Alcohol Abuse

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Risk Factors and Causes

Genetic, biological, environmental, psychological, and sociocultural factors play a part in alcoholism.

Genetic
Scientists suggest that genetics may play a role in the following:

• Increased risk for alcoholism
• Increased tolerance
• Ongoing craving for alcohol

Genes that may be involved in alcoholism have not been identified. A number of studies of twins and adoptions support the idea that genetics may be involved in alcoholism. In one study, identical male twins, raised in separate environments, shared patterns of alcohol use, including dependence. Another study showed a continued likelihood of alcoholism in male siblings born into alcoholic families but adopted into nonalcoholic families.

Biology
Research notes that Chinese, Japanese, and Koreans with a deficiency or absence of alcohol dehydrogenase (a liver enzyme) tend to drink less and are at lower risk for alcoholism. Because their livers do not break down alcohol, these people experience vomiting, flushing, and increased heart rate and don't drink as often. Researchers hope to provide a biological account for the low incidence of alcoholism in Jews who consume a large amount of alcohol. Other groups are at an increased risk for alcoholism. Native Americans (a population with a high incidence of alcoholism) generally don't become intoxicated as quickly as other races and so may tend to drink more.

At least two studies have shown a possible correlation between certain brain wave patterns and an increased risk for alcoholism.

Environment, Psychology, and Culture
Gender, family history, and parenting influence drinking behavior. A substantially higher number of men than women abuse alcohol; some estimate the ratio to be as high as 5:1. However, the number of women who drink, abuse, and become dependent on alcohol is rising. Studies indicate that up to 25% of sons of alcoholic fathers will develop alcohol abuse or dependence.

Most children of alcoholics do not develop dependence. Children in families with multiple risk factors are at greater risk for alcohol abuse and/or dependence. Some of these risk factors include growing up with parents who:

• are dependent on alcohol
• have coexisting psychological disorder(s)
• use alcohol to cope with stress

Family violence and having several close blood relatives who are alcohol dependent are also risk factors.

The expectations and beliefs about alcohol may influence alcohol use. Younger family members tend to mimic the alcohol use patterns of their parents, siblings, and other family members. Peers also influence drinking behavior.

Some studies show that regardless of a family history of alcoholism, a lack of parental monitoring, severe and recurrent family conflict, and poor parent-child relationships can contribute to alcohol abuse in adolescents. Children with conduct disorders, poor socialization, and ineffective coping skills as well as those with little connection to parents, other family members, or school may be at an increased risk for alcohol abuse and/or dependence.

Recently, the NIH reported that lower educational levels and unemployment do not cause higher rates of alcoholism. Results from a 1996 study show that the rates of alcoholism in adult welfare recipients were comparable to those of the general population. The study did show higher rates of death from alcoholism in welfare recipients.

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