Alcoholism and other drug addictions: a primary disease entity, 1991 update.

Intensive work needs to continue on the genetic characteristics of the X-Y chromosome. There needs to be further clarification of the allele penetrants and the oncogenes, as well as determination of the specific chromosomes. It is now apparent that the neurotransmitters, particularly dopamine, seratonin, and norepinephrine, as related to the MFB receptor sites, are a determining factor in the presence or absence of this disease. However, the exact manner in which these neurotransmitters and receptor sites act, particularly in terms of the feed-back systems, remains obscure. New receptor sites are also being discovered and additional neurotransmitter systems, such as the second messenger system, uncovered. It would be naive at this point to attempt to delineate specific receptor sites or neurotransmitter systems as the absolute determinant of the disease. However, the basic heuristic model accepted by the Georgia Impaired Health Professionals Program remains valid. The heuristic model proposed in the past 15 years remains basically intact and valid. In this model, it is apparent that the essential disease criteria are fulfilled by alcohol and other drug addictions. Chemical dependency is a primary, psychosocial, biogenetic disease. The American culture, however, often fails to appreciate the difference between controlled abusive use and the uncontrolled addictive user. They do not understand that controlled abusive use can lead to severe physical changes, even death.(ABSTRACT TRUNCATED AT 250 WORDS)