To what extent can the problem of alcohol abuse in our society be explained in terms of the genetic makeup of the individual involved?

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Zoe Emma Liddiard

To what extent can the problem of alcohol abuse in our society be explained in terms of the genetic makeup of the individual involved?

‘In most cultures, alcohol is the most frequently used brain depressant and a cause of considerable morbidity and mortality. Fortunately, most individuals learn from these experiences and moderate their drinking, thus avoiding alcohol dependence or abuse’ (American Psychiatric Association, 2000).

Alcohol dependence according to the DSM IV TR is indicated by tolerance and withdrawal and compulsive behaviour towards alcohol, whereas alcohol abuse requires fewer symptoms and is therefore less severe than dependence (American Psychiatric Association, 2000). In both dependence and abuse an individual will tend to experience social and interpersonal problems due to their drinking habits (American Psychiatric Association, 2000). It can often be difficult to compare studies as they vary in there use of alcohol, use, abuse and dependence as dependent variable. Alcohol dependence or addiction requires initial exposure to alcohol followed by behaviours seeking to repeat the experience. After repetitions of this behaviour–stimulus sequence, the addiction, dependence becomes established. (West, 2001)

Many theories focus on why particular individuals are more susceptible to alcohol addiction or dependence than others (Clapper et al 1995 cited in West, 2001; Johnson & Glassman, 1998). Individuals who are particularly susceptible to the effects of alcohol, whether biochemically, psychologically or socially, or in need of the effects of alcohol, would obviously be expected to be most at risk of alcohol abuse (West, 2001). Although most studies acknowledge a genetic contribution to individual vulnerability to alcoholism (alcohol abuse or dependence), only some focus directly on genetic susceptibility (Ferguson & Goldberg, 1997). Researchers use twin studies to estimate the proportion of variance in a measured behaviour, which is due the genetic makeup of the individual and that which is attributable to environmental factors, such as social background. This is commonly referred to as hereditability (h2) (Jang, Livesley, & Vernon, 1997). Gorwood, Limosin, Batel, Duaux, Gouya & Adès, (2001) recognize that alcohol dependence is a complex phenotype, with numerous aspects, of which behavioral, psychological, pharmacological, medical and social are a few. Their study which involved adoption and twin research has been used to demonstrate that the vulnerability to alcohol dependence is at least in part associated to an individual’s genetic makeup (Gorwood, et al, 2001).

Cotton (1979 cited in Gorwood, et al, 2001) found that alcoholism aggregated in families, with the risk for alcoholism in relatives of alcoholics being three to five times higher than the risk in the general population. Many other studies have used half siblings, twins and have shown similar results showing that alcoholism is, at least in part, due to genetic liability. Ferguson & Goldberg, (1997) state that ‘[f]amily, twin, half sibling and adoption studies of alcoholic subjects suggest that the heritability of liability to alcoholism is at least 50%’.Finding the genes involved in the vulnerability to alcohol abuse is difficult as alcoholism is a heterogeneous disease with many different phenotypic variation (Gorwood, et al, 2001). Preliminary evidence suggests the existence of a large comorbidity between the different dependencies, other substance abuses (Gorwood, et al, 2001). Acknowledgement that genetic factors may exert an influence on alcohol abuse does not rule out the contributing effect of environmental factors. It is an outdated argument to hypothesize that it is either genetics or environment which influences behaviour (Hamlin1991).

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Not all studies give genetic vulnerabilities the same level of importance. Other vulnerability factors have been widely postulated. These explore the environmental and social conditions which make addiction more or less likely. Studies vary in terms of stressors (Droomers, Schrijvers, Stronks, van de Mheen & Mackenbach, 1999), social roles (Hajema & Knibbe, 1998), social influence and opportunities. (West, 2001)

Khan, Murry, & Barnes, (2002) concentrate on poverty and unemployment as predictors of alcohol abuse, although they do acknowledge that alcohol abuse has been linked to genetic, biochemical, and social causes, among others. Poverty and unemployment impose a forced ...

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