Addictions are frequently occurring mental health problems that are associated with serious morbidity and excessive mortality, suffering of family and friends, societal damage, criminality, public nuisance and in some instances destabilization of certain regions or even countries. In the last decades, effective pharmacological treatments have become available for the treatment of nicotine, alcohol and opioid dependence, whereas new medications are developed and tested for cannabis, cocaine and amphetamine dependence. Unfortunately, the effect of most of the currently available medications is moderate at best. Different strategies have been tested to improve the response to these medications, e.g. combination of different pharmacological treatments, combinations of pharmacological and psychosocial interventions, and patient-treatment matching based on clinical characteristics. So far, these strategies have not been very successful. A promising direction is a better matching of patients and treatments based on differences between patients in their genetic make-up. In this presentation we provide an overview of the pharmacological and genetic background of addiction and the promising findings with regard to recent attempts to improve outcomes by a better matching of treatments and patients based on genetic information.