Genetic Factors

Studies in rodents suggest that genetic variation influences several aspects of the response to cocaine, including preference, stimulant effects, and sensitiza-tion (Miner & Marley, 1995; Schuster, Yu, & Bates, 1977). Cocaine dependence in probands specifically increased the risk of cocaine dependence in siblings (Bierut et al., 1998).

One large-scale twin study of substance use and abuse in male U.S. veterans found that genetic factors played a substantial etiological role in stimulant abuse (Tsuang et al., 1996). However, the effects were generally nonspecific, indicating that the same characteristics that place an individual at risk for cocaine abuse also put that individual at risk for other substance abuse. A second study focusing specifically on cocaine use, abuse, and dependence was conducted in over 800 pairs of female-female twins ascertained from the population-based Virginia Twin Registry (Karkowski, Prescott, & Kendler, 2000). Cocaine use, abuse, and dependence were all found to be strongly influenced by both shared environmental influences and genetic factors, with heritabilities ranging from 69 to 81%. However, both the environmental and genetic factors appeared nonspecific. A third, large-scale twin study examined lifetime history of use and abuse/dependence of cocaine and other drugs in 1,196 male-male twin pairs ascertained by the Virginia Twin Registry (Kendler, Jacobson, Prescott, & Neale, 2003). Ultimately, one must conclude that while cocaine use, abuse, and dependence seem to be strongly influenced by genetic factors, evidence for a cocaine-specific genetic effect is currently lacking.

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