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Am J Psychiatry 1994; 151:184-189
Copyright © 1994 by American Psychiatric Association
Low level of response to alcohol as a predictor of future alcoholism
MA Schuckit
Department of Psychiatry, San Diego VA Medical Center, CA 92161.
OBJECTIVE: As part of a search for measurable attributes of an individual
that might be related to the risk of alcoholism, the author's group
previously compared 227 sons of alcoholics and 227 matched comparison
subjects at the age of about 20 years. Forty percent of the men at high
risk for alcoholism and less than 10% of the comparison subjects
demonstrated a low intensity of response to alcohol challenge. This article
reports the results of the follow-up of the first half of this study group
almost a decade later. METHOD: Of the men who had been tested at about age
20, 223 were about age 30 at this evaluation, which included personal and
resource-person interviews, record searches, urine toxicology screens, and
blood level markers of drinking. RESULTS: A low level of response to
alcohol at age 20 was associated with a fourfold greater likelihood of
future alcoholism in both the sons of alcoholics and the comparison
subjects. Fifty-six percent of the sons of alcoholics with the lesser
alcohol response developed alcoholism during the subsequent decade,
compared to 14% of the men in this group who had highly sensitive alcohol
responses. Neither family history of alcoholism nor response to alcohol
predicted any other psychiatric diagnoses over the subsequent decade, and
neither was a significant predictor of any other substance use disorder.
CONCLUSIONS: In a heavy-drinking society, a lower sensitivity to modest
doses of alcohol is associated with a significant increase in the risk of
future alcoholism, perhaps through increasing the chances that a person
will drink more heavily and more often.
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