A Tough Debate
There are few health issues that have been more hotly debated over the years than alcoholism. Only now beginning to take a backseat to issues related to obesity, alcoholism and its sufferers have long been the subjects of both extreme wrath and extreme pity. Some onlookers continue to insist that the chronic issue is, above all else, a moral failing that could be cured with some combination of education and spiritual awakening. Others have taken on a more scientific approach, viewing alcoholism much the same as one might influenza — simply a disease requiring a specific treatment methodology.
Alcoholism: Disease or Moral Failure?
Most of the population falls somewhere in the middle of the spectrum outlined above. People think of alcohol as a disease at least to some extent, but not on the same level as they’d view, say, brain cancer. The alcoholic is stereotyped as lacking in self-control, motivation and other qualities seen as essential in modern-day America. While many people do recognize that alcoholism runs in families, they think of it less as something similar to the way in which lupus or MS have a genetic link and more along the lines of generation after generation of people lacking in basic moral character.
The scientific versus spiritual debate on alcoholism may continue for decades or even centuries, but for now, experts recognize that there is a genetic link to alcoholism and that the disease can indeed be passed down from one generation to the next. The exact strength of this predisposition is not yet known, but recent research suggests a stronger link than past scientists ever suspected. The National Abuse on Alcohol Abuse and Alcoholism (NIAAA) continues to gather research that backs up claims of hereditary alcoholism. Detailed below is just a small portion of the research currently suggesting that alcoholism likely has a genetic link.
Alcoholism and Genetics: Twin and Family Studies
One of the easiest and most reliable means of gathering information on whether a disease is passed down genetically is to compare evidence for several sets of both fraternal and identical twins. If a disease is thought to have genetic component, it follows that a set of identical twins would present a medical status closer in concordance than a pair of fraternal twins. This would in turn correspond to the risk of various diseases, for, given the fact that their genetic structure is exactly the same; identical twins would be expected to share the same disease risk whenever environmental factors are brought under control. For fraternal twins, the risk will be similar, but slight alterations in genetic makeup will reduce the chances of both fraternal twins contracting any given hereditary disease.
Hereditary Studies: Alcoholism with Identical and Fraternal Twins
Thus far, this hypothesis has easily been borne out in multiple studies. There is a far higher concordance rate of alcohol dependency for sets of identical twins than there is for sets of fraternal twins. Furthermore, the concordance rate of alcoholism is still higher for fraternal twins than it is for pairs of siblings who are not twins. This again would be expected by geneticists, as non-twin siblings are even more genetically separated than fraternal twins.
When combined, these family and twin studies suggest that hereditary accounts for over 50 percent of the variance in risk for alcohol dependency. While this is unfortunate news indeed for those born into families with long histories of alcohol abuse, it is useful for medical professionals to have an understanding of both the individual’s family background and the way in which the hereditary component to alcoholism could come into play at some point. Such an understanding ensures that both the physician and patient will continually be checking for signs of alcoholism so as to avoid the disease’s development at all costs.
Alcoholism and Environmental Contributors
As suggested by the research described above, alcoholism definitely has a genetic component. Those with strong family histories related to the addiction are far more likely to be forced to deal with alcohol abuse them at some point. But if this is true, why is it that even in the identical twin studies, some twins with strong alcoholic backgrounds were still able to escape the disease? The answer may lie on the nurture side of the age-old nature versus nurture debate.
Nature vs. Nurture
Not every person at risk for alcoholism will wind up with the disease. And not every person who supposedly has a low risk of the addiction will be spared. Genetic factors are accompanied by strong environmental contributors. These may include the role models an individual had as a child, the strength of the education system in his or her region, the level of stress in the individual’s day-to-day life, the quality of this person’s support system and so much more. In general, a person growing up in a safe and nurturing environment is less likely to be triggered into self-medicating problems such as alcohol abuse, especially if that person is able to continue maintaining a low-stress lifestyle as an adult.
Preliminary research suggests that religiosity and spirituality may also play a role in staving off alcoholism, although it remains unknown whether this is actually a result of spiritual factors or simply a function of being a part of the type of highly-connected community that tends to arise from religious institutions. The debate surrounding spirituality and alcoholism first became prominent in the early days of Alcoholics Anonymous and still continues to this day.
Multiple Causes, Multiple Solutions
Not only is it completely impossible to pin alcoholism down on one sole cause, it also is highly unfair. Alcohol addiction is not the result of being a moral failure — plenty of amazing, genuinely kind-hearted people have been unfortunate enough to suffer from this disease. It also does not solely arise from having had a bad childhood, although childhood trauma may very well be a factor.
While research suggests that genetics may play a huge role in the development of this mental health concern, this also cannot be claimed as the only cause of alcoholism. As frustrating as it may be for someone trying to determine both the disease’s origins and potential cures, alcoholism is a multi-faceted condition, requiring a multi-faceted approach. The sooner the public understands this reality, the better chance we’ll have of minimizing the disease’s occurrence on a local, national and international scale.