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Genes explain about 60 percent of the risk for alcoholism, while the environment accounts for the rest, according to an expert who has developed a pilot program to prevent high-risk drinking in college freshman. Marc A. Schuckit, MD, Distinguished Professor of Psychiatry at the University of California, San Diego, based the first evaluation of a prevention program on his 30 years of research in the field, with more than 400 families.

Dr. Schuckit recently discussed how genes and the environment relate to the risk for alcoholism at the Association for Medical Education and Research in Substance Abuse annual meeting. He explained the risk factors that impact alcoholism. “Genes operate through these risk factors,” he notes.

Dr. Marc A. Schuckit

One risk factor is having a low sensitivity to alcohol. “Some people are a good deal less sensitive to alcohol from the very first time they drink,” Dr. Schuckit says. “They require higher doses of alcohol to get the effect they want.” Low sensitivity to alcohol is seen in groups of people at high risk for alcoholism, including children of alcoholics and Native Americans, he adds. Low sensitivity to alcohol predicts alcoholism and alcohol-related problems, he says.

This low sensitivity interacts with factors in the environment that magnify the risk, such as associating with heavy-drinking peers, higher levels of life stress and using alcohol to cope with that stress. During the course of his research, Dr. Schuckit has identified four genes related to the low response to alcohol.

His pilot program for 64 students, which he has tested with incoming freshman at the University of California, San Diego, used a questionnaire to identify those with low-and high-alcohol responses. All the selected students, including equal numbers of those with low-and high-alcohol responses, participated in one of two prevention programs, one with an emphasis on how the low response leads to heavy drinking, and one with general information on how to decrease drinking but no mention of the low response. Those students who had a low response to alcohol decreased their drinking more when in the first program compared to the more general education sessions. “The program looks very promising,” he said. “It helps students realize their specific risk and to modify their drinking.”

The study results, published earlier this year in Alcoholism: Clinical & Experimental Research, suggest that tailoring prevention efforts to address specific predisposing factors, such as a low response to alcohol, may help reduce these students’ drinking. He is planning on beginning a much larger, potentially more definitive study in 2013.

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