1. ¹Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Boston, Massachusetts, USA
2. ²Institute for Health Policy, Massachusetts General Hospital/Partners HealthCare, Boston, Massachusetts, USA
3. ³Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
4. ⁴Transdisciplinary Tobacco Use Research Center, Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA

Correspondence: AE Shields, (ashields@partners.org)

Received 1 November 2007; Accepted 2 January 2008; Published online 5 March 2008.

Abstract

Emerging pharmacogenomics research on addiction to nicotine,¹ alcohol,² cocaine, and opiates³ may soon lead to improved clinical outcomes by tailoring the type, dose and duration of treatment to individual patients' genotypes. To realize the potential of pharmacogenomics in reducing the burden of addiction, several challenges related to clinical integration of novel treatment strategies will need to be addressed concomitantly with ongoing empirical research.⁴ These challenges include the preparedness of primary care physicians (PCPs) to incorporate pharmacogenetics into clinical practice, patients' willingness to undergo genetic testing, the resources and infrastructure needed to deliver such services, adequate financing and reimbursement of pharmacogenetic testing, and privacy and antidiscrimination protections sufficient to reassure physicians and patients that genetic testing will not lead to stigmatization and discrimination.⁴