Swedish Study: Alcoholics Predisposed to Addiction Relapse More Frequently
Here is a new addition to my “Dopamine for Dummies” series. Bear with me. I have tried to make this important information easily accessible to laymen like myself.
You will remember that in 1990, when Dr. Kenneth Blum, PhD and Dr. Ernest Noble, PhD found the first official link between genetics and addiction, they were focused on the DRD2 gene, originally called the “alcoholic gene” by the media but correctly called the “reward gene” in their “Journal of American Medical Association” article. Many years of additional research have stemmed from that seminal study, confirming the original findings.
The results of a pilot study were published in the current edition of “Alcohol and Alcoholism”. Research scientists from the Department of Psychology at Sweden’s University of Gothenburg, studied the relapse rate of adults diagnosed as “alcohol dependent.” The number of people studied was small — 10 women and 40 men recruited from two Swedish 12 Step programs. All 50 participants were required to provide blood for genotyping, and to be without severe on-going physical and psychiatric disorders other than alcohol and nicotine dependence.
Variations of a gene are called polymorphisms. In this study only the Taq1A polymorphism of DRD2 “alcoholic” gene was studied.
18 of the 50 alcoholics were found to carry the Taq1 1A polymorphism. The other 32 alcoholics were not carriers.
The study found that after one and a half years, 33 of those who participated in the study had relapsed. 16 of the relapsers carried the Taq 1 1A polymorphism — meaning that only 2 of the 18 genetically pre-disposed to addiction did not relapse. In other words 89% of the subjects that carried the DRD2 A1 allele relapsed. That is a very big and sad number.
By comparison only 53% of those who do not carry the gene (17 of the 32) relapsed.
None of those who relapsed were found to have been triggered by the influence of psychological or socio-demographics. Additionally the study revealed no differences between those who relapsed and those who did not in terms of self-efficacy, mental health, stress, personality, and cravings.
The University of Gothesburg authors concluded that their study suggests an association between the DRD2 gene and relapse. They suggest that other polymorphisms of the DRD2 gene now be studied.
The authors of the study wrote: “The reason for the increased relapse rate in the carriers of the [“alcoholic gene”] remains to be elucidated.”
Additionally – and this is important — they cite two recent studies. One demonstrated that carriers of the same gene variant have a “diminished drinking refusal self-efficacy” (translation: a diminished capacity to stop drinking). The other demonstated that healthy individuals who are carriers of the gene show “impairment in reversal learning situations. “
The authors concluded: “The two studies suggest that alcohol-dependent individuals who carry the ”alcoholic gene” can benefit from more intensive psychological treatment aimed to improve drinking refusal self-efficacy and learning to focus on maintenance of abstinence. The importance of improving treatment of the alcohol-dependent subjects who are carriers of the gene is seriously underscored by the findings of the highly increased mortality rate of those subjects.”
We agree. To achieve long term sobriety, alcoholics predisposed to addiction need to not only become part of the fellowship of Alcoholics Anonymous, but to seek treatment of their dopaminergic dysfunction.
NOTE: After I posted this blog Dr. Blum told me that the DRD2 gene has 7 polymorphisms, 4 of which occur frequently enough to be the subject of ongoing clinical testing about the relationship between the gene and relapse. He said he has identified more than 30 additional genes which show predisposition to addiction, some or all of which would also be important candidates for the studies on the likelihood of relapse.