ELSIcon2022 Flash: Genetic testing for addiction: A qualitative examination of interest, motivations, and concerns among patients with gambling disorder and alcohol use disorder.

The 5th ELSI Congress - ELSIcon2022

Conference

2022-10-27

ELSIcon2022 • Flash • June 3, 2022

Shawn Sorge, Matthew Lebowitz

Rationale: Addictive disorders are increasingly conceptualized as having a genetic basis. Personalized genetic information is not commonly used clinically for addiction, but this may change as precision medicine expands and genetic testing (GT) becomes increasingly common. Patients’ motivations and concerns regarding addiction-related GT are not well understood.

Methods: Twenty adults seeking treatment for gambling (n = 14) and alcohol use (<em>n</em> = 6) disorders were interviewed, using an interview guide aimed at examining beliefs and attitudes about genetic explanations for addiction, including interest in and motivations for GT. Interview transcripts were coded and analyzed utilizing the “grounded theory” approach to qualitative research.

Results: Among all participants, 85% (17/20) expressed hypothetical personal interest in receiving GT. A preliminary qualitative analysis revealed: (1) participants who were interested in GT expressed a desire to identify a specific causal explanation to inform recovery/treatment planning, and to prevent future addictive disorders in family members; (2) participants who were not interested in GT perceived it as lacking clinical utility, given prior success in combating addiction without genetic information, and saw behavior and decision-making as more important than genetics in causing addiction; (3) participants anticipated potential ethical, legal, and social implications (ELSI) for GT, including those related to social stigma, insurance/legal issues, privacy and discrimination, and reproductive decision-making.

Conclusions: Interest in addiction-related GT is linked with perceived clinical utility and may be impacted by ELSI-related concerns. The potential effects of genetic information on illness perceptions and decision-making should be considered before GT becomes widespread in clinical settings.

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