Are you Alcoholic? -- Genetic Testing for Alcoholism: One of a Set of Screening Tools

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Insidious

If you think that you suffer from alcoholism, drug addiction, or any psychological or psychiatric condition, then you already have a jump start on recovery if you need it. Make an appointment with professionals and find out. Given the level of alcoholism in the US, I think it wiser to be even over-cautious and find out you do not have any of these afflictions. A sizable segment of the American population suffers from an average of four Severe Mental Disorders at once and alcohol or substance abuse is usually one of them. During economic downturns like 2007 - 2012, drinking alcohol may rise in frequency and concern, adding to the numbers of the afflicted.

The process of determining alcoholism contains steps after referring a list of symptoms and looking at the drinks-per-day guidelines (there are more than one; I use the Mayo Clinic list in the link at the end of this article), although those can be effective starting points. In some cases, these lists may satisfy a medical practitioner of the diagnosis. If one word can describe alcoholism, insidious is that word. It can hide itself in symptoms of other disorders. Alcoholism can hide itself completely in so-named high-functioning alcoholics that succeed on the job and social activities Monday through Friday and drink to oblivion all weekend. For example, some die and those cleaning out the homes find empty and half-filled liquor bottles by the dozens or hundreds. Many of the bottles are hidden behind other items and bottles are found under car seats and in the trunk.

The American Psychiatric Association in the mid-1980s reported that alcoholism directly or indirectly affects 98% of the American population. With this extent of probem, it is wise to get help if you think you are at risk or if problem drinking by someone you know is affecting you.

I do not drink alcohol, because of several bad experiences I have had with alcoholics among friends, professors and fellow students, at work, among clients, and in athletic clubs. That, and the fact that most beverage alcohol tastes like gasoline, jet fuel, or kerosene smells to me. I do cook with wine occasionally, so I am not condemning alcohol altogether.

Similarly, I don't point to the Bible and say that the "wine" mentioned is not wine. In the original languages it is indeed fermented beverage wine. However, Hebrew tradition was to cut it to 2/3 water and 1/3 wine or 3/4 water and 1/4 wine. That's very low alcohol content. (Now I suppose someone will pipe up that Jesus turned water into wine by hiding a small amount of wine up His sleeve and pouring it into water. Always there are hecklers...)

In addition to symptom lists, genetic testing is available that uncovers alcoholism in certain groups of individuals. About a dozen such tests are used in the early 2010s. Some of these are definitive in their ability to diagnose alcoholism and alcoholic risk.

Carrie Nation

..chopped up bars in taverns, but also helped women claim the right to vote. Hatchets were not the answer to alcoholism.
..chopped up bars in taverns, but also helped women claim the right to vote. Hatchets were not the answer to alcoholism.

CREB

The May 26, 2004 issue of the journal Neuroscience included an article that revealed a gene responsible for some cases of alcoholism. In like cases, the first answer to alcohol detemination is a) whether a client is equipped with a preventive gene or not and b) whether there is any deficiency in that gene. A "No" answer to the second part does not mean, however, that the client might not be able to drink himself into alcohol dependence, which can developed over time. So, we cannot effectively say, " I have the gene, so I can drink as much as I want!" This is equivalent to an obese client saying, "I use low-calorie butter subsititue, so I can safely use twice as much now!"

The gene revealed by the article makes a substance called CREB. This is also known as Cyclic AMP Responsive Element Binding protein. It is a protein. It regulates brain functioning during human development and learning, so it is very important. In a deficiency (not enough) of this protein, a person often becomes anxious and/or depressed and drinks more alcohol than people who have no CREB protein deficiency. Alcohol is, then, a means of self medication for them.

Alcohol is a typical means of self-medication and I have seen this in dozens of pain management cases where clients suffered chronic back and leg pain, anxiety, and depression all at once. Alcohol seemed to word better than their medications, but affected their lives in negative ways. Some were diagnosed later as alcoholics, while others died from combining alcohol and narcotic drugs.

West vs. East

ANTABUSE is administered by Western Medicine to alcoholics to make them sick while drinking. The drug blocks the actions of functioning ALDH2.

