Figure 4. Incorporating stress response into personalized therapeutic development for SUDs.

Individual differences in cumulative aggregated stress and drug misuse exposure result in substantial heterogeneity in the extent of disruption to the adaptive stress response shown in Figure 1. The general approach to intervention development is to assess therapeutics for each specific SUD, without consideration of the effects of stress and drug misuse severity levels across individuals. In the one-size-fits-all approach (A), all individuals are considered the same and therefore presented and treated similarly for intervention development. (B) Cartoon of a precision medicine model for a specific SUD, wherein personalized demographic, clinical, and biobehavioral markers of stress- and drug-interactive disruptions are considered as prognostic diagnostics, facilitating development of precision medicine intervention to increase SUD treatment efficacy.