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 .
Cocaine-Specific Antibodies Blunt the Subjective Effects of Smoked Cocaine in Humans
BACKGROUND Rates of relapse among cocaine-dependent patients are high , and new treatment approaches are needed . Clinical data demonstrate that a cocaine vaccine ( TA-CD ) produces selective anticocaine antibodies , yet the impact of these antibodies on cocaine 's direct effects is unknown . The objective of this human laboratory study was to measure the relationship between antibody titers and the effects of smoked cocaine on ratings of intoxication , craving , and cardiovascular effects . METHODS Ten cocaine-dependent men not seeking drug treatment spent 2 nights per week for 13 weeks inpatient where the effects of cocaine ( 0 mg , 25 mg , 50 mg ) were determined before vaccination and at weekly intervals thereafter . Two doses of TA-CD ( 82 microg , n = 4 ; 360 microg , n = 6 ) were administered at weeks 1 , 3 , 5 , and 9 . RESULTS Peak plasma antibody levels , which were highly variable , significantly predicted cocaine 's effects . Those individuals in the upper half of antibody production had an immediate ( within 4 minutes of cocaine smoking ) and robust ( 55%-81 % ) reduction in ratings of good drug effect and cocaine quality , while those in the lower half showed only a nonsignificant attenuation ( 6%-26 % ) . Self-reported cocaine use while participants were outpatient tended to decrease as a function of antibody titer ( p < .12 ) . By contrast , higher antibody levels predicted significantly greater cocaine-induced tachycardia . CONCLUSIONS The TA-CD vaccine substantially decreased smoked cocaine 's intoxicating effects in those generating sufficient antibody . These data support further testing of cocaine immunotherapy as a treatment 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 .