Substance use disorders: treatment with genetic potential?

Substance use disorders are a growing global public health concern. Recognized by the DSM-V and ICD-10 as a chronic psychiatric disorder, substance use disorders cause significant morbidity and mortality, accounting for almost 5% of the global burden of disease. Substance abusers are at increased risk for psychiatric conditions and have higher rates of comorbid disease, including: HIV, Hepatitis B, Hepatitis C, and Tuberculosis. Economically, substance use disorders cost the United States over 193 billion dollars each year through costs incurred by the criminal court system, healthcare costs from increased morbidity, and loss of productivity from disability and incarceration. The negative stigma attached to addicts and addition causes many individuals to deny their illness and avoid treatment. Significant disparities exist in subsets of the US population in both the prevalence of substance use disorders as well as access and referral to treatment. Individuals from the LGBT community, active service members of the US military, military veterans, women and incarcerated individuals face considerable barriers in accessing treatment. These disorders, due to their chronic nature, require long-term prevention efforts and continued treatment throughout the affected individual’s life. Recovered substance abusers are always at risk for relapse, particularly when they lack support, coping skills and understanding from their community. Substance use disorders are affected by environmental and genetic factors, as well as gene-environment interactions. Through the use of better prevention efforts, improved treatment protocols and changes to the criminal justice system, the public health burden in the United States can be lowered, improving the economy, and setting a positive example for other countries to emulate. Incorporating the information known about genetics and addiction into current treatment practices could have significant positive effects on treatment outcomes and future prevention efforts, improving the overall health of the public