Chinese Medicine uses DAIDZIN. It affects aldehyde dehydrogenase so as to not cause a buildup of acetaldehyde that leads to symptoms of flush, nausa and heart involvement. It may work on brain chemistry to prevent the pleasure in drinking alcohol.

Aldehyde Dehydrogenase 2 (ALDH2) Gene Deficiency

During Autumn 2010, University of California-Berkeley began a program called Bring Your Genes to Cal. This instituted Personalized Medical Treatment based on genetic makeup. This might be useful.

Of three genetic tests given to consenting Autumn 2010 Freshmen, one was a cheek swab for ALDH2 Deficiency. Such a deficiency is responsible for Asian Flush among 40% of the East Asian population at Berkley. The flush is the facial cheek flushing experienced by Asians after drinking alcohol.

It had not occurred to researchers that the test could be 1) a step in possibly determining Asian heritage and of 2) determining increased cancer risk.

ADH breaks ethanol (beverage alcohol) into acetaldehyde (cancer causing), and ALDH2 breaks down the cancer causing substance to acetate, which does not cause cancer. ALDH2 deficiency, denoted as the gene ALDH2*2, allows the cancer causing substance to remain to work DNA damage on the body, because the ALDH2*2 does nothing to the cancer causing substance.

East Asians that inherit the ALDH2*2 gene from BOTH parents will suffer Asian Flush, heart palpitations, and nausea when they drink alcohol. East Asians that inherit only one gene suffer fewer, milder symptoms and are at greater risk for esophageal cancer. Molecular Biology as a field is working on a preventive measure in the 2010s. I addition, esophagus regeneration has been achieved through the use of powdered pig bladder/intestines that grow into the cells and then the structure needed.

Our answer here is that having one copy of the faulty ALDH2*2 gene means that the client is much more at risk for developing alcoholism than those with two copies of this non-working gene. This is a good step to take among Asian populations, especially Far East Asians.

DRD2 TaqI Polymorphism

This is a variation on human dopamin receptors A determining genetic test for it cannot stand alone in diagnosing the presence of alcoholism in a client.

An A1 allelevariation of the polymorphism is the culprit. People that have the variation also have significant risk of becoming addicted to opiates (like narcotics... heroin) and endorphin-releasing drugs -- This includes alcohol. However, this variation is only slightly more common than average in alcoholics and opiate addicts. Thus, it is not a deciding factor. Added to other results from other tests, physicla and psychological, it gives weight to a diagnosis.

In the early 2010s, perhaps a dozen total genetic tests for alcoholism risk existed. Others continue to be found.

Symptom Lists to Use

Would it not be wonderful and miraculous if we could develop gene splicing to cure and prevent alcoholism (and it was not expensive)?. I hope someday for that possibility.

The Mayo Clinic is my choice of experts on symptoms and diagnosis for alcoholism and they use the current Diagnostic and Statistical Manual of Mental Disorders (DMS-IV TR in the 2010s) of the American Psychiatric Association. The DSM rule for diagnosing alcoholism includes the display of at least three or more of the following items within a single 12-month period. You don't need to have all the signs and having just one sign a year ago does not mean you are an alcoholic. See a professional for complete diagnosis.

  1. Tolerance, indicated by ever-greater amounts of alcohol needed to feel drunk.
  2. Withdrawal symptoms: tremors (DTs - delirium tremens), insomnia, nausea, anxiety, panic.
  3. Drinking more alcohol than you planned.
  4. Having an ongoing desire to cut down on alcohol or making unsuccessful attempts to do so.
  5. Spending a lot of time drinking, getting the alcohol, or recovering from drinking.
  6. Giving up important activities. Also, withdrawing and spending more time alone.
  7. Continuing to drink alcohol in the presence of physical and psychological problems (sometimes manifested as legal problems).

Someone that exhibits three or more of the above list of seven items might be an alcoholic. An individual that shows only one of the seven could benefit from talking with a medical professional about related concerns.

Quote From the World Health Organization

  • The harmful use of alcohol results in 2.5 million deaths each year.
  • 320 000 young people between the age of 15 and 29 die from alcohol-related causes, resulting in 9% of all deaths in that age group.
  • Alcohol is the world’s third largest risk factor for disease burden; it is the leading risk factor in the Western Pacific and the Americas and the second largest in Europe.
  • Alcohol is associated with many serious social and developmental issues, including violence, child neglect and abuse, and absenteeism in the workplace.
--http://www.who.int/mediacentre/factsheets/fs349/en/index.html retrieved 9/25/2011.

