For many people, alcohol is a part of their lives—having fun with friends, celebrations or for relaxation. But when alcohol use begins worsening people’s lives or their health, it is no longer something to take lightly. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol use disorder is a medical condition when a patient’s drinking causes distress or harm. The consequences of too much drinking can range from violence to increased risk for some cancers or a shortened lifespan. But what makes drinking alcohol more risky for some people than others?
Research proves that everyone responds differently to alcohol. Researchers are now trying to learn why. On a basic level, it is a combination of different factors—people’s sex, age, where they drink, family history and how healthy they are. Research is beginning to suggest that there might be some difference in how alcohol affects people of different races or ethnicities. Sarah Pedersen, PhD, assistant professor of psychiatry, University of Pittsburgh School of Medicine, says that research has shown that whether people are sensitive to alcohol is based somewhat on their genes. “We know which genetic proteins break down alcohol in our systems and that they can change how bodies process alcohol,” she said. “For instance, in people of Asian descent, if they have this genetic sensitivity to alcohol, they’ll get flushed, hot or really sick when they drink. It’s actually a protective reaction. Drinking makes them sick, so these people tend not to drink heavily.”
A different genetic factor found in about 30 percent of people of African descent may also be protective against alcohol use disorders. But whether or not African Americans have this genetic factor, studies have shown that they may be more sensitive in general to the effects of alcohol use. Studies have also shown that African Americans drink alcohol less than almost any other racial/ethnic group in this country. In fact, Whites drink more than any other population in the United States, says Christina Mair, PhD, assistant professor of behavioral and community health sciences, University of Pittsburgh Graduate School of Public Health. “They drink casually more. They engage in risky drinking behaviors more. But when you look at problems related to drinking (intimate partner violence, community violence, sexual assault, risky sexual behaviors and child abuse/neglect), the problems are not building up in the heaviest-drinking group, the White population. They’re happening more in Latino and African American populations.” Researchers are beginning to look at why this is. Living with high stress levels, a history of discrimination, genetic sensitivity or living in environments with more places to access alcohol are all risk factors for experiencing more problems associated with alcohol.
“Researchers know that living in an environment with more bars, restaurants or liquor stores is associated with more problems at the community level—violence, crime, intimate partner violence, etc.,” said Dr. Mair. “There’s some evidence that there are as many as eight times more liquor stores in predominantly African American neighborhoods than in mostly White neighborhoods.”
Doctor Mair has done a lot of research about how where people drink affects their risk for alcohol-related problems. “It’s not just alcohol use but the places where people drink that put them at risk. For example, if we look at drinking on college campuses, the risk of sexual assault isn’t the same everywhere. It’s different based on drinking at a fraternity party versus drinking at an off-campus party versus drinking at a bar. People’s attitudes and what is socially accepted behavior are different depending on where people drink. In some places, it doesn’t matter if people have one drink or five, the risks are still higher. Now we need to find out why there are these differences.”
Why does it matter where people drink if they are drinking heavily? “We often use the cut-off of four or more drinks for a woman and five or more for a man,” said Dr. Mair. “But the reality is that it depends on what kind of drinker people are. So, if people usually only have one drink, they could have two drinks in a neighborhood with many bars and be at an increased risk for all kinds of problems. If people on a more regular basis have three to five drinks at a restaurant, they may not be at an increased risk for any problems happening. Who you are as a drinker matters. There isn’t some magic number of drinks that puts people at an increased risk.”
Doctors Mair and Pedersen think that a lot more research needs to be done. But knowing different racial/ethnic group’s sensitivities to alcohol and the fact that where people drink affects their risk for drinking-related problems can lead to interventions that could reduce problems related to alcohol use.
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