Is Alcoholism Hereditary?

Alcoholism is also known as alcohol use disorder (AUD). It’s a chronic condition characterized by excessive and compulsive consumption of alcohol, despite harmful consequences. 

In 2021, 28.6 million adults 18 and older (11.3% in this age group) had an AUD. And an estimated 894,000 adolescents 12 to 17 (3.4% of this age group) had AUD during this period.¹

The question, ‘Is alcoholism hereditary?’ is important. Research shows that genetic and environmental factors play a role in its development. 

Is Alcohol Addiction Genetic?

Alcohol abuse often seems to run in families. But while genetics influence our likelihood of developing alcoholism, it’s more complex.

As we’ve learned more about how genes play a role in our health, researchers have discovered that different factors can affect the expression of our genes. This field is called epigenetics. 

Environmental factors also account for the risk of alcohol and drug abuse.² Scientists are learning more about how epigenetics affect our risk of developing AUD.

What is the Genetic Heritability of Alcoholism?

Genes are responsible for about half of the risk for AUD. And multiple genes play a role in a person’s risk for developing AUD. 

Some genes increase a person’s risk. Others may decrease that risk directly or indirectly. 

For example, some people of Asian descent carry a gene variant that alters their rate of alcohol metabolism. This causes them to experience flushing, nausea, and rapid heartbeat when drinking. Many people who experience these effects avoid alcohol, protecting them from alcohol abuse.²

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Is Alcoholism Hereditary or Influenced More by Environment?

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The Genetic Link: Hereditary Factors in Alcoholism and How it Affects You

What is the Gene for Addiction?

Drug misuse acts on the brain's reward system. This is a system that transfers signals via a molecule (neurotransmitter) called dopamine.

Genetic and environmental factors can affect the reward system’s function. A recent study revealed one of those genetic factors.

Research shows that a small infectious agent integrates with a gene that regulates dopamine activity. This agent is a type of RNA virus called human endogenous retrovirus-K HML-2 or HK2.³ 

This ‘alcoholism gene’ is more frequently found in people with substance use disorders. It’s also associated with drug addiction.³

How Do Genes Affect the Brain and Addiction?

Genes can affect the numbers and types of receptors in the brain. This impacts how neurotransmitters like dopamine are regulated.

They are essential in influencing the brain's function and response to addictive substances like alcohol. Certain genetic variations, such as cytochrome enzymes in the liver, can also influence how quickly a person metabolizes drugs. 

Are Children of Alcoholics More Likely to Become Alcoholics?

Children of alcoholics are about four times more likely than the general population to develop an alcohol problem. Children of alcoholics also have a higher risk for other behavioral and emotional issues.⁴ 

But substance abuse isn’t determined only by the genes you inherit from your parents. More than one-half of all children of alcoholics don’t abuse alcohol.

Genetic predisposition plays a role, as specific genes are associated with an increased susceptibility to alcoholism. Additionally, environmental factors contribute to alcohol tolerance and abuse. 

Children of alcoholics may be exposed to family dynamics characterized by: 

• Problematic drinking
• Alcohol normalization
• Impaired coping mechanisms
• Aggressive behavior resulting from alcohol abuse

Witnessing parents abusing alcohol and experiencing the linked disruptions can increase the likelihood of developing problematic drinking patterns later in life.

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The Role of Environment in Alcoholism

The environment in which people live and work heavily affects their attitudes and drinking behaviors.

Environmental influences on alcohol use disorders include: 

• Family members and peer influence
• Stressful life events
• Socioeconomic factors

• Acceptance of alcohol use by society
• Availability, including price, number of outlets, and server practices
• Advertising and marketing of alcohol both nationally and locally
• Public policies regarding alcohol and enforcement of those policies

It’s difficult to determine the precise contribution of gene and environmental interactions in alcohol use disorders. However, the environment tends to have a stronger influence on the development of alcohol and drug abuse than genetics. 

What Can Lead to Alcoholism?

An alcohol use disorder occurs more frequently in the 20s and 30s, though it can start at any age. 

Risk factors for alcoholism include:⁵ 

• Steady drinking over time: Drinking too much regularly for an extended period or binge drinking often can lead to alcohol-related problems.
• Starting at an early age: People who begin drinking — especially binge drinking — at an early age are at a higher risk of substance abuse. 
• Family history: The risk of substance use disorder is higher for people with a family history of alcohol addiction. Genetic factors may influence this.
• Depression and other mental disorders: It's common for people with mental illnesses such as anxiety, depression, schizophrenia, or bipolar disorder to have issues with alcohol or other substances.
• History of trauma: People with a history of trauma are at an increased risk of alcohol use disorder.
• Having bariatric surgery: Having bariatric surgery may increase the risk of developing an alcohol use disorder or relapsing after recovering from alcoholism.
• Social and cultural factors: Having friends or a close partner who drinks regularly could increase your risk of alcoholism. The glamorous way that drinking is sometimes portrayed in the media may also convey that drinking a lot is fine. The influence of parents, peers, and other role models can impact risk for young people.

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Addressing Alcoholism: Prevention and Treatment

Is Alcoholism Preventable?

While alcohol addiction isn’t entirely preventable, specific measures can reduce its risk. 

Prevention efforts for problem drinking often focus on:

• Education
• Promoting responsible drinking habits
• Addressing social and environmental factors that contribute to excessive alcohol consumption
• Providing support for people at risk and encouraging abstinence

The classification of an alcohol use disorder as a disease has significant implications for prevention and treatment. It emphasizes the need for medical and psychological interventions rather than viewing it solely as a moral or personal failing. 

Recognizing alcoholism as a disease promotes early intervention, access to appropriate healthcare services, and ongoing support for people struggling with AUD.

Treatment for Alcoholism

Substance abuse treatment usually involves a comprehensive approach that combines medical and psychosocial interventions. It's essential to tailor therapy to each person. 

Medical interventions for alcohol abuse may include:

• Detoxification to safely manage withdrawal symptoms
• Medication-assisted treatment to reduce cravings and dependence
• Therapy for a co-occurring mental illness

Psychosocial interventions for alcohol abuse often include: 

• Behavioral therapies, such as cognitive-behavioral therapy (CBT) and motivational interviewing. These therapies help people shift their thoughts, behaviors, and attitudes toward alcohol
• Support groups like Alcoholics Anonymous (AA). These groups provide valuable peer support and a structured recovery program

Summary

• Alcoholism, or alcohol use disorder (AUD), is a chronic condition characterized by excessive and compulsive alcohol consumption despite adverse consequences. It affects millions of adults and adolescents worldwide. 
• The development of alcoholism involves a complex interplay between genetics and the environment. Both contribute to the risk.
• Genetic risk plays a significant role in alcoholism, with specific genes influencing susceptibility to AUD. Environmental factors such as family dynamics, peer influence, and societal acceptance of alcohol also contribute to the risk. 
• Children of alcoholics are at a higher risk of developing alcohol problems due to a combination of environmental and genetic factors. This includes exposure to heavy drinking, alcohol normalization, and impaired coping mechanisms within their families.
• Alcoholism treatment usually involves a comprehensive approach that combines medical and psychosocial interventions to address the complex nature of the disorder.

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