Family History of Addiction: Understanding Your Risk

A family history of addiction correlates with an increased risk of addiction.1,2 Genetics is a critical factor that contributes to addiction as well as the environment, your behaviors, and their impact on gene expression (epigenetics).1,3,4

How Genetics Can Contribute to Family History of Addiction

Research shows with a family history of substance misuse, you are twice as likely to develop mental health issues and substance misuse problems yourself.2 One reason for this has been linked to genetics. If there is a family history of addiction, it could be due to a variation of many genes.3

The following are genes that have been identified:3

  • ADH1B
  • ALDH2

Studies are underway showing that the following genes could also impact the risk for traits related to addiction:3

  • GABRA2
  • CHRM2
  • KCNJ6
  • AUTS2

If you have a family member with variations in these genes associated with addiction traits, then there is a likelihood that the variations have been passed down to you. This would increase your risk.3 However, it does not mean you will automatically struggle with addiction as many other factors interact with your genes to lead to alcoholism or drug addiction.

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How Epigenetics Can Influence Family History of Addiction

Epigenetics is the study of how your environment and behavior can impact your gene expression and the way they work rather than alteration of your genetic code and the makeup itself (DNA and RNA).5

This is where the concept of nature versus nurture matter comes to the forefront. For example, while you may have a genetic predisposition to addiction (nature), you can take steps to prevent or lower your risk of gene variations from expressing themselves (nurture).5

Self-Care and Stress Management Techniques

You can use self-care techniques, including ensuring you have healthy sleep hygiene to get adequate rest, participating in art such as drawing and painting, listening to music, going to a show, watching comedies, taking a bath, and/or lighting a candle.6

Although partaking in these activities may not cure or resolve matters with your family, it provides you a mental health break from it.

These can be healthy distractions and balance the tensions resulting from a family history of addiction.

Mindfulness-Based Practices

Research shows that if you slow down and meditate or focus on one task at a time, it gives the brain a chance to refocus.6 This refocusing can allow you to prioritize and ground yourself with your goals and what you would like in your life. It can also allow you time and space to consider how you would like to create and raise your own family.

Exercise and Movement

Whether you decide to weight-lift, cycle, walk, run, do yoga, stretch, do aerobics, do karate, or any other number of exercise modalities, they could provide you with a healthy outlet for any frustrations you may have about things you cannot control, such as your childhood, your environment, or your family history of addiction.6

Exercising also positively impacts mitochondrial function and releases “feel good” chemicals such as adrenaline. This can help with mood.6

Eating Healthy

Research shows that fueling your body in a healthy manner provides it with proper energy.6 When you make healthy food choices, your body tends to function optimally, which is correlated to a lower risk for chronic illness. If you can avoid developing chronic illness and other preventable diseases, you increase your likelihood of not developing comorbid mental health disorders such as depression.

Find Other Healthy Social Supports

Although you might not be able to go to your family for reliable support through the ups and downs of life, you can develop meaningful relationships in other ways.2,6 These could include volunteering with an organization in your community for a cause you are passionate about, work mentors, spiritual leaders (if you have a spiritual practice), neighbors, and friends and their families.

Community Support Groups

Al-Anon is one such group that could help you recover from the effects of a loved one’s drinking or use of illicit substances.2 By attending, you would be educating yourself on the family disease of addiction and learning tools to adjust your behavior and choices.

Learn Healthy Coping Skills

You can learn healthy coping skills by entering therapy to process and learn techniques to manage feelings and emotions related to being exposed to the family disease of addiction.2 On the other hand, if you make choices that are inconsistent with self-care, the epigenetics of the gene variations could enhance gene expression of gene variation in a manner that puts you at risk for addiction.

How Non-Genetic Factors Contribute to Family Disease of Addiction

Several non-genetic factors contribute to the family disease of addiction, including: 7,8

  • Learned behavior/behavior modeling
  • Early exposure to substances
  • Prenatal exposure
  • Hereditary behavioral traits
  • Trauma in home of origin (neglect, food, and housing instability)
  • Inconsistent or erratic parenting
  • Unsupportive communication
  • Denial
  • Setting unrealistic expectations
  • Self-medication
  • Misplaced anger

Learned Behavior/Behavior Modeling

Mirror neurons are cells that can be found in the brain. They respond equally when you perform an action and when you witness someone else performing the same action.9

