Approximately 3 in 10 people will develop a substance use disorder at some point in their lives. A new test aims to predict the likelihood of that happening and provides a personalized approach to prevention.
The test works by analyzing genetic information from a saliva sample and combining it with personal history details, including childhood experiences, previous substance use, and family history.
Called the Comprehensive Addiction Risk Evaluation System (CARES), this new tool was recently introduced by a research center in New Jersey. It costs $149 to cover processing and administrative fees, and results take about six weeks to be delivered.
Genetic testing has long been used to assess risks for conditions such as heart disease and cancer. However, predicting behavioral outcomes like addiction is more complex, as both genetics and environment play crucial roles. CARES integrates these factors and is based on data collected from over 1.5 million individuals.
Experts describe it as the most predictive genetic risk score for a behavioral outcome available today. While it continues to be used for research, the decision was made to make the test publicly accessible in hopes of helping people make informed choices about their health.
How the Test Works
Genetics account for roughly half the risk of addiction, but environmental and behavioral factors also play a major role. Studies show that only about 4% of people with the lowest genetic and environmental risk develop a substance use disorder, compared to up to 84% of those with the highest risk.
The test primarily identifies behaviors linked to impulse control and risk-taking traits often associated with externalizing disorders. These tendencies might appear in various ways, such as engaging in risky behavior, making impulsive decisions, or struggling with self-regulation.
This reflects how the brain processes risk, reward, and consequences. Some individuals have a brain that is highly reactive to immediate rewards, while others naturally weigh long-term consequences before making decisions.
The assessment process begins with a questionnaire asking about personal and family history with substances. Participants also answer questions like when they first consumed alcohol. After completing the survey, they send in a saliva sample using a kit provided by mail. Results are delivered within six weeks via an online report.
The test categorizes risk levels as average, lower than average, or higher than average. For example, a person with a high-risk score might see results stating that 9 out of 10 individuals with a similar profile go on to develop a substance use disorder.
The research behind CARES stems from a groundbreaking study that linked behavioral and medical outcomes across more than 500 genetic locations. Unlike older methods that analyzed only a few genes, this test incorporates the latest advancements in genetic science.
What the Results Mean
In collaboration with psychiatric genetic counseling experts, the test also highlights environmental and behavioral risks that can be modified to lower addiction risk. These might include social circles that encourage substance use or exposure to environments where alcohol and drugs are readily available.
Genetic counseling plays a role in interpreting the results and helping individuals take meaningful action. Counselors help people understand the implications of their genetic information and guide them in using the results in a way that aligns with their personal values.
Before taking the test, experts recommend considering why the results matter to you and how you might react. Many approach genetic testing casually, only to realize later that the results carry significant emotional weight.
For some, learning about a genetic predisposition to addiction can be motivating, leading them to take preventive measures. For others, it may feel overwhelming. On the other hand, those who struggle with guilt over substance use may find relief in knowing that genetics play a role.
Ultimately, the goal is to empower people with knowledge so they can make informed choices. Understanding one’s risk can help individuals take proactive steps to reduce it, reinforcing the idea that genetics are not destiny.
