Changing gene expressions of molecular pathways that play a role in drug addiction create a myriad of social, psychological, ethical and medical implications. If we know the genes that are responsible for vulnerability to substance abuse, what are our duties as a society to prevent the scourge of such a devastating disease?
Genetic engineering are methods to change the way that the traits that genes express, and include selective breeding, cloning, and transgenic technology. Selective breeding is using females and males that display similar traits to produce breeds that have certain characteristics. Cloning produces a genetically identical offspring to another animal by altering early embryonic development. Transgenic techniques allow scientists to either remove or introduce genes into an embryo, utilizing either knock-out or knock-in technology, respectively.
Drug addiction, a large problem globally, has been shown to be derived from 40-60% hereditary factors. What if we could alter someone’s genes, so that they never have to experience the devastation and irreversible effects of addiction? Scientists (Li et al., 2008) meta-analyzed thousands of studies and synthesized the information down to 1,500 human addiction-related genes. Eventually they narrowed it down to five molecular pathways that played an important part in four of the major types of addictive drugs (alcohol, cocaine, nicotine, opioids) in humans. These are common molecular networks with shared rewarding and addictive actions, and may explain some of the hallmark traits of addiction.
Social implications of being able to identify people with a genetic propensity to become addicted to drugs would be on the positive side, a way to get preventative care to those at most risk before they are exposed to drugs. Negatives include discrimination towards those who possess the genes, as well as higher insurance costs.
Ethical problems would be what do we do with those who are afflicted? Do we force them into treatment, even if they do not currently exhibit any symptoms for drug addiction? Who will pay for this treatment? This would also put those who have drug addicted parents at more of a disadvantage than they are at currently. Even if you did not display traits of the disease, if you were born to drug addicted parents you may feel that you will be persecuted against, and rightly so.
Medical impacts would be a more proactive approach to the treatment of the disease as opposed to current methods. Personally I believe treatment for substance abuse is in the Dark Ages where one of the most effective treatments is a 12-step program. Not to discount the efficacy of 12-step programs, but to those who don’t believe in the traditional version of a higher power, they can be very “cultish.” Presently we wait for the drug addicted person to commit a crime, try to hurt themselves or others, and force them into treatment. The eventual life options often cited by drug addicts is “prison, death or treatment,” and at the point that they feel like they have nothing left becomes an epoch in their life and they have the innate desire to change.
The fact that those who are addicted usually do not wish to quit until they have hit rock bottom is another curiosity that will arise as this technology progresses. Would preventative treatment even work, if the person has not experienced the loss that substance abuse creates? Would there be motivation to change the behavior if it had not reared its ugly head yet?
There is a lot to digest about the roles that genetic engineering will play in the future treatment worldwide of substance abuse. Seeing lives destroyed by drug addiction, and having my own drastically changed, I can only hope that the positives will outweigh the negatives in future approaches to this multi-faceted problem.
Li, C.-Y., Mao, X. and Wei, L. “Genes and (Common) Pathways Underlying Drug Addiction.” PLoS Computational Biology 4.1 (2008): E2, 28-32. doi: 10.1371/journal.pcbi.0040002 (retrieved 13 October 2013)