Bad Genes or Bad Luck?
Two scientific papers from January 2026 that remind us how alcohol misuse has both genetic and environmental drivers.
· Icick R et al. Identification of risk variants and cross-disorder pleiotropy through multi-ancestry genome-wide analysis of alcohol use disorder. Nature Mental Health 2026; 3: 253-265.
· Disease burden attributable to intimate partner violence against females and sexual violence against children in 204 countries and territories, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet 2026; 407: 31–52.
The first of these papers uses state-of-the-art analytics to interrogate the results of genomic testing on a total sample of 1,041,450 individuals with European, African, Hispanic, East Asian and South Asian ancestry. The methods are complex and don’t seek to actually tell us what individual genes are at play.
Rather, it gives a map of the whole genome in terms of variation at tens of thousands of individual points – a bit like a genetic fingerprint. Armed with this, the researchers use high powered computation to establish a subset of plausible variants that map to regions of the brain associated with alcohol (based on prior knowledge) bringing the fingerprint down to 37 genetic loci of interest (with some variation between ancestries).
They then looked at overlap between variation at these loci seen with alcohol use disorder (AUD) and other important conditions that are known to pose a higher risk of AUD. Their findings confirm what has been shown in several previous studies with slightly different methodologies, namely that schizophrenia, bipolar disorder, depression, ADHD, neuroticism and opioid use disorder are not complications of alcohol use but rather share a genetic liability (correctly called ‘polygenic risk’) with AUD.
The second study looked at what can happen to us during life and the well-known association of abuse (especially in childhood) on development of substance misuse. The researchers estimated the prevalence and attributable burden of Intimate partner violence (IPV) and sexual violence against children (SVAC) in 204 countries and territories, by age and sex, from 1990 to 2023, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2023 (funded by Gates Foundation).
Depressingly, they found that globally, in 2023, 608 million females aged 15 years and older had ever been exposed to IPV, and 1·01 billion (0·764–1·48) individuals aged 15 years and older had experienced sexual violence during childhood. The downstream effects of this were marked and included several mental health Schizophrenia, bipolar disorder, depression, dissocial behaviour, deliberate self-harm and substance use disorders (including AUD), the latter being one of the most common consequences of SVAC, especially in males.
Summary:
Research by Icick R et al. and findings published in The Lancet suggest alcohol misuse is shaped by both biology and environment. Genetic factors may influence vulnerability, but social context, stress, and exposure play an equally important role. Together, they show behaviour is driven by the interaction between nature and nurture, rather than “bad genes” or simple chance.
Question: Is dry January a good thing?
It All Begins Here
Short answer
Absolutely. Its not the complete solution for everyone but it is a great starting place for anyone.
Long answer
When the UK charity Alcohol Change first introduced the idea of dry January in 2013, approximately 4,000 people signed up. By 2023 the figure had risen to 176,000. The actual number of people planning to have a dry month in January 2026 is estimated to run into the millions [1]. For some, this month may serve a simple desire to save cash or lose some weight after the usual Christmas excesses, however for others, it is a golden opportunity to rethink their relationship with alcohol and perhaps moderate or stop drinking in the longer-term.
These will not generally be people with medically defined alcohol dependence (who make up only about 2-3% of the UK population [2]) but rather the much larger proportion of regular drinkers (about 20% [2,3]) for whom drinking has started to induce concern about the risks posed by the amount they consume. Using the WHO’s International Classification of Diseases 11th revision (ICD-11), such people best fall under the category of “hazardous alcohol consumption”, where their drinking behaviour (weekly consumption and/or binge episodes) appreciably increases risk of harms, but these are yet to occur. Concern about such future risks, which include acute injuries arising from drunkenness and/or chronic risks to mental and physical health, livelihood and relationships (to name but a few), may lead to a recurring feeling that something needs to change.
This would be all well and good if it was easy to do. However, for a good proportion of regular drinkers, dry January will expose the uncomfortable discovery that drinking has become a hard habit to break. At a superficial level this is because drinking is fun. However, the reality is that over the years, the rewards we have obtained from drinking – rooted in ancient biology (namely the chemical effects of alcohol on our brain’s powerful reward system) – will have become deeply learned and memorised. Having made the first step to free our hands from the glass, we must recognise that such learning, a process that started from our very first drink, cannot be unlearnt any more than we can unlearn to ride a bike. But all is not lost. All we need to do is to invoke the very same basic learning principles that reinforced our drinking behaviour in the first place by now “learning to not drink”.
This can be achieved alone (maybe with the help of a book) but is best achieved by joining one of the now numerous, largely online, communities [4] for people who describe themselves as “Sober curious” or” grey area drinkers”. Such non-medical terms have grown up in the last decade to encapsulate the growing population of people described above – those concerned about the hazards posed by their drinking and their ability to control consumption. The emphasis is on education and self-discovery within a socially cohesive support network, but at their core they are re-invoking the two core tenets of experience-based learning – positive and negative reinforcement. Thus, whilst the fun we had from alcohol’s psychostimulatory effects, and its benefits for social interaction were positively reinforcing, we can now similarly celebrate how good we feel and look, our renewed sleep, clarity, energy and focus by not drinking. Likewise, alcohol’s relaxant and sedative properties as a self-medication may have been negatively reinforcing (they made us feel better by taking away negative feelings, emotions and memories). We can now replicate this by acknowledging the absence of not feeling bad anymore (hangover, stress, anxiety etc.). At the same time, a person can start the journey of identifying and addressing the common psychological drivers for which alcohol seemed a solution in the first place, for example low self-esteem or mood, social anxiety and stress – problems that require the clarity of thought provided by a period of abstinence.
I accept that such programs may not suit everyone. For example, dependent drinkers may require medical support. However, the cognitive, social and psychological pillars of such programs, combined with abstinence derive almost directly from Alcoholics Anonymous in the 1930s and are widely applicable. We therefore need to reframe Dry January not as a punishment period to get through, but as an opportunity to learn something better – something that won’t become redundant like a NY gym membership after the hard work has been started.
References:
[2] J. MacKillop, R. Agabio, S. W. Feldstein Ewing, et al., “Hazardous Drinking and Alcohol Use Disorders,” Nature Reviews Disease Primers 8, no. 1 (2022): 80.
[3] M. C. Reid, D. A. Fiellin, and P. G. O’Connor, “Hazardous and Harmful Alcohol Consumption in Primary Care,” Archives of Internal Medicine 159, no. 15 (1999): 1681–1689.
[4] https://alcoholchange.org.uk/blog/grey-area-drinking-what-is-it-and-does-it-add-anything-to-the-alcohol-debate OR BUPA: https://blua.bupa.com.au/healthy-habits/alcohol/grey-area-drinking-when-that-extra-glass-is-more-than-a-treat OR: https://grayareadrinkers.com/about-jolene-park/