February 10, 2011

The complicated genetics of alcoholism

The strongest gene associations found to date involve the so-called Asian flush. Roughly 40% of people of East Asian descent carry one or two gene variations that rapidly convert alcohol into the chemical acetaldehyde, which causes nausea, rapid heart beat and a severe flush. It's a strong deterrent to drinking, much like the drug disulfiram, or Antabuse. "You don't even need a genetic test to detect it," says David Goldman, chief of the Laboratory of Neurogenetics at the National Institute on Alcohol Abuse and Alcoholism. "If you have a dinner party and somebody has this variation, they'll turn red when they drink a glass of wine."

Researchers at the University of North Carolina-Chapel Hill have tentatively identified a similar "tipsy gene" that makes carriers feel inebriated after just one or two drinks. Between 10% and 20% of the population has this variation, which is also thought to protect against becoming alcohol-dependent.

Other people feel especially euphoric when they drink—probably due to variations in the neurotransmitter dopamine in the brain's reward circuits. A variation in the DRD2 dopamine receptor gene was identified in 1990 and found in a large number of alcoholics as well as drug addicts and smokers, although later studies have been mixed.

Last month, researchers at the University of California-San Diego reported that people with the DRD2 variation tend to have friends with the same genetic marker. That would give them both a biological compunction to drink and social reinforcement, the authors noted in the study published in the Proceedings of the National Academy of Sciences.

Like the Asian flush, some alcohol-related genes are particularly prevalent in certain ethnic or geographic groups. A recent study in Nature found that a rare variation in the HTR2b gene, linked to severe impulsiveness, is found almost exclusively in Finnish people. "Almost all these severely impulsive individuals are also alcoholic, and their worse impulsive problems occurred while they were drunk," says Dr. Goldman, the study's senior investigator. 

I have this theory that alcohol facilitates the evolution of non-impulsiveness.To get through life well, you need to be prudent much of the time, but you also need to take a chance on other people some times. So, social drinking allows women to lower their barriers when in selected company, like at an expensive nightclub or a wedding reception (that's the point behind the hit movie Wedding Crashers), men with their fellow soldiers, and for people in general to lower their barriers when with their coworkers or business associates for the purposes of bonding.

Separately, variations in two genes for receptor to neurotransmitter neuropeptide Y, associated with stress and severe withdrawal symptoms from alcohol, are common to about one-quarter of the population. Clearly, not all those people are severe alcoholics.
So much is still unknown that most experts don't advise consumers to use genetic-testing services to try to understand their risk for complex conditions like alcoholism.

"Even if you learn you have a protective version of some gene, you could still be vulnerable due to a gene we haven't discovered yet," says Dr. Goldman, who adds that anyone with a family history of alcoholism should definitely approach alcohol with caution.

"Looking at your family history is simpler, cheaper and at the moment, gives you more information than a genetic test," says Dr. Edenberg. He also stresses that DNA is never destiny when human behavior is involved. "You can carry all kinds of genes, and if you manage to push away the glass or the bottle, you won't have an alcoholism problem."

48 comments:

RandyB said...

Some people might look down on them for not being able to hold their liquor. But on the bright side, they save a lot of money.

Formerly.JP98 said...

"He also stresses that DNA is never destiny when human behavior is involved."

Why do people say things like this? (Or did the reporter misrepresent what the guy said?)

Anonymous said...

"A recent study in Nature found that a rare variation in the HTR2b gene, linked to severe impulsiveness, is found almost exclusively in Finnish people."

Obama's new economic stimulus program is to air drop millions of Finns into our larger shopping malls and car dealerships.

Svigor said...

That would give them both a biological compunction to drink

I do not think that word means, what he thinks it means.

Actually, it's probably the author. There are errors and questionable choices throughout the piece.

Anonymous said...

Dopamine is the newest humor. If you know that dopamine is involved, you know nothing.

I have migraine which if you look it up in Wikipedia means I have a dopamine problem.

Jared Lee Loughner shot up the place. He's a schiozoprenic which means he too has a dopamine problem.

Of course if he were a manic-depressive he would also be said to have a dopamine problem.

So it's not surprising that dopamine problems are also linked to alcholism and ADD and all kinds of drug addiction.

You can buy dopamine on the web. Why wait? Fix right up whatever ails you.

You try it first.

Albertosaurus

Anonymous said...

In 'A Face Like a Chicken's Backside' Colonel Cross describes a tribe in Borneo where the missionaries made the tribesmen quit rice beer, their only source of vitamin B. 'Their health suffered'.

