In a recently published study, it was found that a set of 4 genes (JUN, CEBPB, PRKCB, ENO2, or CEBPG) was shown to predict the diagnosis of heroin addiction with an accuracy rate of around 85 percent. This is an amazing development and could open the door to knowing who is at high risk of opiate addiction before the prescription is written. If similar markers can be found for other drugs of abuse, it might be possible to dramatically improve our prescribing patterns and alleviate the suffering of those who are most at risk for this terrible condition.
However, it remains to be seen how studies like these will be utilized in the current war on drugs. Will this knowledge free the afflicted from the acrimonious condemnation our society metes out to those who suffer from or treat addiction? Or will it be used to discriminate against the carriers as soon as they exit the womb, for the greater good, of course? A little history can help us understand this danger.
At the beginning of the last century, there was an argument in the academic community between those who favored nurture (environment) as the determinant of human behavior, and those who favored nature (genetics). One of the major proponents of the former was B.F. Skinner, famous for being considered the father of Behaviorism. At its extreme, behaviorism holds that all human variation in behavior results from learned habits and reflexes impressed upon a blank slate. He once said, “Give me any child at birth, and I’ll shape him into anything.” Many were swayed by his arguments and those of like-minded researchers.
The communists saw in behaviorism support for their contention that economic disparities led to divergent and unproductive human behaviors. They also believed that the right education and environment could create a “new man,” a perfect citizen, supporting the state and working for the welfare of all. They also believed that an errant citizen, a dissident, could sometimes be “re-educated” and brought back into the state’s good graces. They put these theories into action, and many great thinkers and scientists spent time in prison for daring to think in an unapproved manner. The Soviet citizen who put the first satellite into space and the first man into orbit, Sergei Korolev, spent time in prison for not denouncing a targeted colleague to the satisfaction of the apparatchiks.
At the same time, in Nazi Germany, the opposite contention, that genetics determined the limits of human behavior, had become dominant. The concept, developed into the “science” of eugenics at Cold Harbor in 1910, had made an impact on the young Adolf when he saw the effects of their implementation in the U.S. state of Virginia. In the 1920s, Virginia had implemented a sterilization law prohibiting the “unfit” from being able to reproduce. Upheld by the U.S. Supreme Court, about 65,000 Americans were sterilized throughout the country. Eight thousand of those were from Virginia. These laws weren’t repealed until 1974, and the Supreme Court never truly corrected its original ruling.
Under the Nazi regime, genetics was everything. Taking Mendel’s and Darwin’s discoveries and applying them completely out of context, the Germans developed a strict hierarchy based on these principles. Coming from a “noble” family guaranteed you access to an education and the officer’s corps. Having the wrong genes meant you were considered “Lebensunwertes Leben,” or life unworthy of life. Being a descendant of Jews, Romani, Poles, etc., was enough to sign your death warrant. The regime believed that the DNA of these people made it impossible for them to contribute meaningfully to society, and made them too dangerous to the social order, with no useful purpose, except as slave labor.
In an interesting parallel, when Werner von Braun, Germany’s greatest rocket scientist, complained about the slave labor conditions he saw, he was also put in prison. Proving that extreme positions of dialectically opposed ideologies, taken to the extremes, wrap around and become almost indistinguishable in their tyranny.
Now, in our more enlightened age, we acknowledge that genes create raw materials and generate broad parameters to the limits of development. While understanding that epigenetics and environment shape the clay, so to speak. Or at least some of us do. There are still many adherents in the U.S. today to the arguments of these older systems. The U.S. has by far the largest and most efficient conviction and imprisonment system on earth. These internment and reeducation centers separate families and destroy lives as effectively as the Soviet gulag system, including those suffering from clearly medical issues, like mental illness and addiction. Pregnant or post-partum minority mothers are often targeted for testing and imprisoned if drugs are found.
But what about genetics? Will these tests be used to target citizens by a “precrime” bureau? U.S. laws do not protect the genetic privacy of its citizens. And while we may believe that HIPAA or the Fourth Amendment protects medical information, it absolutely does not. In fact, HIPAA’s law enforcement exception makes all of our medical records available to the authorities. In the pre-HIPAA days, records were on paper and locked in an office. The police had to get a specific warrant to access them. Not long ago, the DEA was found to be trolling through thousands of cloud-based medical records, fishing for targets. How many patients will be willing to tell their physician about their drug problem when they know that federal agents will be reading through their charts? Worse yet, the government has developed algorithms and AI-based platforms to analyze medical and prescription records to find patients and physicians to target and prosecute.
As genetic databases become more common, how long before an authoritarian regime, ours, or someone else’s, starts scanning them for preemptive strikes against those deemed a threat to society? America needs a law protecting the independence of physicians, the sanctity of the doctor-patient relationship, and the absolute privacy of medical records, before these questions are answered in a manner we will not like.
L. Joseph Parker is a distinguished professional with a diverse and accomplished career spanning the fields of science, military service, and medical practice. He currently serves as the chief science officer and operations officer, Advanced Research Concepts LLC, a pioneering company dedicated to propelling humanity into the realms of space exploration. At Advanced Research Concepts LLC, Dr. Parker leads a team of experts committed to developing innovative solutions for the complex challenges of space travel, including space transportation, energy storage, radiation shielding, artificial gravity, and space-related medical issues.
He can be reached on LinkedIn and YouTube.