Your family is "driving you to drink?"
Erik Gunderson, MD, FASAM
Although it may seem at times that your family is “driving you to drink,”
the long-term research of Dr. Marc Schuckit clearly demonstrates that
your family history – specifically whether or not you have a biologic
parent with alcoholism – can influence your reaction to alcohol’s effects,
and, as a consequence, the amount of alcohol you may be consuming.
Combined, your family history and reaction to alcohol influence
your risk for developing an alcohol use disorder.
Dr. Schuckit’s research revolutionized our understanding of genetic
and environmental risks for developing alcohol dependence, or alcoholism. Most importantly, his findings provide clues as to whether you or your family members have increased susceptibility to alcoholism. If you already have an alcohol problem, his research may help explain why.
Dr. Schuckit recently presented an outstanding synopsis of 30 years of his research results at the 2012 annual meeting for the Association for Medical Education and Research on Substance Abuse (AMERSA) in Bethesda, MD.
Here are a few key points:
Family History Positive: Having a parent with alcoholism – let’s call this Family History Positive – leads to a fourfold increased risk for development of alcoholism.
Overall, genetic factors account for about 60% of the total alcoholism risk. The remaining 40% of risk is due to environmental conditions or other characteristics, such as, impulsivity or having a psychiatric disorder.
Early Tolerance (Alcohol Sensitivity): Your family history may influence how sensitive you were to alcohol’s effects when you started drinking; if you have an alcoholic parent, you are more likely to have had greater tolerance (or low sensitivity) to your first drinks. Such early tolerance means that you would require more drinks to feel alcohol’s effect or become intoxicated.
Most people initiate alcohol consumption in their teens or early adulthood. Recall the time when you began drinking. Were you able to drink more than your peers before experiencing alcohol’s effects or getting intoxicated? During your early years of drinking, were you able to “drink people under the table?” If so, this could indicate early tolerance.
Alcoholism Risk: Being family history positive and having inherited early tolerance increases the risk of developing alcoholism! Dr. Schuckit clearly demonstrated the risk increase though in long-term follow-up studies conducted over decades.
Prevention: How do we use these findings? For the past 10 years, I have asked patients about their family history and early tolerance when screening and assessing for alcohol use disorders. Hopefully, counseling patients about the risk factors for alcoholism could lead to behavior change and prevention of future alcohol problems.
Dr. Schuckit currently has grant proposals under review to test educational prevention interventions adapted to an individual’s personalized risk profile. Let’s keep our fingers crossed that his funding will come through, and in a few years, I’ll be able to let you know about even more effective clinical and public health approaches to reduce the personal and societal burden of alcoholism.
Dr. Schuckit receives the
2012 John P. McGovern Award
from Dr. Gunderson, AMERSA Executive Committee Member.