Since the first season of This Is Us, addiction has been a running theme of the show. Everyone's favorite TV dad, Jack Pearson (Milo Ventimiglia), struggles with alcoholism as his father before him did; and in the second season, Kevin Pearson (Justin Hartley) spirals into an addiction to opioids, ultimately pushing him to enter rehab.
"We’re a family of addicts," Kevin says in a season 2 episode. "Our father was an addict. We don’t talk about his drinking problem."
Kevin argues that addiction runs in their family, that in addition to his own addiction to painkillers, his sister Kate (Chrissy Metz) also battles an addiction to food. But how big a role do genetics really play in how likely a person is to develop an addiction?
Indra Cidambi, MD, medical director at Center for Network Therapy, says that while there's no one gene that's been identified as the culprit that leads to addiction, genetics is certainly a factor. But other things, like a person's mental health, are just as influential — if not more so.
"Although genetics may predispose a person to get addicted, some other factors have to come together in order to get a person addicted," she says, citing mental health problems, a history of emotional or even physical trauma, physical pain, and even how old a person was when they were first exposed to drugs and/or alcohol.
"Some people never find the perfect medication for their mental health issues and turn to drugs to find relief," she says. "Some of my patients experimented with drugs at a very early age due to peer pressure and became physically dependent on them. Others were prescribed opioid pain medications or addictive anti-anxiety medications for too long and found that they are addicted to them."
Just because someone might be susceptible to addiction doesn't mean that it's an inevitability, or that it's bound to happen.
In Kevin's case, his addiction to pain medication comes about when he injures his knee on the set of a movie and becomes dependent on the medication to the point of sneaking his one-night-stand's medical prescription pad and forging his own dosage.
As This Is Us tackles Kevin's path to sobriety, it also draws parallels between his journey and the ways Jack battled his own demons. But Dr. Cidambi says that just because someone might be susceptible to addiction doesn't mean that it's an inevitability, or that it's bound to happen.
If addiction runs in your family, she says, you just have to take precautions in the same way that you would if heart disease or diabetes ran in your family.
"Be more aware that it could be an issue for you more so than others," she says. "Be careful about who you associate with, or how much alcohol you consume."
But most of all, you have to ask yourself whether or not you're using a substance in order to cope with something, and if you are, what might that something be — and how else can you address it?
If you are struggling with substance abuse, please call the SAMHSA National Helpline at 1-800-662-4357 for free and confidential information.