Examining Genetics to Identify Risks of Opioid Addiction

SAN ANTONIO — The use of prescription opioids is increasingly common in individuals with chronic pain. Since opioids are associated with a serious dependence potential and long-term risk of addiction, the initiation of opioid pharmacotherapy imparts an increased risk for opioid-related abuse. It is therefore necessary to identify potential genetic, neural, behavioral, and environmental risk factors that may predispose an individual to prescription opioid addiction.

Opioid use disorder is caused by a complex interplay between polygenic traits and wide-ranging environmental factors. According to study findings presented at the 2016 Annual Meeting of the American Academy of Pain Management, in San Antonio, Texas, researchers developed a multi-variant genetic panel that may be used to identify individuals who may be at high risk for developing prescription opioid addiction.¹

Investigators performed a genome-wide association study (GWAS), an established method used to identify multiple common genetic variants or single nucleotide polymorphisms (SNPs), to examine genetic factors associated with increased risk for developing opioid dependence in 70 patients diagnosed with prescription opioid or heroin addiction. They then compared these data to those obtained from 68 healthy volunteers who served as controls.

Researchers targeted their investigation by focusing on the following gene variants: 5-HTR2A (rs7997012), 5-HTTLPR (rs25531), COMT (rs4680), DRD2 (rs1800497), DRD1 (rs4532), DRD4 (rs3758653), DAT1 (rs6347), DBH (rs1611115), MTHFR (rs1801133), OPRK1 (rs1051660), GABA (rs211014), OPRM1 (rs1799971), MUOR (rs9479757), GAL (rs948854), DOR (rs2236861), and ATP-BCT (rs1045642). They then computed a risk score, ranging from 1 to 100, with an elevated risk for addiction operationalized as a score that was higher than 52.

Results indicate that more than 75% of individuals with a current opioid addiction diagnosis, as well as 28% of control participants, presented with an addiction risk score over 52 (Χ2=31.55; df=1; P <.05).

“The prediction algorithm with this multi-variant genetic panel can be used for prescription opioid addiction risk assessment […] and  may provide information to physicians to improve therapeutic decisions in pain management and prevent abuse and addiction,” the authors concluded.

Reference

1. Hudspeth R,  Lopez J, Vairava R, Chang S, Tennant F. Multi-variant genetic panel for risk of opioid addiction. Presented at: AAPM 2016. San Antonio, TX; September 21-25, 2016.

This article originally appeared on Clinical Pain Advisor