July 22, 2005
Alcoholism Gene Factors Show Up in Very Young
In 12-year-olds, kids needing more drinks to get drunk faced highest risk
The first-ever study of its kind has found that kids as young as 12 can show a genetic-driven trend toward alcoholism.
"A variety of things contribute to the risk for alcoholism, and one of these things is the 'hollow leg' -- the relative resistance to the effects of alcohol. Common sense says that if these people are drinking for the effect, they'll drink more and hang out more with people who drink more -- perpetuating this heavy level of drinking," explained lead researcher Dr. Marc Schuckit, a professor of psychiatry at the University of California, San Diego Medical School.
He presented the findings, published in the July issue of The Journal of Studies on Alcohol, at a special New York City media briefing on alcohol dependence held Thursday and sponsored by the American Medical Association.
Another researcher also presented findings that showed that fewer than 1 percent of U.S. health plan members are getting diagnosed with alcoholism or problem drinking -- even though experts estimate that up to 5 percent of Americans suffer from some form of problem drinking that could be helped with treatment.
Schuckit's study focused on the root causes of alcoholism, however. He said experts now estimate that genetic factors are to blame for about 60 percent of the disease, with environment -- especially factors such as the drinking patterns of those in their teens and 20s -- making up the other 40 percent.
Previous work in over-18 adults suggested that "low alcohol response" drinkers -- people whose bodies needed more alcohol to feel drunk -- were at the highest risk for problems. Schuckit hypothesized that if this genetic effect was really key to problem drinking, it should show up even in the very young.
His team looked at data from an ongoing study in the United Kingdom, which looked at (among other things) the drinking patterns of more than 1,000 children at age 12 and 13. According to the study, 80 of those children (almost two-thirds of them boys) reported drinking alcohol an average five times over the previous six months, with the average maximum number of drinks consumed at any one time pegged at just over three.
"When kids start to drink, they are not drinking for the taste -- they drink for the effect," Schuckit pointed out. And, just as was seen in young adults, his team found "a correlation between [the 12-year-old's] level of response -- how many drinks were needed for the effect -- and the maximum number of drinks consumed."
This gene-directed alcohol response was also related to the frequency of kids' drinking bouts and to what the researchers called a "trend" toward alcohol-related problems.
The California researcher stressed that genes that cause you to drink more to get drunk are not the cause of alcohol abuse, but they do increase the risk.
"If you say to yourself, 'OK, I'm never going to have more than three drinks in a 24-hour period,' then a low response is irrelevant, it's not going to have any impact on your risk for alcoholism," he explained.
"Unfortunately, I think most people say 'Hey, let's go out and get drunk tonight,'" Schuckit said. "In those kinds of instances the kids with the low response are the ones more likely to drink a lot more."
Another expert also pointed out that a young person's resistance to alcoholism quickly diminishes as alcohol transforms the living brain.
"Continued exposure to high blood levels of alcohol (heavy daily drinking) results in changes in the brain areas regulating emotion and motivation," said Dr. Mark Willenbring, director of the Division of Treatment and Recovery Research at the National Institute on Alcohol Abuse and Alcoholism. This means that even if young people begin to realize they have a problem, the desire to drink may overwhelm their cognitive ability to change, he said.
That's when therapeutic interventions would be extremely helpful, of course, but a second study found that only a tiny number -- 0.06 percent -- of enrollees in more than 250 of the nation's health plans are ever diagnosed with problem drinking or alcoholism.
In reality, experts estimate, about 4 percent to 5 percent of plan members are probably plagued by alcohol abuse issues.
Researcher Dr. Eric Goplerud, of George Washington University Medical Center in Washington D.C., pointed out that detection and diagnosis rates for alcoholism are below those for other medical conditions.
"Yet we accept low rates of identification and treatment," he said in a prepared statement. "Our approach to alcohol treatment is unlike what we expect and demand for treatment of diabetes, high blood pressure, asthma or virtually any other health condition."
To learn more about the causes and treatments of problem drinking, head to the National Institute on Alcohol Abuse and Alcoholism.