Development of the Comprehensive Addiction Risk Evaluation System: Initial Participant Response to an Online...

We have made tremendous advances in understanding the etiology of substance use disorders (SUDs). Despite these advances, screening for SUDs has remained largely unchanged. In this paper, we describe an effort to build a program that integrates advances across genomics, developmental psychology, and epidemiology to provide individuals with personalized information about their addiction risk profile.

The program was developed based on foundational work from a NIDA-funded project that conducted multivariate analyses of externalizing phenotypes to advance gene identification for SUDs and then characterized how polygenic scores (PGS) and early life behavioral and environmental factors predicted SUDs in diverse longitudinal samples. Based on this work, we created PGS and a behavioral and environmental risk index to generate personalized risk profiles. We carefully considered ethical concerns when developing the program.

We created a user-friendly, self-directed online platform that provides personalized risk information, including overall risk for developing an SUD based on an individual's combination of genetic, behavioral, and environmental risk, and specific information about genetic risk, based on PGS, and behavioral/environmental risk. Data from the first 188 participants enrolled in an ongoing study to evaluate the platform indicate high satisfaction and low distress at receiving genetic information.

Provision of personalized feedback about addiction risk factors, including genetic information along with behavioral and environmental feedback, may be a viable way to promote earlier screening and intervention with the goal of preventing substance use problems before they start.