Concerned About Alcohol Addiction?
Is Alcoholism Hereditary?
“People often ask if alcoholism is a hereditary disease. The answer is not a simple ‘yes’ or ‘no’. Certainly, there is no ‘alcoholic gene’. Addiction is a multifaceted illness and if there is a history of alcoholism in your parental family then that is one risk factor among many. It does not mean that you will suffer from alcoholism. Indeed, many alcoholics have no apparent genetic predisposition to the disease. Here we look at genetic factors and the way that they affect alcoholism treatment.” Chris Burn, Consultant Addiction Therapist.
Alcoholism is Classified as a Disease
Alcoholism, the name commonly used to describe Alcohol Use Disorder (AUD) has been classified as a chronic brain disease in the International Classification of Diseases (ICM) and by major world countries for many years. Its exact causes have never been precisely established, but heredity is one of several contributing factors.1,2
Many health problems, both physical and mental, have a genetic component and alcoholism is no exception. Yet, people with no relevant history in their genes may still suffer from addiction of all kinds.
What Factors Lead to the Development of Alcohol Addiction?
Alcohol addiction is generally considered to result at least in part, from several factors besides genetic predisposition. The main contributors are:
Biochemical
Alcohol, especially when taken repeatedly and in large amounts, can alter the brain’s reward systems, especially dopamine neurotransmitters that produce feelings of pleasure. Alcohol intake increases the release of dopamine so that over time, it leads the brain to associate drinking with pleasure. In chronic drinkers, the natural production pattern of dopamine is significantly reduced resulting in cravings and withdrawals when alcohol is not present.
Environmental
Growing up in a family where parents drink habitually can reinforce the idea that heavy drinking is normal in adult life. Peer pressure to abuse alcohol without apparent negative consequences can also be a powerful incentive to do the same.
Mental Health Disorders
People with mental disorders often self-medicate with alcohol or other drugs as a way to cope with distressing symptoms. For example, someone with anxiety might drink alcohol to calm their nerves, or someone with depression might use alcohol in the hope of feeling happier.
Is Alcoholism Hereditary? Nature vs Nurture
While genetics play a key role in determining who we are and how we progress through adulthood, they are never the sole factor. Just because someone is genetically programmed to have a disease doesn’t mean they will develop that disease. With alcoholism, both nature and nurture can influence the likelihood of whether a person develops an addiction.
Genetic predisposition is certainly an important factor. The American Academy of Child and Adolescent Psychiatry concluded that biological children of alcoholics are four times more likely to develop alcohol use disorder. This is true even if they are raised in an alcohol-free home.3
Several studies have considered the proportional risk of hereditary factors (nature) against social and environmental factors (nurture) and the general conclusion attributes around 50% of the risk to each although individual circumstances have an influence too such as childhood/family situation, current environment, peer pressure, gender, and mental health state.4
Is there an Alcoholic Gene?
Certain genes have been identified as contributing to a person’s risk of developing alcoholism – but hereditary or not, there is no one ‘alcoholic gene’. Some genes are tied to alcohol misuse indirectly and some genes can help avoid addiction because they cause intolerance to alcohol in the body. Here are a few examples:
Genes that Can Help the Body Resist Addiction
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Alcohol Intolerance Gene
There are several genes involved in the body’s metabolism of alcohol. However, there are also two well-known ones – ALDH2 and ADH1B – that can produce a bad reaction to this metabolism process, resulting in facial flushing, nausea, tachycardia and other unpleasant symptoms. These are widely present in the East Asian population and their presence is a natural deterrent to drinking. Thus, someone who has such a gene will be less likely to consume alcohol, and therefore less likely to develop a drinking problem.
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Controlled Consumption Gene
The beta-Klotho gene has been linked to responsible drinking. People who have this gene are more likely to be able to control their alcohol consumption. For example, they can stop after one or two drinks more easily than others and may prefer a sugary drink to an alcoholic one. Conversely, people who do not have this gene are more likely to be unable to control their alcohol intake.5,6
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General Character Genes:
Although this is still an imperfect science, it is believed that people can inherit through their genes, certain attitudes such as moral responsibility, conscientiousness and determination, that could produce responses better suited to help the body resist addictive pressures. A 2013 study reported in the US National Library of Medicine appears to support this view.7
Genes that Are Likely to Promote the Likelihood of Addiction
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Self-Medication Gene
Certain genes, such as GARBB1, can reduce the body’s natural production of GABA, a neurotransmitter that is responsible for inducing relaxation and reducing anxiety. Someone with this gene may have naturally lower levels of GABA, and since GABA production is increased by alcohol, the person will be more likely to consume alcohol as a way of self-medication.8
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Alcohol Reward Genes
There are several genes, such as dopamine receptor D2, that determine how the brain’s reward system responds to alcohol. This is associated with increased alcohol consumption through brain mechanisms involving salience attributions and cravings in alcoholic patients. The stronger the reward effect, the more likely the person is to drink and drink heavily.
