medRxiv PreprintsInternational14 October 2026
Genetic loci associated with cocaine use identified using a novel approach to detect epistasis
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Background Cocaine use disorder (CUD) is estimated to be 50% heritable, yet few genetic variants have been robustly associated with risk. During January 2021 to June 2024, cocaine was involved in 30% of U.S. overdose deaths. Identifying genetic contributors to CUD could inform diagnostics and treatments. The missing heritability may stem from small sample sizes, models that inadequately account for small-effect common variants, and the exclusion of large-effect structural variants like copy number changes. Epistasis likely contributes but remains challenging to detect genome-wide. Results We f
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