The Etiology of Alcoholism: A Working Hypothesis Involving the Interplay of Hereditary and Environmental Factors

Abstract

A working hypothesis of the etiology of alcoholism is presented which postulates that while cultural influences may in a sense be responsible for the development of alcoholism, they probably are not able to operate in this direction unless the individual is metabolically susceptible to alcoholic craving. The hypoth-csis is based on the distinctiveness of the metabolic patterns of individuals in general, for which there is abundant scientific evidence, especially from recent work in the field of biochemical genetics. Variability in drug responses are extremely common because of this individuality in metabolic patterns, and the variable physiological action of alcohol is entirely in line with this and probably has a similar basis. There are numerous appetites, and some aversions, which have some biochemical basis and the development of an extreme appetite for alcohol in some individuals and not in others is in keeping with what is known about other appetites. The total arnt. of physiological investigation which has been directed to the question of why certain individuals crave alcohol to excess is very small. To find the answer to this crucial question attention will have to be directed to distinctive physiologies of individual people rather than to the physiology of the hypothetical average man. The physiological differences which individual people exhibit must constitute the observational data from which the answer is to be derived. To date the physiology and biochemistry of individual differences has never been seriously studied.