Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
EBioMedicine. 2022 Sep;83:104212. doi: 10.1016/j.ebiom.2022.104212. Epub 2022 Aug 12.
Excessive substance use and substance use disorders (SUDs) are common, serious and relapsing medical conditions. They frequently co-occur with other diseases that are leading contributors to disability worldwide. While heavy substance use may potentiate the course of some of these illnesses, there is accumulating evidence suggesting common genetic architectures. In this narrative review, we focus on four heritable medical conditions - cardiometabolic disease, chronic pain, depression and COVID-19, which are commonly overlapping with, but not necessarily a direct consequence of, SUDs. We find persuasive evidence of underlying genetic liability that predisposes to both SUDs and chronic pain, depression, and COVID-19. For cardiometabolic disease, there is greater support for a potential causal influence of problematic substance use. Our review encourages de-stigmatization of SUDs and the assessment of substance use in clinical settings. We assert that identifying shared pathways of risk has high translational potential, allowing tailoring of treatments for multiple medical conditions. FUNDING: SSR acknowledges T29KT0526, T32IR5226 and DP1DA054394; RLK acknowledges AA028292; AA acknowledges DA054869 & K02DA032573. The funders had no role in the conceptualization or writing of the paper.
过度物质使用和物质使用障碍（SUD）是常见的、严重的和复发性的医学病症。它们经常与其他导致全球残疾的疾病同时发生。虽然大量物质使用可能会加剧其中一些疾病的进程，但越来越多的证据表明存在共同的遗传结构。在这篇叙述性评论中，我们专注于四种遗传性医学病症——心血管代谢疾病、慢性疼痛、抑郁和 COVID-19，这些病症通常与 SUD 重叠，但不一定是其直接后果。我们发现了令人信服的证据，表明遗传易感性与 SUD 以及慢性疼痛、抑郁和 COVID-19 都有关。对于心血管代谢疾病，有更多的证据支持有问题的物质使用对其产生潜在的因果影响。我们的综述鼓励消除 SUD 的污名化，并在临床环境中评估物质使用。我们断言，确定风险的共同途径具有很高的转化潜力，可以为多种医学病症定制治疗方法。资金来源：SSR 承认 T29KT0526、T32IR5226 和 DP1DA054394；RLK 承认 AA028292；AA 承认 DA054869 和 K02DA032573。资助者在论文的概念化或撰写过程中没有任何作用。
