Is Alcoholism Hereditary?

For centuries, people have argued loudly that alcoholism is a shameful personal weakness, a stubborn character defect, or a symptom of some underlying moral disorder. Alcoholics rank low in the moral hierarchy because they “choose” their fate (unlike the innocent victims of epilepsy, heart disease, or cancer). “Every human soul is worth saving,” proclaimed J. E. Todd more than a hundred years ago in a tract titled Drunkenness a Vice, Not a Disease, “but if a choice is to be made, drunkards are about the last class to be taken hold of.”

Myths about alcoholism

Despite stunning advances in our understanding of the genetics and neurophysiology of alcoholism, most people continue to believe that alcoholism is a disease of morals, a preventable psychological “weakness.” In a 1979 survey, 67 percent of 2,187 respondents insisted that alcoholism is a sign of “personal emotional weakness”; only 19 percent believed alcoholism is solely a health problem. A recent San Francisco-based Recovery Institute survey reveals that our attitudes towards alcoholics have not changed significantly. The survey, based on interviews with more than two thousand people, concludes:

“Most people see alcoholism as having elements of both disease and weakness.” On average, fewer than one in 100 people say it is a 100 percent disease. In contrast, most of the group surveyed—except psychiatrists and counsellors—say they consider alcoholism at least 25 percent due to personal or moral weakness.”

The shame and stigma associated with alcoholism have persisted. However, from hundreds of studies conducted by thousands of researchers, we know that alcoholism is a progressive, physiological, and genetically determined disease and not a moral or personal weakness.

The individual and family are educated about addiction’s hereditary and biochemical roots in addiction treatment. The shame and guilt are minimized, becoming more receptive to therapeutic inputs.

What does science say?

Over the past eighty years, roughly dating from the foundation of the Yale Center of Alcohol Studies in 1942, neurologists, pharmacologists, geneticists, biochemists, psychologists, psychiatrists, and, most recently, addiction medicine specialists (sometimes called “addictionologists”), have amassed a broad assortment of research projects confirming the hereditary, biochemical, and neurophysiological nature of alcoholism.

One of these researchers is pharmacologist Kenneth Blum. He became interested in alcoholism in the late 1960s, working as an assistant research scientist at the Southwest Foundation for Research and Education in San Antonio, Texas. Teaming up with psychopharmacologist Irving Geller, Blum began a series of experiments focusing on the nature of alcohol’s actions on the nervous system. These early experiments, published in the 1970s, convinced Blum that specific neurotransmitters such as serotonin, GABA, and dopamine are involved in alcohol preference. As the years went by, he became increasingly interested in the actions of alcohol on specific opiate receptor sites in the brain and the neurochemical mechanisms underlying addiction to alcohol.

For the next decade, Blum teamed up with researchers worldwide to conduct research designed to tease apart the mysteries of neurological addiction. By the mid-1980s, Blum found himself powerfully drawn to a field of study in which he had no direct training: molecular genetics. Convinced that genes are involved in the craving for alcohol and the predisposition to alcoholism, he wanted to determine which specific genes were causing the problem. With newly discovered techniques such as “pulsed-field gel electrophoresis” and “southern blot analysis,” researchers could identify specific chromosomal markers for certain neurogenetic diseases, including Huntington’s disease. Using these same tools, Blum hoped to find specific genetic markers for the neurogenetic disease of alcoholism.

Blum’s mind was no doubt—or the minds of the men and women he collaborated with in laboratories ranging from California to Colorado, New York, England, and Italy—that alcoholism is a hereditary disease. All you had to do was look at hundreds of experiments over five decades, confirming the genetic link.

By tampering with the genetic code of rodents, researchers could breed a strain of rats and mice that loved the taste of alcohol and others that couldn’t stand the stuff. The offspring of the alcohol-loving rodents inherit this fondness for booze, while the offspring of the alcohol-hating mice don’t like the stuff.

Confirming the hereditary factor

Adoption studies in humans also provided substantial confirmation of the genetic link. In the early 1970s, University of Kansas psychiatrist Donald Goodwin and colleagues in America and Denmark published studies conducted with adopted children of alcoholics and nonalcoholics. Children with at least one alcoholic natural parent were four times more likely to become alcoholics when adopted into nonalcoholic families than children whose biological parents were nonalcoholics.

Studies have debunked the old argument that alcoholics have underlying psychological or emotional disturbances by finding that adopted children whose natural parents included one or more alcoholics were no more likely to have a psychiatric disorder than adopted children whose biological parents were nonalcoholics. Subsequent adoption studies confirmed Goodwin’s work.

Research pioneered by Henri Begleiter and colleagues at the State University of New York Health Centre in Brooklyn in the late 1970s added further weight to the genetic argument. Begleiter compared the sons of alcoholics, aged seven to thirteen, with the sons of nonalcoholics (neither group had been exposed to alcohol or other drugs). He found that a specific type of electrical activity that occurs in the brain in response to specific sensory stimuli (measured by the amplitude of the P3 brain) was markedly reduced in the children of alcoholics. In Begleiter’s words, these electrophysiological marker studies suggest “that decrements in P3 activity are not a consequence of years of heavy drinking but are genetic antecedents of alcohol abuse.”

These are just a few dozen studies confirming that alcoholism is one of the more than three thousand known genetically influenced diseases in the human population caused by variations in DNA and passed down from one generation to the next.

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