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 .
Exposure to opioid maintenance treatment reduces long-term mortality.
AIMS To ( i ) examine the predictors of mortality in a r and omized study of methadone versus buprenorphine maintenance treatment ; ( ii ) compare the survival experience of the r and omized subject groups ; and ( iii ) describe the causes of death . DESIGN Ten-year longitudinal follow-up of mortality among participants in a r and omized trial of methadone versus buprenorphine maintenance treatment .  SETTING Recruitment through three clinics for a r and omized trial of buprenorphine versus methadone maintenance . PARTICIPANTS A total of 405 heroin-dependent ( DSM-IV ) participants aged 18 years and above who consented to participate in original study . MEASUREMENTS Baseline data from original r and omized study ; date s and causes of death through data linkage with Births , Deaths and Marriages registries ; and longitudinal treatment exposure via State health departments . Predictors of mortality examined through survival analysis . FINDINGS There was an overall mortality rate of 8.84 deaths per 1000 person-years of follow-up and causes of death were comparable with the literature . Increased exposure to episodes of opioid treatment longer than 7 days reduced the risk of mortality ; there was no differential mortality among methadone versus buprenorphine participants . More dependent , heavier users of heroin at baseline had a lower risk of death , and also higher exposure to opioid treatment . Older participants r and omized to buprenorphine treatment had significantly improved survival . Aboriginal or Torres Strait Isl and er participants had a higher risk of death . CONCLUSIONS Increased exposure to opioid maintenance treatment reduces the risk of death in opioid-dependent people . There was no differential reduction between buprenorphine and methadone . Previous studies suggesting differential effects may have been affected by biases in patient selection
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 .