Substance use and substance use disorders (SUD) are highly (and increasing) prevalent both as single disorders and within the context of complex psychiatric and somatic comorbidities. In parallel with the impact of these disorders, research on addictive processes has significantly expanded in recent decades. However, several challenges remain to be addressed on multiple levels. Within the context of continuing evolution of new (illicit and prescription) drugs of abuse and changes in the growing field of behavioral (nonchemical) addictions (gambling, gaming), the epidemiological situation is rapidly changing. On the level of disorder conceptualization and underlying pathogenetic mechanisms many challenges remain to be addressed, impacting a broad spectrum from legislation and public mental health issues to underlying neurobiological processes such as neuroimmune mechanisms and microbiome, and cognitive dimensions. These provide new targets of therapeutic approaches such as neuromodulation, personalized pharmacotherapy, and contingency management.

I consider the implications of this study for future research and policymaking, and I reflect on the legacies of the people and policies I discuss in the book. For instance, I discuss potential applications to healthcare policy, specifically around the opioid epidemic, and education policy. I also address how the themes of the book play out in my own everyday work as a teacher.

In the years following FDA approval of direct-to-consumer, genetic-health-risk/DTCGHR testing, millions of people in the US have sent their DNA to companies to receive personal genome health risk information without physician or other learned medical professional involvement. In Personal Genome Medicine, Michael J. Malinowski examines the ethical, legal, and social implications of this development. Drawing from the past and present of medicine in the US, Malinowski applies law, policy, public and private sector practices, and governing norms to analyze the commercial personal genome sequencing and testing sectors and to assess their impact on the future of US medicine. Written in relatable and accessible language, the book also proposes regulatory reforms for government and medical professionals that will enable technological advancements while maintaining personal and public health standards.

In the years following FDA approval of direct-to-consumer, genetic-health-risk/DTCGHR testing, millions of people in the US have sent their DNA to companies to receive personal genome health risk information without physician or other learned medical professional involvement. In Personal Genome Medicine, Michael J. Malinowski examines the ethical, legal, and social implications of this development. Drawing from the past and present of medicine in the US, Malinowski applies law, policy, public and private sector practices, and governing norms to analyze the commercial personal genome sequencing and testing sectors and to assess their impact on the future of US medicine. Written in relatable and accessible language, the book also proposes regulatory reforms for government and medical professionals that will enable technological advancements while maintaining personal and public health standards.