If you have ever heard the expression, “Monkey sees, monkey does,” it would be apropos to describe mirror neurons. Growing up with a family history of addiction might include seeing and observing some less-than-ideal behavior.7 As a result of mirror neurons, you may start to model this behavior that you see other family members do.9 Eventually, you start doing these behaviors on your own.9

Early Exposure to Substances

Being in a home where alcohol is readily available, or you have been exposed to illicit substances increases accessibility to them.10 With this increased accessibility, you may start drinking or using other mood-altering substances at an early age.10

This could then carry into your adolescent and adult years without ‘aging out’ or proper treatment. “Aging out” can refer to the gradual and natural maturing that occurs as you progress in age.10 As a result, your brain would mature, creating more stable and long-lasting neural connections and pathways, and you will have formed healthy relationships.10

So, your substance use may not naturally turn into overuse or misuse.10 Yet, early exposure to substances increases your risk of becoming addicted due to accessibility and starting at a young age, while the brain is still developing.10

Prenatal Exposure

Most studies discussing neurobehavioral and physical outcomes in newborn infants have shown that prenatal exposure to illicit substances such as opiates, cocaine, and marijuana increases the risk that exposed infants will:11

  • Weigh less
  • Be born prematurely
  • Have smaller heads
  • Not grow as tall as unexposed infants

This is because most illicit substances can easily cross the placenta, thereby affecting fetal brain development.11 This in-utero exposure can have long-lasting impacts on the structure and function of the brain.11 The nervous system tends to be impacted since the exposure occurs before regulatory and homeostatic mechanisms are properly developed in the fetus.11

Hereditary Behavioral Traits

Scientists conducted a review of scholarly research on genetics and addiction. The data measured the following behaviors and demographics of its participants:12

  • Years of education
  • Medical history (heart rate, cholesterol levels)
  • Other comorbid disorders (Diabetes, Parkinson’s, depression)
  • Age smoke started
  • How much was smoked
  • History of smoking cessation (and attempted smoking cessation)
  • Number of consumed drinks per week

These items were then correlated with specific genes connected with addiction. The results indicated over 400 locations in the human genome and 566 variants within these locations that impact smoking or alcohol use, making a connection with genetics and addiction.12

These locations identified host genes that influence synaptic transmission. Furthermore, locations associated with smoking and alcohol affect functions of the following neurochemicals and functions:12

  • Dopamine (behavior and reward neurotransmitter)
  • Glutamate transmission/strength of synaptic connections
  • Acetylcholine (a neurotransmitter that signals the fight-or-flight response)

Although this research was limited to cigarette smokers and alcoholics, it supports findings that hereditary behavioral traits exist in the family disease of addiction. There is additional research being conducted on other illicit substances. Some hereditary behavioral traits include (and are not limited to):11,12

  • Inability to learn that cannot be explained by sensory, intellectual, or other health factors
  • Inability to foster or maintain emotional connections or social relationships
  • General depression, anxiety, or moodiness that does not go away
  • Unexplainable physical symptoms such as headaches and stomach aches while doing ordinary, daily tasks (housework, driving, interacting with neighbors or friends)
  • Inappropriate expression of feelings
  • Inappropriate behaviors under normal, non-stressful circumstances

Trauma in Home of Origin

This would pertain to any neglect on behalf of your family of origin and any food and housing instability while being raised in a family history of addiction.7,10 Research shows that experiencing physical, emotional, and sexual abuse and physical neglect during childhood showed a positive association with developing alcohol dependence.7,10

Inconsistent or Erratic Parenting

Inconsistent or erratic parenting would include a lack of boundaries, family coming and going at random hours of the day and night, and an inconsistent schedule by your family.7,10,11 Behaviors such as these can lead you to have high levels of stress and carry the effects of trauma. If left untreated, it would increase your risk of developing behavioral challenges, disorders or overusing or misusing illicit substances.7,10,11

Unsupportive Communication

This could be done in a nonverbal or verbal manner. For example, unsupportive non-verbal communication would entail frowns, scowls, jeers, and stern expressions. Another one would be being ignored rather than rewarded for your accomplishments.1

Unsupportive verbal communication would entail yelling, name-calling, chastising, cursing, and complaining.1 This treatment by the family history of addiction can trigger you to develop behavioral challenges, disorders, or issues overusing and misusing substances.1


If your family is struggling to accept the fact that they may benefit from treatment, this can elevate the effects of the family history of addiction.2,7

It can be frustrating for you because you may see the problem, and their behavior is invalidating. It can be referred to as “gaslighting.” This can lead to you second-guessing yourself later in life.2,7

Setting Unrealistic Expectations

Sometimes coming from a family history of addiction can involve having family members with high expectations of you. This could be due to the family member(s) needing emotional support or projecting their feelings onto you. It could also be because they fell short of their own goals.2,7,11 So, they put pressure on you to express what they struggle with or to reach goals they were not able to. Sometimes the pressure is familial. For example, they would like you to take over the family business or continue the family’s lineage.

