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 .
Treatment of cocaine and alcohol dependence with psychotherapy and disulfiram.
AIMS To evaluate disulfiram and three forms of manual guided psychotherapy for individuals with cocaine dependence and concurrent alcohol abuse or dependence . DESIGN R and omized controlled trial . SETTING Urban substance abuse treatment center . PARTICIPANTS One hundred and twenty-two cocaine/alcohol abusers ( 27 % female ; 61 % African-American or Hispanic ) . INTERVENTIONS One of five treatments delivered over 12 weeks : cognitive behavioral treatment ( CBT ) plus disulfiram ; Twelve Step facilitation ( TSF ) plus disulfiram ; clinical management ( CM ) plus disulfiram ; CBT plus no medication ; TSF plus no medication . MEASUREMENTS Duration of continuous abstinence from cocaine or alcohol ; frequency and quantity of cocaine and alcohol use by week , verified by urine toxicology and breathalyzer screens . FINDINGS Disulfiram treatment was associated with significantly better retention in treatment , as well as longer duration of abstinence from alcohol and cocaine use . The two active psychotherapies ( CBT and TSF ) were associated with reduced cocaine use over time compared with supportive psychotherapy ( CM ) . Cocaine and alcohol use were strongly related throughout treatment , particularly for subjects treated with disulfiram . CONCLUSIONS For the large proportion of cocaine-dependent individuals who also abuse alcohol , disulfiram combined with outpatient psychotherapy may be a promising treatment strategy . This study underlines ( a ) the significance of alcohol use among treatment-seeking cocaine abusers , ( b ) the promise of the strategy of treating co-morbid disorders among drug-dependent individuals , and ( c ) the importance of combining psychotherapy and pharmacotherapy in the treatment of drug use disorders
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 .