Do Men and Women Have Differing Genetic Risks for Alcoholism?
Alcoholism and Gender
People with alcoholism have a physical reliance on the presence of alcohol (ethanol or ethyl alcohol) inside the brain, as well as dysfunctional changes in brain function and behavior that mark the development of alcohol addiction. Prior to 2013, mental health experts in the U.S. officially classified alcoholism (alcohol dependence) as a distinct illness that could be identified separately from serious, non-addicted alcohol abuse. However, in reality, doctors commonly have a hard time distinguishing serious abuse from alcohol dependence. For this reason, current mental health guidelines eliminate independent diagnoses for alcohol abuse and alcoholism, and instead contain a joint diagnosis for both conditions called alcohol use disorder. Still, both professionals and laymen commonly use the term alcoholism when discussing issues of alcohol dependence.
The basic process for the development of alcoholism is the same for both men and women. However, women suffer disproportionately from certain consequences of the condition. For instance, alcoholic women commonly experience scarring of the liver (cirrhosis) and other forms of serious, physical alcoholism-related harm more often than their male counterparts. Alcoholic women also have an increased tendency to combine drinking with the consumption of prescription medication, a highly dangerous practice that can produce severe or potentially fatal health repercussions. Other gender-specific risks associated with alcoholism in women include greater exposure to sexual assault and other forms of violence, as well as the possibility of giving birth to children affected by fetal alcohol spectrum disorder.
The role of genetics in alcoholism is not straightforward. Instead, potential genetic influences on risks for the condition come from multiple sources in human DNA and can overlap in a number of complex ways. To complicate the picture even further, life experiences and environmental influences can alter the way in which the body’s genes do their job, and can therefore also alter any given person’s risks for developing alcohol dependence. Although the specific mixture of genetic and environmental influences may differ greatly in any particular individual, experts in the field estimate that 50 percent of all risk for alcoholism in the general population has a genetic basis.
Differing Genetic Risks
In the study published in The American Journal of Drug and Alcohol Dependence, researchers from Spain, France and the U.S. looked at the gender-specific influence of one specific gene, called SSAT1, on the odds for developing a diagnosable case of alcoholism. This gene helps determine how toxic alcohol exposure is for any given individual. In turn, relative sensitivity to the toxic effects of alcohol can help determine if a person will develop alcohol dependence and experience two specific symptoms of alcoholism: increasing tolerance to the effects of alcohol intake and the onset of alcohol withdrawal when intake falls below a certain point. All told, the study included 586 participants. Of these participants, 104 had diagnosable alcoholism, while another 273 had significant mental health issues not related to any form of substance use. The remaining 209 participants were unaffected by substance problems or any other mental health concerns.
One specific form of the SSAT1 gene may significantly increase the chances that alcoholism will develop. After comparing genetic testing for the three groups, the researchers concluded that, among the women in the study diagnosed with alcoholism, this genetic variation occurred with unusual frequency. However, they also concluded that the men in the study diagnosed with alcoholism did not disproportionately carry the variant form of the SSAT1 gene. The researchers believe a number of factors may help account for the differing effects of the gene in women, including the ways in which women respond to stress, specific details of the ways in which women react to the toxic effects of alcohol and differing levels of specific substances in the body that help process alcohol. They note the need for additional research to support or disprove their conclusions.