Alcohol & Genetics
You're listening to breaking the bottle legacy with Molly watts, Episode 46. Hi, I'm Molly, after a lifetime living under the influence of family alcohol abuse, spending more than 30 years worrying about alcohol and my own drinking, believing I had an unbreakable daily drinking habit, I changed my relationship with alcohol forever. If you want to change your drinking habits than breaking the bottle legacy is for you. My goal is to help you create a peaceful relationship with alcohol, past, present, and future. Each week all focus on real science and using your own brain to change your relationship with alcohol. Nothing has gone wrong, you're not broken, you're not sick. It's not your genes. And creating peace is possible. I'm here to help you do it. Let's start now. Well, hello and welcome or welcome back to breaking the bottle legacy with me your host, Molly Watts coming to you from a little gray and cloudy Oregon this morning. But you know, it has been pretty rainy the past couple of days. Well, Friday afternoon actually was pretty nice day. But lots of rain. And I know that coming in this evening is supposed to be another real drenching storm. So I will take some clouds and a little sun poking out behind them. That is just the way that Oregon rolls during November. So welcome to the podcast, a little bit of housekeeping first, some free resources are available to you and I just want to make sure you are aware of them. First, there is the mini book that I wrote. It's a short ebook called alcohol truths, how much is safe. And in it I talk about how to use science to help determine what level of risk you are willing to assume with alcohol. In this book, I look at safety from the perspective of physical health, of course, because that's usually what most people are referring to when they ask how much alcohol is safe. But I also address it from the perspective of social health and financial health. And at the end of it, it's only like 25 pages long, so don't get freaked out. There is a practical cost benefits analysis exercise that you can use to help you determine the cons and the pros of your current drinking level versus the pros and the cons of your goal drinking level and really being able to look at them both ways, right. So you can find that over on my website, www dot Molly watts.com. That's Molly with a why watts with an s and it is totally free. Over in the Facebook group. Alcohol minimalists change your drinking habits, which is of course a great free resource in and of itself. There are some files I've made available to the group free that come from the paid book, breaking the bottle legacy how to change your drinking habits. Those files include a recommended reading list, recovery worksheet, and actually today I just uploaded for brain lessons a PDF on forebrain lessons. So in addition to this podcast, all of these resources are available to you free, and with your own intention and effort. I think you can make great strides in changing your drinking habits and I sincerely hope you will join me in creating a peaceful relationship with alcohol. All right. Lastly, in housekeeping, I want to share one of the recent reviews of my book that is available on Amazon. And the headline of the review is game changer and refreshing new perspective. Here's what the review says. Quote as the headline indicates, this book is an absolute game changer in providing a refreshing and new perspective on a relationship with alcohol and poor habit breaking. For so long, I thought I had something hereditary that was ultimately preventing me from changing my relationship and poor habits surrounding alcohol. I also tried some of my own methods to cut back on drinking, but unfortunately they were unsuccessful in discovering this book and podcast. As I read through the content, I learned so much more about how it is 100% possible to break these types of unbreakable habits using our own greatest tool our mind. This book helps explain the neuroscience behind an individual's drinking habits and how to effectively take control and improve your relationship with alcohol to achieve a more peaceful association. So thank you for that review. i Well, of course I like it right. Anyways, if you haven't picked up the book yet, it's available on Amazon and if you read it and you leave a review, it doesn't even have to be a great review like that one. You Let me know that you've left a review either by email, so email me Molly at Molly watts.com, or via direct messenger over on Facebook or Instagram, you will be entered into a drawing for alcohol minimalist swag. Every two weeks I'm going to draw a name from reviews of either the book or the podcast. So it counts to have you leave a podcast review. You don't have to buy anything, just leave a review on your favorite platform. Let me know your reviewer name and YouTube will be entered into the next drawing. Okay, on to this week's episode, I'm coming back to another in my series, alcohol and so and today I am tackling alcohol and genetics. Now for those of you who have listened to this podcast for any length of time, you know that I am an adult child of an alcoholic. I am also told though he had no real nowhere way for me to verify this as he passed away when my mother was a toddler that my maternal grandfather was also an alcoholic. And for a long time, I believed that I was genetically programmed to desire alcohol more. And I worried that because of my genes, I was just destined to become an alcoholic like my mom if I kept drinking. Now, I know I wasn't alone in thinking that alcoholism runs in families. Right. I think you've probably heard that I hear people all the time saying that my my family is full of