A 2023 NIH study identified addiction-related genes in over 1 million individuals, paving the way for personalised treatment while this article explains addressing the addiction crisis and emphasises biomarker development.

Drug abuse and addiction are a public health crisis that involves high social, emotional, and financial costs to families and society at large. There is also significant stigma surrounding addiction, despite increasing evidence that addiction is a disease that is preventable and treatable—much like heart disease, for example.

However, a 2023 NIH study of more than 1 million individuals published in Nature Mental Health found the presence of specific genes associated with addiction. These genes were found to be commonly inherited, regardless of the type of substance use disorder.

The genetic science involved

Prior research has established that substance use disorders are heritable and can involve multiple genes. A process called genome-wide association has been developed to identify genetic variations in genomes. 

These variations, called single-nucleotide polymorphisms (SNPs), can be linked with the same disease, disorder, condition, or behaviour among multiple people.

The sample size was large, with 1,025,550 individuals of European ancestry and 92,630 individuals of African ancestry. The goal was to include globally represented populations. 

The researchers found 19 independent SNPs that were strongly associated with general addiction risk and 47 SNPs for specific substances in the European ancestry sample. Many of the genes co-occurred among addiction and mental disorders, indicating the link in these conditions. 

The researchers note that the findings from the African ancestry portion of the cohort were not useful, most likely due to the small sample size compared with the European cohort.

The researchers noted that taken together, the specific substance risk variants combined with the general addiction-related variants provide strong support for individualised prevention and treatment. These findings can potentially lead to more effective prevention and treatments for substance use disorders. 

The SNPs identified in the study were also associated with dopamine signals, confirming the role of dopamine in addiction. This finding supports the need for research into biomarker development and treatment targets.

This international study was supported by several federal agencies, including the National Institute on Drug Abuse (NIDA), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute of Mental Health (NIMH), the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute on Aging.

Scope of the addiction problem

The NIH pointed out that these drugs are increasingly being tainted with fentanyl. 

“Genetics play a key role in determining health throughout our lives, but they are not destiny.”

- Nora Volkow, MD

The knowledge of the genetic basis for addiction has been limited, and most clinical trials have focused on specific substances rather than addiction overall. 

“Genetics play a key role in determining health throughout our lives, but they are not destiny. Our hope with genomic studies is to further illuminate factors that may protect or predispose a person to substance use disorders—knowledge that can be used to expand preventative services and empower individuals to make informed decisions about drug use,” said NIDA Director Nora Volkow, MD. “A better understanding of genetics also brings us one step closer to developing personalised interventions that are tailored to an individual’s unique biology, environment, and lived experience in order to provide the most benefits.”

Disclaimer: This story is contributed by Carol Nathan and is a part of our Global Content Initiative, where we feature selected stories from our Global network which we believe would be most useful and informative to our doctor members.