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The Genetics of Alcoholism

Despite all the known health and social problems of alcohol, there are millions of staunch defenders of this not-so-innocent beverage.

Alcohol advocates usually support moderate consumption especially for social functions and gatherings.

They argue that it is impossible to wipe it out completely and that a more rational approach is to bring its consumption under control.

They also argue that excessive intake of alcohol is causing all the predicaments and not alcohol per se.

In the United States alone, 30 percent of adults have experienced alcohol abuse or alcoholism. Almost 600,000 college students are injured while under the influence and1,800 die every year. According to health experts, alcohol causes up to 30 percent of all cases of esophageal cancer, liver cancer, liver cirrhosis, epilepsy, homicide and motor vehicle accidents.

Alcoholism is a chronic and often progressive disease in which there is a problem controlling the drinking habit. Alcohol consumption increases to get the same effect (physical dependence) and upon rapidly decreasing or stopping consumption, withdrawal symptoms occur.

The notion that alcoholism runs in families is not new. In the 1970s, some studies documented that many children whose parents were alcoholics later grew up to inherit the drinking habit. What the investigations failed to prove at that time, however, was whether the phenomenon was something genetic or environmental. Did the children become alcoholics because they inherited a gene from the alcoholic parents or because they learned the habit from poor role models?

Scientists later ventured more seriously into this matter and began conducting proper scientific research to find out if there were genetic components involved in alcoholism. In 2004, a researcher and psychiatrist, Dr Subhash C. Pandey from the University of Illinois, suspected a gene that produces cAMP response element binding protein (CREB) to be the possible cause of anxiety-like behavior and thus an inclination to problem drinking. The function of the CREB gene is to regulate the brain in learning processes and it is involved in tolerance, dependence and withdrawal symptoms.

Pandey and colleagues used a group of rats specially bred with deficient CREB protein and observed that they drank 50 percent more alcohol than normal rats, preferred alcohol over water, and showed more anxiety-like behavior which was pacified by alcohol consumption.
 

In a second study by a research group led by Prof José Rico Irles of Granada University conducted in 2007, it was found that addiction to alcohol could be genetically predisposed due to a hereditary lack of endorphins. Endorphin is a chemical released by the brain in response to various conditions such as pain. It is regarded as an endogenous analgesic as it functions by numbing or reducing the intensity of pain.

Chronic alcoholics have low levels of endorphins causing them to seek an external source. As the body becomes accustomed to an exogenous supply and progressively greater amounts of alcohol are consumed, the body eventually stops producing this morphine-like substance and this is when dependence starts.

In his study of 200 families, Irles found that children who had at least one alcoholic parent were found to have lower beta-endorphin levels than normal children. These levels were even lower when both parents were alcoholics. The researchers concluded that there are many ways by which alcohol consumption affects people and the differences of endorphin levels make some more vulnerable to alcoholism than others.

In April 2011, a study by researchers at the University of Michigan Health Systemwas published in Molecular Psychiatry suggesting that variations of the GABRA2 gene play a role in alcoholism by influencing impulsive behaviors. 449 people from 173 families were involved and 75 percent of these families had at least one member diagnosed with alcohol dependence or abuse. Those with certain variations of the GABRA2 gene showed a higher tendency to develop alcohol dependence symptoms and more impulsiveness when responding to stress.

However, all the scientists involved in the study agreed that genetic components do not act alone and simply inheriting the gene does not make alcoholism one’s destiny.

Why Do People Drink?

Why do you drink, one might ask. This very tough and painful question has never found an answer. Surveys, however, give the following top five answers:

    To help me deal with my problems.
    It helps me loosen up and have a good time.
    Drinking makes me happy.
    It’s just cool.
    All my friends drink!

Is Alcoholism Really Hereditary?
 
So the eventually inevitable question: Why would God make someone genetically destined to be an alcoholic and then punish him for that?

Before answering the question, however, several points need to be addressed. First, is it really genetic? Second, does the ‘genetic’ factor make one ultimately destined to be an alcoholic or merely predisposed to it? And third, can genetic predisposition be defeated?

In 1992, Dr Stanton Peele and his colleagues refuted the idea that alcoholism was inborn in “The Truth About Addiction and Recovery”. Peele gave an example by comparing two groups of people researched by sociologists. The first comprised of Jews, Chinese and Italians; they generally view drinking as a habit and alcoholism as a self-initiated problem. This first group has the lowest rates of alcoholism and alcohol consumption.

The second consisted of Slavs, Scandinavians, Irish and Baptists who perceive alcoholism as a disease and believe that humans do not have complete control over the love for alcohol; they have the highest number of addiction and abuse cases. From the observation, Peele believed that to be or not be an alcoholic lies in how alcohol is viewed and not in the gene.

Peele continues to explain that it was also discovered from several documented studies that the majority of untreated problem drinkers reduce their alcohol intake drastically after the age of thirty. This phase, known as ‘maturing out’, is believed by experts to be most likely due to a growing sense of maturity and responsibility towards one’s family and job in addition to peer pressure as people grow older.

Had it been genetic, why would the drinking rate drop so drastically at a certain age? How does one also explain the fact that alcoholism takes a long time to develop and that it is only established after a long and repeated exposure to heavy alcohol consumption?

Peele also pointed out in his work that while it is true that children of alcoholics are two to three times more likely to become alcoholics themselves, there is a big dispute as to whether the phenomenon is genetically inherited or if it is because of environmental influence.

