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Last updated 12:42PM ET
April 21, 2021
Alcoholism 11-1-07
(KUNR) - 11-1-7 Genes and Alcoholism
Nurnberger and Bierut, Seeking the Connections: Alcoholism and our genes. Scientific American, April 2007, 46-53

Despite advances in our understanding of alcoholism, many of us still think that drinking too much is a choice, not an illness. We mistakenly judge alcoholics as being weak, people who choose to keep drinking even when their dependence on alcohol ruins their judgment and their lives.
In the past 10 years, the technology of gene research has become more sophisticated; in 1989 a study of the genetic underpinnings of alcoholism began with support from the National Institute on Alcohol Abuse and Alcoholism. Eight research centers around the country and thousands of alcoholics and their families have participated. What we've found is that about 50% of the causes of alcoholism are genetics one inherits, and the other 50% is caused by the interaction of the personality and environment. That's a huge leap forward in understanding the illness to know over half the cause of alcoholism is in one's genes.
There are many genes that have been found to contribute to alcoholism, and we've found there are many routes, many different combinations of the genes that can end in abuse. Some of the genetic predisposition for substance abuse comes about when the neurotransmitters that allow the brain to pause before acting on impulses don't work well; when the chemicals don't work well that slow one from jumping to action in response to signals from our primitive brain, the person is more likely to use poor judgment and to drink too much. Some of the genetic predisposition comes about when the brain chemistry works such that there's more excitation of the brain and less ability to disinhibit; meaning, when there's intense emotion on board, the person will act out the emotion instead of being able to dial it down as you would dial down a reostat to diminish light. These people who can't dial down their impulses and emotions often get into trouble with conduct disorders, having trouble following rules, staying in school, and brushes with the law. Some of the genetic predisposition for alcoholism can come about when the body's chemistry metabolizes alcohol differently than the body of someone not prone to alcoholism. This can result in being able to consume large quantities of alcohol and not be as effected as other people.
Not all people who are dependent on alcohol, have the genetic predisposition to be alcoholics. It's difficult to separate the two because in the early stages of alcoholism, those with dependency and those with alcoholism look alike. Dependency is defined as having at least 3 of the following symptoms in the past 12 months: tolerance for consuming large doses of alcohol; withdrawel reactions when the drinking stops over time; loss of control over use of alcohol; have tried to stop or cut back; a great deal of time is spent drinking; giving up on other activities in order to pursue drinking instead; continued drinking despite physical or psychological problems exacerbated by alcohol. If you've got 3 of these symptoms, you're at least dependent; if you try to quit and can't, you may be suffering from alcoholism. Psychologists diagnose alcoholism when the drinking behavior creates problems in your social life, your work life, or you've ever been arrested because of drinking.
Some people with alcoholism begin drinking at an early age. Some begin drinking because they're depressed or anxious; they can't tolerate the usual upsetting emotions through which we must all struggle. Some begin drinking because it's fun and they enjoy the lack of inhibition. Regardless of why you start drinking, if you've got the genetic predisposition, alcohol will eventually become a problem if you keep drinking.
Eventually we'll have genetic tests to let you know if you're at risk. It doesn't take genetic testing to look at your parents and your siblings to know if any of them have trouble with alcohol or drugs. If they do, then you may be at risk.
Genetics is not destiny. If you have the predisposition to become dependent on alcohol or drugs, you can choose to not use. If you can't not use, you need help to stop.
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