“Don’t be ashamed or proud of your genetics, for you have no contribution towards it.” ― Mehnaz Ansari
It is often in the darkest skies that we see the brightest stars.” ~ Richard Evans
I hope that I never stop learning and I hope that the same desire fills you. Way back in Part V of the Science of Addiction, I discussed nature versus nurture with regard to becoming an individual with a substance use disorder, the proper term for an addict. I have learned more that slightly changes my discussion on the impacts of environment and heredity on the likelihood that an individual will become addicted. Please join me in Part Va – Nature and Nurture Revisited.
Epigenetics
My education is in oceanography and geology and that is by design. I studied oceanography because I wanted to be Jacque Cousteau, but that name was already taken. I didn’t want to study living things, least of all people, because they have free will and are very confusing to me. So, I focused on geological oceanography because rocks and sediments just do what physics says they must. Therefore, genetics was not something that I had more than a cursory exposure to and that was fine with me. But as I looked into the impact of genetics with regard to addiction. I encountered a concept that was new to me, epigenetics. BEFORE YOU LEAVE THIS PAGE, BEAR WITH ME FOR A LITTLE, I WON’T GO INTO DETAIL. Truth is, I am not sure that I understand the details.
My understanding is that epigenetics says the concept that genes are rigid, static things that determine what you will be like is not entirely true. Genes cause proteins to be made that cells use to create an outcome, whether it be simple like eye color or more complex like an autoimmune disease. We used to believe, based on Mendel’s research (Google it), that heredity was a static expression of certain genes.
I am sure you noticed (and were probably annoyed by) my use of the term static. I used that term because the concept of epigenetics is not static, it says that the result of a certain gene is not predetermined. This idea makes sense when we consider how diverse humans are, even within a given family.
Epigenetics says that certain genes may be “expressed” (turned on) or “silenced” (turned off) by environmental factors. This makes perfect sense to me with regard to things like PTSD. Some people develop PTSD from a trauma that appears to be much less than the trauma needed to cause PTSD in others, and still others don’t seem to develop PTSD at all. If it was simply a static gene, either you would get PTSD from trauma or you would not. Some people conclude that this means some people are just “stronger” than others but that doesn’t fit what we observe. If the response is not a reflection of character but rather a gene that is turned on or not due to environmental conditions (trauma), that better explains what we observe.
Epigenetics says that it is even more complex than just “expressed or silenced”, that genes may interact. It says that the protein made by one gene may change how another gene acts, either by turning that gene on or off or causing it to produce a different protein. This is getting a little complex for me but what I get from it is that there is a lot more room for variability than allowed by the original concepts of genetics. Also, epigenetics says that some changes may persist long after the thing that caused the change is gone.
Epigenetics and Addiction
Reading about epigenetics was a “holy crap” moment for me and I hope that I can do it justice for you. Based on the model of epigenetics we can now understand some of the complexity of addiction. My previous explanation said that your environment (your upbringing and possible trauma) could possibly put you on the pathway to addiction and heredity would determine at what point you will become addicted. I had concluded that these two things both contributed to addiction, with heredity being somewhat more important.
Now I see that heredity and environment interact, that each changes the other. Instead of your experiences leading toward the path of addiction, I understand that your experiences my cause a gene that leads to addiction to be expressed or a gene that protects you from addiction to be silenced. Some environmental risk factors, like trauma, abuse, neglect, etc., are well known but perhaps there are others that are less obvious, that may change whether a gene produces a certain protein, resulting in addiction.
We oftentimes talk about people who do not understand addiction and think that it is weak-will, a character flaw and we bemoan how wrong they are in that belief. Part of their misconception comes from what they see. What we don’t see is the complex role that genetics, modified by environment, plays in addiction. Addiction is far more complex than simple “common-sense”, and this is why people who have not experienced or been educated about addiction do not understand. This is why we must educate people, so that we attack this crisis with knowledge rather than “common-sense” that is incorrect, due to a lack of information.
Epigenetics and Recovery
When I mentioned my newfound understanding of epigenetics to a psychiatrist friend, he challenged me to consider what that means for recovery. Obviously, I do not suggest that we should move away from abstinence, support, and cognitive behavioral therapy (12-step programs). In past posts, I did mention gene therapy and my concerns with editing genes to address addiction. Instead, epigenetics says maybe we can find the gene or genes that are not in the correct state (on or off) and provide the correct chemical signal to change that state. That is a long way off, but when we figure out how to isolate the genes and change their state, we could “turn off” the addiction.
If the concepts that I have shared with you in my discussions of how addiction changes your brain are correct, the pathways to addiction that you built would still remain. Therefore, once you became an addict, you would still never again be able to use abusable/mind altering substances, but your daily battle would be much easier. We might possibly be able to turn off your brain’s misinterpretation that you need your drug of choice to survive and thereby reduce some of the greatest hurdles to recovery, like cravings, triggers, panic attacks and drug dreams.
I hope that you made it this far and I hope that I succeeded in correcting my ideas of heredity and environment for you. More importantly, I want you to see hope for the future and a possible pathway to success in the battle with addiction.