A Conversation with Our Chief Medical Officer about Research into Genetics, Alcohol Use Disorder and Precision Treatment Mayo Clinic and the Hazelden Betty Ford Foundation recently launched a collaborative, five-year research project that could help usher in a new era of addiction medicine. Together magazine caught up with Marvin D. Seppala, MD, chief medical officer of the Hazelden Betty Ford Foundation, to learn more about the federally funded research underway and the potential for lifesaving discoveries. What are the investigators hoping to discover through this research project? Our primary aim is to identify biological markers that would predict a patient's response to acamprosate, which is one of three Food and Drug Administration-approved medications used in the treatment of alcohol use disorder. For some of our patients, acamprosate is an effective treatment supplement because it helps to curb alcohol cravings. For most, the medication has little to no impact. And for others, acamprosate causes negative side effects. By studying the genetics of patients who receive the medication and its effects, we hope to learn which of our patients will benefit most. So the findings could help addiction treatment providers like Hazelden Betty Ford tailor patient care? Definitely. That would be the most immediate application for us—being able to use a blood test to determine which medications could make a significant difference in helping individual patients get sober and stay sober. The research could also inform the development of new medications for substance use disorders. Discoveries about the genetic and molecular drivers of alcohol use disorder could even move us closer to one day being able to predict, genetically, who is most vulnerable to developing the disease. How is the research being conducted? The study will involve 800 people receiving care for alcohol use disorder at Hazelden Betty Ford in Center City , Minnesota, as well as Mayo Clinic-affiliated addiction treatment programs. Study participants will provide blood for genetic testing that will identify variants to help predict their response to the use of acamprosate. This area of inquiry—called "pharmacogenomics"—is very cutting edge. Investigators work at the genetic and molecular level to study how the body processes and responds to medication. Then artificial intelligence is used to pinpoint the biomarkers for response or nonresponse to a medication. Mayo Clinic has already conducted pharmacogenomic research to inform precision medicine in treatment for cancer and depression. People might be surprised to learn that Hazelden Betty Ford uses medication for treatment of alcohol use disorder. When and why is medication advised? Unfortunately, too many people relapse after addiction treatment. We typically recommend acamprosate for patients with alcohol use disorder as a supplement to comprehensive care. Addiction is a complex disease with biological, psychological, social and spiritual components, which is why we take everything into account when we develop a patient's treatment plan—including medications that could boost the prospects of getting sober and staying sober. For some patients, medication can make treatment more effective by easing withdrawal symptoms and/or reducing cravings longer term. That way, the patient can engage more fully in counseling, group therapy, peer support and all that is involved in coming to see and believe that recovery just might be possible. *The acamprosate study is coordinated with and funded by grants from the National Institute on Alcohol Abuse and Alcoholism.