How Genes Can Influence Problem Drinking

Am I at risk for developing an alcohol use disorder? Is my child? How would I know?

These are questions frequently posed to me as the director of one of the largest addiction research centers in the country. We know a lot about why some people are more at risk for developing alcohol problems than others.

Part of the reason lies in our genes. Our genetic codes are a big part of what makes each of us unique. We get that when it comes to whether we have brown eyes or blue, curly or straight hair, but there’s something more mysterious when it comes to how our genes shape our personalities and our life outcomes. It’s more elusive because it’s not just our genes; it’s our environment, too–our parents, our partners, our friends, and the myriad of other people who shape our lives in intentional and unexpected ways.

Researchers like me are working on finding the specific genes associated with alcohol problems and then mapping the complex pathways by which these genes influence alcohol use outcomes and interact with the environment.

In a new paper, my co-authors and I show that some genes influence alcohol problems by directly impacting alcohol use. Included in this group are genes that impact how your body processes and responds to alcohol. If you carry genes that mean you need more alcohol to experience effects, you are at elevated risk. If you carry genes that make it hard for your body to break down alcohol, it decreases your risk (because when your body can’t break down ethanol efficiently, it makes you feel sick). Some genes influence the risk for alcohol problems by impacting other mental illnesses, too, like schizophrenia or depression, which might lead people to drink more.

But we found that many more of the genes that influence alcohol problems operate in another way: They impact self-control. If you carry more genetic variants that make you more sensation-seeking or impulsive, you’re at greater risk of developing alcohol problems. Not only that, these genes elevate your risk for lots of other outcomes related to behavioral regulation–other forms of drug use, smoking and lung cancer, risky sex and HIV infection, binge eating, and obesity.

This is why it doesn’t make sense to talk about genes “for” alcohol problems. Yes, some genes influence alcohol problems by affecting alcohol response, but many more genes influence alcohol outcomes through intermediary traits like our natural tendencies toward risk-taking.

This is great news. If you’re thinking, “Wait, what?” remember that DNA is not destiny. So when we understand the intermediary traits that indicate risk, we can work on curbing potential problems and channeling those dispositions for good. Risk-taking isn’t a bad thing, per se. Fighter pilots, CEOs, and entrepreneurs all tend to be higher on risk-taking.

In the future, we’ll be able to provide feedback about what risk genetic variants you carry, so you can better understand your strengths and potential pitfalls and put in place resources to support you on your path toward health and happiness. In the meantime, knowing how some of these dispositional traits, like impulsivity, put you at risk can serve as a useful proxy.