Abstract
Substance use disorders (SUDs) are a group of highly prevalent and heritable psychiatric conditions yet little data exists on the practice of genetic counseling for SUDs. Previous studies on genetic counseling for other psychiatric disorders suggest this practice can help to promote patient empowerment and decrease a personal sense of stigma. This study aimed to characterize genetic counselors’ encounters with SUDs in clinical practice and identify any obstacles to effective counseling for patients facing a history of SUD. Currently practicing genetic counselors in a patient-facing role were recruited and asked to complete an anonymous online survey. Of the 220 respondents, 82.1% reported never having a patient for whom the primary referral was SUD. When a history of SUD does arise in a session, on average our participants reported that they “often” include it in the patient’s pedigree, “sometimes” offer psychosocial counseling and discuss the hereditary nature of SUD, and “rarely” provide a personalized risk assessment or resources/referrals. A large portion of our respondents (41.2%) received SUD training in their graduate training program while only 10% reported such training in their post-graduate practice. Despite a minority (7.7%) of participants reporting feeling that their training prepared them to provide genetic counseling for SUD, those with training were more likely to engage in certain components of a genetic counseling session, particularly discussing the inheritance of SUD, when presented with hypothetical scenarios involving patients with a history of SUD. When utilizing the Social Distance Scale (SDS) to examine stigma towards individuals with SUD, we found that genetic counselors desired social distance from individuals with SUD in intimate relationships and that having personal and/or professional exposure to SUD did not significantly influence scores on the SDS. Our results show that genetic counselors are likely to offer components of genetic counseling to patients with a history of SUD in the hypothetical but they are not currently offering these services in their clinical practice. As our understanding of the genetics of SUD and the demand for psychiatric genetic counseling services rise, it is imperative that research on and efforts to improve practical, experiential training on SUD continue and that methods to recognize and combat SUD-related stigma be investigated.