alcoholics. And from a statistical standpoint, alcohol use disorder, which is how we term alcoholism these days often seemed to run in families. And it is true that one of the risk factors for developing alcohol use disorder is having a family member who also has the disorder. One in five adult Americans have lived with an alcoholic relative while growing up. And adult children of alcoholics are four times more likely than other children to become alcoholics themselves. But do these statistics mean that there is a genetic link? I want to dive a little more into the science and help you understand that the picture isn't clear from a scientific standpoint, and why believing that you are genetically predisposed to crave alcohol isn't helpful. thinking those thoughts actually fueled my desire to drink. Instead of seeing the full picture and understanding the truth behind the science. I just accepted the headlines that alcoholism ran in families, and that it was something inherited that I was battling as well. In my journey to change my relationship with alcohol, I educated myself on the facts versus the story that I was choosing to focus on. And I want to help you do the same thing. So after we unpack a little of alcohol and genetics, I also want to touch briefly on the idea of an addictive personality, because I also think that falls under genetics to some degree as well. So I'll call it genetics. Here are some of the facts about the connection between alcohol abuse and genetics. A genetic disposition to alcohol abuse does not mean a person will develop an alcohol use disorder. Less than half of the children of people with an alcohol use disorder will develop an alcohol use disorder themselves. Two individuals can develop an alcohol use disorder even if they are not genetically disposed to do so. A person's environment can strongly influence the development of alcohol use disorder. Three, there is no gene or set of genes that puts a person at risk specifically for alcohol abuse. Rather, one possibility is that there are variations in genes that get expressed in different ways in a carrier's body. For example, Gene variations can predispose individuals to depression, which in turn can predispose them to alcohol abuse. For knowing which genes are involved in creating an elevated risk for alcohol use disorder can help researchers to match treatments to genes. For instance, the addiction treatment drug naltrexone may work on specific genes. Psychotherapy may also effectively target certain genes versus others. So that last point is interesting if you listened to last week's episode with Katie lane on the Sinclair method, which employs naltrexone. In researching this episode and just having this conversation recently, I found that there is a relatively small study that found this specific to naltrexone variation in just three brain genes predicts how well now trek zone will work in treating a patient with alcohol use disorder. The study involved 146 treatment seeking alcohol use disorder patients. So these patients were most likely physically dependent and were on the spectrum for severe alcohol use disorder. But what the study found is that only patients with certain combinations of gene variations showed consistently reduced drinking when taking naltrexone. To benefit most from naltrexone, you have to have the gene variations that predict you'll be low in one brain chemical response, dopamine, or m mu opioid, and high in the other. That's what the conclusion was from that study. I'll link the study in the show notes. But what I found interesting, especially given Katie and my conversation is that they measured the success in the study by reduction in the number of binge drinking days defined as five or more drinks for men or for more drinks for women. And across the study indicated a positive effect of the medication. So if you remember in my conversation with Katie, I specifically said I wonder if this really would have an impact for people who are binge drinkers. Right? So I think that that's how what they used as a success. And perhaps you can glean from that, that if you are a binge drinker, and you have this specific combination of genes, which of course, figuring out via genetic testing would be very challenging to get done at this point. But instead, I think it's a good reason to try naltrexone, and see if it works for you. If binge drinking is something that's, that's a challenge for you, right? If it does, you might be able to deduce that you have this combination of gene variations. And this might be a really successful way for you to help reduce your alcohol use. Bottom line on the genetics here is that this was specifically focused on people who were seeking treatment. So they were likely on the severe end of alcohol use disorder spectrum, which is where physical dependence is happening. And as a reminder, this podcast is not aimed at people who are physically dependent, and or experiencing severe alcohol use disorder symptoms. Some of those signs that you might need medical attention include the symptoms of withdrawal, like tremors, nausea, dizziness, heart palpitations, if you wake up in the morning, feeling like you need to drink to take to take to physically feel better. These are signs of physical dependence, and you should probably seek medical attention first, before you tackle the psychological dependence, which is what we talk about here on the podcast. Everybody has to make that decision for themselves. But certainly for myself, I never experienced physical symptoms. I was a moderate mild to moderate severe alcohol use disorder, although I was a heavy drinker. And again, I've talked about that numerous times on the podcast, but nine out