Recovery capital and genetic risk in remission and relapse with Janaka Kosgolla and Doug SmithRecovery capital and genetic risk in remission and relapse with Janaka Kosgolla and Doug Smith
Addiction Audio
Dr Janaka Kosgolla and Professor Douglas Smith talk with Dr Tsen Vei Lim about how recovery capital and genetic risk relate to remission and relapse in substance use disorder. Using large-scale health record and genetic data, they outline what their findings might mean for understanding recovery without claiming anyone is defined by their genes.
20:14•16 Oct 2026
Recovery Capital, Genetic Risk and the Road to Remission
Episode Overview
- Recovery capital includes internal and external resources such as social support, motivation, mental health and practical help like transport to treatment.
- Polygenic risk scores combine hundreds of thousands of genetic variants into a single measure of inherited susceptibility linked to addiction.
- Higher recovery capital is associated with greater probabilities of remission across low, medium and high genetic risk groups, with the strongest effect in the middle range.
- Recovery capital and genetic risk scores show almost no direct correlation, yet their joint pattern in relation to remission is non-linear and complex.
- Genetic risk and treatment indicators from health records offer useful data, but current limitations mean results cannot be used to claim causation or precise individual predictions.
“"Higher genetic liability doesn't mean that you're destined to develop a substance use disorder."”
How do people find strength in their journey to sobriety? This conversation on Addiction Audio takes that question into the research lab, looking closely at how life resources and genetics relate to remission and relapse in substance use disorders. Hosted by Dr Tsen Vei Lim, the episode features Dr Janaka Kosgolla and Professor Doug Smith from the University of Illinois Urbana-Champaign.
Their focus is on "recovery capital" – as Doug puts it, "all the resources, both external and internal, that we think are promotive of addiction recovery." That includes supportive friends, decent mental health, motivation, and even basics like transport to treatment. Janaka breaks down polygenic risk scores in plain language, explaining how tiny differences in DNA letters across hundreds of thousands of genetic variants are combined into a single score linked to addiction risk.
Crucially, he stresses that "higher genetic liability doesn't mean that you're destined to develop a substance use disorder" and that no-one is doomed by their genes. Using data from the All of Us research programme, the team matched information on recovery resources, genetic risk and electronic health records to see how remission patterns changed over time.
They found that higher recovery capital was linked to better chances of remission across low, medium and high genetic risk, with the biggest effect in the middle-risk group. At the same time, recovery capital and genetic risk barely correlated with each other, hinting at a more complex picture than simple cause and effect. The discussion also touches on limits of medical record data, the patchy measurement of mental health, and how future work might inform assessment and treatment planning.
If you're interested in how science is trying to piece together why some people stay in remission and others relapse, this episode gives you plenty to chew on – and maybe prompts you to ask what "recovery capital" looks like in your own life.
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