Understanding the Genetics Behind Alcoholism

alcoholism

If you are a suffering alcoholic or a loved one of an alcoholic, you have probably wondered at some point if your disease is genetic.  You may have a parent or other close relative that you witnessed battling this disease known as alcoholism.  Perhaps you may believe that your drinking was not by choice, or that you could not avoid becoming an alcoholic like your mother, father, or uncle.

When an individual decides to drink alcohol, it is a choice.  This choice is influenced by outside factors like peer pressure, family disapproval, availability. 

It is still a choice, nonetheless. When the drinking becomes habitual, the risk of developing alcohol dependence is more determined by their genetic makeup.  In other words, some people respond differently to alcohol. Alcoholism is not a matter of choice and should also not be viewed as a moral failure or a lack of willpower.  It is biological.

A Look at What Causes Alcohol Use Disorder

Addiction involves several complex risk factors; such as:

  • Genetics
  • Family History
  • Environment
  • Gender
  • Mental Health

Stress from work or home life can be a trigger for addiction.  When a person consumes alcohol, they may feel happy and relaxed compared to how stressed they feel when they are sober.  This stress-free period can reinforce a desire to use alcohol as a coping mechanism. People who have a mental illness, specifically anxiety, depression, bipolar disorder, and schizophrenia are more likely to have a co-occurring alcohol use disorder.

Genetics are passed down through families, but family history also involves the environment that a person was raised.  Childhood abuse, parental struggles, and mental illness in close family members are all contributing factors to the development of addiction to drugs or alcohol.

Family History

History shows us that one of the most reliable indicators of a person’s risk for developing alcoholism is their family history.  In most cases, when looking at an alcoholic’s family history, one or both of their parents were alcoholics.

Some studies show children of parents who suffered from alcohol dependency are about four times more likely to also suffer from problems with alcohol.  They are also at a higher risk of developing emotional and behavioral issues.

The Influence of Genes on Alcohol Use Disorder

Alcohol Use Disorder, or alcoholism, can run in families.  Scientific studies talk about an “alcoholism gene.” Genetics influence the likelihood of developing AUD, but it is not as simple as that.

According to research, genes are responsible for about half the risk of developing an alcohol use disorder. Still, it is not accurate to say that genes alone can determine this development.  There are environmental factors to consider, as well as gene and environment interactions, account for the rest of the risk factor.

Many genes play a part in a person’s risk of having an alcohol dependency.  Genes can increase or decrease a person’s risk, whether it be directly or indirectly.  For example, some ethnic groups carry a gene variant that alters the rate of alcohol metabolism, causing unwelcomed symptoms like flushing, nausea, and rapid heartbeat when they drink.  People who experience this type of side effect from drinking tend to avoid alcohol, which in turn helps to protect them from developing AUD.

Research has also dived into the study of epigenetics, which means that different factors can alter the expression of our genes.  Scientists continue to study epigenetics and how its effects on the risk of alcoholism.

Genetic v. Hereditary

Scientifically speaking, addiction is viewed as a chronic disease of the brain that affects the reward and motivation centers.  Scientists have argued for decades about the genetic and hereditary components of addiction.

Alcohol Use Disorder has been linked to some specific genes.  If an individual’s parent or sibling struggled with alcohol use disorder, it increases the chances of them also struggling with the addiction.

Genetics and heredity are closely related, but from a medical perspective, there are differences between genetic and hereditary diseases.  Biologically, parents pass their genes down to their children, so naturally, children inherit the genes.  

When a person has a genetic disorder, they have an abnormality in their genome.  A person with a hereditary disease has a genetic mutation from their parents’ DNA.  The scientific debate on whether alcohol use disorder is hereditary or genetic is based on if the condition stems from a broader set of genes that are passed down or if the disease is a result of a mutation in some genes.

One estimate suggests that as many as 18 million, one in 12 adults in the country battle alcoholism.  Every year, about 100,000 people die from alcoholism, including deaths due to cirrhosis and other organ damage.  Habitual heavy drinking also increases the risk for other conditions like kidney disease, diabetes, and several cancers.

