Not all in the genes.

The fault, dear Brutus, is not in our stars, but in ourselves," William Shakespeare wrote.

What can you do about your genes if you think that you have inherited a certain disease? Not very much. Unless, of course, you are an alcoholic.

Blaming our genes is often a cop-out. There are less than a dozen diseases that are actually genetically transmitted (or inevitably "passed on"), and all are extremely rare, with weird-sounding names.

By contrast, common killers like heart disease, diabetes, and alcoholism are caused by multiple factors, and genes often play only a minor role. The transmission of these diseases is genetically "influenced," or a person is genetically "predisposed" to getting them.

Alcoholism runs in families. What about alcoholism specifically? Hippocrates observed that alcoholism runs in families. Modern research shows that children of alcoholics, even if they're adopted away at birth, are four times more likely to develop alcoholism than adoptees from nonalcoholic parents.

So there is definitely something genetic going on. But no matter how you split the genes or crunch the numbers, alcoholism is not directly transmitted; genes are only part of the cause. How big a part? Fifty percent at best. Other causal factors are psychological and cultural.

Psychological cultural factors. Psychological factors work like this: if you are shy, compulsive, chronically nervous, or depressed, or have insomnia, impotence, frigidity, and so forth, you might start using alcohol to change how you feel. If your genetic predisposition is heavy (there are lots of alcoholics in your family tree), you will probably become an alcoholic very fast, especially if you have several psychological factors tilting the scale. With less genetic loading, it'll take longer. With very little genetic influence, you will eventually become a problem drinker, a heavy social drinker, or a periodic alcoholic, all of which are euphemisms for "functioning alcoholic."

Cultural factors work in similar ways. If your family members, college chums, country club buddies, coffee klatch girl-friends, and fellow workers are all heavy drinkers--and your genetic loading is heavy--you may be off and running from your first drink on. If your genetic load and cultural factors are less, it will take longer. In other words, the outcome depends on the balance of genetic, cultural, and psychological input.

Countering genetics. There is good news about your alcoholic genes: you can remove their effect. If you have a heavy alcoholic family history, bear in mind that your alcoholic genes don't do a thing unless you, for whatever reason, drink alcohol. The answer is clear: Don't drink! After all, life doesn't require alcohol. We don't need alcohol like we need water, food, and shelter.

If you choose to drink in spite of your genetic predisposition, then don't kid yourself. It's not your genes that are making you drink--it's psychological pressures and cultural factors. It means that you want to drink to fix how you feel psychologically and/or to gain peer acceptance, to avoid being "different."

What risk are you taking? You are enabling your genes to turn you into a full-blown alcoholic, if that's what your genetic potential is.

What if you don't learn about your genetic history until you are already a full-blown alcoholic? Even then you can still remove the influence of your alcoholic genes. How? Just do what cardiac patients have to do about their cardiac problem: remove the risk factors by changing your lifestyle. How? Don't drink. Join AA, where you meet people who can accept you as a nondrinker. Get some therapy if necessary. Consider yourself fortunate--cardiacs, diabetics, and others don't have it that easy. There is no Cardiacs Anonymous or rehab programs for "cardioholics."

Just as Brooke Shields used to purr that nothing comes between her and her Jordache jeans, you can control what comes between you and your alcoholic genes. If you eliminate the alcohol, you have, in effect, bought yourself a brand-new set of genes.