Is Alcoholism Genetic or Hereditary? Everything You Need to Know

What Causes Alcoholism?

Alcoholism (now known as alcohol use disorder) refers to a consistent pattern of abusing alcohol and developing a tolerance to drinking. Alcoholism does not discriminate against whom it impacts, and it’s estimated that nearly 30 million Americans met the criteria for an alcohol use disorder in the past year.² Researchers have not pinpointed a single cause of alcoholism. However, certain risk factors may increase the risk of developing an addiction.³

Possible risk factors of alcoholism include:

• Having a parent with an alcohol use disorder
• Drinking steadily over time
• Experimenting with alcohol at a young age
• Spending time with peers who drink heavily
• Having a co-occurring mental health disorder,

Is Alcoholism Genetic?

Genetics may play a significant part in the likelihood of developing alcohol use disorder. The science of genetics focuses specifically on gene mutations, whereas hereditary focuses on how genes are carried from one generation to another. Therefore, genetic diseases may or may not be hereditary.

Genetic factors affect our predisposition for certain behaviors, personality traits, or mental health symptoms. Genes may increase the risk of developing addiction, including substance use disorders and other behavioral addictions, but limited research is available to support the idea of an addictive personality. However, genes may explain some common traits people with addictive tendencies exhibit.

Is There a Gene for Alcoholism?

Researchers have established that alcoholism is a complex genetic disease entailing numerous genes, and ADH1B and ALDH2 have been identified as risk factors for alcoholism. These genes affect how the body metabolizes alcohol. For example, ALDH2 is prevalent in parts of Asia and may account for red facial flushing and nausea (which may deter drinking alcohol, as it has similar effects as Antabuse). Conversely, research shows that people with copious levels of ADH1B have higher blood alcohol concentrations, meaning they may metabolize alcohol faster.⁴

Is Alcohol Tolerance Impacted by Genetics?

Alcohol tolerance refers to how the body reacts to alcohol in the moment and over time. People with “high tolerances” need more alcohol to achieve desired effects. In contrast, people with “lower tolerances” often feel the impact of alcohol after one or two drinks. Tolerance is likely affected by drinking habits, age, overall health, and gender.

There isn’t much research examining if alcohol tolerance is genetic. However, in one study, researchers found that people with the CYP2E1 gene on chromosome 10 showed increased levels of alcohol sensitivity. They were more likely to become intoxicated faster with less alcohol, possibly due to how their bodies metabolized alcohol.⁵

Is Alcoholism Hereditary?

The term hereditary refers to how a trait is genetically transmitted throughout generations, and many assume that these factors influence the likelihood of developing alcohol use disorder. Alcohol use often runs in families, and one study found that people were eight times more likely to develop a substance use disorder if a first-degree relative had an addiction.⁶

Will Children of an Alcoholic Parent Inherit the Condition?

While children are at an increased risk of developing an addiction if a parent has one, this does not mean the child is inherently doomed. Many children do not have addiction problems despite their family of origin. However, when children are placed in stressful environments that correlate with addiction (poverty, physical abuse, neglect), the risk of problematic drinking increases.

Can Alcoholism Skip a Generation?

It is possible for alcoholism to skip generations (i.e., the grandparent has an addiction, the parent does not, but the child develops one). This may be due to both genetic and environmental factors. Similarly, not everyone with addiction in their families carries the same genes or develops a substance use disorder.

How Much Does Genetics Increase Your Risk of Addiction?

Regarding addiction and genetics, genes likely play a 50% role in the likelihood of or predisposition to alcoholism. Research on twin studies confirms this genetic influence, and these estimates have been consistent across groups.⁷ When examining identical male twins, if one twin abuses alcohol, the other twin is 50% as likely to also struggle with drinking (the risk goes to 33% for fraternal male twins).

However, it’s always important to consider the context of various environmental factors. For example, access to alcohol, early childhood trauma, low self-esteem, and mental health conditions are known risk factors for addiction. These traits may or may not coincide with specific genetic sequences.

Genetics may play a role in risk factors for alcoholism, such as:

• How alcohol is metabolized in the body
• Sensitivity to alcohol’s effects
• Alcohol withdrawal symptoms
• How physical health conditions interact with alcohol

What Other Factors Contribute to Alcohol Use Disorder?

While genetics and alcoholism appear to be connected, examining the other risk factors associated with addiction is important. Still, risk factors should not inherently be considered direct causes, but exhibiting several risk factors may certainly increase someone’s predisposition to alcoholism or misusing substances.

