Can a DNA test predict addiction?

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?

Understanding Nature vs. Nurture

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.

Your Body Gives You Clues

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.

DNA tests for addiction risk

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.

LifeKit Predict

• -Opioid-specific risk assessment
• -Administered by a doctor
• -Clinically validated and FDA approval is underway
• –16 genetic locations are assessed
• -Results within 48 hours

GARS by MyGenx

• -Assesses the general risk of addiction and impulsivity
• -GARS = Genetic Addiction Risk
• -An at-home DNA test, no doctor needed
• -Aims to ‘diagnose’ ‘Reward Deficiency Syndrome’
• -Focused on dopamine pathways
• -At least ten genes are assessed
• -Results within 20 days

Reducing your risk of addiction

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.

Limit your access to potential vices

Other than genetics, the largest risk factor for addiction is exposure and access to a given drug or activity. Those with a genetic predisposition should make choices that limit the availability of a potential vice.
You won’t always be able to avoid some substances or activities – opioids are required in some instances of injury, surgery, or pain. But, you can take active measures to control your intake and limit use. Communication with a support network of family, friends, or medical professionals is paramount.

Seek treatment for co-morbid illness

“The term comorbidity describes two or more disorders or illnesses occurring in the same person.” – NIH NIDA
Even without a genetic disposition and exposure to potentially addictive substances or activities, some other factors can increase your addiction risk. There are strong correlations between addiction and depression, ADHD, anxiety, and PTSD. Seeking effective treatment for any psychological disorder will immediately reduce the risk of co-morbid substance abuse.

Lower your stress to limit addiction risk

Stress – both physical and mental – is a highly impactful and pervasive state of mind and body. Not only can acute stress push you toward vice and addiction, but it can also change how some genes function. Long-lasting stress can eventually cripple your brain’s reward system – a phenomenon that can persist even after the stress is lifted. Especially if you have a genetic risk, reducing and avoiding stress is a significant step toward reducing your predisposition for addiction.

You can always ask for help

Finally, If you struggle with alcohol or drugs, you don’t need a DNA test before seeking help. Addiction is when anything – substances or otherwise – negatively impacts your life. If you are having difficulty staying away from these harmful activities, please seek help through family, friends, or medical professionals.

SAMHSA’s National Helpline: 1-800-662-HELP (4357)

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.