Polymorphisms of the DRD2 , ANKK1 , DAT1 , DBH , and DRD4 genes have been found to moderate the effects of pharmacotherapy  of alcohol , opioid , and cocaine use disorders .
The integration of genetic information with clinical data will inform health professionals of the most efficacious pharmacotherapeutic intervention for substance use disorders .
Substance use disorders have significant personal , familial , and societal consequences .
Despite the serious consequences of substance use , only a few therapies are effective in treating substance use disorders , thus highlighting a need for improved treatment practice s. Substance use treatment response depends on multiple factors such as genetic , biological , and social factors .
It is essential that each component is represented in treatment plans .
The dopaminergic system plays a critical role in the pharmacotherapy for addictions , and an underst and ing of the role of variation of genes involved in this system is essential for its success .
Vaccine Pharmacotherapy for the Treatment of Cocaine Dependence
BACKGROUND Cocaine abuse has no established pharmacotherapy , but active immunotherapy with a cocaine vaccine shows promise as a therapeutic intervention . METHODS An open label , fourteen week , dose-escalation study evaluated the safety , immunogenicity , and clinical efficacy of a novel human cocaine vaccine ( TA-CD ) in eighteen cocaine dependent subjects . Ten subjects ( 400 microg total dose group ) received four-100 microg injections over the course of eight weeks . Subsequently , eight subjects ( 2000 microg total dose group ) received five-400 microg vaccinations over twelve weeks . Intent to treat analysis of thrice weekly urine toxicologies and cocaine antibody titers were compared . RESULTS Sixteen of 18 subjects completed the study . There were no serious adverse reactions and the vaccine was well tolerated . The 2000 microg total dose group had a significantly higher mean antibody titer response ( 2000 units ) as compared to the 400 microg total dose group ( 1000 units ) ( p = .05 ) . The 2000 microg group was more likely to maintain cocaine free urines than those in the 400 microg group ( Z = -3.12 , p = .002 ) . Despite relapse in both groups , most reported an attenuation of cocaine 's usual euphoric effects at the six month follow-up time points ( 63 % in the 400 microg and 100 % in the 2000 microg groups ) . CONCLUSIONS The conjugated cocaine vaccine was well tolerated and cocaine specific antibodies persisted at least six months . The likelihood of using cocaine decreased in subjects who received the more intense vaccination schedule
Polymorphisms of the DRD2 , ANKK1 , DAT1 , DBH , and DRD4 genes have been found to moderate the effects of pharmacotherapy  of alcohol , opioid , and cocaine use disorders .
The integration of genetic information with clinical data will inform health professionals of the most efficacious pharmacotherapeutic intervention for substance use disorders .
Substance use disorders have significant personal , familial , and societal consequences .
Despite the serious consequences of substance use , only a few therapies are effective in treating substance use disorders , thus highlighting a need for improved treatment practice s. Substance use treatment response depends on multiple factors such as genetic , biological , and social factors .
It is essential that each component is represented in treatment plans .
The dopaminergic system plays a critical role in the pharmacotherapy for addictions , and an underst and ing of the role of variation of genes involved in this system is essential for its success .