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Alcohol Tolerance Genes
Some genes influence a person’s intolerance to alcohol but no gene predisposes a person to a greater tolerance to alcohol. If someone has a high tolerance for alcohol, they are more likely to drink more, and therefore develop an addiction but they will most likely have acquired this tolerance through learned behaviour that accustomed their body to the drug.
Alcoholism and Other Hereditary Factors
There are many psychological disorders linked to genetic predisposition, including depression and schizophrenia. In general, people with mental health issues other than addiction tend to be at a higher risk for alcoholism. Given the ready availability of alcohol and its sedative properties, there is always the risk that people with distressing mental health conditions such as anxiety or PTSD will use alcohol as a means of managing their symptoms, leading to chronic misuse and AUD.
Gender
The random outcome of birth – whether a person is male or female, is another important hereditary factor. This can then be further exacerbated by societal and environmental pressures for men and women.
Biological aspects: women’s bodies react differently to alcohol because their metabolism, hormones and body size differ. Perhaps unfairly, women tend to have a lower tolerance to alcohol and to suffer more physical damage from its misuse. Although most women consume less alcohol per head than men, they risk more severe cognitive and other physical damage from prolonged alcohol misuse. This is largely due to the smaller size of their vital organs and a generally lower body mass.9
On the other hand, men are more likely to drink heavily and generally appear more predisposed to abuse alcohol. They also generally experience more peer pressure to drink heavily than women. This, of course, leads to higher levels of addiction among men.10
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Genetics and Addiction Treatment
The interaction of addiction and genetics is the subject of much ongoing study that is already proving fruitful in the treatment of addiction. Clinicians are already using genetics to personalise treatment plans in a more targeted manner than can be achieved by say, psychological assessment tools. Here are some key areas:
Improved understanding of the biochemistry of addiction: this can lead to more focused treatment strategies for each person. For example, a person whose genetic makeup indicates a reduced number of dopamine receptors in the brain might be assessed as more likely to engage in pleasure-seeking behaviours. For them, a medication such as Naltrexone, which reduces dopamine release during alcohol consumption, might be considered together with therapies that focus on alternative forms of reward, such as CBT.
Improved understanding of comorbidities: addiction often occurs with other mental health disorders such as depression or anxiety. Although there may be other factors involved, especially environmental, research and knowledge of the genetic sources of mental health disorders can often lead to a more integrated and holistic treatment approach.
Increased knowledge of genetic makeup can improve outcome predictions and thereby lead to more focused preventative measures. Thus, a person whose genetic predispositions point to a risk of relapse might be encouraged to undertake intensive relapse prevention measures (including practical techniques) to address the danger before the completion of treatment.
Genetics and Pharmacology
It might be tempting to think that research into genetics and addiction might one day produce a situation where a person’s genes that lead to a high risk of addiction might be simply identified and then ‘neutralised’ by an appropriate drug. Although medications such as Naltrexone and Disulfiram have been available for several years and have helped many people, their use is not an exact science and they should never be seen as a simple answer to the highly complex problem of addiction.
Drugs such as these affect different people in different ways and can have dangerous side effects if misused. They can represent a highly effective tool in the fight against addiction but they seldom provide a solution on their own and should only ever be taken when prescribed by a healthcare professional.
A Hereditary Pre-disposition Is Not a Guarantee of Alcoholism
If you have a family history of alcoholism, you are unfortunately at a higher risk of becoming an alcohol addict yourself. Your genes are a part of this story. However, they are not the only part – your environment, mental health, and stressors are all also risk factors.
Just because you have a gene with an alcoholism risk does not make you an alcoholic. Instead, it would help if you considered it a potential risk.
Forewarned is forearmed. If you know you are at risk of becoming an alcoholic, it could serve as motivation to prevent future problems. You can avoid heavy drinking and be vigilant about spotting any signs of alcoholism.
At the same time, if you do have an active alcohol addiction, you should not place all the blame on your parents. Environmental factors and free will contribute a large part to addiction. A major part of addiction recovery is to admit that you have a problem and take responsibility for your actions. A genuine desire for personal change rather than blaming external factors is an important requirement to be successful in recovery.
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If you or someone you care about is struggling with alcohol dependency, don’t wait to find answers. Explore our comprehensive treatment programmes and start the journey to recovery today. Contact us now for a confidential consultation.
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References
- Understanding alcohol use disorders and their treatment. American Psychological Association
- International Statistical Classification of Diseases and Related Health Problems. World Health Organisation
- The Role of Genetics in Alcoholism. November 16, 2023
- Psychology Today. Robert Weiss Ph.D. Nature, Nurture, and Addiction.
- Gene Cards, The Human Gene Database .
- NBC News. Gene might affect how much you drink.
- Bogg T, Roberts BW. The case for conscientiousness: evidence and implications for a personality trait marker of health and longevity. Ann Behav Med. 2013 Jun
- 8 What to know about GABA. Medical News Today.
- Ceylan-Isik AF, McBride SM, Ren J. Sex difference in alcoholism: who is at a greater risk for development of alcoholic complication? Life Sci. 2010 Jul
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