The role of genetics, you may ask? If you’ve been through addiction and recovery work, you know relapse can feel like someone waiting to ambush you around a corner. But did you ever stop to think how much your genes might play a hidden role in that risk? Yes, your family tree, your inherited biology, these can influence how likely relapse is for you.
At her practice on the premises of The Way Recovery Centre in Pretoria, Dr Jolandi Meyer works with addiction patients not only on behaviour and therapy, but also on recognising biological vulnerabilities. Let’s explore how genetics contributes to relapse risk and how you can still shape your recovery despite inherited risks.
Understanding Addiction as a Complex Trait
First things first: addiction is not caused by one gene. Rather, it’s a complex, multifactorial trait. That means many genes, each with a small effect, interact with each other and with your environment to shape your vulnerability. Think of it like a recipe: many ingredients, all interacting, determine the final dish.
Researchers estimate that heritability — the proportion of risk explained by genes — for various substance use disorders is roughly 40 to 60 percent. That leaves plenty of room for environmental influences, personal choices, trauma, stress, and treatment interventions. Genes are part of the picture, not the whole picture.
The idea isn’t that your genes doom you to relapse, it’s that they may increase your sensitivity to certain triggers or make it harder to maintain sobriety under stress. Knowing about that risk doesn’t excuse relapse, it helps you prepare and strengthen your defences.
Key Genetic & Biological Mechanisms Linked to Relapse Risk
What do these genes do, exactly? While the science is still evolving, certain biological pathways have been reliably associated with addiction vulnerability and relapse risk.
Dopamine and Reward Circuitry
One of the most studied systems is the dopaminergic reward pathway. Variants in genes involved in dopamine signalling, such as dopamine receptor genes (e.g. D2, D3), dopamine transporter genes, and regulatory genes, can influence how intensely someone experiences reward, craving, or reinforcement from substances. If your brain is less responsive to natural rewards (food, relationships, hobbies), you may be more vulnerable to turning to substances for that “boost.”
Neurotransmitter Systems & Stress Response
Other systems implicated include GABA, glutamate, serotonin, and stress regulation (HPA axis). Genes affecting how your brain regulates stress, mood, and inhibition can alter how you respond to triggers, cravings, or negative emotions.
Epigenetics: Genes Meet Environment
Even if you inherit risk genes, whether they “switch on” depends heavily on your environment and experiences. That’s where epigenetics comes in. Epigenetic modifications (DNA methylation, histone modifications, etc.) can regulate how genes are expressed, and those modifications can be influenced by stress, trauma, substance use, sleep, diet, and more. This means your genes are not your destiny, your life context and habits also matter a great deal.
Shared Genetic Markers Across Substances
Interestingly, modern large-scale genetic studies (genome‑wide association studies) have identified shared genetic risk factors across different addiction types, meaning that the vulnerability may generalise rather than be substance‑specific. That helps explain why some people substitute one addiction for another, or why relapse sometimes occurs with a different substance or behaviour than the original one.
How Genetics Interact With Environment & Choices
Genetic risk is probabilistic, not deterministic. In practice, the risk of relapse emerges from the interplay of:
Genetic susceptibility
Stressors, triggers, trauma
Support structures and coping skills
Treatment, therapy, community
Lifestyle factors (sleep, nutrition, exercise)
For instance, a person with higher genetic risk might do fine under low-stress conditions and strong support, but struggle when life becomes chaotic, when sleep fails, or when emotional pressures mount.
Also, genetic risk might influence the threshold at which relapse becomes more likely, someone with lower genetic risk might have more “buffer” before slipping. But everyone benefits from proactive relapse prevention strategies, regardless of risk level.
What Genetics Means for Relapse Prevention
Recognising genetic vulnerability doesn’t make recovery harder, it can make it smarter. Here’s how knowledge of genetic risk can shape your approach:
Tailored Monitoring & Support
If you know you may have higher biological sensitivity to relapse, you might benefit from:
More frequent check‑ins in early recovery
Ongoing therapy or counselling rather than short‑term care
Extended aftercare plans
Medication support when needed
Strengthening Buffer Systems
Because your genetic risk may amplify response to stress, building robustness in other systems is critical:
Stress management skills (mindfulness, breathing, grounding)
Healthy routines for sleep, nutrition, exercise
Social support and accountability
Early warnings and rapid response plans for emotional turbulence
Avoiding Complacency
Knowing that genetics play a role should not lead to a fatalistic attitude, it should fuel vigilance. People with greater risk must be more intentional about their recovery than someone who feels less vulnerable.
