Technical, ethical and social issues in the bioprediction of addiction liability and treatment response

This chapter examines technical, ethical, and social issues in the bioprediction of addiction liability and treatment response. Genetic information could also be used to select the most effective treatment for people who are alcohol or nicotine dependent. Effective use of pharmacogenetics to personalize treatment of alcohol dependence also requires highly prevalent genes that are strongly predictive of treatment response. Genetic information on addiction risk may potentially be used by insurance companies, employers and educators, and the courts. This information may affect not only individuals being tested but also their close relatives. Genes expressed in the central nervous system and associated with complex behavioral phenotypes are likely to influence multiple phenotypes. Therefore, genes associated with addiction may also carry information about the risk of developing other mental disorders. The pharmacogenetic test for naltrexone response does have the potential to provide actionable information, assuming the consumer can correctly interpret the test result. Public health professionals are also concerned about the potential misuse of genetic risk information by industries that wish to promote harmful forms of consumption.