This can lead you to take on excessive family responsibility and personal success goals. Although it is healthy to want to reach personal and professional goals, you may feel overly burdened with this task, creating anxiety and insomnia, among other physical complications related to anxiety (elevated blood pressure and heart rate, disturbed sleep, and agita). You may constantly want to succeed and have difficulty relaxing, taking breaks, or going on vacation.2,7,11


Sometimes there is an underlying mental health issue in your family. This, in turn, can create substance misuse issues.1,13 It can also work the other way around. Using substances illicitly for periods can create co-morbid mental health conditions.1,13 Viewing this in the family history of addiction could create hypervigilance for you and perhaps even influence you to be overprotective of your children and loved ones.1,13

Misplaced Anger

Your family may be unable to process their feelings and emotions because of the family history of addiction. As a result, the main expressed mood by them might be anger. In some families, it is expressed outwardly in an explosive manner. In others, it may be “stuffed,” and members may struggle to express it.1, 2,14

Whichever expression of anger you observe and experience in your family history of addiction would be the one you would be susceptible to picking up later on in life.1,2,14

If you or a loved one feels treatment is the right fit, or you’re unsure of where to start, contact a treatment specialist at 800-948-8417 Who Answers? .


  1. Lander, L., Howsare, J., & Byrne, M. (2013). The Impact of Substance Use Disorders on Families and Children: From Theory to Practice. Social Work in Public Health, 28(3-4), 194-205.
  2. Substance Abuse and Mental Health Services Administration. (2022, May 10). Resources for Families Coping with Mental and Substance Use Disorders.
  3. Edenberg, H. J., & Foroud, T. (2013). Genetics and Alcoholism. Nature reviews. Gastroenterology & hepatology, 10(8), 487-497.
  4. Center for Disease Control and Prevention. (2020, August 3). What is Epigenetics?
  5. National Institute of Drug Addiction. (2019, August 5). Genetics and Epigenetics of Addiction DrugFacts.
  6. Lee, J., Papa, F., Jaini, P. A., Alpini, S., & Kenny, T. 2020. An Epigenetics-Based, Lifestyle Medicine–Driven Approach to Stress Management for Primary Patient Care: Implications for Medical Education. Am J Lifestyle Med. 14(3), 294-303.
  7. Fenton, M. C., Geier, T., Keyes, M., Skodol, A. E., Grant, B. F., & Hasin, D. S. (2013). Combined Role of Childhood Maltreatment, Family History, and Gender in the Risk for Alcohol Dependence. Psychological Medicine, 43(5), 1045-1057.
  8. Center for Disease Control and Prevention. (2020, Oct 22). High-Risk Substance Use Among Youth.
  9. Acharya, S., & Shukla, S. (2012) Mirror Neurons: Enigma of the Metaphysical Modular Brain. J Nat Sci Ciol Med, 3(2), 118-124.
  10. Mennis, J., Stahler, G. J., & Mason, M. J. (2016). Risky Substance Use Environments and Addiction: A New Frontier for Environmental Justice Research. International Journal of Environmental Research and Public Health, 13(6), 607.
  11. Ross, E. J., Graham, D. L., Money, K. M. & Standwoord, G. D. (2015). Developmental Consequences of Fetal Exposure to Drugs: What We Know and What We Still Must Learn. Neuropsychopharmacology, 40(1): 61–87.
  12. National Institute on Drug Addiciton (2019, Jan 14). Scientists closer to finding inherited traits in addiction.
  13. National Institute on Drug Addiction. (2020, July 13). Drug Misuse and Addiction
  14. Whitesell, M., Bachand, A., Peel, J., & Brown, M. (2013). Familial, Social, and Individual Factors Contributing to Risk for Adolescent Substance Use. Journal of Addiction, 2013, 579310.
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