Substance use disorders remain a serious threat to public health. In the current analysis, we examined the combination of clinical, environmental, and genetic risk factors for determining who is more likely to develop a SUD in early adulthood. We used previously validated measures of environmental and clinical risk [11, 29, 30] and polygenic scores for externalizing problems [31], depression [32], problematic alcohol use [33, 35], alcohol consumption [34, 35], cigarettes per day/nicotine dependence [34, 36], and schizophrenia [37, 38]. The combination of genetic and social-environmental measures was significantly associated with the development of SUDs. The overall association was strongest for drug dependence, followed by any substance dependence, nicotine dependence, and alcohol dependence.
