Research Points to Test for Alcoholism Risk

From the WebMD Archives

March 22, 2000 (New York) -- Researchers have shown that a blood test for a substance in the body called beta-endorphin done after drinking alcohol may indicate who has a genetic risk for developing alcoholism. The results support a growing body of evidence that when drinking, alcoholics have enhanced stimulation in certain parts of their brain's chemical system. The research appears in the March issue of the journal Alcoholism: Clinical and Experimental Research.

Lead author of the study, Janice C. Froehlich, PhD, says she is often asked why a person would want to know if they were at increased risk of alcoholism. "The question of whether or not you'd want to be tested for alcoholism is the same essentially as whether you'd want to be tested for any other disease. ... With alcoholism, the individual actually has a chance to prevent the development of the disease by staying away from alcohol. ... [Knowing their risk] gives the individual more freedom and more control over their own destiny than would a test for diabetes or cancer." Froehlich is professor of medicine at Indiana University School of Medicine in Indianapolis.

"We know that a large proportion of the risk for alcoholism is genetic rather than environmental. The question becomes, 'What do you inherit when you inherit a predisposition to drink alcohol?'" Froehlich tells WebMD. She explains that researchers have been trying to determine various bodily responses to alcohol in order to identify what leads to the development of alcoholism.

Froehlich explains that beta-endorphin is released in response to drinking alcohol. It acts like morphine to produce feelings of well-being and euphoria. "The current thought is that release of [beta-endorphin] during alcohol drinking may contribute to the high you get from alcohol, particularly right after you drink," says Froehlich.

Blood levels of beta-endorphin were tested in 88 pairs of twins. The results showed that beta-endorphin levels were strongly inherited. That is, the responses of identical twin pairs were much more similar than the responses of fraternal twin pairs

"We wouldn't suggest that people run out and get blood tests of their beta-endorphin response to alcohol yet," says Froehlich. She suggests that it may be used as part of a battery of tests that could help identify those individuals at risk for developing alcoholism. "If we could start early intervention programs and counseling, that might serve to decrease the probability that those individuals would become addicted to alcohol."

Christina Gianoulakis, PhD, a researcher in this area from McGill University, agrees that beta-endorphin may prove to be a marker for vulnerability to alcoholism but also sees it as one of many tests that should be used.

"At the present time, my opinion is that there is not a single marker than can be used to diagnose people who could develop alcoholism in the future," Gianoulakis tells WebMD. She was not involved in the study.

When asked for his opinion of the Froehlich paper, Gary Wand, MD, a professor of medicine and psychiatry at the Johns Hopkins School of Medicine in Baltimore, says the study "comes close to being the last nail in the coffin in testing whether [this system] really creates a vulnerability to alcoholism and is involved in heavy alcohol drinking.

"I'm not that interested in the use of beta-endorphin as a marker. We already know, just by taking a history, that the children of alcoholics have between a four- and tenfold risk of developing alcoholism. That's enough of a marker for me to say we should be counseling children of alcoholics and saying that even if you carry some genetic baggage for alcoholism, it's not a fait accompli that you will become alcoholic," says Wand.

Wand believes the power of the findings concerning beta-endorphin lies in its potential to increase the understanding the mechanisms behind alcoholism. He says this study should provoke the government and pharmaceutical companies to pursue drug development to treat alcoholism through the beta-endorphin pathway.

Vital Information:

  • Drinking alcohol triggers the release of a substance called beta-endorphin, which produces feelings of well-being. Researchers think this chemical activity may contribute to the high that drinkers feel from using alcohol.
  • After studying identical and fraternal twins, researchers report one's beta-endorphin response is inherited and may identify people at increased risk of alcoholism.
  • Observers note the study tells more about how the body reacts to alcohol. But beta-endorphins don't tell the whole story about one's risk of alcoholism, and simply asking patients about the disease in their family is an effective way to find people at increased risk.