Alcohol Dependence in Taiwan: From Epidemiology to Biomedicine

Alcohol-related problems cause a tremendous social and public health burden worldwide. Alcohol dependence (AD) is a common, chronic and relapsing psychiatric disorder, with prevalence varying among different ethnic populations, and determined by a combination of genetic and environmental factors. The heritability of AD is estimated roughly as 50%–60%. Until recently, the only genes established to affect the risk AD, were those encoding several alcohol metabolizing enzymes such as ADH1B and ALDH2. However, we are still in the early stages of understanding the physiology of other risk gene loci. Both ADH1B*2 and ALDH2*2, found more frequently in Asians compared to Caucasians, are considered as protective alleles, potentially explaining a lower prevalence of AD in Taiwanese people. Alcohol intake produces a long-lasting neuroadaptation, which is involved in developing and maintaining AD. Toxicity, such as oxidative damage associated with chronic alcohol consumption, also contributes to the addiction process. Emerging evidenceprovides an insight into the understanding of the mechanisms of how alcohol disrupts the synergistic homeostasis of bodily systems, and results in behavioral and physiological dysfunction.