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Risk, Prevention, and Epidemiology

What is the prevalence of alcohol use and alcoholism?

What is the risk of inheriting alcoholism?

What other risk factors are associated with alcoholism?

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What is the prevalence of alcohol use and alcoholism?

Prevalence refers to the current number of people suffering from an illness in a given year. This number includes all of those who have been diagnosed in prior years as well as in the current year. Per capita alcohol consumption has declined from its peak in 1980 of 2.8 gallons per year to its current level of about 2.2 gallons. Rates vary regionally and are higher in New England and lower in the Midwest and Southeast, with Florida as the exception. Amounts peak in the 18- to 29-year-old group and then gradually decline.

Currently, nearly 14 million Americans, or 1 in every 13 adults, abuse or are dependent on alcohol.

Currently, nearly 14 million Americans, or 1 in every 13 adults, abuse or are dependent on alcohol. About 4.6 million of these individuals are women. When considering percentages, the following apply to the U.S. adult population:

• Current drinkers: 44%

• Former drinkers: 22%

• Lifetime abstainers: 34%

• Abuse and dependency in the past year: 7.5% to 9.5%

• Lifetime prevalence: 13.5% to 23.5%

• Adult hospital inpatients: 20%

• Emergency room visits that are associated with alcohol: 10% to 46%

• Patients in community-based primary care practices who engage in at-risk drinking: 1 in 6

• Traffic fatalities in 1998 that were related to the presence of alcohol in one or more of the accident participants: 38%

• The U.S. adult population who were currently abusing or dependent on alcohol and that had received any treatment in the 12 months before interview: 10%

• Individuals with a past diagnosis of alcohol dependence who reported ever having any kind of alcohol treatment: 28%

• People who recovered from a previous alcohol disorder and who did so without having received any treatment (often termed "natural recovery"): 75%

• Costs for alcoholism each year in the United States: $185 billion

In contrast to the U.S. statistics, the WHO examined mental disorders and found that alcohol dependence or harmful use was present in 6% of patients evaluated in primary care offices worldwide. In Britain, one in three patients in community-based primary care practices had at-risk drinking. Alcoholism is more common in France than it is in Italy, despite virtually identical per capita alcohol consumption.

What is the risk of inheriting alcoholism?

Increasingly, all kinds of conditions or diseases are attributed to genes. What exactly does this mean? Genes are a series of molecules that are passed on from parents to children. They provide a code for proteins. Proteins are the workhorses that make people into who they are physically, cognitively, and behaviorally. The question of what genes do in coding for people's personalities and behavioral propensities has never been completely understood. The cascade of interacting effects that begins with a series of genes transcribed into a protein that ultimately leads to a propensity toward alcoholism is too vast to be fully elucidated. Consider a simple trait that is fully determined, such as eye color. Even in the instance where the likelihood of two blue-eyed parents having a blueeyed child is almost certain, it remains possible for them to have a brown-eyed child possibly due to local environmental, albeit biological, effects. Environment actually entails not only what people commonly think of including their culture, nationality, occupational choices, friends, family, how many bars and liquor stores are available, but also local cellular environments that include other genes, proteins, and various chemicals interacting on a specific gene — then one begins to appreciate the complexity of the question. It is difficult enough to work out the influence that genes have on physical structures. No scientist has yet to predict with 100% accuracy how genes determine the developmental biology of even simple organisms. Genes are not a blueprint in the way that blueprints are conceived. If biological development is so fraught with unpredictability, imagine the degree of difficulty in being able to predict behavioral problems as a result of genetic influences.

Gene a specific sequence of nucleotides in the DNA and RNA, which is a unit of inheritance that controls the transmission and expression of specific traits in people and other living organisms. Scientists and clinicians believe that alcohol dependence and abuse is influenced by genetic factors.

Mendelian the central tenets of genetics developed by Gregor Mendel. They relate to the transmission of hereditary characteristics from parent organisms to their children; they underlie much of genetics.

Muscular dystrophy a group of heritable diseases characterized by the progressive wasting of muscles.

Cystic fibrosis an inherited disease found in Caucasians that appears early in childhood.

Phenylketonuria an inherited metabolic disease that causes mental retardation because of the inability to oxidize the metabolic product of phenylalanine.

Down's syndrome a person with Down's syndrome is mentally delayed and has characteristic facial features.

 
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