A systematic review: Candidate gene and environment interaction on alcohol use and misuse among adolescents and young adults

Background and Objectives: Youth drinking is a pervasive public health concern with serious negative developmental implications. Candidate gene and environment interaction studies (cGxE) show that environmental effects on drinking behaviors may differ by individuals’ genotypes. Yet little is known about whether genetic and environmental effects on drinking behaviors are developmentally specific. Methods: This systematic review evaluated 42 cGxE studies of drinking in adolescence and young adulthood. Results: Although there are mixed findings, studies of cGxE effects involving DRD4, 5-HTTLPR, DRD2, and OPRM1 genotypes showed relatively consistent patterns. The effects of under-controlled environments (eg, low levels of parental monitoring) on early and middle adolescent drinking appeared to differ across DRD2 or OPRM1 genotypes. Effects of alcohol-facilitating environments (eg, heavy drinking peers) on late adolescent and young adult drinking appeared to differ across DRD4 or OPRM1 genotypes. Interactions between 5-HTTLPR genotype with stressful environments (eg, negative life events) were found throughout adolescence and young adulthood, although there were some inconsistencies regarding the risk-conferring allele. There was limited evidence for other cGxE effects due to the small number of studies. Conclusions and Scientific Significance: This review suggests that GxE findings may advance our knowledge regarding which developmentally specific conditions result in the expression of candidate genes that influence youth alcohol use and misuse. However, since a significant number of studies had small sample sizes and most studies had small effect sizes, findings need replication across independent studies with large samples. (Am J Addict 2018;27:345–363).