A low LR to alcohol as defined by multiple objective and subjective measures has been successfully established as being a prospective risk factor for developing alcohol-related problems (Pollock 1992;Eng et al. 2005;Erblich, Earleywine 1999;Schuckit et al. 2005a;Schuckit et al. 2005b;Schuckit et al. 2006;Schuckit 2002). Low LR is envisioned as a risk factor for heavy drinking since individuals with low LR must theoretically drink more to obtain the desired effects of alcohol. Heavy drinking behavior, in turn, is hypothesized to promote associations with heavy-drinking peers, alter expectations of alcohol’s effects and contribute to acquired tolerance [see (Schuckit 2009)]. Interestingly, low LR does not seem to alter the course of alcoholism. In one study, while low LR was associated with a high risk for AD it was not related to most aspects of the course of alcohol problems once dependence developed (Schuckit, Smith 2001). This suggests that while low LR may be a risk factor for heavy drinking and subsequently dependence on alcohol it does not appear to be associated with any specific symptoms or subtypes of alcohol dependence.
