Understanding the Genetics of Alcoholism


Alcoholism, or alcohol dependence, is a serious problem affecting many people worldwide. It’s when you’re so used to drinking alcohol that your body and mind can’t do without it, and it starts causing problems in your life.

Alcoholism can lead to various health issues, such as liver and heart disease, brain damage, depression, anxiety, and even a higher risk of suicide. It can also cause problems in your relationships, job, legal issues, and can lead to violence.

Alcoholism doesn’t happen for no reason – it’s due to a mix of things around you (your environment), your mind (psychological factors), and your body’s makeup (genetics).

This article will help you understand how the genetics of alcoholism work and how understanding the genetics of alcoholism can help prevent alcoholism. So, let’s get started!

Quick Note:

Genetics plays a significant role in determining an individual’s susceptibility to alcohol addiction. Research has identified specific genes that influence how alcohol is metabolized (such as ADH1B and ALDH2) and how the brain responds to alcohol (like GABRA2 and GABRG1). Studies involving twins, families, and adoptions have shown a notable genetic component in the risk of developing alcoholism.

Genetic variations also affect medication responses. For example, variations in the OPRM1 gene can influence the effectiveness of treatments like naltrexone.

However, it’s important to recognize that genetics is just one part of the picture. Environmental influences and personal choices also significantly impact the development and management of alcoholism. Understanding these various factors is key to effectively preventing and treating AUD.

If you want to understand it in more detail, keep on reading the article.

Defining Alcoholism

Alcoholism is a health problem where you’re physically or mentally dependent on alcohol.

It’s officially called an alcohol use disorder (AUD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which doctors use to diagnose mental health issues.

The seriousness of AUD is based on the number of criteria you meet. To be diagnosed with AUD, a person must meet at least two out of 11 criteria within a 12-month period.

The criteria include:

  1. Drinking more or longer than intended
  2. Having a persistent desire or unsuccessful attempts to cut down or control drinking
  3. Spending a lot of time obtaining, using, or recovering from alcohol
  4. Having a strong craving or urge to drink
  5. Failing to fulfill major obligations at work, school, or home due to drinking
  6. Continuing to drink despite having recurrent social or interpersonal problems caused or worsened by drinking
  7. Giving up or reducing important social, occupational, or recreational activities because of drinking
  8. Using alcohol in situations that are physically hazardous
  9. Continuing to drink despite knowing that it causes or worsens a physical or psychological problem
  10. Developing a tolerance for alcohol, meaning that more alcohol is needed to achieve the desired effect
  11. Experiencing withdrawal symptoms when stopping or reducing drinking

If you meet 2-3, it’s mild. If you meet 4-5, it’s moderate. If you meet 6 or more, it’s severe, which is what we usually call alcoholism.

Alcohol dependence is considered a severe form of AUD that involves at least three out of seven criteria from the previous version of DSM (DSM-IV), which are:

  1. Tolerance
  2. Withdrawal
  3. Drinking more or longer than intended
  4. Persistent desire or unsuccessful efforts to cut down or control drinking
  5. Spending a lot of time obtaining, using, or recovering from alcohol
  6. Giving up or reducing important social, occupational, or recreational activities because of drinking
  7. Continuing to drink despite knowing that it causes or worsens a physical or psychological problem

You can also take a self-test online here.

Prevalence of alcohol dependence globally

Alcoholism is common and harmful worldwide. About 5.1% of people aged 15 years and older had AUD in 2016, according to the World Health Organization. That’s about 283 million people. Among them, about 107 million people had severe AUD or alcoholism.

Alcoholism causes more than 200 diseases and injuries and 3 million deaths every year. It can affect the health and well-being of others, such as family, friends, co-workers, and strangers.

Alcoholism can cause big social and economic problems. It can affect a person’s ability to work or study, cause relationship problems, financial issues, legal problems, and social stigma.

According to WHO, the cost of alcoholism is estimated to be 1.3% of the money made by high and middle-income countries.

Causes of Alcoholism

Alcoholism happens due to a mix of things in your environment, your mind, and your genes.

Your environment affects your alcoholism risk. This includes:

  • how easy it is for you to get alcohol
  • how much it costs
  • how it’s marketed and advertised
  • what the laws on alcohol use are
  • what your culture and society think about drinking
  • if you’re exposed to stress or trauma that can trigger or worsen drinking

Your psychological factors, like personality, mood, self-esteem, self-control, motivation, beliefs, attitudes, and mental disorders, can also affect your risk of alcoholism.

