Subduing the Pandemic of Addiction

Danielle Dick, an expert on the role of genetics and the environment in addiction
"Historically, and tragically," says Danielle Dick, "we focused on criminalizing addiction and punishing individuals who suffered from substance use disorders. Fortunately, that is changing. Stigma is decreasing and people are realizing that substance use disorders are medical conditions, influenced by both genes and environments."
Photography by Nick Romanenko

Danielle Dick, an expert on the role of genetics and the environment in addiction, is the inaugural director of the Rutgers Addiction Research Center, which will be a one-stop resource to coordinate the university’s extensive resources in addressing addiction nationwide.

If, as Danielle Dick says, the brain is medicine’s last frontier, she is certainly one of its most prominent pioneers. For 20 years, she has conducted extensive research on the intersection of genetic and environmental influences on human behavior, publishing more than 350 peer-reviewed studies in the areas of child development, mental health, human and molecular genetics, human behavior, and addiction. Of the last, she says, “I like a good challenge, and there aren’t many areas as challenging—and as important—as trying to tackle addiction.” In January 2022, she was named inaugural director of the Rutgers Addiction Research Center (RARC), founded at the Rutgers Brain Health Institute to address the epidemic of substance abuse now raging across the United States. 

The center will bring together and coordinate Rutgers’ vast resources in four major domains: basic science (including neuroscience, genetics, and epidemiology); prevention and intervention; treatment and recovery; and public policy. Essentially, Dick says, “The RARC will be a one-stop resource for all things addiction-related at Rutgers.” It will promote collaboration, offer start-up funds to researchers and enable them to secure funding from the National Institutes of Health, and create pipelines between researchers and addiction treatment providers. Rutgers Magazine spoke with her about the very complex subject of addiction and the impact the new center can have on those who struggle with it.             

RUTGERS MAGAZINE: Historically, our country hasn’t done a very good job of addressing addiction. Why is that, and do you believe it’s a problem that can be mitigated?
DANIELLE DICK: Historically, and tragically, we focused on criminalizing addiction and punishing individuals who suffered from substance use disorders. Fortunately, that is changing. Stigma is decreasing and people are realizing that substance use disorders are medical conditions, influenced by both genes and environments, like other common complex biomedical conditions, like cardiovascular disease. Because substance use disorders and related mental health conditions affect so many of us—one in four adults will be affected—it’s a moral imperative that we do a better job of tackling addiction. The RARC will play a critical role in the fight against addictive disorders by advancing research on the biological and social processes that contribute to risk, and using this knowledge to develop more effective prevention, treatment, and public policy. I am also passionate about researchers doing more to get scientific advances to the people who can use them. I wrote a book for parents, The Child Code: Understanding Your Child’s Unique Nature for Happier, More Effective Parenting (Avery, 2021). It helps parents understand how their children’s genetic codes impact their behavior and how we can use that information to help stop problems before they begin.  

 RM:You note that both environmental factors and genetics can predispose a person to addiction. How do we know that there’s a genetic element involved in addiction?
DD: We’ve known for a long time that substance use disorders run in families, but that can’t tell us whether it’s due to shared genes or shared environmental factors. The way we estimate the degree of genetic influence is through twin and adoption studies. Hundreds of thousands of twins have been studied on virtually every outcome you can think of. And we’ve seen that identical twins, who share their full DNA sequence, are far more likely to share a tendency toward addiction (or lack thereof) than fraternal twins, who share on average just 50 percent of their DNA variation. And in studies of adopted children and their birth parents, it’s been repeatedly found that kids whose biological parents had substance use problems or other psychiatric conditions were much more likely to have those problems. Having an adoptive parent with mental health challenges raised the risk a little bit. But having a biological parent with those challenges—even one with whom children never had contact—raised the risk much more. These studies demonstrated the powerful role of our genes in addiction and mental health.  

RM:You have a special interest in substance use and mental health outcomes in youth and young adults. Why is that?
DD: Genetic predispositions don’t just suddenly show up; no one wakes up one morning to discover they had an onset of alcohol use disorder overnight. Instead, genetic risk starts to show up as behavioral tendencies that we can see very early on in kids. Some people have brains that are more primed for “go” responses. They’re more novelty seeking; they discount long-term consequences; and they think more about the reward that’s right in front of them. This shows up initially as problems with self-regulation in children. When impulsivity goes unchecked, it can contribute to substance use and other addictive disorders. Other people have brains that tend toward worry, anxiety, and depression. These tendencies can lead to the use of substances to cope with some of these challenges. These genetic dispositions show up in children. So, the reason I’m so passionate about studying kids and youth is because the earlier that we can intervene and address these dispositional traits—by teaching kids life skills to manage their tendencies—the more likely we are to reduce subsequent substance use problems.

RM:How else might we be able to prevent substance use problems?
DD: There are many ways we can engage in effective prevention. Programs can be targeted at individuals, helping them to understand risk and protective factors and learn about ways to reduce risk. We can also think about prevention at the level of the family, the school, or the neighborhood. We know that there is no one magic bullet to prevent addiction. We need to take a multi-pronged strategy.

RM: How can public policy affect substance abuse?
DD: Policy can play a powerful role in curbing substance use problems. Laws surrounding taxes, marketing, packaging, alcohol sales, and the legality of various substances can all affect rates of substance use and problems. Health care policy can play a major role in determining whether individuals who are affected are able to get the help they need. And policies surrounding programming in schools can affect whether we have the resources we need to intervene early and prevent the development of problems in our children. One of the many wonderful things about Rutgers is that we have leading researchers who study public policy. This will be an important component of the RARC.   

RM: What appears to work best for treatment?
DD: There are many evidence-based treatments that are known to work, and they tend to involve combinations of medication and psychotherapy. One of the things we plan to focus on at the RARC is precision medicine. How do we tailor the right treatment to the right person at the right time? 

RM: What kind of impact do you think the RARC can have?
DD: Rutgers is an amazing place for addiction research. We already have great researchers who are advancing our understanding of addiction through basic and applied science. We have training programs to educate students, professionals, and the community about addiction. And we have devoted clinical providers. The RARC will strategically build upon this foundation to make Rutgers one of the top addiction centers in the country, and the world, for tackling substance use and other behavioral addictions. Rutgers, and New Jersey by extension, really has the opportunity to lead the way.