Neurogenetics of acute and chronic opiate opioid abstinence  treating symptoms and the cause

Blum, Kenneth; Gold, Mark S.; Jacobs, William; McCall, W. Vaughn; Febo, Marcelo; Baron, David; Dushaj, Kristina; Demetrovics, Zsolt; Badgaiyan, Rajendra D.

doi:10.2741/4544

Cited by 10 publications

(7 citation statements)

References 249 publications

(289 reference statements)

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“…1–4 The United States consumes 80% of the world's supply of prescription opioid analgesics (POAs), and opioid prescriptions have climbed by 300% since 1991. 5 The rise in opioid prescriptions has also widened the demographic of individuals dying from opioid overdose; historically, overdose was most prevalent in urban, minority adolescent males; however, today these lethal effects are similar across race, gender, socioeconomic status, and geography. 7–11 The spike in prescriptions has also directly contributed to an increase in the number of first-time consumers of illicit opioids (heroin, which is commonly laced with fentanyl or its analogs), which has continued to climb since the mid 1990's.…”

Section: Introductionmentioning

confidence: 99%

Emerging Evidence for Cannabis' Role in Opioid Use Disorder

Wiese

Wilson-Poe

2018

Cannabis and Cannabinoid Research

128

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Introduction: The opioid epidemic has become an immense problem in North America, and despite decades of research on the most effective means to treat opioid use disorder (OUD), overdose deaths are at an all-time high, and relapse remains pervasive.Discussion: Although there are a number of FDA-approved opioid replacement therapies and maintenance medications to help ease the severity of opioid withdrawal symptoms and aid in relapse prevention, these medications are not risk free nor are they successful for all patients. Furthermore, there are legal and logistical bottlenecks to obtaining traditional opioid replacement therapies such as methadone or buprenorphine, and the demand for these services far outweighs the supply and access. To fill the gap between efficacious OUD treatments and the widespread prevalence of misuse, relapse, and overdose, the development of novel, alternative, or adjunct OUD treatment therapies is highly warranted. In this article, we review emerging evidence that suggests that cannabis may play a role in ameliorating the impact of OUD. Herein, we highlight knowledge gaps and discuss cannabis' potential to prevent opioid misuse (as an analgesic alternative), alleviate opioid withdrawal symptoms, and decrease the likelihood of relapse.Conclusion: The compelling nature of these data and the relative safety profile of cannabis warrant further exploration of cannabis as an adjunct or alternative treatment for OUD.

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Section: Introductionmentioning

confidence: 99%

Emerging Evidence for Cannabis' Role in Opioid Use Disorder

Wiese

Wilson-Poe

2018

Cannabis and Cannabinoid Research

128

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“…Prescribed opioids for nonmalignant pain, heroin access, and the emergence of cheap, potent synthetic opioids drive this epidemic of overdoses and OUDs [74]. Currently, the clinical consensus is to treat OUD as if it were an opioid deficiency syndrome with long-term to life-long opioid substitution therapy [75]. Using opioids to treat OUD forever seems counterintuitive at best.…”

Section: Discussionmentioning

confidence: 99%

A Novel Precision Approach to Overcome the “Addiction Pandemic” by Incorporating Genetic Addiction Risk Severity (GARS) and Dopamine Homeostasis Restoration

Blum

Kazmi

Modestino

et al. 2021

JPM

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This article describes a unique therapeutic precision intervention, a formulation of enkephalinase inhibitors, enkephalin, and dopamine-releasing neuronutrients, to induce dopamine homeostasis for detoxification and treatment of individuals genetically predisposed to developing reward deficiency syndrome (RDS). The formulations are based on the results of the addiction risk severity (GARS) test. Based on both neurogenetic and epigenetic evidence, the test evaluates the presence of reward genes and risk alleles. Existing evidence demonstrates that the novel genetic risk testing system can successfully stratify the potential for developing opioid use disorder (OUD) related risks or before initiating opioid analgesic therapy and RDS risk for people in recovery. In the case of opioid use disorders, long-term maintenance agonist treatments like methadone and buprenorphine may create RDS, or RDS may have been in existence, but not recognized. The test will also assess the potential for benefit from medication-assisted treatment with dopamine augmentation. RDS methodology holds a strong promise for reducing the burden of addictive disorders for individuals, their families, and society as a whole by guiding the restoration of dopamine homeostasisthrough anti-reward allostatic neuroadaptations. WC 175

