313543
Understanding Prescription Drug Abuse Problem using Genotype in Chronic Pain Patients
According to the CDC, nearly three out of four prescription drug overdoses are caused by prescription painkillers—also called opioid pain relievers.
Objectives
To explain the effect of mesolimbic genetic predispositions on the risk of opioid misuse and abuse in chronic pain patients in 8 US states.
Subjects
6487 chronic pain patients (3822 female, 2667 males) randomly selected from 20 pain management clinics in the states of Texas, California, Ohio, Missouri, Kentucky, Indiana, Arizona, and Oklahoma.
Methods
The following single nucleotide polymorphisms (SNPs) were evaluated using TaqMan SNP genotyping assays: Serotonin 2a Receptor (5-HT2a 1438 G/A), Serotonin Transporter (SLC6A4), Catechol-O-Methyltransferase (COMT Val108/158Met), Dopamine D2 Receptor (DRD2 A2/A1, A1/A1), Dopamine D1 Receptor (DRD1 -48A/G), Dopamine D4 Receptor (DRD4 -521C/T), Dopamine Transporter (SLC6A3 UTR3 C/T), Dopamine Beta Hydroxylase (DBH -1021 C/T), Methylene Tetrahydrofolate Reductase (MTFHR C677T), Human Kappa Opioid Receptor (OPRK1 36G>T), Gamma-Aminobutyric Acid (GABA) (1519T>C GABA(A) alpha 6 gene), and Human Mu Opioid Receptor (OPRM1 A118G).
RESULTS:
A chi-square association test found no association between Gender and NRI (Narcotic Risk Index score which helps to determine risk of Opioid abuse, 0-36 with 19 as cutoff). More than 10% prevalence was found in the homozygous mutation for certain genes in all 8 states; DRD1, DRD2, DRD4, DAT, DBH and OPRK. Genes with more than 20% prevalence are; 24% DRD4 homozygous mutation was found in Arizona and Texas, 28% DRD4 homozygous mutation in California and Indiana, 26% DRD4 homozygous mutation in Kentucky, 25% DRD4 homozygous mutation in Missouri and Ohio and 24% and 29% have homozygous mutation for DRD2 and DRD4 in Oklahoma.
Conclusion: This study suggests that there is no difference between males and females for risk of opioid addiction. It also shows that there is a prevalence of homozygous mutations in dopaminergic genes in the patients across all 8 states.
https://www.dropbox.com/sh/nv9zmo9jjiuui3z/Pnx0WDHtqo
Learning Areas:
Administer health education strategies, interventions and programsAdvocacy for health and health education
Planning of health education strategies, interventions, and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Learning Objectives:
describe and explain the effect of mesolimbic genetic predispositions on the risk of opoiod misuse and abuse in chronic pain patients.
demonstrate that genetic predisposition to opioid abuse has nothing to do with gender
Keyword(s): Public health or related laws, regulations, standards, or guidel, Public health or related public policy
Qualified on the content I am responsible for because: I am a Ph.D-trained neuroscientist whose research focus has been on the genetics of neuropsychiatric disorders. As a member of Proove Biosciences, I have been involved in the planning and implementation of clinical research studies investigating the association of Single Nucleotide Polymorphisms (SNPs) with the risk of abusing or misusing opioids.
Any relevant financial relationships? Yes
| Name of Organization | Clinical/Research Area | Type of relationship |
|---|---|---|
| Proove Biosciences | Genetics, Pain | Employment (includes retainer) |
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.