Brief History of Alcoholism
Alcoholism: The Fetters of Genetic Predisposition and Environmental Influences
Very few can attest to never encountering an individual who suffered from alcoholism, whether it be through family, friends, associates, or a personal affliction. In fact, recent statistics reveal 4-5% of United States citizens as having confirmed alcohol dependency issues (Foroud et al., 2010, p.64). These cases only account for those participating in the survey and it’s probable that many more individuals suffer from alcoholism throughout the United States. Alcoholism can be defined as little to no control over an excess of alcohol consumption despite the subsequent consequences (Fein & Cardenas, 2015, p.125). Many alcoholics continue drinking, day after day, despite their conscious acknowledgment of the problems directly caused by their affliction. Alcoholics can be found at all spectrums of the occupational and ethic level, consequently making the study of the causes for alcoholism an arduous endeavor. At a first glance, many assume alcoholism is simply a disorder brought on by environmental factors such as parental upbringing and peer pressure. While environmental factors remain noteworthy influences, many ongoing studies are showing a significant correlation between genetics and predisposition to alcoholism. In reality, alcoholism is dependent upon environmental factors, genetic predisposition, and the interactions between these factors (Ducci & Goldman, 2008, p.1418). The continuation of studies regarding these factors and their implications is paramount in developing strategies for both the prevention and treatment of alcoholism in the years to come.
Brief History of Alcoholism
For many, alcoholism seems to have become an accepted societal norm. Whether the stereotypical bum shambling along a dark alley with his paper wrapped jim beam bottle in hand, or the successful business woman ordering her first of several habitual martinis, the image of the alcoholic is widely accepted in society. One need go no further than watching an episode of popular American sitcom, Cheers, to understand the depth of this acceptance, as the entire show revolves around a group of alcoholic friends. Alcohol takes first place for the world’s most widely used addictive drug (Ducci & Goldman, 2008, p.1414). It’s interesting that the most widely used drug is also the most culturally accepted drug worldwide and many times in involved in cultural rituals and ceremonies. The World Health Organization (WHO) estimates a total of 2 billion alcohol users among the world’s population (Ducci & Goldman, 2008, p.1414). With such a large portion of the world using alcohol, it’s no surprise that alcohol has a detailed history in terms of societal involvement worldwide. Asides from being the most widely used, alcohol is also the oldest used addictive drug in the history of human civilization (Cohen & Inaba, 2011, p.5.3). Reference to the use of alcohol can be noted in several historical documents from civilizations throughout the global timeline.
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Consequently, one can also note several examples of alcoholism throughout history as well. One prime example is the Gin Epidemic of the 1700’s. The unrestricted use and production of gin in 1700 England led to widespread instances of societal unrest involving public intoxication, sickness, truancy from employment, and even death (Cohen & Inaba, 2011, p.5.4). Several similar accounts have been cited from all around the globe. In response, governments have often implemented restrictions to the production, sale, and even use of alcohol. In fact, almost the entirety of countries worldwide has restricted or banned alcohol at one period of time or another (Cohen & Inaba, 2011, p.5.4). In the United States, this took the form of the prohibition movement of the 1920’s. Alcoholism has had a profound impact throughout the course of human history and still affects a significant proportion of alcohol users to this day. One statistic reveals, “10-12% of the 140 million adult drinkers in the United States are alcohol dependent (Cohen & Inaba, 2011, p.5.19). Needless to say, alcoholism is a very widespread and current affliction. In order to fully understand this affliction, one must examine the causation of alcoholism.
Genetic Predisposition and Environmental Influences
Over the last 30 years, developments in genetics technology have allowed the confirmation of a long suspected genetic correlation with alcoholism. “Women who drink wine excessively give birth to children who drink excessively of wine Aristotle, 350 B.C. (Cohen & Inaba, 2011, p.5.21). Like Aristotle, many individuals throughout history have suspected a genetic influence on susceptibility to alcoholism. Through advanced genetic testing and statistical analysis, there is undeniable proof of this correlation. Several twin, adoption, and family studies have been conducted in the effort to provide support for genetic correlation in certain diseases, such as alcoholism (Foroud et al. 2010, p.65). These tests provide data with which to assess the heredity of diseases like alcoholism by conducting studies between related and non-related subjects for comparison and contrast. One study of 3516 twins concluded that 48-58% of the influences for alcohol associated disorders were genetically determined (Cohen & Inaba, 2011, p.5.22). This study conclusively demonstrated a genetic correlation with alcoholism and is only one of thousands conducted. Another study of around 10,000 twins classified alcoholism as a “moderately to highly heritable disorder (Ducci & Goldman, 2008, p.1415). The data collected from these studies alone is enough to leave little doubt of the genetic influence on alcoholism. Aside from the evidence provided by these various studies, advancement in genetics technology has revealed a connection between several specific genes and alcoholism.
