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NEW DELHI: Addiction may not be just about choice or circumstance. A new study by the National Drug Dependence Treatment Centre at the All India Institute of Medical Sciences (AIIMS) suggests that a stress-linked genetic variation could significantly influence the risk of opioid addiction among Indians, pointing to a biological vulnerability behind dependence.Opioids are strong pain-relief drugs that include heroin, morphine, opium-based substances, codeine, and certain prescription painkillers and cough syrups. Several of these are commonly misused in India and are highly addictive. The concern is particularly acute as India has a high burden of opioid use, driven largely by heroin. As per the 2019 report Magnitude of Substance Use in India by the Union ministry of social justice and empowerment, opioid use rates in India are three times the global average.Participants were assessed for substance-use behaviour and tested for genetic variations linked to the brain’s stress-response system, focusing on the galanin pathway, which influences mood, anxiety and reward behaviour.The study, authored by Dr Atul Ambekar and Dr Ramandeep from the Department of Psychiatry, AIIMS New Delhi, along with Rizwana Quraishi and Ram Kumar from the National Drug Dependence Treatment Centre, AIIMS New Delhi, analysed 170 men—85 diagnosed with opioid dependence and 85 healthy controls. Researchers found that a specific genetic variant, GALR1 rs9807208, was significantly more common among opioid-dependent patients. Those with addiction had more than twice the prevalence of this gene variant compared to individuals without dependence, suggesting an inherited susceptibility to addiction.GALR1 is a receptor in the brain that responds to galanin, a chemical messenger activated during stress. It plays a role in emotional regulation and how the brain processes reward—mechanisms closely associated with addiction. Variations in this system may heighten sensitivity to stress and drug exposure.Doctors say opioid dependence often develops alongside chronic stress, anxiety and mood disorders, and stress is a known trigger for both initiation of drug use and relapse after recovery. The study found no association between the gene variant and the severity or pattern of drug use, indicating that genetics may influence vulnerability rather than disease progression.Commenting on the findings, Dr. Mantosh Kumar, senior consultant at Adayu, a Fortis Network Hospital, said heroin remains the most habit-forming opioid, while prescription painkillers and cough syrups, though regulated, still carry abuse potential. “Addiction develops through a complex interaction of biological vulnerability, psychological factors and social stressors, not genetics alone,” he said.Conducted between February and September 2023, the exploratory study involved only male participants, and researchers cautioned that larger and more diverse studies are needed. Experts say the findings reinforce the view of addiction as a medical condition shaped by both biology and environment, rather than a moral failing.