of 10 of us do not fall under the category of physical dependence. And so it's important to to be mindful of that you may not, you probably don't have physical dependence, even if you are a heavy drinker. Okay, back to alcohol and genetics. What does the research show us about alcohol abuse and genetics? Some of the most cited research studies on this subject are studies that are done on twins. And in fact, Dr. David Nutt in his book drink the new science of alcohol in your health, which I will link in the show notes and I've shared both on the podcast and in my book. He shares that it was a Danish study done in the 1950s that actually spurred his interest in alcoholism. He says, quote, one of the reasons I got interested in alcoholism was reading about Danish adoption studies from the 1950s and 60s, on the children of alcoholics. It showed that these children's risk of becoming alcoholics as adults was the same whether they were brought up in a drinking family, a normal family or an abstinent family. This strongly suggests some inherited basis for alcoholism, rather than it being a behavior learned from an alcoholic parent. He goes on to say, but you don't just inherit alcoholism. In many cases, you inherit one or more of the various different traits that make it more likely you'll be addicted, for example, impulsivity, or conduct disorder, as shown by more recent studies on twins. So one of the most important findings on vulnerability to alcoholism came from research on the sons of alcoholics by Professor Mark schukat, at the University of California at San Diego. And so, it said that it found that male children of male alcoholics had significantly higher rates of alcoholism than the general population. And more detailed analysis of those boys found that they seem to have an inherited have inherited a tolerance to alcohol, possibly even from the first time they drank it. This meant they were able to tolerate higher amounts than their peers. Yet despite Being to some extent pre tolerant, they were more likely to be alcoholic, it could be that they got some kind of prestige from being able to drink more, or that they just found it easy to drink more than their friends. And this made them vulnerable. Or it could be that they're heavier drinking produced other changes in the brain that lead to dependence and alcoholism. This is what Dr. Net says I believe the trait being passed on sub sensitivity to alcohol may be due to an alteration in the GABA system, and GABA that's referring to GABA and glutamate, glutamate the neurotransmitters. So basically, there's two studies here, there's different studies here we're talking about. So there's a twin study that kind of shows that there's potentially an inherited some sort of genetic basis for alcoholism, because the twins that were raised in separate homes and under different families had a equal chance of being alcoholics. And then also it shows in this additional study that children of male alcoholics had a higher tolerance may have inherited a higher tolerance. So, again, this is showing that there is potentially some genetic link, right, some genetic link. And according to a study by the National Institute on Alcohol Abuse and Alcoholism, an estimated 40% 40 to 60% of factors that influence alcoholism, are genetic. This means that people with a family history of alcohol addiction are up to 50% more likely to develop this condition than those with no genetic influences. The following are ways in which genetics may increase the risk of alcoholism. One varied serotonin levels, abnormal levels of serotonin in the brain have been linked to a genetic predisposition to alcoholism. to lack of warning signals. A person who has a genetic history of alcohol addiction may interrupt the warning signs of too much alcohol differently. Little or no bodily or mental warning signs may be experienced by people predisposed to alcoholism, three smaller parts of the brain. Some studies have shown that individuals who are predisposed to alcoholism have smaller amygdala is the amygdala is a part of the brain believed to be linked to cravings and emotions and for predisposition for mental illness. Many mental illnesses are believed to be genetic having a mental health disorder can increase the risk of alcohol addiction by up to 50%. So there is no one gene that predetermined a person's risk for alcohol addiction. Rather, hundreds of genes can work to increase someone's predisposition to alcoholism. how a person responds to these genes, as well as countless environmental factors are what determines whether he or she develops alcohol use disorder. You can also and here's some some good news, you can also inherit a tendency to be less likely to become an alcoholic. And probably the best known tendency for protection comes from the alcohol flushing reaction. One estimate is that 70% of East Asians, Japanese, Chinese, Taiwanese and Korean ethnic groups have had groups have this and 5% of European ethnic groups. And we know that Chinese people have lower rates of alcoholism and reduced rates of the toxic effects of alcohol such as cirrhosis and liver cancer too. If you have this trait, you will have a variant of the gene aldehyde dehydrogenase that slows down the breakdown of the alcohol byproduct, acid aldehyde, which is a poison, which is what makes you flush and sweat as well as give you a headache, nausea, nausea and speeds up your high heart rate. Side note, it's the alcohol treatment, di su for RAM, which is also known as anti abuse. It also blocks this enzyme which is why people who take anti abuse get all those symptoms, right so you basically get the same effect, as if you had this variant of the gene when you take and abuse. It