Use of Emerging Tools
As research evolves, polygenic risk scores (PRS) or genetic addiction risk assessments may become more clinically useful. But for now, they are primarily research tools, not definitive clinical diagnostics. Use them cautiously, in consultation with professionals.
What Dr Jolandi Meyer and The Way Recovery Centre Offer in This Context
In my practice and through the services at The Way Recovery Centre, we provide care designed to respect both biology and personal agency. Here’s how we integrate the genetics-informed approach:
Comprehensive assessments of mental, physical, and genetic vulnerabilities
Ongoing medical oversight and medication management when needed
Counselling that addresses emotional response, coping strategies, and relapse triggers
Extended aftercare and relapse prevention programmes
Psychoeducation about biological risk to reduce shame and increase empowerment
We believe that understanding your biology is one tool in your recovery toolkit, not an excuse to give in, but a reason to build smarter defences.
For information on our 28-day in-patient programme with professional qualified medical detox from addiction and a platform of different approaches to addicts suffering from long-term gambling, alcohol and/or drug addiction, get in touch with Dr. Jolandi Meyer at The Way Recovery – Gambling, Drug & Alcohol Abuse Treatment Facility in Pretoria. A six-week outpatient programme with individual counselling, group therapy, and family support is also available from The Way Recovery.
The Way Recovery Halfway House in Pretoria offers a reintegration, aftercare programme to aid the addict who has finished a detox programme in adjusting to society for the recovering addict who still struggles.
Myths and Misunderstandings About Genetic Risk
When we begin talking about genetics in addiction, some common myths surface. Let me address a few:
“If it’s in my genes, I’m doomed.” No. Genes raise probabilities, not certainties. Your actions, environment and healing matter a lot.
“Genetics means no blame.” While biology helps explain, recovery still requires accountability and growth.
“Knowing genetic risk means I will relapse.” Not necessarily. It gives you insight so you can tailor your recovery plan.
“Genes are static.” They aren’t. Through epigenetic changes and healthy lifestyle, gene expression can shift.
By demystifying genes, we empower you to use that knowledge without fear or fatalism.
Practical Steps to Reduce Genetic Relapse Risk
Here are actionable strategies that work well when you understand your inherited vulnerabilities:
Engage consistently in therapy or counselling
Use relapse prevention tools before pressure builds
Monitor sleep, stress, diet and physical health
Build a circle of sober support and accountability
Avoid complacency even when feeling stable
Use early intervention when symptoms of craving or emotional instability arise
Consider medical support if symptoms push you toward relapse
These strategies are not optional, they’re protective armour when genetic risk is in play.
Genetics play a role in addiction relapse risk, but they are not destiny. The interplay between your biology and your environment shapes how relapse risk unfolds. By acknowledging genetic predispositions, you don’t resign yourself to relapse, you become better equipped to anticipate, protect, and respond.
With the medical foresight, compassionate guidance, and integrated care offered by Dr Jolandi Meyer, in collaboration with The Way Recovery Centre, people can learn to walk through relapse risk with eyes wide open, not naive, but empowered.
If you or a loved one would like to discuss how your biology might influence your recovery path, reach out. Learning about your unique makeup is not about labels, it’s about shaping a stronger, more resilient journey forward.
Common Ailments Treated by Dr. Jolandi Meyer
Dr. Jolandi Meyer’s expertise and comprehensive treatment options make her an exceptional General Practitioner for addressing all ailments. She provides personalised care, empowering patients to achieve optimal health. Her compassionate approach ensures patients receive the highest quality treatment. Her practice is located in Garsfontein, Pretoria on the same premises as The Way Recovery Centre.
With her support and guidance, patients can embark on a journey towards improved well-being and a healthier, happier life.