Hi Reddit! Wouldn’t it be wonderful to attribute our compulsion for addictive damaging activities, such as overeating, taking illicit drugs or smoking, wholly to our genetic make-up? Then, we would have a clear explanation for these complex behaviors. Yet, environmental influences shape and are shaped by our genetic predispositions. A key issue is that we know that certain behaviors are bad for us but we still do them. Why? My research explores the latest public health and brain research behind addictive behavior. Personalized medicine provides plenty of research linking genetics and disease. But establishing a relationship between genetic variation and behavior is trickier. From these genetic and environmental perspectives, how do we understand and explain the recent epidemic of opioid overdose deaths? First prescription opioid deaths increased in the USA and more recently heroin deaths have markedly increased. How do biological and environmental factor explain how these two epidemics are related to one another? What can be done to address these serious health issues? Genetics plays a key role but is only one part of the puzzle. Environments, including intrauterine, early childhood, school, neighborhood and broad social settings, all play a key role in determining addiction outcomes. The three strands of biological, psychological and social elements working together is key to both understanding and intervening to prevent or treat addictions. This AMA is facilitated by the American Association for the Advancement of Science (AAAS) as part of their Annual Meeting Wilson Compton, MD, Deputy Director, National Institute on Drug Abuse, Bethesda, Md. Understanding Vulnerability to Substance Addictions I will be back at 3 pm EST (12 pm PST, 8 pm UTC) to answer your questions, Ask Me Anything!