<p>Actually, we now know that there are 23 gene alleles related to alcoholism.</p>
<p>The point being that one might counsel our present or future college students differently from each other, depending on genetic predisposition. For some, heavy drinking is not going to be a problem if they can stay away from automobiles and rape/sexual assault situations. For others, even occasional binge drinking or “moderate drinking” might not really be a viable option.</p>
<p>I am surprised that Blum and Noble can still garner any publicity on this issue. Their 1990 claims for diagnosis of alcoholism with the DRD2 A1 Allele were thoroughly discredited by the other researchers as summarized in JAMA 269, 1676, 1993 by Gelernter, et al.</p>
<p>I don’t know about particular genes, but it is certainly true that different bodies react differently to alcohol, with or without further differentation caused by different personality types.</p>
<p>I was somewhat surprised by the A1 Allele work as well, given that the research has gone so much further at this point. The way I have always read the earlier work is that it was incomplete as opposed to erroneous - I’ll have to go pull out the JAMA article again.</p>
<p>Per Gelernter: “Our analysis shows that, when all studies subsequent to the original study are considered, there is no significant difference in DRD2 A1 allele frequency between alcoholics and controls.”</p>
<p>Is this another one of those areas where the definition (alcoholic) that is too broad and sweeps in not only those with differing physiology but also cases where, say, people just hate their jobs or their spouses or are bored silly?</p>
<p>I think it is logical that there would be a genetic component as certain racial groups have problems with ingesting certain foods. (Hispanic & asian = higher lactose intolerance.) Why wouldn’t certain genetic types be more susceptable to dependence? </p>
<p>In my family, there is definitely a pattern of alcohol intolerance-- if more than relatively small amounts are consumed.</p>
<p>“Is this another one of those areas where the definition (alcoholic) that is too broad and sweeps in not only those with differing physiology but also cases where, say, people just hate their jobs or their spouses or are bored silly?”</p>
<p>Do you really think so? (I’m seriously asking). The universally accepted definition, which comes from the DSM-IV, is very narrowly drawned, allows one to eliminate those who are simply heavy drinkers from the definition, and requires a level of physical response that is not substantially impacted by environmental stimuli.</p>
<p>Am I missing something? The allele-related evidence to date (23 alleles identified) just seems so overwhelming (and mounting) at this point, that it is isn’t so easily explained away. (In contrast, what isn’t so easily explained away are the numerous cases of spontaneous remission, although this is a pattern we see with type II diabetics, though not with such frequency.)</p>
<p>I am way out of my league here, but my points are:</p>
<p>The quiz in the newspaper that determines whether you are an alcoholic has questions like: Do you ever have a few too many? Does your spouse tell you you drink too much? Do you actually think you are funny when you drink too much? If this is the test, biological science is wasting its time.</p>
<p>On the other hand, everybody who pays attention knows that different people (by race, perhaps, but also among siblings and other blood relatives) have different physiological reactions to various amounts of drink. The specific definition of alcoholism or a tendency in that direction could make a big difference in trying to determine a specific genetic link.</p>
<p>The concept of alcoholism as a disease is useful in justifying treatment and obtaining reimbursement. Likewise the DSM definition is man made. The distinction between heavy drinking and alcoholism should be considered arbitrary and subject to change. None of these definitions tell us anything about a possible genetic basis for alcohol use or abuse. Even if we accept the definitions, there is no certainty that alcoholism is a single disease or the definition covers a multitude of diseases. Analogies to other better understood diseases tell us nothing about the nature of alcoholism. There appears to be some genetic factors involved, certainly there are environmental factors and then there is that pesty, ill-defined factor of free will and choice. It does not help that Blum and Noble get publicity whenever they reintroduce their single gene approach. The scientific rebuttals never receive that attention.</p>