Anonymous said...

Indeed, both my parents used to flush when they drank and both were abstemious with alcohol.

I flush, too, but I find not all alcoholic drinks are equal in their effects on me. I can drink Kentucky bourbon almost until I pass out, with no hangover. Rum, on the other hand, gives me a cracking headache -- two drinks will make me spew. It truly is the Devil's urine (Black Adder alert).

Anonymous said...

What about American Indians and Eskimos? Whether they have Asian flush or not, they sure love to drink. I hear drinking is a major problem also in Japan. So, Asian flush or not, drinkers will drink.

Anonymous said...

Isn't there a theory that says love of drink began with taste for rotten fruits. Supposedly, rotting fruit has certain enzymes and bacteria that are good for your digestive system; and little alcohol is good for circulation. So, apes and primitive man with taste for rotten fruits had better chance of survival than apes and primitive man that didn't eat that stuff. And taste for rotten fruits wasn't harmful since one had to eat A LOT of them to get drunk. So, for apes and primitive man, love of the taste of alcohol pretty much amounted to them eating rotten fruit which was good for them.

But when man found a way to make alcohol, this advantage turned into a disadvantage(for some anyway)cuz too much of a good thing is a bad thing. Same is true for love of sweetness. Since sweet stuff have lots of calories, it was advantageous for animals and primitive man to love fruits to store more calories into their bodies. But once man developed refined sugar, the evolutionary advantage turned into a disadvantage since people could gorge on all the sugary stuff they desired.

Anonymous said...

I flush, too, but I find not all alcoholic drinks are equal in their effects on me.
don't mistake the alcohol flush for a histomine flush - sometimes from products that are aged in oak. vs. ones that are not.
for example lots of people get headaches from red wine even from just a couple of glasses. if you take an anti-hstomine like ibuprofen it prevents it but that's hell on your liver so better to not drink at all.

Seriously has anyone every calculated the effect of alcohol on the economny.

Nanonymous said...

I have this theory that alcohol facilitates the evolution of non-impulsiveness.

No need to get evolutionary psychology involved here. Lots of animals LOVE getting drunk! And not just domestic and not just man-made drinks.

Bill Sheridan said...

Having spent a good portion of my life in bars, I believe 99% of people that society calls alcoholics have no physical need to consume booze. Every "alcoholic" I've know was just someone who enjoyed the lifestyle. That might be colored by the region where I live and the culture that surrounds me.

I live in the South, and have zero experience drinking with people of other races.

Anonymous said...

hey Steve, remember when you disrespected the huffington post??


well, here, they bitch-slap you: http://webcache.googleusercontent.com/search?q=cache:http://www.huffingtonpost.com/2011/02/10/huffington-post-bloggers_n_821446.html

Anonymous said...

"I have this theory that alcohol facilitates the evolution of non-impulsiveness."

"No need to get evolutionary psychology involved here. Lots of animals LOVE getting drunk! And not just domestic and not just man-made drinks."

True, but humans have found a USE for alcohol, and culture can influence genes too. Suppose one uptight guy never drinks while another uptight drinks on occasion at social gatherings. The latter might gain the courage/charm to talk to some girl, which may lead to marriage, and have children. So, the drinker will get a girl and pass down his genes while the non-drinker may never develop the courage to talk to a girl.

dearieme said...

Is there any evidence that the Viking berserkers were mainly Finns? Did Viking leaders send recruitment missions to Finland?

Anonymous said...

" Supposedly, rotting fruit has certain enzymes and bacteria that are good for your digestive system; and little alcohol is good for circulation. So, apes and primitive man with taste for rotten fruits had better chance of survival than apes and primitive man that didn't eat that stuff. And taste for rotten fruits wasn't harmful since one had to eat A LOT of them to get drunk. So, for apes and primitive man, love of the taste of alcohol pretty much amounted to them eating rotten fruit which was good for them."

Lots of animals like eating rotten fruit. Some birds, for example, will seek out rotten fruit, cos it gets them drunk.

Apparently, all sentient life likes to get drunk once in while.

Cennbeorc

Anonymous said...

I grew up with quite a few drug addicts, alcoholics, codependents, etc. I tend to agree with Eric Berne who developed Transactional Analysis and think alcoholism is just a high-level game. Also, I tend to think that if Alcoholism was mainly genetic it's highly unlikely that Alcoholics Anonymous would have a 60% success rate.

Svigor said...

for example lots of people get headaches from red wine even from just a couple of glasses.

