Dr. Keith Humphreys

But other genes for things like impulsivity, that would put you at risk for, you know, across substances.

Being sensation seeking, you're going to try more drugs.

That means it's more likely that, you know, you're going to get exposed to one.

Another thing we see happening which is really fascinating and poorly understood, I of course know doing what I do, lots of people are in recovery and I've known people and had people in my studies who have been say clean and sober in their sense for 20 years

and then all of a sudden they develop like a very strong sexual compulsion or they gain 30 pounds because they're just eating and eating and eating.

And it's like the underlying diathesis, whatever it is, has found a new phenotypic expression because it was never actually resolved.

What was resolved was the particular set of behaviors that went with the addictions they had when they got into recovery.

This is worth getting into.

So use disorder is a much broader spectrum thing.

So if you diagnose someone with alcohol use disorder, it can be mild, moderate, or severe.

And the people at the mild end, everyone at AA would laugh at.

This is a person who occasionally drinks too much, has some harms, but basically life is still put together.

And people would be like, you got to be kidding me, that's your problem.

It's only when you get up to the severe end where we see the things, it looks like addiction.

So they aren't actually the same thing, addiction and use disorder, use disorder is broader.

And it was there to sort of move alcohol like other health behaviors that you might start addressing, particularly in like primary care.

So, you know, just like we would like, you know, doctors to intervene when someone is 15 pounds overweight and has moderate high blood pressure,

so that they don't later develop a more serious problem.

That was the idea, well, let's have a lower severity problem that a doctor might, while the person still has a fair amount of control, advise you, hey, if you could just cut back a bit now, you could avoid a lot of suffering later.

That's where that came from.