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Predicting Addiction

Behavioral genetics uses twins and time to decipher the origins of addiction and learn who is most vulnerable

Lisa Legrand, William Iacono, Matt McGue

In 1994, the 45-year-old daughter of Senator and former presidential nominee George McGovern froze to death outside a bar in Madison, Wisconsin. Terry McGovern's death followed a night of heavy drinking and a lifetime of battling alcohol addiction. The Senator's middle child had been talented and charismatic, but also rebellious. She started drinking at 13, became pregnant at 15 and experimented with marijuana and LSD in high school. She was sober during much of her 30s but eventually relapsed. By the time she died, Terry had been through many treatment programs and more than 60 detoxifications.

Her story is not unique. Even with strong family support, failure to overcome an addiction is common. Success rates vary by treatment type, severity of the condition and the criteria for success. But typically, fewer than a third of alcoholics are recovered a year or two after treatment. Thus, addiction may be thought of as a chronic, relapsing illness. Like other serious psychiatric conditions, it can cause a lifetime of recurrent episodes and treatments.

Figure 1. Steve, Debbie and Terry...Click to Enlarge Image

Given these somber prospects, the best strategy for fighting addiction may be to prevent it in the first place. But warning young people about the dangers of addiction carries little force when many adults drink openly without apparent consequences. Would specific warnings for individuals with a strong genetic vulnerability to alcoholism be more effective? Senator McGovern became convinced that his daughter possessed such a vulnerability, as other family members also struggled with dependency. Perhaps Terry would have taken a different approach to alcohol, or avoided it altogether, if she had known that something about her biology made drinking particularly dangerous for her. 

How can we identify people—at a young enough age to intervene—who have a high, inherent risk of becoming addicted? Does unusual susceptibility arise from differences at the biochemical level? And what social or environmental factors might tip the scales for kids at greatest risk? That is, what kind of parenting, or peer group, or neighborhood conditions might encourage—or inhibit—the expression of "addiction" genes? These questions are the focus of our research.

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