Love the happy buzz from wine, but yep, red wine gives me an instant hangover. My head feels swollen and the top of my neck/back of my head hurts.

Maxwell said...

I must've picked up that nausea gene to wine after a bad night of Cisco and Nightrain my freshman year in college- ever since then, any grape wine makes me feel very unpleasant from the first sip.

Whiskey said...

Steve, you're not thinking in the right (pre-modern clean water) direction.

Booze, mixed with water, can kill lots of germs. In Europe, most of the population lived on either beer, watered down whiskey, or watered down wine.

Which acted both as pre-aspirin pain killers but also anti-germ (some of them anyway) factors. Indeed increased urbanization in the ME (pre-Islam of course) coincided with increased beer and wine making and consumption. Before the Germ theory of infectious diseases, and any real effort to create sewers and water treatment plants, places like London (as late as the 1850's) were open sewers, and those who drank beer, or wine, or watered whiskey were much healthier than those who only drank water.

none of the above said...

Formerly.JP98:

Depends on the DNA. Huntingtons looks a hell of a lot like destiny (or doom, perhaps). But complicated genetic predispositions to/against alcoholism actually fit that phrase quite well--there's not some gene that guarantees you'll become a drunk.

none of the above said...

Anon:

Ibuprofin isn't an antihistamine, it's an anti-inflamatory (COX inhibitor, same family as aspirin).

A common reaction to wine is caused by sulfites, but I don't know if the same compounds are in other kinds of alcohol. (I think it's not the same kind of hypersensitivity reaction as you get with, say, a peanut allergy, but I may be misremembering. I'm not sure how useful antihistamines would be, but if you used the older kind, I imagine you'd be dozing off after your second glass anyway.)

none of the above said...

The horrible toll alcoholism takes on populations that didn't have brewing before suggests pretty strongly that alcohol has an effect on evolution.

It wouldn't be a huge shock if had other, less obvious effects, leading to changes in gene frequencies. And those would have evolved in parallel with social mechanisms to deal with alcohol.

Lots of drunks and drug addicts are said to be trying to self-medicate to compensate for some serious mental illness. Presumably, self-medicating for less serious problems works better, or at least isn't so likely to lead to disaster. I wonder if there are mental illnesses/problems that are effectively self-medicated by access to, say, alcoholic drinks, coffee, chocolate, cigarettes, qat, coca leaves, peppers, etc. If so, you'd expect that to have an effect on gene frequencies over time--that tendency toward mild seasonal depression or social phobias or whatever becomes less impairing.

Anonymous said...

////
I believe 99% of people that society calls alcoholics have no physical need to consume booze. Every "alcoholic" I've know was just someone who enjoyed the lifestyle.
////

Sounds like you've never met a real alcoholic. I am a (hopefully) recovering alcoholic, my father is an alcoholic, my best friend is an alcoholic and I've met many alcoholics in my life. There is no "lifestyle" for alcoholics to enjoy. 95% of the time, we get drunk at home, alone and drinking until blackout. 24/7/365. Waking up with a terrible hangover every morning. Spending first half of the day fighting desire to drink and planning drinking during the rest of the day around life's few remaining obligations. Few alcoholics want to be alcoholics! Many have been through torture (and considerable expense!) of rehabs many times. And it gets worse. Every time. Not pretty and nothing enjoyable, believe me.

Okay, so for the benefit of alcoholics who may be reading: Some slow pharmaceutical progress is being made. The so-called "Sinclair Method", while not a panacea, appears to be effective in a significant percent of cases (hard to say but probably better than 50%). It probably saved my life. I still drink but no longer every day and within "safe" limits (rarely more than half a bottle of wine or three beers a day). The Sinclair Method is not a cure - you have to take the pills every time before drinking. (Do read Wikipedia article on TSM but take it with a grain of salt - the article is way too optimistic).

Some/many who do not respond well to naltrexone have had success with baclofen and/or topiramate. It can be tricky but seems to work (again, seems to depend on genetics - some people respond wonderfully and some don't at all).

There is a lot of self-treatment experimentation going on among alcoholics today. Aided greatly by Internet and Indian pharmacies that require no prescription for most things and the influence of rehab industry lobby that basically pushes AA dogma on everyone. But doctors are slowly opening up to the pharmaceuticals away from counseling and abstinence bullshit.

Anonymous said...

////
it's highly unlikely that Alcoholics Anonymous would have a 60% success rate.
////

You got that right. AA doesn't have 60% success rate. That's a bold-faced lie. AA's real success rate is less than 5%. Difficult to know exactly but definitely below 5%.

