Genetics of Addiction

Genetic and epigenetic mechanisms underlie addiction risk and treatment response with growing clinical relevance. The session covers heritability estimates from twin and family studies, GWAS findings for alcohol, nicotine and opioid use disorders, pharmacogenomics of MAT response (CYP2B6 and methadone, OPRM1 and naltrexone, CYP2D6 and codeine), polygenic risk scores in clinical application, the ethical implications of genetic testing for addiction risk, and clinical-translation pathways through the NIDA Genetics consortium. Discussion addresses epigenetic mechanisms of stress and trauma, family-screening conversations, and the equity implications of pharmacogenomic testing across populations underrepresented in GWAS reference cohorts.