High Genetic Addiction Risk Score (GARS) in Chronically Prescribed Severe Chronic Opioid Probands Attending Multi-pain Clinics: an Open Clinical Pilot Trial
Year: 2021
Type: article
Study design: Observational Study
Abstract: Millions of Americans experience pain daily. In 2017, opioid overdose claimed 64,000 lives increasing to 84,000 lives in 2020, resulting in a decrease in national life expectancy. Chronic opioid use results in dependency, drug tolerance, neuroadaptation, hyperalgesia, potential addictive behaviors, or Reward Deficiency Syndrome (RDS) caused by a hypodopaminergia. Evaluation of pain clinic patients with the Genetic Addiction Risk Score (GARS) test and the Addiction Severity Index (ASI- Media Version V) revealed that GARS scores equal to or greater than 4 and 7 alleles significantly predicted drug and alcohol severity, respectively. We utilized RT-PCR for SNP genotyping and multiplex PCR/capillary electrophoresis for fragment analysis of the role of eleven alleles in a ten-reward gene panel, reflecting the activity of brain reward circuitry in 121 chronic opioid users. The study consisted of 55 males and 66 females averaging ages 54 and 53 years of age, respectively. The patients included Caucasians, African Americans, Hispanics, and Asians. Inclusion criteria mandated that the Morphine Milligram Equivalent (MME) was 30-600 mg/day (males) and 20 to 180 mg/day (females) for treatment of chronic pain over 12 months. Ninety-six percent carried four or more risk alleles, and 73% carried seven or more risk alleles, suggesting a high predictive risk for opioid and alcohol dependence, respectively. These data indicate that chronic, legally prescribed opioid users attending a pain clinic possess high genetic risk for drug and alcohol addiction. Early identification of genetic risk, using the GARS test upon entry to treatment, may prevent iatrogenic induced opioid dependence.
Source: Molecular Neurobiology
Authors: Mark Moran, Kenneth Blum, Jessica Valdez Ponce, Lisa Lott, Marjorie C. Gondré–Lewis, Sampada Badgaiyan, Raymond Brewer, B. William Downs, Philip Fynman, Alexander Weingarten, Jean Lud Cadet, David E. Smith, David Baron, Panayotis K. Thanos, Edward J. Modestino, Rajendra D. Badgaiyan, Igor Elman, Mark S. Gold
Institutions: Eötvös Loránd University, University of Vermont, Wright State University, Dominion Diagnostics (United States), Western University of Health Sciences, Howard University, Syosset Hospital, New York Medical College, National Institutes of Health, University of San Francisco, University at Buffalo, State University of New York, Curry College, Harvard University, The University of Texas at San Antonio Health Science Center, Audie L. Murphy Memorial VA Hospital, Icahn School of Medicine at Mount Sinai, Washington University in St. Louis
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,860
OpenAlex ID: W3134825259