Background: Over 100 people die daily from opioid overdose and $78.5B per year is
spent on treatment efforts, however, the real societal cost is multifold greater. Alternative strategies
to eradicate/manage drug misuse and addiction need consideration. The perception of opioid addiction
as a social/criminal problem has evolved to evidence-based considerations of them as clinical
disorders with a genetic basis. We present evaluations of the genetics of addiction with ancestryspecific
risk profiles for consideration.
Objective: Studies of gene variants associated with predisposition to substance use disorders
(SUDs) are monolithic, and exclude many ethnic groups, especially Hispanics and African Americans.
We evaluate gene polymorphisms that impact brain reward and predispose individuals to
opioid addictions, with a focus on the disparity of research which includes individuals of African
and Hispanic descent.
Methodology: PubMed and Google Scholar were searched for: Opioid Use Disorder (OUD), Genome-
wide association studies (GWAS); genetic variants; polymorphisms, restriction fragment
length polymorphisms (RFLP); genomics, epigenetics, race, ethnic group, ethnicity, ancestry, Caucasian/
White, African American/Black, Hispanic, Asian, addictive behaviors, reward deficiency
syndrome (RDS), mutation, insertion/deletion, and promotor region.
Results: Many studies exclude non-White individuals. Studies that include diverse populations
report ethnicity-specific frequencies of risk genes, with certain polymorphisms specifically associated
with Caucasian and not African-American or Hispanic susceptibility to OUD or SUDs, and vice versa.
Conclusion: To adapt precision medicine-based addiction management in a blended society, we
propose that ethnicity/ancestry-informed genetic variations must be analyzed to provide real precision-
guided therapeutics with the intent to attenuate this uncontrollable fatal epidemic.