Alcoholism is identified by severe dependence or addiction and cumulative patterns of characteristic behaviors. The frequent drunkenness of an alcoholic is obvious and destructive; interfere with the ability to socialize and work. These behaviors can lead to loss of work and relationships (Merck, 1999). Strong evidence suggests that alcoholism is hereditary (Schuckit, 2009). According to a study published by Schuckit (1999), monozygotic twins had a significantly higher risk of alcoholism if one of the twins was an alcoholic. Ehlers, Lind, and Wilhelmsen (2008) conducted a study to investigate the influence of a single opioid receptor on alcohol dependence rates among Native Americans. Ehlers et al. (2008) noted that people at lower risk of becoming alcoholics were more sensitive to the effects of alcohol, while people at higher risk of alcoholism were less sensitive to the effects. The research team also discussed the firewater myth, common in present-day Native American culture, which posits a constitutional predisposition to alcoholism resulting from an impaired innate response to alcohol (Ehlers, et al. , 2008). When alcohol is consumed, an enzyme called alcohol dehydrogenase metabolizes the alcohol into acetaldehyde at a rate of one standard drink per hour (Schuckit, 2009). After repeated exposures, tolerance may develop due to adaptive changes in cells of the central nervous system (Merck, 1999). The increased tolerance may cause the patient to consume alcohol in greater quantities than before to achieve the same intoxicating effects. Alcoholics suffer dramatic long-term damage to their health. The most common forms of specific organ damage in alcoholics are cirrhosis, peripheral neuropathy, brain damage, American Indian and Alaska Native care. What language does your patient suffer from? (2nd ed.). (pp. 21-28). St. Paul, MN: EMC Paradigm. Schuckit, MA (2009). An overview of genetic influences in alcoholism. Journal of Addiction Treatment, 36(1), S5-S14. doi:10.1016/j.jsat.2008.05.012Spector, R.E. (2009). Health and disease among the American Indian and Alaska Native population. Cultural diversity in health and illness (7th ed.). (pp. 204-228). Upper Saddle River, NJ: Prentice Hall. U.S. Census Bureau: El Paso County, Colorado. (November 4, 2010). Retrieved from http://quickfacts.census.gov/qfd/states/08/08041.html Villanueva, Michael, Tonigan, J. Scott, & Miller, William R. (2007). Response of Native American clients to three methods of treating alcohol dependence. Journal of Ethnicity in Substance Abuse, 6(2), 41-48. doi: 10.1300/J233v06n02_04