The Factors Involved

When questioning if alcoholism is genetic, remember to consider multiple factors.  Culture, environment, and other genes play a role. Researchers believe that specific genes can make drinking a pleasant or unpleasant experience. 

This experience can be a determining factor in whether a person becomes a habitual drinker or not. A gene that regulates the rate at which a body metabolizes alcohol can determine the risk level for alcohol dependence.

Other causal factors that can be environmental or behavioral are:

  • Binge Drinking – The act of overindulging in alcohol by habitual binge, or heavy drinking over some time, that affects the brain’s reward center.
  • Underage Drinking – When alcohol consumption begins early in the teenage years when the brain is still developing, the risk of developing alcohol dependence later in life is higher.
  • Alcoholic Environment –This factor is when an individual grows up with parents who abuse drugs or alcohol.  An estimated 70% of adult children of alcoholics will also suffer from compulsive behaviors.
  • Trauma – A person who suffers from a severe traumatic event attempts to self-medicate with alcohol to cope with the experience.

Dr. Michael Genovese, a chief medical officer of addiction and mental health treatment provider at Acadia Healthcare, stated that people are influenced by nature, nurture, and neighborhood, or the community that surrounds you. 

 Individuals can have a genetic susceptibility to a dependency on alcohol, which often coincides with a predisposition to other mental health conditions.  Dr. Genovese also said that repeated exposure to alcohol consumption and abuse could impact drinking behaviors later in life. Continued genetic research is needed to assist with eliminating the guesswork and help with the identification, prevention, and individualized treatment of substance use disorder.

In a study by Trusted Source, researchers of the Psychiatric Genomics Consortium made a comparison of the genomes of 15,000 people who were diagnosed with alcohol dependence to that of 38,000 people who did not have an alcohol dependency.  

The study found that those with the ADH1B variant of the alcohol dehydrogenase (ADH) gene, which serves as a regulator of the body’s ability to convert alcohol to a substance called acetaldehyde, were more likely to become alcohol dependent than those who did not have this variant of the gene. 

ADH1B reduces the clearance rate of alcohol from the liver, while people who have ADH1B, another variant of the ADH gene, process alcohol quickly, which elevates levels of acetaldehyde faster, the alcohol metabolite that causes hangovers.

It has been proven that genetics plays a significant role in the development of alcohol-related disorders.  These types of studies and information can make it possible for physicians and those who specialize in addiction to formulate new evaluation procedures to assist with the diagnosis of alcoholism in a timelier manner.

The Effects of Genes on Treatment?

Scientists are looking into the influence of genes’ effectiveness on treatments for alcohol use disorder.  The drug naltrexone has helped some patients who suffer from alcoholism, not all, reduce their drinking.

Research has also shown that individuals with AUD who have variations in a specific gene have positive responses to treatment with naltrexone, while those without this particular gene do not.  A deeper understanding of the influence of genes on treatment results can assist doctors with prescribing the appropriate treatment for their patients.

In Summary

Genes play a role in the risk of alcohol dependency.  There are specific genetic variants that affect alcohol metabolism and help to determine whether an individual will enjoy drinking or not. 

Continued research could help with establishing a genetic profile for people who are at risk of alcoholism and make treatments more effective.

If you or a loved one are suffering from alcoholism, we want to help. Contact us today.

Article Reviewed by David Sherman, MD

David Sherman, MDDavid Sherman, MD is a Fellow of the American Society of Addiction Medicine (FASAM) and board certified in Addiction Medicine with the American Board of Preventive Medicine. He is a native Missourian and graduated medical school at the University of Missouri-Columbia School of Medicine. Dr. Sherman completed a two-year fellowship in Addiction Medicine at the University of Florida in Gainesville. He leads a highly trained staff of master level certified addiction professionals. Men and women from all over Missouri and the United States come to Sana Lake Recovery Center to get the care they need and deserve.