The Important 0.1 Percent

(Nineteenth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)

DNA sequences for any human is approximately 99.9 percent identical to every other human. That means that only 0.1 percent of our genetic makeup is unique to us. Genes are functional units of DNA that make up the human genome. But don’t be fooled into thinking that 0.1 percent variation is insignificant. It is nearly 3 billion base pairs of DNA which boils down to 3 million differences that determine our physical features like hair and eye color and health risks or protection from diseases such as heart disease, diabetes – and addiction. Genes influence the numbers and types of receptors in peoples’ brains, how quickly their bodies metabolize drugs, and how well they respond to different medications.

The National Institute of Drug Abuse (NIDA) reports that family studies that include identical twins, fraternal twins, adoptees, and siblings suggest that as much as half of a person’s risk of becoming addicted to nicotine, alcohol, or other drugs depends on his or her genetic makeup. Scientists estimate that genes – including the effects environmental factors have on a person’s gene expression, called epigenetics – account for between 40 and 60 percent of a person’s risk of addiction.

Epigenetics – epi meaning “above” – is the study of functional, and sometimes inherited, changes in the regulation of gene activity and expression that are not dependent on gene sequence. This means exposures or choices people make can actually “mark” (remodel) the structure of DNA at the cell level. So epigenetic regulatory systems enable the development of different cell types (e.g., skin, liver, or nerve cells) in response to the environment. These epigenetic marks can affect health and even the expression of the traits passed to children. For example, when a person uses cocaine, it can “mark” the DNA, increasing the production of proteins common in addiction which is believed to correspond with drug-seeking behaviors.

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Choosing to Look Away: Pain avoidance

In these weeks of living life in a new way with the Coronavirus pandemic, I have found myself doing something I am not normally inclined to do: choosing to look away from the ongoing Opioid Epidemic. Sadly, it has been easy to do. John and I arrived in Melbourne in March on the last flight from LAX allowing non-residents into Australia. When we planned our trip in January to be here for the completion and delivery of our new Tiny Home, Covid-19 was barely in the news.

After our 14-day quarantine, and during our first few weeks here, we were supposed to speak at two events which were cancelled. When the meetings switched over to Zoom, we were then able to share the story of Opiate Nation. It was well received and appreciated, as it brought to light pitfalls and vulnerabilities that parents and their children face in the 21st century. Since then, we have been busy setting up our new home, arranging installations, and finding furniture and appliances. We are thankful and feel blessed to be able to be here with our daughter and family – and to be in a country where the leaders have been honest and proactive, where the government has a wide social safety net and comprehensive health care for everyone, and where the public is almost uniformly willing to trust and follow their stipulations.

Meanwhile, in the back of my mind, I have continued to think about people struggling with addiction and wondering what their lives are like during these times that are challenging – even for the rest of us. With the restrictions to help slow the spread of the virus, many rehab and recovery programs are now not an option. For those who have had jobs, many of which are hourly-wage or temporary positions, they may now be unemployed. If they are taking medication as part of their harm reduction/medication assisted treatment, how will they pay for it?

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