Half of risks for addiction lies in genes

For decades, addiction was viewed as a personal failure. Science now shows that addiction risk is rooted in our genetics. A study published in Nature Mental Health has revealed that genetics accounts for 50% of the risk for alcohol and drug dependence.

Precision medicine does more than diagnose. It gives a personalized plan to prevent addiction. The genetic blueprint can help guide people to make better lifestyle choices.

Addiction Risk Lies in Genes

Inside every human cell lies a wealth of genetic information, blueprints that shape how the body and brain respond to the world. In the case of addiction, large-scale genetic studies have uncovered nearly twenty key markers that influence risk. Many of these are involved in dopamine signaling, which is the reward and motivation system of the brain. This shows that addiction is not merely a matter of choice, but of biological predisposition.

Certain genetic variants explain why one person might feel euphoria from a drug, while another feels nothing at all. For instance, variations in the CHRNA5 gene significantly increase nicotine addiction risk, while the OPRM1 gene influences how the brain responds to opioids. The ALDH2 gene, commonly found in East Asian populations, causes a physical aversion to alcohol. These genetic traits don't determine fate, but they do shape probability.

Epigenetics Pulls the Trigger

Genetics provides the script, and epigenetics determines how that script is read. Epigenetics refers to the chemical switches that control gene activity, the switches that are responsive to lifestyle choices. Stress, diet, physical activity, sleep, trauma, and social relationships all have measurable impacts on how genes behave.

This means that even someone with a high genetic risk for addiction or chronic disease can reduce that risk through conscious, sustained choices. Research shows that physical exercise can reverse inflammation-related gene expression, and mindfulness can downregulate stress-related genes. Certain medications, like antidepressants or mood stabilizers, can restore disrupted DNA packaging caused by substance use.

Epigenetic reprogramming is not science fiction. It's already underway, and it's being guided by genetic knowledge. Individuals are no longer confined by their DNA; they are equipped to respond to it.

Precision Medicine for Better Outcomes

Precision medicine tailors care to the individual, beginning with their genes. Better than treating addiction, or any chronic condition, as a one-size-fits-all challenge. Polygenic risk scores, which combine hundreds of genetic markers, are now being used to flag individuals at high risk for substance use disorders even before exposure occurs. This early warning system offers a powerful opportunity to intervene with lifestyle adjustments and behavioral strategies before dependency takes hold.

Pharmacogenomics, the practice of selecting medications based on a person's genetic makeup, also helps guide addiction prevention. For example, individuals with fewer dopamine receptors, as indicated by the DRD2 A1 allele, may benefit more from specific therapies that boost motivation and engagement. This personalized approach increases treatment success and minimizes trial-and-error prescribing.

Precision medicine empowers people to live more healthfully. When patients understand their genetic risks, such as addiction, diabetes, heart disease, or depression, they can take action. Adjusting their environment, habits, and mindset influences how their genes behave.

The Lifestyle Prescription

Armed with genetic insights, healthcare is moving beyond reactive care into proactive, preventive strategies. For a young person with a family history of addiction, early counseling and healthy coping strategies may be recommended. For someone with genes linked to poor metabolism of alcohol or higher opioid sensitivity, education and support can guide avoidance or alternative treatments.

Diet, sleep hygiene, social environment, and mental health support are all part of the lifestyle "prescription" now informed by precision medicine. It's a shift from treating illness to cultivating wellness. From waiting for symptoms to emerge to using data to keep them at bay.

With precision medicine, healthcare becomes deeply personal. Genetic information, once seen as fixed, is now the foundation of choice. And with each new insight, individuals are better equipped to reprogram their health, gene by gene, habit by habit.

About BGI Genomics

BGI Genomics, headquartered in Shenzhen, China, is the world's leading integrated solutions provider of precision medicine. Our services cover more than 100 countries and regions, involving more than 2,300 medical institutions. In July 2017, as a subsidiary of BGI Group, BGI Genomics (300676.SZ) was officially listed on the Shenzhen Stock Exchange.