Nearly 50% of AUD risk is heritable, i.e., transmissible from parent to offspring, with the other 50% attributable to environmental factors.26 A survey of more than 17,000 adult members of a health maintenance organization identified childhood and adolescent stressors, including verbal, physical, and sexual abuse and household instability (e.g., physical violence directed at the mother, parental psychiatric illness, including substance use; incarceration of household members), as environmental factors associated with AUD.27 There was a strong, graded association between the number of stressors reported and the risk of AUD and an interaction of stressors with a parental history of AUD, consistent with a model in which environmental factors augment a biological predisposition to AUD.27
