Episode 399: How Genes, Biomarkers, and Epigenetics Shape Addiction with Dr. Evelyn Higgins (Rebroadcast)

Would you have made different decisions if you’d known, early in life, that you had a genetic propensity toward addiction? Dr. Evelyn Higgins asks that question, and it opens up a bigger one: what changes when we look at the biological side of addiction? In this conversation, we talk about how understanding our biology can move us away from seeing addiction as a moral failing, and toward more understanding.In this episode, I’m revisiting my conversation with Dr. Evelyn Higgins, which first aired as Episode 217 in January 2023. We talk about the biological side of addiction: genes, biomarkers and brain chemistry, and how they connect with stress, trauma and the environments we live in. Evelyn shares how her years in pain management and her own family’s experience with addiction led her to ask what was happening in the body, not just in behavior.We also talk about why addiction is not a moral failing. Looking at the biology can feel uncomfortable, because it means there are some things we don’t have total control over. But it can also bring more understanding, both for the people who are struggling and for the families who love them.In This EpisodeEvelyn’s path into this work, from pain management to her family’s experience with addictionWhat epigenetics means, and how, in Evelyn’s view, stressors in our lives can influence how our genes are expressedThe difference between describing symptoms in our own words and looking at objective lab informationFamily history, genetic propensity and having open conversations with young people before they experimentHow seeing addiction through a biological lens can change the way families respond to a loved oneKey TakeawaysAddiction is not a moral flaw. Evelyn points out that no one wakes up wanting to lose their family, job or home. We don’t call someone with diabetes weak, and she argues that addiction deserves the same understanding.Biology and behavior work together. Evelyn notes that addiction is described as a biopsychosocial condition, yet the biological part often goes unexamined. She’s clear that behavior change remains just as important. Biology adds to the picture rather than replacing the work of recovery.“White-knuckling” may point to something unaddressed. Evelyn describes people who are sober but still angry and struggling every day. In her view, this can happen when a person’s physiology hasn’t been looked at.Understanding can bring hope. Evelyn shares that when she goes over lab results with people, some