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Wednesday, October 10, 2007

IMAGEN: IMPLICATIONS FOR ADDICTION SCIENCE AND SCIENCE POLICY
Addiction 102 (11), 1699–1700.


Substance use disorders are among the leading public health challenges worldwide, with alcohol use alone accounting for approximately 4% of the global disease burden . Neither the investment in biomedical addiction research, nor health service provision in this area adequately reflect the magnitude of the problem. In fact, the view of substance use disorders as medical conditions much similar to other chronic, relapsing disorders is still not widely accepted. Ultimately, this can only change if research elucidates the pathophysiology of drug seeking behavior, and points to effective, mechanism-based treatments.

Linking genetics and brain functions subserving motivation and emotion will be key for changes to occur. In this issue, Prof Schumann provides a good illustration of current developments . Cleverly chosen intermediate phenotypes, and integration between levels of complexity are beginning to provide us with a hope of reaching a mechanistic understanding that goes beyond traditional statistical association studies. The role of genetic variation at the SERT and COMT loci, and their interaction, for processing of negative affective stimuli described by Prof Schumann provides a model for this kind of paradigm. The IMAGEN project Prof Schumann describes offers the promise of applying this type of approach directly to substance use disorders. In some ways, the IMAGEN project follows in the footsteps of the Collaborative on the Genetics of Alcoholism (COGA) in the US. They both show the value of collaborative efforts that standardize assessment methodologies across a number of sites, enabling them to collect populations that simply cannot be recruited by a single institution. A key lesson from COGA is the importance of a sustained, long-term commitment. These ambitious projects simply take time to provide a return on the investment.
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