Knowing your genetic risk is key to knowing your chance of developing problems.
Posted May 08, 2020

Quarantinis. Jokes about happy hour, any hour. Social media is being flooded with memes about increased alcohol use during the pandemic.
The data bear out this trend: alcohol sales are soaring, with a 55 percent increase in a single week as shelter in place orders were issued across the nation.

What’s behind this increase? Why are so many people drinking more during the COVID-19 pandemic? More importantly, should we be worried?

I am a researcher who studies risk for alcohol use problems. I’ve written hundreds of papers on why some people develop problems and others don’t, analyzing data from thousands of research participants.
Here’s what we know: changes in the environment change the likelihood that people will develop problems. Environments that are more permissive or accepting of alcohol use increase the likelihood that people will use.
There’s no question that our environments have changed dramatically as a result of the pandemic. Many of those changes are conducive to higher alcohol use: reduced stigma surrounding drinking at all hours, decreased accountability by co-workers and friends as individuals are isolated in their homes. Alcohol also has anxiety-reducing effects, and let’s be honest, a lot of people are feeling a lot of anxiety right now.

But here’s the part most people don’t realize: the people who are most at risk are the ones who are genetically predisposed to develop problems.
The chance that we will develop any given health problem—including substance use and mental health challenges—is related to the genetic codes we are born with. Some people are more at risk for cardiovascular disease, some people for cancer, and some people for alcohol use disorders.
Just because you are born with a genetic predisposition doesn’t mean you are destined to develop problems—it just means you have an increased risk. But here’s the kicker: environments that are risk-enhancing—say, for example, a global pandemic—can drastically increase the likelihood that people who are genetically at risk will develop problems.

How do you know if you are at increased risk?
There’s no genetic test you can take (despite what some websites tell you). Researchers like myself are working hard to find the genetic variations that make people more at risk, but there are likely tens of thousands of them, and so we’re still a far way off from being able to give people accurate genetic risk scores.

But there are other indicators that can tell you whether you are at an increased risk of developing problems. There are a few different pathways by which our genes can alter our risk for substance use problems. Some genes increase our tendency toward depression or anxiety. People who carry these genetic variants are more likely to use alcohol to cope, which increases their risk of developing alcohol use disorders.

Genes also influence the way our brains are wired to process risk and reward. Some of us are more prone to impulsivity. We’re drawn to immediate rewards—to chasing the fun. We are less likely to pause and think about the long term consequences. “Should I do a Zoom party with friends tonight and drink a pitcher of margaritas? Why not?!”, our impulsive brains tell us… without weighing that 8 am Zoom call with the boss, or thinking ahead to the
kiddos that will be waking us at 6 am needing to be entertained all day.

Genes also influence the way our bodies process alcohol. Some people need more alcohol to get the same effects as other people. It might take them a bottle of wine or a six-pack of beer before they start to feel that anxiety-reducing “buzz.” Needing more alcohol to experience its effects leads to a pattern of heavier drinking, which makes these individuals more at risk of developing problems.

If you’re someone with any of these tendencies anxiety/depressive proneness, high risktaking, or needing more alcohol to experience effects—it’s a good idea to keep an eye on your alcohol consumption during the pandemic.

These tendencies indicate that you are at greater risk of developing alcohol problems, and the environmental conditions of the pandemic might push you in that direction. If you have a family history of alcohol problems, that’s also a good indicator that you may be genetically
at risk. The more family members you have that have struggled with alcohol problems, the more likely it is that you are carrying a genetic predisposition that puts you at increased risk of developing problems.

Remember—genes aren’t destiny. But if you see yourself in any of these risk-enhancing
tendencies, it might be a good idea to check your quarantini drinking as the pandemic
stretches on. Even if you have made it past the period of greatest risk for the onset of problems (the mid-20s), the huge environmental shift we are experiencing could lead to the development of new problems. This is especially true for individuals who carry a disposition toward anxiety or depression. Alcohol problems related to drinking to cope tend to onset later in life, and the pandemic is likely to be a particularly salient risk enhancing environment for individuals with this tendency.

The pandemic is wreaking enough havoc on our lives; let’s support one another, and our family and friends who are at elevated risk, so that the development of new alcohol use disorders isn’t yet another casualty of the coronavirus.


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