Alexandra LaFollette
March 11, 2023

The Role Genetics Can Play in Alcohol & Drug Addiction

Addiction is a complex disorder that results from a combination of genetic, lifestyle, and environmental factors. The role of genetics in addiction has been widely studied over the last few decades, and research has shown that certain genetic factors contribute to an individual's susceptibility to addiction.

One of the most studied genetic factors in addiction is the presence of specific variations in genes that encode proteins involved in the brain's reward system, such as dopamine and serotonin receptors. These variations may affect how these proteins function, leading to alterations in the brain's reward circuitry, which can result in addiction. Other genes linked to addiction include those involved in stress response, impulse control, and decision-making.

For example, researchers have identified specific genes that may influence an individual's response to drugs and alcohol, including genes that affect the metabolism of drugs, the neurotransmitter systems involved in reward and pleasure, and the stress response system. And while research in this area is still ongoing, some genes linked to addiction or protection against addiction include:

  • GABRA2 and CHRM2: Linked to alcohol use disorder and early onset of alcoholism.
  • COMT, SLC6A4, and MAOA: Those with these genes may have personal differences in how they respond to stress, which, combined with other factors, may influence addiction.
  • HIST1H2BD: Linked to cocaine dependence
  • CUL3, PDE4B, and PTGER3: Play a role in smoking and alcohol use
  • CHRNA2: Low expression levels of CHRNA2 are linked to cannabis use disorder 
  • ADH1B and ALDH2: These genes influence alcohol metabolism. Generic differences that result in lower ALDH2 or higher ADH1B activity can cause a person to experience uncomfortable symptoms when they drink alcohol. Such variations may have a protective effect against alcohol abuse.

Moreover, family studies that include siblings, fraternal twins, identical twins, and adoptees suggest that as much as 50% of a person's risk of becoming addicted to alcohol, nicotine, or other drugs depends on their genetic makeup.

Research on the human genome reveals that humans are 99.9% identical on a genetic level. But the 0.1% variation is critical as it's responsible for the differences in their sequence of DNA bases. These differences contribute to visible variations like hair color and height and invisible traits like protection from or increased risk for diabetes, stroke, heart attack, and addiction. 

Other Risk Factors for Addiction

Genetics is just one factor that contributes to addiction, and the influence of genetic factors can vary depending on an individual's environment and life experiences. Furthermore, not everyone with a family history of addiction will develop substance abuse disorder. People without genetic risk factors still have a risk of developing an addiction. Here are some other factors that contribute to addiction: 

  • Exposure to adverse early life experiences: Adverse early life experiences, such as neglect, abuse, or trauma, can impact behaviors like emotional regulation, social skills, decision-making abilities, and impulse control, increasing susceptibility to addiction. 
  • Family factors: Family factors such as parental substance use, parental neglect, and other forms of family dysfunction can increase the risk of addiction. These factors may create an environment conducive to substance use and lead to learned behaviors that increase the likelihood of addiction.
  • Environmental factors: Environmental factors such as exposure to stress, social and cultural norms, and peer influence can contribute to addiction. Exposure to stress, for example, can increase the likelihood of substance use as a coping mechanism, while social and cultural norms may normalize substance use.
  • Learned behaviors combined with brain changes: Learned behaviors such as social modeling and peer influence can lead to brain changes that increase susceptibility to addiction. For example, repeated drug use can change the brain's reward circuitry, making it more difficult to stop using drugs.
  • Inflammation/neuroinflammation: These can result from various causes, such as infection, injury, or chronic stress. The conditions have been linked to mental health disorders such as depression, anxiety, and ADHD, which increase the risk of addiction. 
  • Psychiatric factors: Mental health issues like bipolar disorder, major depression, and schizophrenia are often linked to addiction.

How the Knowledge of Genetic Influences Can Inform Addiction Treatment Approaches

Genetic research has provided a better understanding of the complex interplay between genes and diseases like addiction. Today, mutations like BRCA 1 and 2 that predispose patients to a high risk of ovarian and breast cancer serve as crucial medical tools in assessing one's risk of severe diseases. Researchers can now unravel the genetics of single-gene disorders like breast/ovarian cancer, sickle cell anemia, cystic fibrosis, and addiction.

Understanding the genetic basis of addiction makes it easier to identify individuals who are more susceptible to addiction. By using genetic testing to identify these variations, healthcare providers can better evaluate a person's unique addiction risks. But this is an area that needs more research.

In addition to identifying individuals who are more susceptible to addiction, the knowledge of genetics can also inform addiction treatment approaches through pharmacogenetics. Pharmacogenetics studies how an individual's genetic makeup affects their response to medications. By tailoring addiction medications to an individual's genetic makeup, healthcare providers can improve treatment efficacy and reduce the risk of adverse side effects.

What to Do If you have a Genetic Predisposition to Addiction

If you have a genetic predisposition to addiction, taking proactive steps to manage your risk and prevent addiction is essential. Here are some things you can do:

  1. Educate yourself: Learn as much as you can about addiction and its genetic components. Knowing your risk can help you be more mindful of your behavior and take steps to manage your risk.
  2. Be honest with your healthcare provider: If you have a family history of addiction or suspect you may be struggling with it, it is essential, to be honest with your healthcare provider. They can help you evaluate your risk and provide addiction prevention and treatment resources.
  3. Practice self-care: Engage in activities that promote physical and mental health, such as regular exercise, healthy eating, and stress-reducing techniques like meditation or yoga.
  4. Avoid triggers: Know your triggers and avoid situations that may increase your risk of addiction.
  5. Seek professional help: If you are struggling with addiction, seek professional help from a healthcare provider or addiction treatment specialist. Treatment can help you manage your addiction and start the path to long-term recovery.
  6. Get support: A robust support system can help prevent addiction and promote recovery if needed. This can include family members, friends, or support groups.

Remember that having a genetic predisposition to addiction does not mean that you will automatically develop an addiction. Taking proactive steps to manage your risk and getting help if needed can reduce your chances of addiction and help you live a healthy, fulfilling life.

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