Translating Addiction Genomics Research into Practice: Examining Ethics & Policy

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DESCRIPTION (provided by applicant): Studies are currently underway to examine the genetic factors contributing to a range of addictions, including critical public health problems like smoking and alcohol abuse. New approaches use emerging technologies-such as genome-wide association studies-to map and characterize inherited and drug-induced alterations in the human brain. By providing a better understanding of the biological mechanisms involved in addiction, this unfolding body of research is expected to fuel developments in pharmacogenomics and the creation of new genetic tests, and ultimately, to provide the basis for innovative strategies for prevention and treatment. However, translating the results of genomic research into public health interventions and treatment programs will require the resolution of a host of ethical and policy challenges. Although molecular genetic research on the addictions is still in its infancy, it is likely to induce fundamental changes in our views of addictive disorders, which in turn will have a significant impact on existing and future policies to reduce the harms of substance abuse disorders. The identification of genetic variations associated with dependence will contribute to the emergence of a "genetic understanding of addiction" that may cast additional stigma on those affected or, if understood in an overly simplistic and deterministic way, may shift responsibility for addiction away from key factors in the social environment and onto individuals' genetic make-up. Based on our initial work (R01DA14577), and in consultation with our multi-disciplinary Advisory Board, the project's empirical aims are to: 1) characterize how individuals undergoing treatment for addiction integrate emerging genetic findings into their self-identity, including understandings of personal responsibility; 2) track how a genetic understanding of addiction circulates into broad popular discourse, with a primary focus on how research findings are covered by major media and translated for the public, and; 3) examine how addiction phenotypes are ascertained and used in genetic studies, and more specifically, how an emerging genetic understanding will affect future revisions of diagnostic classification schemes used in behavioral genetics research (i.e., DSM). Primary methods include in-depth interviews and ethnographic observation. Informed by our empirical work, the ethical and policy aims target the translation of genomic research findings into practice. We will: 4) delineate and evaluate the foreseeable impact of genetic explanations of addiction on existing programs, such as public health campaigns and treatment programs, and; 5) identify and analyze key ethical, legal, and social consequences of a genetic understanding of addiction in order to inform future policy making. The ultimate goals of the proposed project are to provide policy makers with a clear understanding of the potential impact and limitations of genomic research on the addictions, ensure that research findings will integrate harmoniously into current public health measures to reduce the adverse health outcomes of addiction, and contribute to a responsible use of genetic research findings in future formulations of public health policy.