Caroline Freiermuth of the University of Cincinnati Medical Center sees life or death situations every day as an emergency room doctor, and she is continually faced with the difficult decision of whether or not to give a patient in extreme pain an opioid prescription.  Does the patient have genetic markers for addiction?  There's not way to tell...yet.“I’m faced with this battle.  How do I decide how much pain medication to give someone?” she asked.  She doesn’t want her patients to suffer, but at the same time, she is worried about contributing to the epidemic.  She must rely on her own decision-making abilities to arrive at the right answer – time and again.But, that may soon change.  As scientists continue to try and come up with innovative ways to combat the crisis, a new prospect has been the focus of discussion – what if there was a genetic test that could be performed which would identify whether someone is at high risk of developing an opioid addiction?

Photo by Christin Hume on Unsplash

A $1.6 million study by the University of Cincinnati and Ohio State University, which will officially launch in January 2020, will attempt to take a deeper dive into the topic and determine if one’s genetic makeup can increase this risk.   Researchers plan to ask for the help of up to 1,500 emergency room patients, some diagnosed with opioid use disorder (OUD) and those who have never or rarely used opioids.  They will swab their cheeks and send the genetic information to Genemarkers for testing.In order to maintain anonymity, the researchers will ensure the patients’ DNA profiles will not be linked to their names or made available to law enforcement.  Ohio Attorney General Dave Yost’s office is planning to oversee the study and hopes that the testing will help to inform opioid addiction prevention.Yost said he “wants to know why he was able to take painkillers after a back surgery without becoming addicted to the drugs, but his friend, a U.S. Marine, had his life upended by opioids.”  Yost is hopeful that genetics will provide a missing link that will cause those who are more susceptible to think twice about ingesting opioids.“This is not a guy that lacks willpower,” Yost said. “Why am I standing here today drug-free and he is struggling to maintain, years later, his sobriety?”A recent study headed by the National Bureau of Economic Research (NBER) titled “Did the War on Terror Ignite an Opioid Epidemic?” did find that opioid use disorder was risk amongst U.S. Marines who experienced combat while deployed.  The NBER study estimated the economic impact of opioid addiction among service members is roughly $1 billion a year, and for heroin, $470 million.  It is difficult to determine whether Yost’s friend’s involvement in the Marines was a factor in his subsequent addiction.Dr. Jon Sprague, who leads the Attorney General’s Future of Forensic Sciences at Bowling Green State University, said, “If researchers could predict who might be predisposed to opioid addiction, that could be an invaluable tool for doctors.”Physicians would be provided with some guidance concerning whether or not to move forward with an opioid prescription.  Yost added, “I hope the day comes when you don’t have to make that decision anymore without guidance.”

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What if genetic test could alert you to future addiction to opioids?Combat troops at higher risk for opioid and heroin abuse, study says