The root causes of addiction are complicated, but it does seem to run in families. Does this mean addiction is inherited and comes with “bad genes”?
The truth is a little more complicated than that.
Addiction and Genetics
There is definitely a genetic link involved with susceptibility to addiction. For example, a gene called HK2, seems to affect intravenous drug use. This gene is actually caused by an ancient retrovirus, meaning that if your very distant ancestors caught a certain disease…
Drugs of abuse act on your brain’s reward system. Alcohol and certain activities can also affect your reward system. Genetics explain why some people who exercise heavily become addicted to the so-called runner’s high, while others remain unaffected. The American Psychological Association believes that at least half of your susceptibility to addiction is linked to genetic factors. Genetic susceptibility can also be the root cause behind situations where somebody gets sober but instead becomes addicted to exercise, gambling, or food.
However, some people with genetic susceptibility can remain clean and sober, indicating that there are other factors involved.
The other part of the puzzle is, of course, the environment in which you grow up. Somebody with an alcoholic father might follow their parent into addiction; or they may take one look at his behavior and avoid alcoholism by never touching a drop. Susceptibility to addiction is strongly affected by stress. Stress can even cause epigenetic changes that trigger the development of addiction. So, somebody can go their entire life without a problem, then experience a sudden job loss, bereavement, or homelessness that pushes them over the edge into addiction. Having a parent who is an addict is a double whammy; they may have given you a susceptibility gene and they are also modeling the poor behavior. Other risk factors include child abuse, mental health issues, and trauma.
Another factor is availability. Somebody may be susceptible to addiction in general, but the form that takes is affected by what they are exposed to or encouraged to experiment with. Unfortunately, prohibition of drugs tends to cause other issues and seldom reduces the level of addiction (instead, it only makes it harder to seek help).
What Should People With a Family History of Addiction Do?
The most important thing to realize is that you are not destined to be an addict just because somebody else in your family, even one of your parents,is.
Knowing you have a higher susceptibility can lead you to make wise decisions, such as avoiding experimenting with problem substances in the first place or practicing stress reduction. Seeking the help of a counselor or therapist during difficult times of your life can help prevent you from developing a problem whether you have a genetic susceptibility or not.
Other recommendations include drinking only in certain circumstances, such as special occasions. For most people, a drink or two a day is not risky, but if you happen to have a gene that predisposes you to alcoholism it can be. Avoid pressure to drink and if necessary avoid people who pressure you to drink. You could also make yourself popular by volunteering to be the designated driver.
Also, make sure that your primary care provider knows about your family history as it might affect decisions they make if you need pain management. Addiction to prescription opioids is a major problem.
The short version is: Addiction itself is not genetic, but a predisposition to it is. Being aware of your genetics can help you avoid becoming an addict and potentially help you recover better. Other factors, such as stress, peer pressure, and epigenetics also come into play. Addiction is a condition, not a choice, and should be treated as such. And as such, it can run in families and those with a family history need to be especially careful to avoid it.