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It’s no secret that addiction is hereditary. If someone in your family struggles with addiction, your risk of developing an addiction is higher. Even more so if the person to whom you are related in a close relative, such as a parent.
Of course, having a higher risk doesn’t mean addiction is your destiny. Your lifestyle, your choices, and your overall health ultimately determine your future when it comes to addiction. This is the case with most mental health disorders. Genetic risk can be present without the disorder ever manifesting.
But what does this mean for those concerned their DNA could lead to a substance abuse disorder? And is it worth taking a genetic test if you aren’t sure if addiction runs in your biological family and you have concerns?
Let’s start with a century’s old debate: nature vs. nurture.
Is it out biological that determines who we are and what happens to us or is it our circumstances?
Most scientists can agree that it’s a combination of both for most things. They cannot agree on what’s more important and that’s likely because it varies from person to person. In some people, the things they were exposed to throughout their lives overrode their genetic predisposition. But in other cases, events in their lives had little to do with where they ended up, and what was in their DNA was unavoidable.
What does that mean for addiction?
Most researches agree that one of the primary links between DNA and addiction is the so-called reward pathways of the brain. How your brain reacts to a drug influences whether or not you will develop an addiction to it. If you experience a great deal of pleasure from using a drug that reaction was likely programmed into your DNA and it puts you at a higher risk for becoming addicted to it than someone whose brain has a less-intense reaction.
In a way, it’s your body’s way of warning you. If addiction runs in your family, it’s probably better not to experiment. You have a greater likelihood of a reaction that will lead to difficulty controlling your use of the substance.
In addition to the initial reaction to a substance, genetics also plays a role in how our bodies metabolize substances. If your body’s metabolism is slow to rid your body of the toxins produced by substance use, you’re less likely to develop an addiction because the “hangover” is so unpleasant. On the other hand, if your body bounces back quickly, you’re less likely to be deterred by the aftermath of a binge.
You can see this effect play out in the real world with people of East Asian heritage. East Asians tend to process alcohol very slowly which means after drinking they feel uncomfortable for a much period. This biological factor shared within their DNA has resulted in a lower risk for an alcohol abuse disorder. It doesn’t mean you have no risk if you have East Asian heritage, but it does mean you have a lower risk.
It’s important to note that just because someone in your family has a substance use disorder doesn’t mean that gene was passed on to you. There’s also no specific “addiction gene.” As of 2019, there are at least 10 genetic variations that have been confidently associated with a higher risk of addiction. The majority affect dopamine-related pathways and also correlate with measures of impulsivity and compulsivity. In people with all these ‘risk variations,’ there is a very strong association with a clinical diagnosis of alcohol dependence.
Comprehensive genetic testing would be the best option to help you identify your risk, but at-home DNA tests could also help.
If you believe taking a DNA test could negatively affect you when it comes to addiction, it might be better to avoid testing. Some people might resign themselves to a certain future if they know there’s a risk. In these cases, it’s better to just make the best choices possible without confirming anything via DNA.
But if you are curious and you do take a test that shows you have a higher risk, it’s important to understand what you can do to mitigate that risk.
People with a heightened risk for addiction should avoid vices and find healthier ways to cope. This means not only avoiding drugs or alcohol when you are unhappy or anxious or upset but avoiding it in celebratory moments, too.
It’s also important to make sure you are maintaining your health overall. This is especially true if you are afflicted with disorders that are known to co-occur with addiction, such as depression or anxiety or bipolar disorder.
The healthier you are and the more you focus on healthy life management, the less likely you are of triggering any addiction risk in your DNA.
Addiction is most likely to first appear in the late teens and early adulthood. But, it is an affliction that can strike at any time, to anyone. Knowing if you have a genetic predisposition may help direct lifestyle decisions and take appropriate precautions. However, while addiction does run in the family, there are a million factors that might have held it at bay for previous generations.
If you’re curious or concerned, there are some commercial DNA tests available that are as easy as 23andMe or Ancestry - employing a simple cheek-swab. As with any DNA test, there are pros and cons, and negative results can still be harmless, given the right context.
Whether a DNA test indicates that you are at risk - or not - there are some concrete actions you can take to limit your chances of developing an addiction.
The Substance Abuse and Mental Health Services Administration’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.