Abstract and Keywords
The tools of genetic epidemiology—family, adoption, and twin studies—show convincingly that substance use behavior and substance use disorders are influenced by both genetic and familial and extrafamilial environmental factors. Environmental factors appear to play a more influential role in the early stages of substance use, whereas genetic factors become more important in the development of problem use and substance use disorder. Moreover, some genetic effects are likely conditional on conducive environments; research employing both behavior genetic approaches and measured genes point to important gene–environment interactions that promote substance use and dependence. Consequently, a full understanding of the addiction process requires investigating substance use behavior within its comorbid context. The identification of specific genetic mechanisms underlying these heritable influences is elusive. These findings have prompted the development of new strategies for testing the joint effect of multiple genetic variants in gene-based or gene pathway analyses.
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