Genetics and Alcoholism: Is Alcoholism Genetic or Hereditary?

Is Alcohol Tolerance Genetic?

Alcohol tolerance means that equal amounts of alcohol lead to lesser effects over time, generating a need for higher quantities of alcohol to feel the same desired effects.² While it may seem like there is a genetic predisposition for alcohol tolerance, tolerance is not inherited.

Tolerance results from drinking substantial amounts of alcohol over long periods of time.³ However, alcohol intolerance may be genetic.⁴ Most commonly seen in those of Asian descent, alcohol intolerance is when the body has an adverse reaction to the presence of alcohol, such as when a person’s skin flushes or their nose gets stuffy right after drinking alcohol.⁴ This is a result of issues with alcohol metabolism, which is believed to be hereditary.⁴ Key definitions related to this topic include:

• Genetics. This is the study of how genes and their building blocks (i.e., DNA) contain sequences that determine the qualities and traits of a person. Each person has approximately 20,000 genes.⁵
• Heredity. Heredity is the passage of characteristics and traits from parent to offspring through changes in DNA.⁵
• Genetic predisposition. When someone has a genetic predisposition, their  genes and heredity create an increased likelihood of having a certain disease, trait, or behavior.⁶ A predisposition doesn’t always cause a disease or trait to develop, but instead it tends to contribute to its development.⁶ Therefore, you may be predisposed to something but it never develops.⁶
• Learned behavior. This term refers to behavior developed from observing your surroundings or through direct experience. It is not heritable. Learned behavior can be established through associating one stimulus with another (classical conditioning), imitating parents in the early stages of life (imprinting), and failing to respond to a stimulus after repetition (habituation).²

Is There an Alcohol Addiction Gene?

Many genes and variations of genes impact a person’s risk of developing an alcohol use disorder.⁷ Thus, no one “alcohol gene” leads to the development of an alcohol use disorder.^7,8 Researchers have found more than 400 locations in all the genetic information in an organism (genome), and at least 566 variants within these locations could influence the extent that someone may suffer from alcohol misuse.⁹ Genes that relate to alcohol metabolism, particularly ADH1B and ALDH2, seem to be most closely tied to the risk for problem drinking.⁷

A family history of alcohol use disorders may increase the risk of a genetic predisposition to developing an alcohol use disorder, with risks heightened for parent-child transmission.⁸ Environmental factors also play a role in developing an alcohol use disorder when an individual has a family history of alcohol misuse. However, with multiple genes involved in the development of an AUD, it is possible that this disease could skip a generation. If parents do not have an alcohol use disorder, it does not mean that the offspring cannot develop an AUD.⁸ Similarly, if a grandparent has an alcohol problem but the parents don’t, that doesn’t mean a child won’t be predisposed to alcoholism.⁸

Can a Person Be Born with an Alcohol Use Disorder?

Because of the interaction of genetics and environment, a person cannot be born with an alcohol use disorder.¹⁰ Although people can have genes that predispose them to developing an alcohol use disorder, genetics only account for approximately half of a person’s overall risk.¹⁰ The rest of these predispositions come from the social and environmental factors that a person encounters throughout their childhood and life.^7,10

Tests Used to Diagnose Alcoholism

A physician may use several tests to diagnose an AUD. These include:

• The Alcohol Use Disorders Identification Test (AUDIT).¹¹ This is a 10-item clinician-administered and self-reported screening to assess alcohol consumption, drinking behaviors, and alcohol-related problems. Questions such as “How often do you have six or more drinks on one occasion?” are scored. A score of 8 or higher indicate hazardous or harmful alcohol use.¹¹
• The carbohydrate-deficient transferrin (CDT) test. The CDT is a blood test that detects biomarkers of excess alcohol use.¹³ It can potentially detect if someone is a binge drinker or a daily heavy drinker.¹²
• Electroencephalography (EEG). A diagnostic and screening tool uses EEG to identify patients with possible AUDs.¹³ Some researchers advocate for this to reduce the subjectivity of the AUDIT screening tool.¹³ Alcohol-misuse-related EEG signals could enable physicians to make a more definitive diagnoses of AUD.¹³

Am I at Risk of Becoming Addicted to Alcohol?

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a person’s genetic makeup accounts for roughly half of their risk for developing an AUD. However, environmental influences (including how those exposures interact with a person’s genes) also play a significant role.¹⁰ So while genetics may affect your likelihood of having issues with alcohol, you may be able to mitigate some of the inherent risks through recognition of certain potentially problematic scenarios and modification of corresponding behaviors.

Just like drug and alcohol addiction treatment isn’t a one-size-fits-all solution, there’s no single best way to sidestep alcohol issues. The key is to try one approach, and if it doesn’t work, opt for another tactic. Along with permanently abstaining from alcohol use, the NIAAA offers the following tips to reduce your chances of developing alcohol misuse issues:¹⁴

• Establish goals. If you’re going to drink, decide how many days per week you will drink and how many drinks per day you will consume. It’s probably helpful to have some days when you don’t consume any alcohol, but by planning your consumption—and sticking to the plan—you’ll have established some personal guidelines around your drinking. Plus, your guidelines will help quickly clue you in to any developing issues.
• Track your consumption. To ensure you stick to your plan and you’re not consuming more than you think, keep track of your drinking. You can do this via simply making check marks on a printed calendar or in a notebook, or you can get a little fancy and use some kind of tracking app. Also be sure to educate yourself about what constitutes a standard drink so you can count your drinks properly.
• Identify alternatives. If many of your activities and hobbies involve alcohol, it may be helpful to find alternatives that deliver similarly rewarding social interactions minus the alcohol. Similarly, if you’ve used alcohol to cope with stress, help ease the jitters in social situations, etc., seek out other coping methods and/or professional guidance to work on coping skills.
• Sidestep triggers. People, places, and events can often trigger people to drink. If you want to curb or eliminate drinking, it helps to first identify these triggers and then make plans to sidestep them before they occur.
• Remember your reasons. When you have an urge to drink at a time outside of your plans, try to remind yourself of the reasons you’ve made your plans in the first place. Consider making note of these reasons and storing them in a wallet, purse, or phone for easy reference. Also consider reaching out for support from family, friends, and/or professionals. Some proactive measures can reduce risky behaviors before they lead to an AUD.

Tips to Stop the Family Cycle

If you’re a parent and alcohol misuse runs in your family, there are several things you can do to prevent or delay alcohol use in your children and discourage use in adult children. Some strategies include:¹⁶

• Sharing developmentally appropriate information and education about the dangers of alcohol use and your family history.
• Keeping track of how your child spends their time and recommending alcohol-free activities.
• Setting family rules that include abstaining from alcohol use.
• Helping your child develop skills such as problem-solving, communication, and listening.
• Building your child’s confidence and sense of responsibility through youth leadership programs and the observation of older role models.

Take Our Alcohol Abuse Self-Assessment

Take our free, 5-minute alcohol abuse self-assessment below if you think you or someone you love might be struggling with substance abuse. The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of a substance use disorder. The test is free, confidential, and no personal information is needed to receive the result.