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 .
DBH gene as predictor of response in a cocaine vaccine clinical trial
We examined a pharmacogenetic association of the dopamine β-hydroxylase ( DBH ) gene with a response to an  anti-cocaine vaccine that was tested in a recent clinical trial . This gene is associated with cocaine-induced paranoia , which has a slower onset than the euphoria from cocaine . The vaccine reduced euphoria by slowing the entry of cocaine into the brain , but it may not reduce aversive symptoms like paranoia . A 16-week Phase IIb r and omized double-blind placebo-controlled trial of 114 cocaine and opioid dependent subjects who received five vaccinations over the first 12 weeks was examined . We genotyped 71 subjects for the rs1611115 ( -1021C > T ) variant of the DBH gene and compared vaccine to placebo subjects on cocaine-free urines . Using repeated measures analysis of variance , corrected for population structure , vaccine pharmacotherapy reduced cocaine positive urines significantly based on DBH genotype . Patients with the low DβH level genotype dropped from 77 % to 51 % on vaccine ( p=0.0001 ) , while those with the normal DβH level genotype dropped from 83 % to 72 % . Placebo showed no effect on cocaine use overall or by genotype . This study indicates that a patient 's DBH genotype could be used to identify a subset of individuals for whom vaccine treatment may be an effective pharmacotherapy for cocaine dependence
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 .