Alcohol in Culture

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Comments 11 comments

Lord De Cross profile image

Lord De Cross 5 years ago

This is a social calamity. Friday nite..thru sunday nite people will have an issue related to this problem; from date rape, to DUI. Actually o.5 % either will die or will become disabled permanently.And sadly some will not able to say bye to their loved ones. Genetics is a good reason but also is the way society is. Financial distress helps to feed this problem too.vOTED UP Pat!

LORD


Patty Inglish, MS profile image

Patty Inglish, MS 5 years ago from North America Author

Thanks so much for reading and responding so quickly. it is a devasating problem in the world.


FloraBreenRobison profile image

FloraBreenRobison 5 years ago

other signs my brother had before sobriety-he drank a lot when he was alone and at weird hours of the day.


Patty Inglish, MS profile image

Patty Inglish, MS 5 years ago from North America Author

We had a fellow student in high school that went to work half-days in an office where they gave her alcohol at age 16. She never stopped drinking heavily until she died.


road2hell profile image

road2hell 4 years ago from Linden, AB

Just curious. If a person is found to be an alcoholic, should he/she be able to have a driver's license? If it is a disease, like epilepsy, then either one shouldn't be allowed to drrive unless iit is under control according to a doctor.


Pamela99 profile image

Pamela99 4 years ago from United States

This is an excellent article on alcoholism. The advances in DNA testing for numerous diseases and conditions is astounding.

I have been around binge drinkers who go long periods of time (usually weeks or months in abstinence) but when they start drinking they seem to stay drunk for days or weeks at a time. Others are like my neighbor who was a high functioning alcoholic. He was a lawyer and drank daily because I think he needed to maintain a somewhat constant blood level of alcohol as he did this over many years. I think your article is very helpful since such a vast number of people are affected by alcoholism in one way or another.


Patty Inglish, MS profile image

Patty Inglish, MS 4 years ago from North America Author

Dear road2hell - interesting and practical thoughts. If America has millions of unrecovered alcoholics, which we might, then removing their right to drive might also slow down car sales and increase cases of driving without a license. It would be very interesting to see the exact results of such a law and hopefully the auto-related death rate would not increase - instead of decrease, which would be a goal of the law.

Pamella99 - Thanks for sharing your post. I have seen this as well. We wonder sometimes how many secret alcoholics are out there.


alekhouse profile image

alekhouse 4 years ago from Louisville, Kentucky

I used to think my sister was an alcoholic. She drank a bottle of wine every day. But swore she could stop at any time. And you know what? She did. She had a stroke and I guess she knew instinctively that she had to give it up.


road2hell profile image

road2hell 4 years ago from Linden, AB

Well, the streets would be safer and it would reduce the amount of carbon dioxide emissions and other toxic particles and gases into our atmosphere. If we remove alcoholic drivers off the road, and keep them off the road, drunken driving would decrease. But we know a certain percentage of drunk drivers are the "once in a blue moon" social drinking and this would be another matter to attend to.


Buildreps profile image

Buildreps 2 years ago from Europe

Very nice article. Good points you mention. But in my country are so many alcoholics that it is hard to believe it's genetic. Perhaps for a little group that disappears in the majority. It is probably a combination of more then one thing. Genetics is certainly not the cure, possibly for the minor group. I believe it's a combination of availability, genetic, raising, friends, family, tolerance and much too low punishments. All mammals get drunk in the orchard when the fallen fruit starts to ferment and none of them can resist it.


Patty Inglish, MS profile image

Patty Inglish, MS 2 years ago from North America Author

@Buildreps - Thanks for insights about alsochol use and in your country. The Amer. Psychiatric Assn. DSM 5 manual published in 2013 has become quite controversial in its handling of alcohol use as a psychiatric condition, because it increases the number of people likely to be diagnosed with what is now a contiuum of Alcohol Use Disorder.The 5 Types of alcoholism defined by another national organization are not considered,.

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