Lastly, your genes play a big role in alcoholism. Genetic factors influence your risk of alcoholism by affecting how your body processes alcohol and how you respond to alcohol.

These genetic factors are not static. They can be changed by mechanisms that alter gene activity without changing the actual DNA sequence like epigenetic.

Genetics of Alcoholism

Changes in our DNA can affect our genes, which can in turn influence our susceptibility to diseases and behaviors, including alcoholism.

There are also two main types of genetic variations: common ones that are seen frequently in the population and have small effects on disease, and rare ones that are not seen often but have large effects on disease.

Some diseases, like sickle cell anemia, are caused by changes in a single gene. Others, like diabetes, result from the combined effects of changes in multiple genes along with environmental factors like diet and exercise.

Type of Studies Done to Find Genetics of Alcoholism

To understand if genetics play a role in alcoholism, researchers have conducted several types of studies.

These include twin studies, family studies, and adoption studies. For example, they compare if identical twins (who share all of their genes) are more likely both to be alcoholics than fraternal twins (who share only half their genes).

The results from these studies show that yes, our genes do have a big impact on whether we become alcoholics or not.

The scientists also looked at the DNA of people from different families and found that close relatives of alcoholics are more likely to be alcoholics themselves.

This suggests that the “alcoholism gene” could be passed down through generations. Adoption studies also support this – children who were adopted away from alcoholic biological parents were still more likely to become alcoholics, showing that the environment alone doesn’t cause alcoholism.

But what specific genes are linked to alcoholism?

Scientists have found several genes that make people more or less likely to become addicted to alcohol.

These genes are responsible for various functions, like breaking down alcohol in the body, controlling how the brain responds to alcohol, and even managing stress and the body’s immune response.

Alcohol Metabolising Genes

Two such genes are ADH1B and ALDH2. They make enzymes that help the body get rid of alcohol.

People with certain versions of these genes break down alcohol quicker or slower than others, affecting how drunk they get and how alcohol makes them feel.

Some folks, especially those with Asian backgrounds, have an ALDH2 gene version that causes unpleasant feelings like becoming flushed, nauseous, or having a fast heartbeat when they drink alcohol.

This reaction discourages them from drinking and protects them from alcohol addiction.

Genes Affecting Neurons

Then there are genes like GABRA2 and GABRG1 that control how a chemical in the brain called GABA works. This chemical helps manage brain activity and our moods.

It also plays a part in how good or sleepy we feel after drinking alcohol and in our responses to stress and anxiety.

Changes in these genes can make people feel alcohol’s effects more or less strongly.

Stress Managing Genes

Genes like CRHR1 and NR3C1 also play a part in alcohol addiction. They make proteins that help our bodies manage stress. Alcohol activates this stress-managing system and can lead to us craving alcohol and potentially relapsing.

Changes in these genes can influence how this stress system reacts to alcohol or other stressful things, making some people more or less likely to become addicted to alcohol.

Immune Response Genes

Finally, genes like TNF and IL10 are linked with alcoholism too. They produce molecules that control our immune systems and inflammation in our bodies.

These molecules are involved in addiction because they can change how our brain’s reward system works and can affect our moods and thinking.

Changes in these genes can influence how these molecules work, making some people more or less likely to develop alcohol addiction.

So, to answer the question, “Is alcoholism genetic?” – yes, our genes can influence our likelihood of becoming addicted to alcohol.

However, this doesn’t mean that if you have these genes, you will definitely become an alcoholic. It’s a complex mix of our genes, our environment, and the choices we make.

The study of the genetics in alcoholism helps us better understand and treat this condition.

How Epigenetics Connects to Alcoholism

Epigenetics is the study of changes that happen in our body that influence the way our genes work without altering our DNA.

These changes can switch genes on or off and determine which proteins are transcribed. They are influenced by various factors such as our lifestyle, age, and environment, including alcohol.

Alcohol can change these “epigenetic markers,” causing different reactions in our brain. It can alter how we respond to stress, how we feel reward or motivation, and even how we make decisions.