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“…Brain-derived neutropenic factor (BDNF), and Neurotrophin-3 NT-3 are neurotrophic genes, and OPRM1, G-protein alpha subunits, 5q33, GABA (A) gamma2 the GABA receptor subunit genes, and OPRK1, alpha2-adrenoceptor are involved. The TTC12, ANKK1, NCAM1, and TTC12 are important for drug exposure in heroin dependence [51] and morphine stimulates zinc finger CCHC-type, RNA-binding motif 1 (ZCRB1) (10) and RGS-R7 [42][43][44][45]. Other genes involved include Interleukin-2, Gbeta5, MAO-A, 287 A/G polymorphism of catechol-O-methyltransferase, serotonin transporter, Ca2+/ cAMP responsive element binding protein, CNR1, ABCB1, P-glycoprotein, UGT2B7, and CREB.…”

Section: Opioid Pain Compound Avoidancementioning

confidence: 99%

“…Findings by both, Kenneth Blum, Ph.D. and Ernest Noble, Ph.D and others [50] concerning the role of genes in shaping cravings and pleasure-seeking, opened the doors to comprehension of how genetics control our actions and effect our mental and physical health. Moreover, technology that is related to KB220 variants in order to reduce or eradicate excessive cravings by influencing gene expression is a cornerstone in the pioneering of the practical applications of nutrigenomics/neurogenetics [51]. Continuing discoveries have been an important catalyst for the evolution, expansion, and scientific recognition of the significance of nutrigenomics and its remarkable contributions to human health.…”

Section: Pro-dopamine Regulationmentioning

confidence: 99%

The Benefits of Genetic Addiction Risk Score (GARS™) Testing in Substance Use Disorder (SUD)

Blum¹,

Modestino²,

Gondré–Lewis³

et al. 2018

Int J Genom Data Min

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Following 25 years of extensive research by many scientists worldwide, a panel of ten reward gene risk variants, called the Genetic Addiction Risk Score (GARS), has been developed. In unpublished work, when GARS was compared to the Addiction Severity Index (ASI), which has been used in many clinical settings, GARS significantly predicted the severity of both alcohol and drug dependency. In support of early testing for addiction and other RDS subtypes, parents caught up in the current demographic of 127 people, both young and old, dying daily from opiate/opioid overdose, need help. In the past, families would have never guessed that their loved ones would die or could be in real danger due to opiate addiction. Author, Bill Moyers, in Parade Magazine, reported that as he traveled around the United States, he found many children with ADHD and other spectrum disorders like Autism, and noted that many of these children had related conditions like substance abuse. He called for better ways to identify these children and treat them with approaches other than addictive pharmaceuticals. To our knowledge, GARS is the only panel of genes with established polymorphisms reflecting the Brain Reward Cascade (BRC), which has been correlated with the ASI-MV alcohol and drug risk severity score. While other studies are required to confirm and extend the GARS test to include other genes and polymorphisms that associate with an hypodopaminergic trait, these results provide clinicians with a non-invasive genetic test. Genomic testing, such as GARS, can improve clinical interactions and decision-making. Knowledge of precise polymorphic associations can help in the attenuation of guilt and denial, corroboration of family gene-o-grams; assistance in risk-severity-based decisions about appropriate therapies, including pain medications and risk for addiction; choice of the appropriate level of care placement (i.e., inpatient, outpatient, intensive outpatient, residential); determination of the length of stay in treatment; determination of genetic severity-based relapse and recovery liability and vulnerability; determination of pharmacogenetic medical monitoring for better clinical outcomes (e.g., the A1 allele of the DRD2 gene reduces the binding to opioid delta receptors in the brain, thus, reducing Naltrexone's clinical effectiveness); and supporting medical necessity for insurance scrutiny.

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Neurogenetics of acute and chronic opiate opioid abstinence treating symptoms and the cause

Cited by 10 publications

References 249 publications

Emerging Evidence for Cannabis' Role in Opioid Use Disorder

Emerging Evidence for Cannabis' Role in Opioid Use Disorder

A Novel Precision Approach to Overcome the “Addiction Pandemic” by Incorporating Genetic Addiction Risk Severity (GARS) and Dopamine Homeostasis Restoration

The Benefits of Genetic Addiction Risk Score (GARS™) Testing in Substance Use Disorder (SUD)

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