Substance use and common contributors to morbidity: A genetics perspective

Area of Science:

• Genetics
• Psychiatry
• Internal Medicine

Background:

• Substance use disorders (SUDs) are prevalent, relapsing conditions frequently co-occurring with other major diseases.
• These co-occurring conditions contribute significantly to global disability.
• Accumulating evidence suggests shared genetic factors underlie SUDs and other medical conditions.

Purpose of the Study:

• To review the evidence for common genetic architectures between SUDs and four heritable conditions: cardiometabolic disease, chronic pain, depression, and COVID-19.
• To explore the potential causal role of substance use in these co-occurring conditions.
• To advocate for de-stigmatization and integrated care approaches for SUDs.

Main Methods:

• Narrative review of existing literature.
• Focus on studies investigating genetic liability and shared pathways.
• Analysis of evidence for genetic overlap versus direct causal influence.

Main Results:

• Strong evidence supports a shared genetic liability predisposing individuals to SUDs and chronic pain, depression, and COVID-19.
• For cardiometabolic disease, problematic substance use appears to have a more direct causal influence.
• Identifying shared risk pathways offers potential for integrated treatment strategies.

Conclusions:

• Genetic factors play a significant role in the co-occurrence of SUDs with chronic pain, depression, and COVID-19.
• Problematic substance use may causally impact cardiometabolic disease progression.
• Understanding shared genetic risks can inform personalized medicine and de-stigmatize SUDs.