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 .
Pharmacogenetic Randomized Trial for Cocaine Abuse: Disulfiram and Dopamine β-Hydroxylase
BACKGROUND Disulfiram has been an effective cocaine addiction pharmacotherapy , and one of its possible mechanisms of efficacy is through copper chelation and inhibition of an enzyme involved in catecholamine metabolism , dopamine β-hydroxylase ( DβH ) , which converts dopamine to norepinephrine . A variant in the gene encoding DβH leads to reduced DβH activity , and as such , disulfiram might not be an effective treatment of cocaine dependence for individuals with this variant . This study explored that potential matching . METHODS Seventy-four cocaine- and opioid-codependent ( DSM-V ) subjects were stabilized on methadone for 2 weeks and subsequently r and omized into disulfiram ( 250 mg/day , n = 34 ) and placebo groups ( n = 40 ) for 10 weeks . We genotyped the DBH gene polymorphism , -1021C/T ( rs1611115 ) , that reduces DβH enzyme levels and evaluated its role for increasing cocaine free urines  with disulfiram . RESULTS With repeated measures analysis of variance , corrected for population structure , disulfiram pharmacotherapy  reduced cocaine-positive urines from 80 % to 62 % ( p = .0001 ) , and this disulfiram efficacy differed by DBH genotype group . Patients with the normal DβH level genotype dropped from 84 % to 56 % on disulfiram ( p = .0001 ) , whereas those with the low DBH level genotype showed no disulfiram effect . CONCLUSIONS This study indicates that the DBH genotype of a patient could be used to identify a subset of individuals for which disulfiram treatment might 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 .