Alcohol dehydrogenase 1B (ADH1B) and Aldehyde dehydrogenase 2 (ALDH2) are enzymes directly responsible for the ability to metabolize alcohol, with specific genes coding for them and their functionality (Ducci & Goldman, 2008, p.1417). These enzymes convert alcohol into different forms with which the body can appropriately filter and dispose of. A faulty gene coding for irregular levels of either or both of these enzymes results in an adverse and uncomfortable response to alcohol ingestion. Individuals possessing this faulty gene portray a resistance to alcoholism brought on by the deterrence of adverse, uncomfortable reaction. Alcohol is a psychoactive drug and affects many of the body’s neurological pathways, including the following: the dopaminergic, serotoninergic, GABA, and glutamate pathways (Banerjee, 2014, p.20-21). Genes encoding for the functioning of these pathways can have a profound effect on predisposition and susceptibility to addiction. For example, the dopamine DRD2 receptor gene can code for predisposition to addiction in general (Cohen and Inaba, 2011, p.522). Individuals possessing this gene or several others are more susceptible to addiction of alcohol and others substances or behaviors. Genetic mutations of the SERT gene, a gene involved in the serotonin pathway, have also been associated with alcoholism (Banerjee, 2014, p.26).
With all of the genetic tests and statistical studies available, there can be little doubt that heredity plays a huge role in the root of alcoholism.
Although genetics play a major role in the development of alcoholism, environmental factors hold a significant influence as well. It’s no secret that much of what makes up an individual is heavily influenced by the environment around them and the development of alcoholism is not exempt. Tumultuous home life, pressure from friends, alcoholic parents, and acute stress are all recognized as environmental influences on susceptibility to alcoholism (Cohen & Inaba, 2011, p.5.22). These factors, among many more, can play a significant role in an individual’s vulnerability to alcohol.
One major environmental influence on an individual’s developing of alcoholism is exposure to physical, emotional and/or sexual abuse. One specific case study of 831 individuals under care for alcohol abuse, found that 20% of the males and 50% of the females under study claimed exposure to physical and/or sexual abuse (Cohen & Inaba, 2011, p.5.22). Environmental influences make a definite impact on the development of an alcohol addiction. Despite their significance, many individuals under exposure to said influences don’t develop alcoholism. This is due to the fact that environmental causes are not only influential in their own right, but in their correlation with genetic causes for alcoholism. Gene and environmental interaction involves different reactions to environmental stimuli based on an individual’s genetic makeup (Ducci & Goldman, 2008, p.1418).
This means separate individuals will react differently to the same environmental conditions because of their genetic differences. Suppose there are two individuals who both experienced sexual abuse as a child. One individual possesses a gene like the aforementioned DRD2 dopamine receptor while the other is devoid of the gene. The individual in possession of the gene is predisposed to addiction and therefore develops alcoholism as he responds to abusive stimuli by seeking solace in alcohol. The other individual, who experienced the same stimuli, may have sought the same solace in alcohol at some point, but never developed an addiction to alcohol. Genetic and environmental influences go hand in hand when it comes determining the causes for alcoholism. Each factor stands prominent as an influence and can affect the sway of the other. One must understand and take account for both in determining the reasons why individuals develop alcoholism.
Alcoholism remains a common and dangerous affliction in modern day society. Individuals from every ethnic, racial, and occupational background struggle with their alcohol addictions and lives are adversely affected every year. A recent statistic reports, “76 million people suffer from an alcohol consumption disorder (Cohen & Inaba, 2011, p.5.3). Strategies to counteract this epidemic are necessary in order to treat and prevent alcohol addiction. The future of alcoholism treatment and prevention depends wholly on the understanding of the genetic and environmental influences surrounding alcoholism. Research in genetics continues in its efforts to isolate the genes responsible for susceptibility to addiction (Cohen & Inaba, p.5.24). Understanding which genes code for addiction is paramount in establishing preventative strategies and developing medications to treat those afflicted.
Research on strategies to counter environmental pressures continues on issues like drinking age, child-abuse, retail of alcohol, and stress reduction (Cohen & Inaba, 2011, p.5.24). Understanding both the genetic and environmental factors of alcoholism and how they affect each other is vital in developing treatment and prevention strategies for alcoholism. Another crucial strategy must be an effort educate and raise awareness concerning alcoholism and its causes in the general public. With continuing research and an effort to raise awareness, society may one day break free from the genetic and environmental fetters of alcoholism.