problems and misuse.

Alcohol withdrawal syndrome

Kindling also results in the intensification of psychological symptoms of alcohol withdrawal. The kindling effect leads to persistent functional changes in brain neural circuits as well as to gene expression. Individuals who have had multiple withdrawal episodes are more likely to develop seizures and experience more severe anxiety during withdrawal from alcohol than alcohol-dependent individuals without a history of past alcohol withdrawal episodes. Severe acute withdrawal symptoms such as delirium tremens and seizures rarely occur after 1-week post cessation of alcohol.

Always consult a qualified healthcare provider with any questions regarding a medical condition or treatment. Clarity Clinic is NOT a rehab center or alcohol treatment center. Find the right mental health therapist near you and begin your treatment journey today at Clarity Clinic, the best mental health clinic in Illinois. Our programs DO NOT treat alcohol addiction, rather na vs aa the co-existing mental health issues.

Talk to your healthcare provider if you’re under stress and think you may be at risk for relapse. They may start drinking to cope with stressful events like losing a job, going through a divorce, or dealing with a death in their family or a close friend. Studies show most people with this condition recover, meaning they reduce how much they drink, or stop drinking altogether.

Is Alcoholism Genetic? Understanding the Genetics of Alcoholism

For example, the social environment plays such a crucial role in shaping drinking behaviors in humans, but it is difficult to identify corresponding rat and mouse behaviors and environmental factors. Thus, specific mouse strains have displayed their tendencies to drink more or less alcohol by choice repeatedly across 50 years of studies. Given their methodological power, it is surprising how little research into this area has been done using genetic animal models. Advances in genetic technologies already have allowed researchers to explore the genome in ever greater detail, and with the advent of whole-genome sequencing, complete delineation of genetic variation soon will be available. However, to be able to use such models, researchers first need to demonstrate that corresponding genes exist in these organisms and that they actually have similar functions. For example, researchers now can manipulate genes so that they are expressed only in certain cell types or during particular developmental periods.

If the condition is serious, attempts to stop drinking very suddenly may lead to severe complications, including withdrawal syndrome and seizures. In addition, people may strongly narrow their interests to addiction while neglecting previous activities, as well as personal hygiene and care. Withdrawal symptoms include nausea, nervousness, sleep disturbances, the strong urge to drink (“binge drinking”), irritability, and depression. When patients reduce or abruptly stop heavy drinking they may experience a withdrawal syndrome. This progression, continuing until the individual hits the bottom with excessive drinking and then moves back up to rehabilitation, is called the Jellinek curve. If cotton fever symptoms the affected person can function, doctors often refer to them as a functioning alcoholic.

While the D2 dopamine receptor gene did not have the effect expected on alcoholism, the study contributed to moving forward genetic research. The study found that there was a very strong connection between the D2 dopamine receptor gene and the development of alcoholism or problematic drinking behaviors. In 1990, cocaine health risks an initially promising study of the genetic basis of alcoholism was conducted by Kenneth Blum, a professor at the University of Texas Health Science Center.

Early genetic studies were focused on delineating whether environmental factors, genetic factors, or both contributed to the risk for alcohol dependence. Twin, adoption, and family studies conclusively demonstrated that genetic factors account for 50 to 60 percent of the variance in risk for developing alcoholism. The researchers found that the genetic risk factors related to alcohol dependence also were linked to risk for other psychiatric disorders, such as depression, schizophrenia, ADHD and the use of cigarettes and marijuana.

No matter how serious the problem seems, people can recover from alcoholism and live happier, more productive lives. It is a multifaceted and complex disease, so while someone may inherit a predisposition to the disorder, genes do not fully determine a person’s outcome. If you think you may have alcohol use disorder, you’re not alone.