Alcohol can trigger three major types of epigenetic changes:

  1. DNA methylation
  2. Histone acetylation
  3. Histone methylation

These changes to our genes can last even after we stop drinking and can affect various aspects of alcohol addiction:

  1. Tolerance and dependence: Alcohol can change our genes in ways that make us need to drink more to feel the same effects (tolerance) or make us feel like we need alcohol to avoid withdrawal symptoms (dependence).
  2. Craving and relapse: The changes alcohol makes to our genes can also mess with how our brain feels reward and manages stress, leading to strong urges to drink and making it harder to stay sober.
  3. Cognitive impairment and brain damage: Over time, the changes that alcohol makes to our genes can damage the structure and function of our brain, leading to problems with thinking, memory loss, and even brain damage.

Other Factors Affecting Alcoholism

Genetics is one of the players but is not the only one. Other factors heavily influence your chances of getting alcohol addiction.

Social and Economic Factors

Social and economic factors play a significant role in alcoholism. These include things like how much money you earn, your level of education, and the type of job you have.

For instance, if you don’t earn much money, you may have more stress and less access to healthcare, which could lead to increased drinking.

If you didn’t go far in school, you might not know about the dangers of excessive alcohol use. If you’re out of work, you might start drinking because you’re bored or upset.

Living in a rough neighborhood can lead to drinking as a way to cope with crime or violence.

Not being able to get healthcare can mean you don’t get the help you need for alcohol addiction or other mental health issues.

Lastly, if you don’t have friends or family to lean on, you might turn to alcohol to deal with feelings of loneliness.

Mental Factors

Your mental state can also influence whether you become dependent on alcohol. This can include feelings of stress, mental illnesses like depression or anxiety, or certain personality traits.

For example, if you’re stressed, you might drink more to cope with it. If you have mental health disorders like depression, anxiety, or ADHD, these can influence your drinking behavior.

Some people may also drink to ease their symptoms or the side effects of their medication. Certain personality traits, like being impulsive or seeking new experiences, can make you more prone to alcohol dependence.

Outside Factors

Lastly, things in your environment can affect your chances of becoming dependent on alcohol. This includes peer pressure, cultural norms, and how society views alcohol use.

For instance, you might start drinking because your friends, family, or co-workers do it. Different cultures have different attitudes towards drinking, which can influence your own behavior.

And if society generally accepts alcohol use, you’re more likely to drink.

How Alcoholism Affects Your Health

Alcoholism, or alcohol addiction, is a serious problem that can harm different areas of your life.

It can lead to health problems, affect your mood and behavior, and create issues in your social life.

Physical Health Problems from Alcoholism

Drinking too much alcohol can hurt different parts of your body:

  • Brain: Alcohol can change the way your brain works, affecting your mood and behavior. It can make it harder to think clearly and move smoothly. Too much alcohol can also cause brain damage and memory loss.
  • Heart: Alcohol can harm your heart, leading to problems like a weak heart muscle, irregular heartbeat, stroke, and high blood pressure. These issues increase the chance of heart failure, heart attack, and even death.
  • Liver: Alcohol can inflame and scar your liver, leading to problems like fatty liver, hepatitis, and cirrhosis. These conditions can make it harder for your liver to clean your blood. Severe liver damage can lead to serious problems like infection and cancer.
  • Pancreas: Alcohol can cause your pancreas to make toxic substances, leading to a dangerous condition called pancreatitis. This can lead to severe belly pain, nausea, vomiting, weight loss, and diabetes.
  • Cancer: Drinking alcohol can increase your risk of several types of cancer. It can also weaken your immune system, making it harder for your body to fight off diseases.
  • Immune System: Alcohol can weaken your immune system, making you more likely to get infections and diseases.

Mental Health Problems from Alcoholism

Alcohol can also affect your mental health:

  • Anxiety and Depression: Alcohol can make feelings of anxiety and depression worse. It can also lead to other mental health issues like bipolar disorder and PTSD.
  • Addiction and Dependence: Alcohol can make you feel good, which can lead to a strong need to drink, even when it causes problems. Over time, this can lead to addiction and dependence, making it hard to control your drinking.
  • Craving and Relapse: Changes in your brain from alcohol can make you crave alcohol and make it harder to deal with stress. These cravings can make it hard to quit drinking.

Social Problems from Alcoholism

Alcoholism can also cause social problems:

  • Relationships: Alcohol can make it harder to communicate and get along with others. This can lead to problems like fighting, divorce, and isolation.
  • Work: Alcohol can make it harder to do your job or work. This can lead to problems like being late, making mistakes, and getting injured.
  • Legal and Financial Issues: Alcohol can increase the risk of illegal or risky behavior. This can lead to legal problems, financial problems, and even bankruptcy.