An interesting irony is that most children of alcoholics, Peele says according to research, are in fact non-drinkers or only consume moderate amounts mainly because of the extra caution they exercise upon seeing how alcohol negatively affected their parents. Peele claims that various studies similarly suggested that the genetic component in the subject of alcoholism is negligible and other factors such as environmental, psychological and personal choices give the final and ultimate outcome.

Peele goes on to write that Robin Murray, Dean of the Institute of Psychiatry at Maudsley Hospital in Britain, studied a group of identical and fraternal twins. Considering that the genetic makeup of identical twins is completely similar, the identical twin of an alcoholic is predicted to more likely become an alcoholic as compared to the case of a fraternal twin whose genetic makeup is no different than any other normal sibling.

The verdict showed no difference between the two groups and therefore the notion that alcoholism is genetically transmitted was doubted. Murray concluded, writes Peele, that “Students of alcoholism must continually beware lest they fall victim to the extravagant swings of intellectual fashion that so bedevil the field, and nowhere is such vigilance more necessary than in considering the possible etiological role of heredity.”

Overall, the hypothesis is still highly inconclusive. No single gene has been clearly recognized as causing alcoholism or alcohol addiction. Rather, research so far vaguely points to a number of genes or a group of genes that are likely to be linked to or associated with the tendency to abuse alcohol.

Scientists are still unsure whether the genes identified are solely responsible for the drinking habit or are more related to certain types of traits that can lead to alcohol addiction such as being anti-social, being vulnerable to schizophrenia, or suffering from depression and drug addiction.

Islam and Alcohol
 
Islam is clear and straightforward in its stance on alcohol. The prohibition of alcohol in Islam is mainly to preserve the sanctity and to safeguard the welfare of humans. Alcohol’s prohibition came in three stages during the Prophet’s time.

The first verse revealed pertaining to alcohol was in Chapter 2: Surat Al-Baqarah, verse 219:

They ask you about intoxicants and games of chance. Say: In both of them there is a great sin and means of profit for men, and their sin is greater than their profit. And they ask you as to what they should spend. Say: What you can spare. Thus does Allah make clear to you the message, that you may ponder.”

Following the revelation, Muslims at that time began to understand that God disliked alcohol and similar drinks that could interfere with men’s judgment. However, they were not absolutely forbidden at this stage. It was just a reminder from a loving God telling men that while they may find some commercial value or benefits in alcohol, the disadvantages far outweigh its benefits.

Here it is an intellectual discourse in which God was educating men about the concept of weighing between pros and cons in facing a problem so as to reach the best solution. He then ends the verse by highlighting the importance of thinking and deep reflection.

The second stage of prohibition was in Chapter 4: Surat An-Nisa’, verse 43 of the Holy Qur’an.

O you who believe! Do not go near prayer when you are intoxicated until you know (well) what you say.”

This was a turning point for the Muslims to begin abstaining from alcohol around the times of prayers. Daily prayers are taken seriously as one of the five pillars of Islam and as the most significant way of being in contact with and in constant remembrance of God. Allah wanted those who had faith in Him to be in the clearest and purest state of mind when humbling themselves before Him.

The third and final verse was in Chapter 5: Surat Al-Ma’idah, verse 91:

O you who believe! Wine and the game of chance and idols and divining arrows are only the abomination of Satan’s handiwork. So shun each one of them that you may prosper.”

With the revelation of this strong and definite command, alcohol became officially forbidden in Islam. Alcohol and intoxicants were grouped along with other undesirable practices that hinder men’s progress and empowerment such as gambling, worshipping idols and fortune telling.

Here Islam has come not to restrict men or deny their freedom but to liberate their minds from all kinds of undignified practices and superstitious beliefs. Only with such true emancipation will men be able to realize their best potentials and make progress in a real sense, as the phrase referred by the Qur’an says: “that you may prosper.”

Islam wants to elevate men; instead of running away from problems, humans are taught to patiently face their problems, learn the correct life skills to handle them and understand that no obstacle in life is impossible to deal with. This is in support of verse 286 of Surat Al-Baqarah where God says,

Allah does not burden a soul beyond that it can bear.”

Last but not least, social pressure in the dilemma of alcohol is tackled by Islam’s emphasis on the importance of knowledge and understanding before imitating or adopting a habit. In Chapter 17: Surat Al-‘Isra’, verse 36, God challenges men:

Do not pursue that (matter) of which you have no knowledge, for ears, eyes, and heart all are accountable.”

Here God clearly instructs men not to simply and blindly follow the crowd. Rather, He commands them to study, search and understand an issue before making conclusions or getting involved in something.

Whether the answer to the question: is alcoholism genetically inherited is yes or no or both yes and no, a ban on alcohol remains relevant. As for now, scientific findings supporting the genetic theory of alcoholism are uncertain and disputable according to some researchers in the field.

If one day it is ascertained that alcoholism is indeed a genetic predisposition, then the prohibition of alcoholism may become even more necessary to protect genetically susceptible groups from harming themselves through alcohol consumption.

There are two valid justifications for further study and research in this area. The first is to identify individuals who are genetically more vulnerable to alcoholism (considering the genetic assumption to be true) as a preventive measure against the disease. The second is to design or formulate a therapeutic regimen or rehabilitation steps to cure alcoholics and problem drinkers by way of understanding the genetic makeup and manipulating it.

 Source: OnIslam