Genetic research provides the opportunity to examine how both genetic and environmental factors are associated with the etiology of addictions. As shown in several of the studies reviewed10,52, adjusting for sociodemographics altered the patterns of relationships, for example with Whites no longer having significantly lower likelihood of AUDs than Native Americans and instead having higher likelihood than Blacks and Hispanics. This highlights the importance of examining the role of environmental factors on prevalence and co-occurrence of addictive behaviors. Testing models like the PACE framework, which incorporates genetic, biological, environmental, situational, and learning factors that may vary across ethnic groups, will improve our understanding of the complex interplay among risk and protective factors involved in the development of addictive behaviors. Elucidating how these factors are related to addictive phenotypes based on patterns of use and comorbidity, including their similarity and differences across ethnic groups, will further our understanding of common and unique mechanistic pathways in the etiology of addictions.