Getting Help for Alcoholism

Alcoholism, or alcohol addiction, is a serious problem. It can be hard to overcome without help.

The type of help can change depending on how bad the problem is, if there are other mental or physical health problems, and what the person wants to achieve.

Here are some ways to get help:

  • Brief Counseling: This is a short talk with a healthcare provider. They’ll talk to you about the problems that can come from drinking too much and help you find ways to drink less. This can be helpful for people who drink too much but aren’t addicted to alcohol.
  • Detoxification: This is when you stop drinking and get the alcohol out of your system. It can be done at home, in a doctor’s office, or in a hospital. Doctors might need to help with this part because stopping alcohol suddenly can cause problems like seizures or hallucinations. This is usually the first step for people who are addicted to alcohol.
  • Therapy: This is a type of treatment where you talk to a therapist about your drinking. They can help you understand why you drink, learn ways to stay sober, and deal with any other mental health problems you might have. Therapy can be one-on-one or in a group, and there are many different types of therapy that can help.
  • Medication: Some medicines can help reduce the desire to drink or block the good feelings that come from alcohol. Other medicines can treat other health problems that might be affecting your drinking. Some of the medicines that might be used include disulfiram, naltrexone, acamprosate, baclofen, ondansetron, and psilocybin.
  • Support Groups: These are groups of people who all have problems with alcohol. They can give each other support and encouragement. There are many different types of support groups, like Alcoholics Anonymous (AA), SMART Recovery, and Celebrate Recovery.

Treatment and management of alcoholism should be tailored to the individual’s needs and preferences and should involve a multidisciplinary approach.

Professionals should also address any genetic factors that may influence alcoholism, such as variations in genes that affect the metabolism or response to alcohol.

How Genetic Information Can Help Dealing With Alcohol Dependence

Alcohol addiction is a tricky problem that is affected by both genes (the ‘blueprint’ for our bodies) and the world around us.

Our genes can change how we react to alcohol, how likely we are to get addicted, and how well we recover. Knowing more about a person’s genes can help us find the best treatment for their alcohol addiction.

Let’s look at a couple of ways genetic knowledge can help:

  • Genetics and Medicine: This is all about studying how different genes can change how we react to medicines. It can help find the best dose and type of medicine for each person. For example, there’s a medicine called naltrexone that can help with alcohol addiction. But not everyone reacts to it in the same way. Studies have shown that changes in a specific gene (OPRM1) can affect how well naltrexone works. People with a certain version of this gene respond better to naltrexone than others. Similarly, changes in other genes can also affect how well other medicines work. This kind of genetic testing can help find the best medicine for each person.
  • Risk Factor Identification: Some genetic variants can increase your likelihood of developing alcoholism under certain environmental conditions. For example, variants in the gene ADH1B have been associated with a higher risk of alcoholism, particularly if an individual is exposed to stressful environments or trauma. If genetic testing reveals such variations, it allows you to proactively manage your stress levels and avoid potentially triggering situations.
  • Identifying Protective Measures: Conversely, certain genetic variants can help protect against alcoholism under the influence of positive environmental factors. For example, a specific variant of the gene GABRA2 has been associated with a lower risk of alcoholism, especially in people who have strong social support networks. If your genetic profile shows this variant, it underscores the importance of fostering strong, supportive relationships in your life.
  • Understanding Cravings: Genes can also influence how strongly you might crave alcohol. For example, variants in the gene ANKK1 have been associated with higher alcohol cravings. If genetic testing shows such a variant in your profile, this can signal the need for a treatment approach that focuses heavily on managing and reducing cravings.

Final Words

In conclusion, the genetics of alcoholism plays a pivotal role in understanding this complex issue. Recognizing the interplay between genetics in alcoholism and environmental factors is crucial.

Our genetic makeup can influence our likelihood of developing alcoholism, how we respond to treatment, and how we can manage the disorder.

Understanding our genetic predispositions, such as increased alcohol cravings or heightened susceptibility to environmental stressors, enables us to take proactive steps to manage these factors.

Using genetics in the fight against alcoholism provides a powerful, personalized approach. By understanding the genetics of alcoholism, we can more effectively tackle this pervasive issue and pave the way for improved, tailored treatments in the future.


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