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 .
Efficacy of disulfiram and cognitive behavior therapy in cocaine-dependent outpatients: a randomized placebo-controlled trial.
CONTEXT Disulfiram has emerged as a promising treatment for cocaine dependence , but it has not yet been evaluated in general population s of cocaine users . OBJECTIVES To compare the effectiveness of disulfiram therapy with that of a placebo condition in reducing cocaine use and to compare the effectiveness of 2 active behavioral therapies-cognitive behavior therapy ( CBT ) and interpersonal psychotherapy (IPT)-in reducing cocaine use . DESIGN R and omized , placebo-controlled , double-masked ( for medication condition ) , factorial ( 2 x 2 ) trial with 4 treatment conditions : disulfiram plus CBT , disulfiram plus IPT , placebo plus CBT , and placebo plus IPT . SETTING A community-based outpatient substance abuse treatment program . PATIENTS A total of 121 individuals meeting the criteria for current cocaine dependence . INTERVENTIONS Patients received either disulfiram ( 250 mg/d ) or placebo in identical capsules . Medication compliance was monitored using a riboflavin marker procedure . Both behavioral therapies ( CBT and IPT ) were manual guided and were delivered in individual sessions for 12 weeks . MAIN OUTCOME MEASURES R and om regression analyses of self-reported frequency of cocaine use and results of urine toxicology screens . RESULTS Participants assigned to disulfiram reduced their cocaine use significantly more than those assigned to placebo , and those assigned to CBT reduced their cocaine use significantly more than those assigned to IPT ( P<.01 for both ) . Findings were consistent across all study sample s ( eg , intention to treat , treatment initiators , and treatment completers ) . Benefits of disulfiram use and CBT were most pronounced for participants who were not alcohol dependent at baseline or who fully abstained from drinking alcohol during treatment . Adverse effects experienced by participants who received disulfiram were mild and were not considerably different from those experienced by participants who received placebo . CONCLUSIONS Disulfiram and CBT are effective therapies for general population s of cocaine-dependent individuals . Disulfiram seems to exert a direct effect on cocaine use rather than through reducing concurrent alcohol use
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 .