And Finally

Tackling the Genetics of Addiction

By Scott Rogers

My, how times change. Twenty years ago, my mother was diagnosed with a disease that carried with it a substantial social stigma, including frightful guilt and isolation. It seems hard to believe today, but that disease was breast cancer.

At the same time, several Utah scientists recognized in Utah families trends in cancer that suggested one cause of this disease might be something quite out of the control of the individual: bad genes. The very idea that complex diseases could be related to defects in single genes was met with considerable skepticism, but this did not stop the scientific inquiry. Combining the remarkable resources of the genealogical database of the LDS Church with the newly developed experimental tools emerging from the field of molecular genetics gave Utah scientists a unique opportunity. The University of Utah created the Department of Human Genetics, and recruitment of leading genetic scientists began. We know the outcome. The genes responsible for multiple cancers were tracked through family members, and specific mutations that altered gene function were identified. If one argues that basic research is the fuel of medical revelation, this is a stellar example.

Clearly this dramatic contribution to understanding the origins of cancer was made possible only through the combined efforts and pioneering spirit of these scientists, the courage of the families who participated, and the substantial financial contributions from every sector of our society. We can now envision a time when these genetic defects are rationally targeted with drugs or even corrected. Of course, there is still a long way to go in this battle, but we have also come a long way.

However, dark clouds threaten our silver linings. We must not forget about other diseases that carry with them both heavy social stigma and dreadful costs to the individual, family, and society. One such threat is addiction and substance abuse.

Now, here is something we don't like to talk about. Almost certainly each one of us could relate a story about ourselves, a friend, a relative, or a public figure who has been affected by addiction and substance abuse. Society frowns, and often we are embarrassed to discuss it. We feel frustrated by the fact that afflicted people "just don't stop," as reflected by the proliferation of campaigns to curb the use of tobacco, alcohol, and drugs. While the "Just Say No" advertising tactics have an impact on drug abuse, it is clear that they fail to reach the entire population. For example, according to the National Institutes of Health, in the United States in 1999, of 35 million individuals that had a "strong desire" to stop smoking, fewer than seven percent succeeded. The fact is that substance abuse is a serious problem that is affecting our youth, our ability to fund and deliver health care, crime rates, and the subsequent costs for courts and prisons. And the problem, especially among elementary and junior high school students, is worsening at an alarming rate. Many kids, when exposed to the awful consequences of long-term smoking or substance abuse, begin to squirm, but often only because they can't wait for their next cigarette.

There is something else that drives these self-destructive behaviors. Emerging clues point to a genetic component. Scientists now have the molecular and medical tools available to approach the biological processes underlying addiction. For example, we are on the threshold of capturing the image of the brain in the very process of formulating a thought. Methods to unravel the complex interactions of genes and cellular processes that are fundamental to our unique ability to learn, memorize, and interact with each other are being revealed daily. In the science of substance abuse, recent advances have begun to identify genetically defined mouse strains that, if offered the choice of an addictive compound, will completely reject it, take just a bit, or consume it at all costs until they die. Sound familiar?

So where to go from here? Much like the battle with cancer, the time is upon us to make a similar impact on revealing the genes that make some people captives of substance abuse. Our first goal is not to "cure" addiction, but rather to understand this disease, and to return to the individual responsibility and freedom of choice. I am convinced that Utah scientists are again on the verge of embracing an idea that, with the support and resources of our community, will realize a future where the biological causes of addiction, like cancer, are approached with compassion, insight, and knowledge.

—Scott Rogers PhD'86 is a research investigator at the Salt Lake City Veterans Administration Hospital Geriatrics Research, Education and Clinical Center, and an associate professor of neurobiology and anatomy and human molecular and biology programs at the University of Utah Medical Center.

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Copyright 2000 by The University of Utah Alumni Association