The Genetic, Environmental and Social Precursors to Alcoholism
Alcoholism is considered a disease, compulsive need and addictive illness. The disease is so widespread that the World Health Organization estimates there are over 140 million alcoholics across the globe.
While the causes of alcoholism can be multifaceted to the point of absurdity, common definitions of alcoholism are less elusive.
What is alcoholism? Alcoholism is often defined as s pattern of drinking that causes clinically significant impairment over 12 or more months. Significant impairment essentially means an impairment in one’s ability to negotiate work, school, or home duties. To determine one’s dependence also includes aspects of physiological withdrawal and social impairment.
Roots of Alcoholism
The American Medical Association contends that alcoholism is both physical and mental in nature. The following factors may alter the chances of developing alcohol dependence: stress, poor mental health, family history of alcoholism, ethnicity, age, and gender. Alcoholism may eventually be sustained through tolerance and physical dependence, as well as the user’s uphill efforts to curb withdrawal symptoms.
Alcoholics will typically develop a compulsive need to continue drinking in light of withdrawal symptoms that disincentivize quitting cold turkey. That said, sustained use of alcohol can cause medical problems, such as liver cirrhosis and brain damage, as well as psychiatric disturbances.
Nature and Nurture
Both environmental and genetic factors may predispose a given individual to develop an alcohol dependence. There are genes that regulate how alcohol is metabolized, and these differences affect one’s chances of developing an alcohol dependence, according to research from the New York Academy of Sciences.
Of special importance in tracing the genetic risk factors for alcoholism is a rich genealogy of heavy drinking in one’s family tree. In fact, modern research indicates that individuals with either a genetic predisposition towards alcoholism or an alcoholic family member are much more likely to begin drinking at any early age.
Research also demonstrates that binge drinking in adolescence is associated with a higher risk of developing alcoholism later in life. Etiologically, over 40 percent of alcoholics reported drinking to excess in their teens. The correlation between early drinking and later alcoholism may not be causal. That is, both early drinking and alcoholism may be informed by a genetic predisposition.
Males Versus Females
Numerous studies have shown that males are more likely to have met the diagnostic criteria for both alcohol abuse and alcohol dependence in the past year. Perhaps more troubling, however, are the rates of alcohol abuse on college campuses. The 2010 National Survey on Drug Use and Health showed that approximately 43 percent of males reported binge drinking in the last two weeks whereas only 32 percent of females reported binge drinking over the same time period. In addition, young adult males consumed ten or more drinks per night at over three times the rate of females, according to the 2011 Monitoring the Future study.
Eighteen million Americans and counting are alcoholics, according to National Institutes of Health findings. The prevailing opinion on addiction is that most substance dependence starts with an attempt by the user to escape an unhappy state of mind. The user accomplishes such a goal with the help of alcohol, opiates, or various narcotics.
One risk factor for developing alcoholism is stress. Importantly, stress is also an effect of alcoholism. In other words, a heavy drinker often seeks solace in alcohol to curb background stress, but subsequent cravings for alcohol are usually associated with withdrawal symptoms brought on by the alcohol itself.
Ethnicity and Alcoholism
Scientific research is increasingly demonstrating a link between ethnicity and alcoholism. As Africans, Asians, Americans, and Indians metabolize alcohol in different ways, each group has a different level of predisposition towards alcoholism. For many years science could not parse why certain ethnic groups had chronically higher rates of alcoholism. Ethnic variation in enzymes and alcohol metabolism seem to explain ethnicity’s role in the chances of developing alcoholism. While African-Americans and Native Americans have an allele that reduces the risk of alcoholism, groups deficit in alcohol-metabolizing alleles are at an increased risk of alcohol dependence.
Genes and Neuroscience
Genetic factors may account for one-half of the total risk of developing alcoholism. Research indicates that more than one gene is responsible for an increased risk of developing alcoholism, yet abnormalities in certain brain regions are implicated in alcohol dependence. For instance, the amygdala is usually smaller in individuals with a family history of alcoholism. The amygdala controls emotional responses and cravings.
Serotonin is a neurotransmitter thought to control feelings of well-being, sleep, hunger, and relaxation. Low levels of serotonin have been linked to an increased risk of developing tolerance and dependence to alcohol. In addition, high levels of a certain dopamine receptor are thought to hinder behavioral responses to alcohol and effectively prevent alcoholism.
Alcohol can affect brain chemistry, blood flow, and the integrity of neurons. In many ways a lack of blood flow to the prefrontal cortex is both a cause and effect of alcoholism. That is, alcohol inhibits blood flow to the frontal lobes, but a lack of activity in the prefrontal cortex may have predisposed the alcoholic to prioritize instant gratification over long-term goals in the first place.
Alcohol also seems to exhibit paradoxical effects when viewed from different perspectives. Although alcohol temporarily spurs the release of dopamine and serotonin, long-term alcohol dependence may deplete one’s store of these feel-good neurotransmitters. In addition, the brain produces more epinephrine when drinking ceases. The end result of these changes in brain chemistry – decreases in serotonin and dopamine alongside spikes in epinephrine – is a downward spiral into cravings and withdrawal. Eventually, alcoholics are drinking solely to arrest withdrawal symptoms. Higher amounts of alcohol are needed for the same effect, and the body’s organs are dangerously overtaxed in the process.
Relapse and Social Factors
Over 80 percent of people treated for alcohol dependence relapse. The following factors are implicated in relapse: anger, frustration, social pressure and internal cravings. Counselors conjecture that alcoholics employ alcohol to control or dim strong, negative emotions. Alcoholics often claim that alcohol provides solace and excitement in lieu of company or environmental stimulation. Perhaps high relapse rates are the result of mere tedium in light of sobriety.
Aspects of temperament and culture impact the risk of developing alcoholism. In other words, possessing an impulsive disposition may increase one’s risk of developing alcoholism. Alternatively, a person who has a high amount of trait or state anxiety might be especially susceptible to experimentation with alcohol to quell intense feelings.
Peer pressure may also play a role in developing and sustaining an alcohol dependence. Alcohol is both legal and socially acceptable in U.S. culture. Also, adolescence is a life stage marked by experimentation and an intense desire to fit into one’s social group. These factors combine to predispose one to binge drinking, and perhaps alcoholism. In fact, over half of 20-year-old young adults have consumed alcohol in the past year. That said, only a minority of these young drinkers will develop alcoholism later in life.