Anonymous said...

I had only been drunk about five times in my life before I started reading Sailieri's blog. Now, I drink just about every day.

I've lost a few neurons, to be sure, but I do seem to remember something about correlation is pretty much causation on one or more of these posts.

Difference Maker said...

Is there any evidence that the Viking berserkers were mainly Finns? Did Viking leaders send recruitment missions to Finland

Berserking is not just impulsivity, although high testosterone does lead to relative disinhibition.

Fear of death is suspended, so one might say consequences and foresight are ignored as well. But berserking is a marker of high value and dominance, of course not consciously in so many words.

Having tasted of feelings like berserking, it is something sacred, of which my sleep deprived mind is unsuited to describe in proper glory

Anonymous said...

I always speculated that alcoholism would be associated with liver metabolism.

Normal people have livers that leave them with massive hangovers the next day [which, in turn, has them swearing to The Good Lord that they'll never drink alcohol again]; alcoholics, on the other hand, seem to wake up the next morning, and say, "When can we start drinking again? How about now?"

Anonymous said...

Anonymous wrote:
"You got that right. AA doesn't have 60% success rate."

I got the 60% success rate quote from Jamie Lee Curtis. I figured it's probably true since she comes from a family of alcoholics/drug addicts but obviously not the most reliable source.

Anonymous said...

Someone mentioned "The Sinclair Method" for treating alcoholism, and pulled a "probably greater 50% success rate" out of thin air. Depends on what success means, I guess. If you read some of the "success stories" on its discussion forum, you see folks who still have 8 drinks a day, but that's down from 12, and so are successful, or got totally sh*t-faced, but only from habit, and not because they have to, or someone who has been doing the program form 12 months with little change, but is absolutely sure that he is due to get better any day now.

Basically, a bunch of self-deluded alcoholics desperately wanting a miracle cure. Pathetic.

Anonymous said...

Finns are impulsive? I always had them figured for a stereotype of dour and relentless; Swedes without the colorful personality.

Anonymous said...

There must be a link between alcoholism and bleak climate/long, dark cold winters.
If the link is genetic, due to some psychological winter coping mechanism, I don't know, but the correlation (eg Scots, Irish, Finns, Russians, Poles etc) is definitely there.

DanJ said...

Many Finns have a gene associated with impulsiveness?

Finnish social convention strongly discourage any kind of impulsive behaviour. Slow and steady is the norm.

This social control might originate from a particular need to control impulsiveness, a trait traditional agrarian society had little use for.

Alcohol has provided relief. In Finland "I was drunk" has always been the only passable excuse for any kind of idiotic behaviour.

Perhaps one day, as our Finnish social conventions start to align with the Anglo-American, we will also be allowed to make fools of ourselves while sober.

Anonymous said...

"I must've picked up that nausea gene to wine after a bad night of Cisco and Nightrain my freshman year in college- ever since then, any grape wine makes me feel very unpleasant from the first sip."

That's called Taste Aversion.

http://en.wikipedia.org/wiki/Taste_aversion

It's the reason rats are so damn hard to poison, and the reason I still can't drink Bailey's Irish Cream 20 years after a foolish teenage expedition into my parents' liquor cabinet.

Anonymous said...

Don't northern europeans tend to binge more than southern?

Some people theorize that wine is part of the family culture in Italy - you drink at the table w/ the family and a heavy meal vs. going to the pub and getting slogged.

English used to have less of an alcohol problem than scots, because pubs were social rather than just a place to get drunk.

On the other hand, temperance movements were probably a reaction to alcohol problems - but pretty much were non existant in catholic countries.

Lastly, just because ones dna is prone to alcoholism there are other factors during the 18th century gin craze in the UK England was becoming a bunch of drunks, muscular Christianity, temperance movements, religious revival tempered that (in fact methodist workmen were so much more efficient than others that rivals used to smash their tools)

as peter hitchens has pointed out, the reform will probably come from Islam this time - including whites - you can't have the sort of decadence we have in the west now and survive as a society, and it doesn't look like christianity has the stomach to confront it.

Anonymous said...

I don't know, but the correlation (eg Scots, Irish, Finns, Russians, Poles etc) is definitely there.
other theory is they have been drinking wine less than Meds, same reason (but not to the extent) Red Indians have high degrees of alcoholism.

Anonymous said...

