Keeping familial alcoholism in perspective. (Addiction: Maybe It's in the Genes) (Cover Story)

We have been witnessing an explosion of interest in the problems of adult children of alcoholics (ACOAs), from best-selling books to TV talks shows and specialized conferences. What began as a term useful in describing the impact of alcoholism on others, primarily children grown to adulthood, has now become a movement unto itself. And the movement has expanded to include other groups, as witnessed by the fact that currently many of those attending ACOA conferences and the 12-step self-help programs such as A1-Anon have no "known" alcoholic parent or relative. This has lead to a plethora of new 12-step programs--Co-dependents Anonymous, Adult Children of Dysfunctional Families, Debtors Anonymous, etc. A common link among all these programs are high numbers of attendees who state that they have a "disease," most often termed codependency.

This movement presents a special challenge for those of us who are in the position to assess and diagnose, for we are frequently being asked to determine if someone has an alcoholic relative lurking in the recesses of their genetic history.

A key to the momentum of the ACOA movements is in many ways prevention--prevention of alcoholism and its transmission through succeeding generations and prevention of the behaviors that accompany this disease.

Once a genetic marker is determined, the whole range of this work will be altered. Adolescent ACOA's will more easily be able to determine the risk they wish to assume in experimentations with alcohol use. Parents will be able to more confidently attempt to regulate and intervene as their adolescents comply with group norms of drinking and drunking.

As adults,…