Alcoholism's evolutionary and cultural origins.

Alcoholism's heritability has been convincingly documented but the question of why a disorder that is so damaging to the individual and to society should continue to persist is still baffling. A widely held assumption is that whatever genotype is involved, its components must originally have conferred survival value else it would never have evolved. The corollary to that assumption is that when conditions favoring that genotype changed, the former advantages became detrimental. However, the genotype has persisted because it does not affect sexual function, if at all, until after peak productive years. An appreciation of the evolutionary biology and the historical-cultural context associated with alcohol consumption may lead not only to a better understanding of this disorder but to treatment alternatives based on that understanding.