is estimated that while there are over a dozen genes that contribute to the tendency towards alcohol abuse, each on its own shows unlimited correlation to alcoholism without environmental stressors. Therefore, the more genes present, the higher the likelihood is of developing alcohol use disorder, and thus we can infer that genetics do play some role. Some recent advances in technology have made it possible to measure changes in all the genes in the body. This is called whole genome analysis. Analyzing data from about half a million people a team from the Imperial College London which is where Dr. David Nutt is a professor found four already six new genetic markers linked to alcohol intake, which together accounted for 7% of the variation in people's total drinking. The team also identified genetic pathways shared between alcohol intake and brain networks associated with psychiatric disorders such as schizophrenia. Through all of this evidence, a person's genetics account for only an estimated half of a person's risk of developing an alcohol addiction. Having a genetic predisposition for alcohol addiction does not automatically many mean you will become an alcoholic. And the more important understanding for me was that my genetics was not causing me to crave alcohol more. I want to highlight here that the science in terms of craving and whether or not there is a genetic association with cravings as it relates to alcohol use disorder is not clear or conclusive. Some of the latest studies came about because of the decision to include craving as a diagnostic tool in the DSM five. And again, I will link the DSM five in the shownotes. I've, I've shared it in my book, I share it all the time here. The studies couldn't show a genetic link to cravings, only that people who expressed severe alcohol use disorder had cravings. The science actually was weak at lower levels of alcohol use, but with strong with higher levels of alcohol use. So this which suggests to me that the cravings might be more of a symptom of a physical dependence, as opposed to being a predictor. But again, the science here is inconclusive. The DSM five tries to articulate the feeling of craving as a diagnostic criterion for alcohol use disorder. The question is, have you in the past year, quote, wanted to drink so badly that you couldn't think of anything else? Unquote. And reminder, the DSM five is largely based on the behavioral aspects of abusing alcohol, and only one of the criteria is focused on physical withdrawal symptoms. There are 11 criteria for alcohol use disorder with the timeframe of the past year. If you answer yes to six of the 11, you are considered to have severe alcohol use disorder. So before we talk about addictive personalities and those genetics, I want to review what the data I've shared here suggests, is there a genetic component to alcohol abuse and alcohol use disorder? Yes, while there is not one alcoholic gene, there are combinations of genes that may predispose you to abusing alcohol. However, and this is a big However, that does not mean you are pre determined. Having these genes does not mean you will become an alcoholic. I would make this comparison ladies, most of us have probably heard of the BRCA gene mutation and increased odds of developing breast or ovarian cancer if you have these gene mutations. actress Angelina Jolie made a very public decision to have a double mastectomy and an Ooh hoo hoo correct me because she has those gene mutations. Here is what science says about the BRCA BRCA gene mutations, about 50 out of 100 women with a BRCA one or BRCA two gene mutation will get breast cancer by the time they turn 70 years old. That's compared to only seven out of 100 women in the general United States population. So 50 out of 100, half, fully half. If you have those gene mutations will develop breast cancer as compared to only seven out of 107% that 2% Chance versus 7%. And about 30 out of 100 women with BRCA one or BRCA two gene mutation will get ovarian cancer by the time they turn 70 years old, compared to fewer than one out of 100 women in the general US population. So in this instance, there is a very clear, specific and increased disease risk from a genetic link. This is not what the genetic links to alcohol abuse say at all. Just because you come from a family of alcohol abuse, it does not mean that you will abuse alcohol if you drink. Alcohol Use Disorder is progressive. And anyone regardless of their genetics, can with time and repetition, become psychologically and then physically dependent on alcohol. You are not genetically wired to desire alcohol more just because you are an adult child of an alcoholic. Could genetics be a factor? Yes, but even if they are, they likely account for no more than 50% of your behavior. other external factors account for the The other 50% and I'd actually propose that that 50% external, which is anchored in lifestyle, may be even more important. So, the thing is to that even the 50% that might have a genetic influence won't be expressed. If you choose how to include alcohol in your life and understand the science of alcohol itself, your mindful decisions around alcohol matter. We aren't simply our genes. Behavioral epigenetics seeks to explain how nurture shapes nature, where nature refers to biological heredity, and nurture refers to virtually everything else that occurs during the lifespan. For example, social experiences diet and nutrition exposure to toxins, toxins. Behavioral epigenetics attempts to provide a framework for understanding how the expression of genes is influenced by experiences and the environment to produce individual differences in behavior, cognition, personality, and mental health. Clearly, behavioral epigenetics is a whole nother podcast, but just know that there is a neuroscience study that supports both nature and nurture. All right, let's touch briefly on addictive personalities you've definitely heard this term thrown about. And here is what I can tell you about the science here. Of the 30,000 genes in the body, about 89 are linked to an addictive personality. Of these 89 genes. 