I like how the article explains that substance abuse only requires one of four abuse criteria, while substance dependence requires at least three of seven dependence criteria. It shows that use and disorder are not just different levels of the same thing, and that they have different scales/ systems of diagnosis. That makes me think the move from casual use to dependence and then abuse probably depends more on environmental factors, like stress, mental health, surrounding friends/family, and support systems. Even if genetics plays a role, these environmental factors may be what cause someone to meet multiple dependence/ abuse criteria, which just genetic data may miss.

I think this intro sets up an important point we've talked about in class: SUDs are polygenic, so they are influenced my multiple genes at once, but their effects depend a lot on the environment. The same genotype can lead to different phenotypes depending on factors like stress, trauma, and other environmental exposures, partly through epigenetic changes (like methylation which we learned about in class) that turn certain genes up, down, on, or off. This makes me wonder how many high-risk alleles for SUDs only become problematic and take affect in specific environments, and how focusing on genetics alone gives an incomplete picture of who is actually vulnerable to SUDs.