A Common Issue Today
Alcohol is the most prevalent substance used in the United States, and a substantial minority of individuals cannot control their drinking. Alcohol dependence affects 12.5% of people in their lifetimes, with approximately 4% affected at any given time. Alcoholism can wreak havoc on a person’s body; it is associated with depression, anxiety, malnutrition, cirrhosis of the liver, chronic pancreatitis, cancer, and nervous system damage.
Over time, chronic alcohol abuse changes brain circuitry and can impact cognitive abilities. But alcoholism does not just affect the individual who drinks. Family members are profoundly affected by alcoholism, as alcoholics have mood and interpersonal problems that spill into family dynamics. If your family has a history of alcoholism, it is important to think carefully about your own relationship with alcohol as well as to develop strategies to cope with challenging family dynamics.
Know the Symptoms of Alcoholism to Ensure Your Mental Health
The Diagnostic and Statistical Manual of Mental Disorders sets forth criteria for alcohol dependence that many medical practitioners use to diagnose the condition.
Individuals with alcohol dependence manifest three or more of the following symptoms:
- Alcohol tolerance, defined by a need for increasingly greater amounts of alcohol to become intoxicated or a diminished effect when drinking the same amount of alcohol over time.
- Withdrawal symptoms, which may include sweating, racing heart, insomnia, nausea or vomiting, hand tremors, hallucinations, anxiety, seizures, or psychomotor agitation. Some alcoholics never develop withdrawal symptoms, because they continue drinking to avoid these effects.
- Using larger amount of alcohol than intended.
- Persistent desire or unsuccessful attempts to stop using alcohol.
- Spending a large amount of time obtaining, drinking, or recovering from the effects of alcohol.
- Reducing time spent doing activities (such as job responsibilities, social obligations, or hobbies) because of alcohol use.
- Continuing to drink despite having physical or psychological problems related to alcohol use.
If you or a loved one meets these criteria, alcoholism may be a problem. Some evidence suggests that alcoholism runs in families, making it essential to observe these symptoms and seek help when needed.
Get the Facts: The Genetic Basis of Alcoholism
In many families, multiple family members struggle with alcoholism, suggesting that alcohol dependence is partially genetic. Scientific studies following twins and children of alcoholic parents have found that genetic influences increase risk of alcoholism. However, this does not mean that there is a single “alcoholism gene.” Numerous genes are associated with alcohol use disorders, and many more years of research are needed to identify how they interact with one another. Dozens or even hundreds of genes may affect an individual’s risk of developing alcohol problems.
This also does not mean that individuals with a family history of alcoholism are doomed to experience the same problems. More than half of children with alcoholic parents do not suffer from alcohol-related problems. The interactions between genetic factors and environmental influences are very complex, and scientists are just beginning to disentangle the factors that affect susceptibility to alcoholism.
Making Difficult Choices about the Role of Alcohol in Your Life
Certain factors are associated with a greater propensity to develop alcohol-related problems in adulthood. Underage drinking has been shown to increase risk for alcoholism. This effect is partially due to genetic risk, but environmental factors also play a strong role. Try to cultivate friendships and social activities that do not include drinking, which reduces temptation to engage in underage drinking.
Enjoy Alcohol in Moderation — Or Consider Abstaining Entirely
The choice to drink alcohol is a very personal one, and many factors may influence your decision. Some individuals with a family history of alcoholism decide that drinking in moderation is fine for them, while others prefer to completely abstain from alcohol use. Remember that the guidelines for moderate, healthy alcohol consumption are no more than one drink per day for women and two drinks per day for men.
Before making a decision, consider several factors:
- Do you feel comfortable drinking alcohol given your family history, or might it bring up emotional baggage that you need to untangle?
- Are you comfortable being around other people drinking? What if your significant other or spouse drinks (in moderation)? Perhaps dating someone who drinks heavily would make you uncomfortable, but you’re fine if your significant other has a few drinks on occasion. Knowing your limits and comfort zone helps you establish boundaries to use in your social life.
- Have you tried other substances (such as cigarettes) and found it difficult to control your use? Some evidence suggests that alcohol addiction is related to addiction to other substances. Struggling with addiction to other substances may be a sign that alcohol misuse could be a problem for you.
- Do you have positive role models in your life who are moderate drinkers? Surrounding yourself with people who enjoy alcohol in moderation makes your choice to drink or abstain easier. In contrast, having a peer group that drinks heavily increases your exposure to social pressures that may change your drinking behaviors.
- Can you commit to moderate alcohol consumption and avoid binge drinking? Binge drinking is defined as having five or more alcoholic beverages (four or more for women) on a single occasion. Scientific evidence suggests that binge drinking, combined with a family history of alcohol abuse, increases your likelihood of developing alcohol abuse or dependence. If you choose to drink, avoiding binge drinking and keeping your alcohol use within moderate limits decreases your risk of alcoholism.
- Are you comfortable defending your decision to drink — or not — to others? Drinking is strongly intertwined with many social situations, such as New Year’s Eve or bachelor parties. Choosing to drink or abstaining from alcohol may cause others to challenge your decision. Being comfortable briefly yet firmly reiterating your choice makes these social situations easier to navigate.
Seek Professional Help
Even if you do not struggle with alcohol problems, having a family history of alcoholism can be challenging to navigate. Consider seeing a therapist who specializes in working with family members of alcoholics. A therapist can help you unpack your complicated feelings about alcohol and make decisions that are appropriate for your situation. Even if you’ve made peace with your genetic risk factors and family history, certain social situations may trigger uncomfortable feelings. Seeing a mental health care professional can help you cope with the difficulties of having alcoholic family members.
Family History Matters
Make sure you also mention your family history of alcohol to your medical provider. Discussing your risk for alcoholism with a doctor or nurse can help you make an educated choice about whether drinking is safe for you. Your care provider can also help you monitor your alcohol use, noting changes in your drinking pattern that may signal alcohol abuse or dependence.
There are dozens of factors to consider if you have a family history of alcoholism. Above all, remember that a family history of this disease does not doom you to have problems with alcohol use. Many individuals with alcoholic family members are able to drink in moderation without problems. Carefully consider your alcohol use and discuss your choices with a doctor or mental health professional to ensure that you stay safe and healthy.