Background <p>Genetic factors play a significant role in addiction, but integrating genetic explanations into addiction treatment raises complex issues. This study explores how American addiction treatment providers discuss genetic factors in the context of addiction treatment and conceptualize the relationship of genetic attributions with susceptibility to addiction, prognostic expectations, patient agency, blame, stigma, and ethical concerns.</p> Methods <p>We conducted qualitative interviews with 20 clinicians from four American addiction professional organizations. Transcripts were analyzed using thematic analysis.</p> Results <p>Clinicians recognized the significance of genetics in influencing susceptibility to addiction but emphasized that genetics constitute only one of multiple contributing factors. Currently, the practical value of genetic insights for addiction treatment is perceived as limited. Genetic explanations can reduce patient self-blame, yet concerns about fostering fatalism and diminishing patient agency were noted. Furthermore, genetic attributions could paradoxically either alleviate or exacerbate societal stigma by shifting public perceptions of addiction from moral failure to biological determinism. Ethical concerns about the use of genetic information centered on privacy safeguards and the risk of discrimination by employers and insurers, despite existing legal protections.</p> Conclusion <p>Clinicians have ambivalent views on genetic explanations for addiction, recognizing possible benefits in stigma reduction but wary of potential negative impacts on personal responsibility and discrimination risks. As genetic explanations are integrated into addiction treatment, careful consideration should be devoted to their potential impact on patients’ self-perceptions and public attitudes.</p>