Anatomical, pharmacological and human post-mortem studies suggest the dopamine D 3 receptor (DRD3) gene as a candidate for drug dependence. We thus performed an association study of the Bal I polymorphism at the DRD3 gene, including 54 opiate addicts and 70 controls. Opiate addicts had a higher sensation-seeking score (on the Zü ckerman scale) than controls (P = 0.001), particularly a subgroup (70%) who had a distinctly higher score, exceeding 24. There were no marked differences in genotypes between patients as a whole and controls. However, patients with a sensation-seeking score above 24 were more frequently homozygotes for both alleles than patients with a sensation-seeking score under 24 (P = 0.038) or controls (P = 0.034). Although obtained in a sample of limited size, these results suggest that the DRD3 gene may have a role in drug dependence susceptibility in individuals with high sensation-seeking scores. This hypothesis is consistent with the role of DRD3 in mediating responses to drugs of abuse in animals and the association of homozygosity at the Bal I polymorphism with drug abuse in schizophrenic patients (see companion article by Krebs et al).Addiction to substances, including drugs and alcohol, probably arises from a combination of environmental and genetic factors. 1-3 Alcohol, opiates and psychostimulants share the ability in animals to enhance the activity of mesolimbic-mesocortical dopaminergic neurons, thought to be involved in drug reward and reinforcement. 4 The dopamine D 3 receptor (DRD3) is selectively expressed in the projection field of dopaminergic mesolimbic-mesocortical neurons. 5 Stimulation of DRD3 enhances the reinforcing properties of cocaine in rats 6 and monkeys; 7,8 behavioral sensitization occurring after repeated administration of an indirect dopamine agonist, a process also observed after repeated administration of opiates and psychostimulants, is accompanied by a selective induction of DRD3 gene expression. 9 Furthermore, DRD3 binding 10 and gene transcripts 11 are elevated in the ventral striatum of cocaine fatalities. These experimental and clinical observations suggest the DRD3 gene as a candidate for susceptibility to drug dependence.We recruited 54 patients with opiate dependence and without schizophrenia, both according to DSM-III-R criteria (mean age ± s.d. 32.3 ± 6.1 yrs), and 70 controls without drug use or any psychiatric disease (mean age 42.2 ± 7 yrs), all white males of French ancestry. The older age of controls minimises the risk of including not yet revealed addicts. Twenty-nine patients had less than three life-time comorbid substance dependences, and 25 more than three comorbid dependences. The age of first opiate use was 18.6 ± 2.9 yrs.The sensation-seeking score, as assessed using the Zü ckerman scale, was significantly higher in patients (26 ± 5) than in controls (17 ± 6, P = 0.001). The sensation-seeking score in patients was found inversely correlated with age (r = −0.37, P = 0.005), as it is in the general population. 12 However, testing for normali...