21 are linked to triggers and desires for using. So out of 30,000 genes in the body 21 Only are linked to desires for using genetics are a factor, but it's not the only factor. Other influences such as environment also play a large role. It's kind of a theme, right? For everything, whether it's addictive personality or genetics and alcohol abuse. genetics may play a role, but they are not the only factor. The fiction is the concept of a specific addictive personality. Most researchers in addictive addiction today would caution against the idea of a single generic personality that is prone to addiction. In fact, some seemingly disparate traits can lead peep different people to become addicted to alcohol, or drugs, depending on other factors. Did you hear that seemingly disparate traits so opposite traits can lead different people to become addicted to drugs or alcohol, depending on other factors. While there are several different types of traits that can be recognized in individuals who develop substance use disorders, they are not all present in every person who becomes addicted. Therefore, the image that some people see of the socially Outcast criminal is an accurate version of the individual who becomes addicted to drugs or alcohol. In popular culture, this addictive this subconscious image of the addictive personality is the individual who is considered all but destined to develop a substance addiction. And, of course, it's not a surprise that because of that pop culture image. People are worried about developing an addiction to drugs or alcohol often try to figure out what the traits of an addictive personality might be. They want to know what to watch for either to absolve themselves of this label or to give themselves a reason never to start using alcohol or drugs to begin with. However, the simple fact is that this whole idea is based on a mix of truth and fiction. There is no question that genetic makeup has at least some effect on a person's risk of developing addiction. As described by many studies, having a close family member who is struggling with addiction can make it more likely that you will develop an addiction as well. In fact, certain portions of the human genome have been identified as having a direct connection to specific addictions. Still, genetic potential is no guarantee that an individual will develop addiction. Other complex environmental factors also contribute to the potential that a genetic predisposition will become a true substance use disorder along with genetic connection, other individual health traits that can correspond with a higher risk of addiction is the presence of pre existing mental health disorders. People who struggle with various mental health disorders can are likely more likely to abuse and become dependent on alcohol. These conditions include but would not be limited to depression, bipolar disorder or other mood disorders, anxiety or panic disorders, post traumatic stress disorder schizophrenia and other psychotic psychotic disorders, and antisocial personality disorder. So, what does all of this mean for those of us who want to create a peaceful relationship with alcohol, when it really comes right back to our brains and understanding why we're drinking alcohol in the first place. In the very first episode of this podcast, I said that I wanted to increase the understanding of emotional numbing, and why I believe that not using alcohol to numb away negative emotion is essential and changing your drinking habits and creating a peaceful relationship with alcohol. To be clear, I am not suggesting that processing negative emotions is the same as treating a mental health disorder. And as with any medical condition, mental health disorders require diagnosis, and treatment by a medical professional. If you suffer from mental health disorders, please seek appropriate medical help. All right, my friends, this has been a lot of information. And I just want to wrap it up by saying this, believing that I was genetically wired to crave alcohol more was not a belief that served me. I believed that thought for so long for so many years, it went unchallenged, that my drinking habits seemed like a natural consequence. And something that felt unbreakable. As hopefully I hope I've helped you see here today, that thought wasn't true. And it wasn't helpful. Might I have some genetics that put me at risk for developing alcohol use disorder? Yes. But that does not mean that it's predetermined. And when I figured out that it was actually my own thoughts, that were creating my desire for alcohol, and that I had the power to change my drinking habits and I wasn't at the mercy of the quote unquote, alcoholic gene. It changed everything. It changed what I believed it changed my habits, and it changed my relationship with alcohol. That's all I have for you this week. And until next time, choose peace, my friends. Thank you for listening to breaking the bottle legacy. This podcast is dedicated to helping you change your drinking habits and to create a peaceful relationship with alcohol. Take something that you learned in today's episode and apply it to your life this week. Transformation is possible. You have the power to change your relationship with alcohol. Now, for more information, please visit me at www dot Molly watts.com
