Is alcoholism a familial trait?

Recent studies have shown that genetic trait contributes to progression from social drinking to alcoholism in about 50% of individuals. Alcoholism is often a familial trait. Differences in sensitivity of various neuronal systems to alcohol among 'predisposed' and 'not predisposed' individual have been demonstrated.

There is no single reason for why people drink. Diverse feelings and behaviors are provoked by alcohol in different individuals and in the same individual on different occasions. Alcohol can make people happy as well as sad, curious as well as mean, talkative as well as silent, friendly as well as hostile. All this cannot be explained on the basis of pharmacological actions alone. Attitudes, beliefs, peer groups, social setting and learned experiences all have a bearing. Alcohol is said to produce good mood, sense of well being, self-confidence, sociability etc. But these in fact are learned behaviors. Drinking is often related to 'celebration' and 'high living'. There is 'wine sobbery' in high social groups.


To some, excess excitement of risk taking. People often boast of their capacity to drink. To the young, drinking many be symbol of rebellion against the oppressive older generation and rejection of the values of the establishment. 'Binge drinking' is a specific behavioral pattern of bouts of excessive drinking. Alcohol is often an excuse for bad behavior. Society's view that intoxicated person is unaware of his actions- makes intoxication an attractive state, because there is increased freedom of what one can say or do after drinking. Thus, there is variety of motivations for drinking.

Pathology caused by alcohol drinking

Delirium tremors: This results from the long continued action of the poison on the brain. It occurs in chronic alcoholics due to
(1) Temporary excess (2) sudden withdrawal (3) shock after receiving an injury, such as fracture of a bone, or (4) from acute infection, such as pneumonia, influenza, erysipelas etc

It typically begins 72 to 96 hours after the last drink. There’s an acute attack of insanity in which the main symptoms are coarse muscular tremors of the face, tongue and hands, insomnia, restlessness, loss of memory, agitation, confusion, disorientation, uncontrollable fear and has tendency to commit suicide, homicide or violent assault or to cause damage to property. Other symptoms are diarrhea, dilated pupils, fever, tachycardia, tachyapnoea and hypertension. There is disorientation as to time and place and a peculiar kind of delirium of horrors owing to hallucination of the sight and hearing. The patient imagines that insects are crawling under the skin, or snakes are crawling on his bed it is considered unsoundness of mind and not intoxication. Death occurs in about 5 to 5$ of the cases. To control agitation diazepam should be given

Alcoholic Polyneuritis and Korsakoff’s Psychosis: The symptoms of Polyneuritis are weakness; pain in the extremities, wrist and food drop, unsteady gait, loss of deep reflexes and tenderness of muscles of arms and legs

Alcoholic paranoia: In this there are fixed delusions but no hallucinations. The person becomes deeply suspicious of he motives and actions of those he meets and of his family members.

Acute Alcoholic hallucinations: Persistent hallucinations develop within 48 hours after cessation of alcohol intake. The hallucinations may be auditory or visual and their content is usually unpleasant and disturbing. The disorder may last several weeks or months

Alcoholic epilepsy: seizures occur after a say or more of the terminations of as drinking session Sometimes the attack may occur while the patient is actually drinking

Wernicke Encephlopathy: This results from a brain or spinal cord lesion due to heavy drinking, Vitamin B1 deficiency occurs

Symptoms include disturbance of consciousness, drowsiness, amnesia, peripheral neuropathy, external ocular palsies and stupor. It has a high mortality and can cause death in 24 hours. If untreated it can progress to a more chronic condition called Korsakoff psychosis, in which impairment of short term memory with inability to learn new information and confabulation (recitation of imaginary experiences to ill gaps in the memory) are seen


Cardiac dysrhythmias: In alcohol withdrawal tachyrhythmias are common probably because of high adrenergic nervous system activity, which may cause sudden death.

Marchiafava Syndrome: Degeneration of the corpus callosum may occur in alcoholics.

Mallory-Weiss Syndrome: Ruptured esophagus with mediastinitis occurs

Other pathologies include Malnutrition, Gastric and peptic ulcer, Cirrhosis, Myocarditis pancreatitis and Mental illness

Can alcohol elicit Criminal Behaviour?

A strong relationship exists between the abuse of alcohol and the occurrence of accidents and acts of violence. As the suppressed feeling of aggression and hostility are released, the drinker goes into a state of artificial display of bravery. Tasks, which require control of speed and sensorimotor coordination in keeping a vehicle on its course and braking in impaired at 50 mg%. The driver experiences an increase in boldness and impulsiveness, this results in a tendency to drive faster and more erratically. Acute alcohol intoxication is a factor in suicides and homicides.

Alcohol slows the reactions of the victim and he may not be able to protect himself in time form an assault. He may be struck with a minimum or no defense injuries. Alcohol causes dilation and congestion of blood vessels, so that injuries will result in greater an prolonged bleeding, If there is chronic alcoholic liver disease which impairs the clotting of blood, the bleeding will be more extensive. If a victim is severely intoxicative, he may die from inhalation of blood or vomit while lying on his back following injuries, especially of the head or face.

Physiological effects and relative concentrations of alcohol

Physiological effects at blood alcohol concentration

0 to 50mg%: No significant effect or mild euphoria

50 to 100mg%: Decreased inhibitions, increased self confidence, decreased attention span, mild incoordination, alteration of judgment, nystagmus

100 to 150mg%: Some mental confusion, emotional instability, loss of critical judgment, ataxia, impaired memory, sleepiness, slowed reaction time

150 to 300mg%: Loss of muscular coordination, staggering gait, marked mental confusion, drowsiness, exaggeration of emotions, dizziness, decreased pain response, disorientation, and thickened speech.

300 to 400mg%: Stupor, marked incoordination, marked decreased in response to stimuli, possibly coma

400 mg% or more: Anesthesia, depression of responses, respiratory, failure, deep coma, and death


Relative concentration of alcohol at equilibrium

Whole Blood: 1.00
Plasma or serum: 1.12 to 1.2
Brain: 0.85
Spinal fluid: 1.1 to 1.27
Vitreous: 1.2
Urine: 1.3
Liver: 0.85
Alveolar air: 0.021