Factors that contribute to developing alcohol use disorder may include:

• Environmental factors: A person’s physical and social environment can impact the development of alcohol use disorder symptoms. Triggers vary but may include chronic, acute, or toxic stress; unhealthy family dynamics; or other relationship problems.
• Trauma: Trauma is a significant risk factor for addiction, and research shows many people with substance use disorders report histories of trauma. It’s also important to note that living at home with an alcoholic parent can make someone more prone to abuse (especially neglect). A person with a trauma history may be more inclined to drink to self-medicate trauma-related symptoms.
• Mental health conditions: Mental health conditions often go hand-in-hand with alcoholism, and both conditions can exacerbate symptoms in one another. Individuals often misuse alcohol to manage anxiety or depression. However, the more they drink, the more anxious or depressed they feel.
• Co-Occurring substance use disorders: Alcohol use disorders often coincide with other substance use disorders, including opioid use disorder, cocaine use disorder, and stimulant use disorder. The presence of multiple substance addictions is known as polysubstance abuse.
• Societal or cultural drinking perceptions: When heavy drinking is normalized, people may be more inclined to consume alcohol. Over time, these socialized patterns can reinforce misuse, particularly in individuals who may already be predisposed to addictive tendencies.

How to Reduce Your Risk of Developing Addiction

Knowing your genetic predisposition to alcoholism and the risk factors can help you take preventive steps to protect yourself. There are ways to reduce or stop drinking before your habits become problematic, but early intervention is critical.

You can help prevent a genetic predisposition to alcoholism from becoming an addiction by:

• Maintaining healthy relationships
• Understanding your family history
• Practicing healthy stress management
• Getting treatment for trauma or unhealthy family dynamics
• Engaging in healthy self-care practices
• Practicing harm reduction with drinking
• Stopping drinking altogether

Alcohol Use Disorder Treatment Options

Addiction treatment tends to be multifaceted, and alcoholism recovery varies based on individual needs. What works well for one person may not be as beneficial for someone else. Likewise, some people need to engage in different treatment methods before finding a strategy that works.

Treatments for alcohol use disorder may include:

• Medical detox: People with moderate or severe addictions may need medical detox to avoid dangerous alcohol withdrawal symptoms. Detox provides 24/7 monitoring and evaluation.
• Rehab/inpatient programs: Some people may benefit from seeking inpatient rehab treatment. This type of treatment is residential, meaning clients live on the property and participate within a therapeutic community throughout the day.
• 12-Step programs: Alcoholics Anonymous (AA) offers anonymous, peer-led support. These meetings focus on working the 12 steps and building community by working with a sponsor and connecting with a fellowship.
• Therapy: Individual, group, and couples therapy may be beneficial for overcoming the emotional factors underlying alcohol use disorder while also focusing on co-occurring mental health needs.
• Oral medications: Naltrexone, Acamprosate, and Disulfiram are all FDA-approved for decreasing drinking.
• Lifestyle changes: Stress management and other holistic measures (eating well, practicing self-care, and building self-esteem) can help treat alcohol use disorder.
• Family-based interventions: Loved ones may stage an intervention to set boundaries with someone experiencing alcohol addiction. An intervention is intended to encourage someone to seek treatment.

When to Seek Professional Support

Treating alcoholism on your own can be challenging, and seeking professional support is a good idea if you feel like you can’t stop drinking. This is especially true if you are concerned about the impact of withdrawal or the possibility of relapse. Therapy, whether in-person or online, is a good place to start. In addition, numerous in-person and online therapy options can support you during this time. You can ask your doctor or a trusted loved one for a therapist referral or look through a therapist directory for a professional with expertise in treating substance use.

The link between genetics, heredity, and alcohol addiction does mean those predisposed will experience or develop alcohol use disorder. Genetics only paints some of your life experiences. Even if you are struggling, you can overcome your difficulties and recover.

In My Experience

I have worked with many clients struggling with alcoholism in my therapy practice. Genetics likely do play a role in shaping behavior and temperament, but it’s never as simple as saying one issue causes another. It’s more important that clients consider their own relationship with alcohol. Are you drinking more than you’d like? Do you drink to cope with troubling mental health symptoms? Do you hide, lie about, or otherwise try to downplay your alcohol consumption to others? If so, those are key signs it may be time to reach out for support.