Alcoholism - Risk Factors

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Alcohol also affects the older body differently. People who maintain the same drinking patterns as they age can easily develop alcohol dependency without realizing it. It takes fewer drinks to become intoxicated, and older organs can be damaged by smaller amounts of alcohol than those of younger people. Also, up to one-half of the 100 most prescribed drugs for older people react adversely with alcohol. Medications used for arthritis or pain pose a particular danger for interaction with alcohol.

Gender

Most alcoholics are men, but the incidence of alcoholism in women has been increasing over the past 30 years. Studies indicate that 9% of men and 2% of women are heavy drinkers, and 23% of men are binge drinkers compared to 9% of women. In general, young women who are problem drinkers follow the drinking patterns of their partners, although they tend to engage in heavier drinking during the premenstrual period.

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Women tend to become alcoholic later in life than men, and it is estimated that 1.8 million older women suffer from alcohol addiction. Even though heavy drinking in women usually occurs later in life, the medical problems women develop because of the disorder occur at about the same age as men, suggesting that women are more susceptible to the physical toxicity of alcohol.

Genetics and Family History

Alcoholism often runs in families. The risk for alcoholism in sons of alcoholic fathers is 25%. The family link is weaker for women, but is still a factor in many cases. Genetics certainly play a role in many people with alcoholism, but negative alcoholic behaviors by the parents can also be significant contributors in the risk for alcoholism in the children. They often play off each other in a perpetuating and tragic spiral. A 2002 study, for example, reported that alcoholic parents have a higher risk for being separated from their children, and such children then face a higher risk for alcoholism in adulthood. (A stable family and psychological health, however, cannot fully protect a person with a genetic risk.) Unfortunately, there is no way to predict which members of alcoholic families are most at risk for alcoholism.

History of Abuse

Individuals who were abused as children have a higher risk for substance abuse later on. In a 2003 study, for example, 72% of women and 27% of men with substance abuse disorders reported physical or sexual abuse or both. They also had worse response to treatment than those without such a history.

Ethnicity

Overall, there is no difference in alcoholic prevalence among African-Americans, Caucasians, and Latin Americans. Some population groups, however, such as Irish and Native Americans, have an increased incidence of alcoholism while others, such as Jewish and Asian Americans, have a lower risk. Although the biological or cultural causes of such different risks are not known, certain people in these population groups may have a genetic susceptibility or invulnerability to alcoholism because of the way they metabolize alcohol.

Psychiatric and Behavioral Disorders

Psychiatric Disorders. Severely depressed or anxious people are at high risk for alcoholism, smoking, and other forms of addiction. In a major study of alcohol-dependent people, 78% of men and 86% of women also suffered from an accompanying psychiatric or substance abuse disorder. Either anxiety or depression may increase the risk for self-medication with alcohol.

Depression is the most common psychiatric problem in people with alcoholism or substance abuse. Estimates of depression in people with alcoholism are as high as 67%. Studies have reported depression accompanies about one-third of all cases of alcoholism. According to a 2000 study, for instance, the risk for heavy drinking in women who are depressed was 2.6 times greater than the risk in women who are not depressed.