Finally, we must remember that the major purpose for the study of the genetics of addiction is to ultimately improve our care for individuals with this disorder. Our current treatments for alcohol and nicotine dependence are related to the pharmacologic response of these substances. For example, we exploit the aversion to alcohol by administering disulfiram, a medication that interferes with ALDH, and thus increases acetaldehyde levels when alcohol is ingested. This build up of acetaldehyde causes symptoms of nausea, vomiting, flushing and headache, and is similar to the biologic response seen in individuals who carry an alcohol metabolizing gene deficiency. We may be able to utilize the variation in nicotinic receptors and nicotine metabolizing genes to improve our treatments for smoking. As we begin to understand more of the genetic diversity that influences an individual's specific risk to dependence, we will highlight new biologic pathways and neural circuitry that may be exploited pharmacologically. By identifying genetic risks that contribute to dependence, we can begin to dissect different contributions of genes and environments that lead to dependence, and in turn we can improve interventions to reduce dependence and improve cessation.
