Excessive Use of Alcohol

Excessive use of alcohol is a significant drain on the United States economy. It is estimated that in 2010, the extreme use of alcohol cost about $249.0 billion with the taxpayer bearing the burden of about 100.7 billion of that number (Sacks, Gonzales, Bouchery, Tomedi, & Brewer, 2015). This is nearly $807 for each man, woman, and child in the country whether they drink alcohol or not. To say this is a heavy burden for the American public would be a substantial understatement. The scientific community must examine the causes for this problem and develop solutions to reduce the risks associated with alcohol use as well as diminish the impact it has on citizens, their families, and children across the country. This paper will examine the biological basis for alcohol use and abuse; in addition, it will examine the environmental factors which may also increase the risks associated with substance abuse.

Examining lineage and genetics in general is important in the discussions regarding inherited traits. Parents, grandparents, aunts and uncles alike admire children at birth. Often, they say things such as, He has his mother's eyes or She has her grandmother's mouth. From a genetic perspective, these things are expected. A child will inherit their hair color, eye color, height, and body shape from their parents. This is the nature of genetics. If a child has the dominant gene for red hair then the child will likely have red hair. It is evident that not all genetic traits are as easy to identify as hair color.

It is well understood that our biology is an important part of the risk for cancer or heart disease. People are not so clear about the relationship biology has to alcoholism. Many traits tend to show up again and again in the same family such as eye color, body size, and certain health problems. Some of these traits run in families because of the effect of living in that family, or in other words, their environment. Alcoholism also runs in families. There is general consensus within the scientific community that there are specific alleles within the genetic code which have a significant impact on the risk for development of alcoholism. It is common for people to believe that it runs in families because of the effect of living in that environment. The question arises as to whether there is a genetic predisposition for alcoholism or does the environment play a role. Research should be conducted in order to be clear as to whether environment, biology, or a combination of both would be a good indicator as to whether an individual has the potential to become an alcoholic.

Adoption research on alcoholism has been conducted in Denmark, Sweden, as well as in the United States and tends to provide a clear understanding of why a particular trait runs in a family. In most families, the parents who give birth to us and give us our biological traits are the same parents who raise us. It is usually hard to know whether biology or our home environment is causing specific traits to run in the family. When people are adopted at a very young age, the parents who gave birth to them and the parents who raise them are different. Researchers can study this group to discover whether they are more like their birth parents or more like their adoptive parents on any particular trait. This will tell us a great deal about the nature of risk for developing alcoholism. Is it something that individuals can change, like our environment, or is it something that cannot be changed, like biological traits.

Several studies (Goodwin, 1973; Bohman, Sigvardsson, & Cloninger, 1981; & Newlin, Miles, van den Bree, Gupman, and Pickens, 2000), specifically examined adopted children whose birth parents did not have alcoholism. Some grew up with an adoptive parent who did have alcoholism and others grew up with adoptive parents who did not. Many people believe alcoholism runs in families because of the effects of being raised with it. If this were correct, researchers could expect to see less or even none in the group adopted by parents who did not have alcoholism, as well as higher rates in the group adopted by parents who did have alcoholism. Research has instead demonstrated that, as adults, both groups had about the same rate of alcoholism.

These studies show that, contrary to what many people believe, alcoholism does not run in families simply as a result of the effect of living with a parent who drinks too much. This is not to say that these children do not experience emotional pain, or that they do not learn from their experiences. The research demonstrates that this is not the direct cause of their developing alcoholism.
Another important lesson is that alcoholism can and does occur even among people with no family history. Some of the children in portions of these studies had birth parents with alcoholism, yet some of them developed it anyway, regardless of the environment in which they were raised. This is because everyone has some level of biological risk for developing alcoholism.
Family incidence studies established the need for research that could separate heredity and environment (nature and nurture). Adoption research filled that need and, in turn, lessened the need for further studies on family incidence.

Well-designed studies all concur that alcoholism runs in families due mostly to heredity rather than the effect of being raised with a parent who has alcoholism. Each study also indicates that problem drinking that does not meet strict standards for defining alcoholism might not be genetically influenced.

Twin research is the best way to answer questions about the nature of specific genetic markers and alcoholism. It gives us the clearest understanding of the role that genes play in the development of any condition. There are two types of twins: identical and fraternal. With identical twins, there is one egg, one sperm, and one conception, which split at some point, producing two babies with identical genetic makeup. The other type of twin is fraternal: two eggs, two sperms, two conceptions, two babies with similar but different genetic makeup who simply share space for nine months. Genetically, fraternal twins are no more alike than any other brothers or sisters. They share 50% of their genetic material.

Twin research looks at whether both twins share any particular trait or condition. If both twins share a trait or condition, they are concordant. If one twin has it and the other does not, they are discordant. The concordance rate, or the rate of alikeness, is the percent of times both twins are the same. By comparing the rate of alikeness in identical and fraternal twins we can find out if genetics contributes to the development of any particular condition, and if so, how much it contributes.

Not all traits are controlled by genes, but a genetically controlled trait has a 100% concordance rate in identical twins. Eye color is an example of a genetically controlled trait. If one identical twin has blue eyes, the other twin will have blue eyes 100% of the time. If alcoholism is genetically controlled, and if one identical twin has alcoholism, then we would expect to see the other twin develop alcoholism 100% of the time.

But the rate of alikeness for alcoholism among identical twins is not 100%. Research shows that when one identical twin has alcoholism, only 50% or less of the other twins develop alcoholism. (Maes, et al, 1999) This provides evidence that alcoholism itself is not inherited or controlled by genes. One twin is not predestined to develop alcoholism if the other twin does, and people are not predestined to have alcoholism if their parents do.

Since fraternal twins only have similar genetic makeup while identical twins have exactly the same genetic makeup, comparing the two types of twins can tell researchers more about the role of heredity. If heredity plays no role at all, then the rate of alikeness in fraternal twins should be the same as in identical twins. But if heredity does play a role, the rate should be higher in identical twins since they are more alike than fraternal twins. Results of twin studies show that for alcoholism, the rate of alikeness, in fact, is two times higher in identical twins than in fraternal twins. (Koopmans, J. R., & Boomsma, D. I., 1996) This difference helps explain what role heredity does play in alcoholism.

Based on the research, it is well-established that all people are born with different levels of biological risk, or different trigger levels for alcoholism, but they are certainly not born with alcoholism. It is also known that there are genetic markers which can contribute to that trigger level. This would seem to indicate that it is a combination of environment, biology, and choices which determines whether an individual will develop alcoholism.

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