Alcohol use disorder (AUD) can have a hereditary component, but not everyone living with AUD has a family history of AUD.

Alcohol use disorder (AUD) is a diagnosis once referred to as “alcoholism.” It’s a condition characterized by patterns of excessive alcohol misuse despite negative consequences and major distress in important areas of daily function.

According to the 2021 National Survey on Drug Use and Health, AUD affects approximately 29.5 million people in the United States. More than 800,000 of the people affected are children between the ages of 12 and 17 years.

Many factors are involved in the development of AUD, but having a relative, or relatives, living with AUD may account for almost one-half of your individual risk.

Your genetics can influence how likely you are to develop AUD, but there’s currently no evidence of a specific gene that directly causes AUD once you start drinking.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), a clinical diagnostic guidebook, indicates that AUD often runs in families at a rate of 3–4 times higher compared with the general population.

According to the DSM-5-TR, the more relatives you have living with AUD and the closer they are to you in relation, the higher your individual genetic risk becomes.

That doesn’t mean you’ll absolutely develop AUD if you have a family member living with the condition. You may have a higher genetic predisposition, but the underlying causes of AUD are multifaceted and complex.

What gene is responsible for increased AUD risk?

No single gene or genetic variant is solely responsible for AUD risk. Multiple genetic factors have been noted in research. The more genetic factors you have, the higher your risk may be of having AUD.

A 2023 study, for example, found a link between AUD and mutations in a group of genes previously identified for their role in neuronal plasticity and pain perception.

A review of studies from 2020, which looked at a genome-wide analysis of more than 435,000 people, found 29 different genetic variants that increased the risk of problematic drinking. Nineteen of those variants were previously unknown.

Your genetics don’t only increase your risk of AUD — they may have protective elements as well.

According to a review from 2016, genes that promote alcohol metabolism and the production of enzymes, such as alcohol dehydrogenase and aldehyde dehydrogenase, can be protective against AUD.

Having a close family relative, such as a parent, can account for up to 60% of your risk of developing AUD.

Genetics aren’t the only way your parents or caregivers can influence AUD risk. Living in a household where you’re regularly exposed to parental alcohol use can also increase your chances of AUD, regardless of your genetic predisposition.

What does genetic risk mean?

Your genetic risk refers to the likelihood that specific genes or genetic variants passed down to you will lead to a particular condition.

A genetic risk isn’t the same as having a genetic disorder. Genetic disorders are diagnosable conditions directly caused by genetic mutations that are inherited or occur later in life from environmental exposure.

While genetics can play a significant role in your overall AUD risk assessment, it isn’t the only factor that can elevate your chances of developing AUD.

Other risk factors for AUD include:

  • alcohol use at an early age
  • regular exposure to alcohol use by others
  • living with a mental health condition or experiencing an altered state of mental health
  • a history of trauma
  • chronic stress
  • being naturally impulsive
  • easy access to alcohol
  • lack of alternative coping mechanisms
  • cultural acceptance of alcohol use
  • homelessness
  • unemployment
  • low socioeconomic status

Just as risk factors increase your chance of experiencing a condition, protective factors lower your risk. Some protective factors, such as natural optimism, may remain fixed over time. Other factors, such as friend groups and level of financial security, may be subject to change.

When it comes to AUD, protective factors can include:

  • positive self-image
  • a high level of natural optimism
  • mindfulness
  • positive family support and parental involvement
  • access to after-school resources and community activities
  • limited access to alcohol
  • strong personal or spiritual beliefs against alcohol use
  • focus on personal health
  • friend groups that abstain from alcohol use
  • alternative coping strategies and opportunities
  • secure financial situation
  • higher socioeconomic status

What is socioeconomic status and why does it matter?

Your socioeconomic status is made up of economic and societal factors such as your income, level of education, employment, location of residence, and available resources.

Your socioeconomic status can directly affect your mental and physical well-being. If you live in a situation of poverty, for example, or in an area with limited resources, you may be less likely to have access to quality foods, community services, or adequate healthcare.

Was this helpful?

AUD isn’t directly caused by genetics, but genetics may predispose you to developing AUD later in life. This risk is considered hereditary and may be passed down to you if you have a family history of AUD.

While genetics can account for up to 60% of AUD risk, not everyone with a family history of AUD will develop the condition.

The causes of AUD are complex and can involve a variety of factors, including early exposure to alcohol use, peer group pressure, and living with other mental health conditions.