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Medical Journal

Alcoholism vs. drinking too much
Scripps Howard News Service


January 06, 2010

We're at the time of year when people who tend to over-imbibe in the alcohol department, perhaps, make resolutions about changing that behavior.

Officially, the National Institute on Alcohol Abuse and Alcoholism says its surveys indicate three quarters of American adults never pass the threshold for problem drinking -- five or more drinks for men or four or more drinks for women (some guidelines say six and five) in any one day. The other danger sign is two drinks a day for men, one for women, daily.

But then again, the surveys also show a quarter or more do go over the line.

Also, the measures of alcohol use assume that a drink is a 12-ounce beer, 5 ounces of wine and an ounce-and-a-half of 80-proof liquor -- a somewhat quaint menu that doesn't account for supersizing. Researchers have found many establishments tend to over-pour and amateur bartenders at holiday parties may be at least as apt.

The National Academies' Institute of Medicine estimates about 20 percent of American adults have a drinking problem, and about 5 percent are physically addicted to alcohol. Excessive drinking is responsible for at least 85,000 deaths each year in the United States and many more injuries.

Although people with a family history of alcoholism have cause to worry, studies have also shown that more than half of children of alcoholics do not become dependent themselves.

Several studies, mainly on mice, have identified genes that appear to influence alcohol consumption -- one set identified in 2006 prompts excessive consumption; another, reported in 2007, seems to slow down communication between brain cells, perhaps leaving the brain unaware of consuming too much.

Other researchers working with human subjects reported earlier this year that patients with a specific variant of an opioid receptor gene were much more likely to respond well to a drug that's intended to reduce or eliminate the desire to drink. Drinking alcohol increases the release of opioids, natural compounds produced in the body that act to promote a sense of pleasure or well-being.

The drug, naltrexone, acts to block brain receptors for those opioids, making it easier for patients to remain abstinent or stop quickly if they slip.

Researchers at the NIAA and the Medical University of South Carolina found that 87 percent of the patients with the genetic variant who got naltrexone had a good outcome, compared to 49 percent of patients who got the inactive drug. However, among patients who got specialized alcohol counseling as part of their treatment, there was no difference in outcome between those getting the drug or a placebo.

The work indicates that gene typing may eventually allow doctors treating alcoholics to customize medications and other interventions.

Finally, another study reported in October, this time on rats and humans, also looked at the pleasure and reward pathways of the brain.

Scientists concluded that while there are genetic sets that predispose some rats and humans to drink more, those traits are not the same genes that predispose them to alcohol dependence.

Boris Tabakoff, a researcher at the University of Colorado, Denver, who led the study, said it demonstrates that there are genes that drive us to drink, but that they don't automatically lead to a loss of control over drinking and alcoholism.

"Because different sets of genes seem to influence the level of alcohol consumption as opposed to propensity for alcohol dependence, we're confronted with a lot of variation in humans,'' Tabakoff said, although increased consumption is almost always found among the alcohol dependent.

So, it may be too soon to say for certain that a few drinking genes can always predict trouble with booze.

In the meantime, the NIAAA has a "Rethinking Drinking" Web site -- -- that helps people understand risky drinking patterns, look up the alcohol content of drugs and gives the signs of alcohol problems.

The agency' s site also has a link to a 10-question survey that you can use to evaluate whether drinking is a problem for you or a loved one.


Contact Scripps Howard News Service health and science correspondent Lee Bowman at bowmanl(at)
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