A University of Michigan research group is using genomics to extract clues about how to contain the opioid crisis. The details were included in a recent article about the effort (see: U-M Precision Health Effort Looking Beyond Genomics in Researching Opioid Crisis). An excerpt from it is presented below:
The University of Michigan's Genomics Initiative last week recruited the 50,000th patient who will contribute a biological sample for genomic analysis and phenotypic data to a growing repository for longitudinal research....The initiative's first project will investigate the many characteristics, including genomics, that can contribute to a person's ability to respond to opioids, make them more likely to abuse these drugs, or become addicted to them.....Today, more than 90 Americans die daily from overdosing on opioids, which include prescription pain relievers and heroin. The management of this crisis is a nationwide priority, but more so in states like Michigan, where it has had a significant toll....
Within the University of Michigan effort, researchers will initially study and compare the genetic and phenotypic characteristics of those using and not using opioids among the 50,000 patients who have donated their blood samples to the Genomics Initiative. Within the opioid project,...researchers will to explore these types of associations by looking at, for example, the genetic, environmental, and societal factors that play into how many pills patients take after surgery. Researchers will also investigate the various characteristics that may hinder a patient from responding to painkillers or predispose them to experiencing side effects like nausea, which deters some from taking opioids after surgery or a visit to the dentist.....[I]t's largely accepted that CYP2D6 allelic variations impact people's ability metabolize codeine, where poor metabolizers don't derive adequate benefit from normal doses and rapid metabolizers experience sleepiness or confusion. GWAS studies have also found SNPs and genes associated with opioid addiction or abuse, though the effect sizes are small.
Obviously, clues about how different people metabolize codeine is an absolutely necessary ingredient for managing this medical crisis. Pharmacogenomics has become a necessary component of sophisticated healthcare delivery (see: DRUG-GENE TESTING). There is only one phrase in this article that gives me pause: the study of societal factors that play into how many pills patients take after surgery. The country is now seriously divided along cultural lines and there may be limited tolerance for research findings relating to the societal factors contributing to the opioid crisis. However, mainstream media are already probing issues such as distressed and disconnected patients (see: What’s really causing the prescription drug crisis?). Here's a suggestion about one possible remedy from this latter article:
...[S]tarting in the early 2000s, Switzerland assigned addicted people to clinics where they were given opiates under supervision by a nurse. Crucially, they were also given extensive social support to turn their lives around, including therapy and help finding a job or housing. They gave you the drug, and at the same time, they dealt with the underlying pain that made you feel you needed the drug in the first place.