The Appreciation and Therapy for Alcoholism

Over the past few decades, there has been an increased focus on the treatment and management of alcoholism, which is now recognized as a disease by many researchers. While questions about the hereditary nature of alcoholism have been raised for years, recent studies have clinically verified that certain genetic factors contribute to an individual's likelihood of developing alcoholism.

However, because people respond to alcohol differently, there are both proponents and opponents of the idea that alcoholism is a disease. The idea of alcohol dependence and related issues being passed down through families dates back to ancient times, leading to the belief that hereditary factors may be at play.

Although it is widely known that higher levels of alcohol consumption increase the risk of developing drinking problems and addiction, only certain individuals may be susceptible due to genetic or environmental factors, such as personality traits, psychiatric disorders, variations in alcohol-metabolizing enzymes, or abnormal brain neurophysiology. Additionally, other complications arising from alcohol consumption and physical addiction may be attributed to independent hereditary or environmental factors.

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Despite being a complex disorder, alcoholism is unique in psychiatry because research has identified the role of genetics in its development. Family studies have shown that individuals with affected family members are more likely to develop alcohol dependence and related problems than those without affected family members (Cook & Gurling, 1989).

Twin and adoption studies have also demonstrated that this familiality is at least partially hereditary (Cook & Gurling, 1989). This paper aims to examine the evidence supporting the recent explanation that there is a genetic predisposition to alcoholism. Adoption studies have revealed two subcategories of alcoholism, with type 1 being strongly hereditary, linked to criminality in adoptees and fathers, and starting at an early age, while type 2 is only slightly hereditary and begins at a later age.

Sigvardsson and colleagues (1996) replicated the Stockholm adoption study and found evidence that confirms the distinction between type 1 and type 2 alcoholism. These findings align with the more reasonable interpretation of twin studies, which suggests that a higher hereditary subcategory of alcoholism is associated with unfavorable characteristics or criminal behavior (Sigvardsson et al., 1996).

Epidemiological studies have strongly suggested that genetic factors and family history are significant contributors to an individual's vulnerability to alcoholism and excessive alcohol use. The findings of twin studies, adoption and cross-fostering studies, and family pedigree analyses all point to the familial clustering of alcoholism.

However, the relationship between genetic factors and environmental influences is complex and can either increase or decrease an individual's susceptibility to alcoholism (Cloninger et al.; Goldman & Linnoila). Research has shown that the children of parents with alcohol dependence are four to nine times more likely to develop alcoholism than those whose parents are not dependent (Cloninger et al.; Goldman & Linnoila).

However, not all children inherit the genetic factors associated with an increased susceptibility to excessive alcohol consumption. A comparison of physiological, hormonal, and psychological responses to alcohol consumption in individuals with positive and negative family histories of alcoholism has been carried out to identify potential biological markers for identifying high-risk individuals in families with a hereditary predisposition to alcoholism.

Epidemiological studies provide clear indications that hereditary factors and family history play a major role in determining an individual's susceptibility to high alcohol usage and alcoholism. Twin, adoption, cross-fostering, and pedigree studies all suggest that alcoholism tends to run in families. However, multiple genes interact with environmental factors in complex ways, increasing or decreasing a person's susceptibility to alcoholism (Cloninger et al.; Goldman & Linnoila).

Children of parents with alcohol dependency are at a four to nine times greater risk of developing alcoholism compared to children of non-dependent parents, but not every child inherits the susceptibility to high alcohol consumption (Cloninger et al.; Goldman & Linnoila).

To identify individuals in high-risk families who have inherited the susceptibility for high alcohol consumption, biological markers such as behavioral, physiological, or biochemical markers can be utilized (Gianoulakis, 310). Studies have found that physiological reactions, such as electroencephalographic, heart rate, and hormonal changes, may differ among individuals with or without a family history of alcoholism. Environmental factors, such as culture and stress, also play a role in increasing or decreasing the risk of alcoholism.

Thus, alcoholism is likely a multi-factorial disease with a hereditary tendency interacting with specific environmental factors. The disease concept of alcoholism has recently been reinforced by the notion that certain individuals are at risk due to their hereditary tendency to alcohol abuse. Researchers believe that this tendency to alcohol abuse can explain the broad diversity in human reactions to alcohol. Behavioral and molecular genetics research indicates that alcoholism is partly heritable (Yoshida, 227).

However, it is possible that there are no specific genes that directly predispose individuals to alcoholism, but rather genes that predispose to personality traits, such as impulsivity and sensation-seeking, which in turn mediate alcohol use. Behavioral genetics research has not been very successful in identifying mediators between genes and behavior, but may eventually shed light on how these genetic effects arise (Yoshida, 227).

Some researchers and practitioners believe that identifying the hereditary determinants responsible for vulnerability to alcohol abuse would be the best way to prevent and treat alcoholism. This knowledge could be used, for example, to develop screening tests to detect individuals at risk before they start drinking. If such tests were available for at-risk youth, appropriate preventative measures could be taken. However, caution is needed in interpreting and utilizing data on the hereditary and behavioral factors that contribute to alcoholism.

Reference

1. Cloninger CR, Bohman M, Sigvardsson S, Von Knorring AL. Psychopathology in adopted-out children of alcoholics: The Stockholm adoption study. Galanter Marc, editor. Recent Developments in Alcoholism. New York: Plenum Press; 1985.
2. Cook, Chris and Hugh Gurling. Genetic factors in alcoholism. In: The Molecular Pathology of Alcoholism. Palmer, T. Norman (editor). USA: Oxford University Press; 1989.
3. Gianoulakis, Christina. “Influence of the endogenous opioid system on high alcohol consumption and genetic predisposition to alcoholism”. Journal of Psychiatry and Neuroscience. 26.4 (2001): 304–318.
4. Goldman, David and Markku Linnoila. “Genetic approaches to alcoholism”. Progress in Neuro-Psychopharmacology and Biological Psychiatry 10.2 (1986): 237-42.
5. Sigvardsson, Soren, Michael Bohman and C. Robert Cloninger. “Replication of the Stockholm adoption study of alcoholism”. Archives of General Psychiatry 53.8 (1996): 681-687.
6. Yoshida, Rin. Trends in Alcohol Abuse and Alcoholism Research. 1^st ed. New York: Nova Science Publishers, 2006.

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