Genetic research

Some Gene Research Just Isn’t Worth the Money

How should we set priorities in medical research? Officials at the National Institutes of Health will grapple with this question as they allocate billions of dollars from the agency’s budget this year.

Two geneticists, Dr. Kathleen Merikangas of the National Institute of Mental Health and Dr. Neil Risch of Stanford University, have taken on this challenge by introducing an intriguing framework for setting priorities for genetic research.

The best candidates for genetic research, they believe, are disorders whose emergence and course cannot be derailed by changes in personal habits or manipulation of the environment. Examples are autism, Type 1 diabetes and Alzheimer’s disease.

In contrast, lower priority on the genetic research hierarchy should go to conditions like Type 2 diabetes or alcohol or nicotine addiction, they argue. Type 2 diabetes, after all, can be largely avoided through exercise and weight loss, and teenagers will buy less beer if taxes on alcohol are high enough. Similarly, a combination of smoking bans, social pressure and taxes have had an impact on smoking.

Psshaw!! These “experts” clearly do not care for real patients. Despite social pressures, many intelligent patients continue to smoke. Their addiction is very real. They understand why they should stop; they want to stop; yet they just cannot succeed.

If we better understand what causes some people to become addicted to drugs and alcohol, perhaps we could better understand how to help them. What makes their medical problem (and yes I believe it is a medical problem) less important than the others cited?

How should one prioritize medical research? Is not obesity our major health problem? Exercise and diet does work for most of us, but why is this so hard to do. Please do not assume “lack of will”. I believe it is clearly much more complex than that.

The article makes the case against genetic research into understanding addiction. I take a contrarian view. We do need to understand why some people are more prone to addiction than others. Why am I never tempted to get drunk? I like a couple glasses of wine – and that is enough for me. I know many people who enjoy drinking much greater quantities than me. What makes us different?

If we could understand addiction with relation to nicotine and alcohol, we might help millions of people. If we could understand why so many patients overeat, perhaps we could help tens of millions of people. If we could understand why type II diabetes mellitus develops, perhaps we would better understand the “metabolic syndrome”. Knowing this might lead to methods for greatly decreasing health care costs in this country.

Each of these “lifestyle” diseases costs billions of dollars. If genetic research can help these patients, what makes them less worthy.