Somewhat off topic, but many Jews drink very little or not at all. I reason that Jews are already uninhibited enough as it is. So alcohol doesn't affect Jewish personalities much.

Dutch Boy said...

Whiskey said...
Steve, you're not thinking in the right (pre-modern clean water) direction.

Booze, mixed with water, can kill lots of germs. In Europe, most of the population lived on either beer, watered down whiskey, or watered down wine.

Indeed, back in the 1950s in Germany we were warned not to drink water from the German water systems unless we treated it with halozone tablets first. The only water the Germans drank was mineral water (and of course plenty of beer and wine).

Anonymous said...

GHB is a cure for alcoholism. The two drugs are incompatible--alcohol ruins the high from GHB. Just substitute GHB for alcohol for a month and then quit both. Afterwards you will find that alcohol no longer gives you as much pleasure. You can drink in moderation without the desire to get drunk etc. It worked for me, and I was a real alcoholic.

Anonymous said...

Don't northern europeans tend to binge more than southern? Some people theorize that wine is part of the family culture in Italy - you drink at the table w/ the family and a heavy meal vs. going to the pub and getting slogged.

It could be.

And it could explain the love-hate relationship that Northern Europe has towards alcohol.

Binge drinking could also be called bipolar drinking, in the literal sense of the term, with no connection to bipolar disoder. A binger is practically a different person when drunk. It's no surprise that a Northern European wrote "Dr. Jekyll and Mr. Hyde", or that werewolf legends are from Northern Europe.

(And I wonder that aspect of South East Europe contributes to its regional vampire legends? Absinthe?)

Also the social attitudes of N-Europe are also love-hate towards alcohol, rather than true hypocrisy. It's not hypocrisy when you can't remember being a different person.

"I got so drunk that I slept on the bench with a prostitute, and spat on the local church? Ban alcohol now!"

Anonymous said...

it doesn't look like christianity has the stomach to confront it.

Christians do confront it, and are called "haters" by white, liberal atheists.

Anonymous said...

"Somewhat off topic, but many Jews drink very little or not at all. I reason that Jews are already uninhibited enough as it is. So alcohol doesn't affect Jewish personalities much."

More or less the same could be said for Italians, relatively low levels of inhibition as well as low levels of alcoholism. And Italians are supposed to be more closely related to Jews than any other European population according to what I've read. Both very creative people too.

Anonymous said...

An alcoholic up my family tree and I have no taste for the stuff. The most I can manage to get down my esophagus is a glassful of light beer of a kind called pale ale, fried in a microbrewery, and even that makes me kinda sick.

The spectacle of people drinking for pleasure, and jumping up and down for joy in beer ads, has always struck me as incomprehensible lunacy.

Anonymous said...

he most I can manage to get down my esophagus is a glassful of light beer of a kind called pale ale, fried in a microbrewery, and even that makes me kinda sick.

The spectacle of people drinking for pleasure, and jumping up and down for joy in beer ads, has always struck me as incomprehensible lunacy.

consider yourself lucky sweetheart, you've saved probably 100,000.00 over your lifetime, not to mention your health.

Anonymous said...

"he most I can manage to get down my esophagus is a glassful of light beer of a kind called pale ale, fried in a microbrewery, and even that makes me kinda sick.

The spectacle of people drinking for pleasure, and jumping up and down for joy in beer ads, has always struck me as incomprehensible lunacy.

consider yourself lucky sweetheart, you've saved probably 100,000.00 over your lifetime, not to mention your health.

Actually if you look at all cause mortality and morbidity moderate drinkers are healthier than teetotallers. Partly due to the protective effect alcohol has on the heart (most noted with middle aged men), but I also get the anecdotal impression that teetollers are a rather sickl lot.

Anonymous said...

There's an obvious set of confounding variables there. Frex if teatotalers are often avoiding alcohol because it interacts badly with some other medicine they're on, you've got a sicker (at least more heavily medicated) population not drinking. Similar comments apply to teatotalers who avoid drinking because of their problems with drink and drugs in the past.

Alcohol Rehab New York said...

The risk of alcoholism is higher for people who've had parents abusing alcohol. Researchers have shown in numerous ways that the age old perception of alcoholism running in families is more than just coincidence and that it is more than a matter of learning to act like our parents and grandparents.

Alcohol Rehab New York said...

The risk of alcoholism is higher for people who've had parents abusing alcohol. Researchers have shown in numerous ways that the age old perception of alcoholism running in families is more than just coincidence and that it is more than a matter of learning to act like our parents and grandparents.