Genetic Panel Test May Help ID Optimal Opioid Dose Needs
| The following article features coverage from PAINWeek 2017 in Las Vegas, Nevada. Click here to read more of MPR‘s conference coverage. |
According to results of a study presented at PAINWeek 2017, a high percentage of severe chronic pain patients had genetic variations in dopamine receptors and a low variation in opioid receptors, possibly explaining why some patients may require increased doses of opioids for pain control.
The study performed genetic testing on 70 patients with severe chronic pain that were unresponsive to standard medical therapy and required >100mg/day of morphine equivalence for pain control. Buccal swab was used to obtain test samples and 16 single nucleotide polymorphisms (SNP) were analyzed. The 4 categories of genetic markers included in the panel were receptor binding and activity (including dopamine, opioid, serotonin, and galanin receptors), neurotransmitter transporters, central nervous system (CNS) enzymes, and cytochrome P450 enzymes.
Results of the study found that genetic variations in the 3 dopamine receptors tested (DRD1, DRD4, DOR) were observed in 97 to 100% of patients included in the analysis. The study authors also reported that only 17 to 30% of patients were found to have genetic variations in the opioid receptors tested (OPRK1, OPRM1, and MUOR). Additionally, it was found that only the dopamine receptor makers had >90% genetic variation, suggesting that potent stimulation of the opioid receptors was required to obtain pain relief for these patients.
“These results suggest that since the dopaminergic pathway was defective, these pain patients relied on potent stimulation of their opioid receptors to obtain adequate pain relief,” the study authors add.
Based on the results of this study, some severe chronic pain patients may require higher doses of opioids for pain control due to genetic variations found in pain receptors. The study authors add, “These findings need to be investigated in other groups of pain patients who require high dose opioids to determine if dopaminergic defects are an underlying, genetic cause of high dose opioid requirements in some chronic pain patients.”
Read more of MPR’s coverage of PAINWeek 2017 by visiting the conference page.
Filed under: General Problems
I had to genetic testing done in Spokane Washington prior to finally starting pain management a year and a half after a severe fall that caused a disc betweenL4 and L5 to be ejected from my spine. The genetic testing revealed that i am an ultra rapid Metabolizer of morphine based drugs. My options were methadone and fentynal patches, because of the high risk of addiction to those I am chose to remain on hydrocodone 10 mg 3 times A-day Which of course when finally starting working would only provide me with about 15 minutes of relief But at least I was getting some relief which would give me the chance to relax. That provider and ARNP after 8 months of continuous care discharge me saying that I was a behavioral problem and had failed my drug test, Completely untrue and and substantiated . Now I am refused treatment for anything under the Sun because I have been profiled and blacklisted in red flagged. I have a multitude of chronic verifiable painful conditions and am currently extremely suicidal due to the fact that those that are in the power to protect us are the ones inflicting the most harm to us .I have contacted the ACLU and will be sending them a detailed email regarding civil rights civil liberties crimes against humanity and domestic terrorism regarding what’s happening to people across this country which should not be happening anywhere and it is forbidden under International law to abuse and torture specially those who are considered disabled. I will also be accusing 4 persons responsible for the supposed guidelines that are just a suggestion they have caused extreme suffering for those of us with any type of physical pain That is verifiable And documented.
I have spent many months researching these avenues and feel that it is our only hope for our survival and quality of life . Furthermore, I think that any prescription medication complete with warning labels and explain to by recipients of prescription medications is a binding contract between the recipient the doctor and the pharmacy and those who purposely chose to abuse those medications And suffer the consequences and od Or die did so of their own volition and therefore should not Be construed as otherwise. When you purposely abuse your pain medication it’s either because what you’re being given isn’t working anymore or you are trying to get high, If you’re abusing your pain medication it is because you have not talk to your provider about putting on something that will work for you Or because you are getting high or selling them. Drugs like heroin Should not be included in the war on opiates for those people who were in chronic pain and taken opiates should be excluded from the war on drugs. I seriously doubt anyone who has taken the prescriptions as directed has died. The medical climate today has made it easy for providers to blacklist and red flag Anyone they want Due to the fear of loss of license and imprisonment. I believe that this is a direct violation of their hypocratic oath and that the Opiate guidelines and those responsible for writing it have created this environment and therefore should be held accountable. I am physically disabled And protected by the Rights under ADA. I can no longer sit Idly by While there are a 124 plus million people in this country being abused and tortured by the very people responsible for our quality of life. I am just one person And I have concerns that because of the nature and degree of my accusations that those who are in a position to offer us help will deny a so in fear of retaliation and loss of monies and grants . I will not stop I will not go away and I will fight for us for as long as I physically can but I urge you all To go on the Internet to your area’s ACLU and submit this information so that the ACLU across this country will know that I am not the only one that we matter and that we deserve to have quality of life .
If any of you would like to contact me my email is daisym1567@gmail.com I welcome any advice and suggestions.
Now this might have some promise! Especially in our Central Pain Syndrome condition & others that have damage to the Central Nervous System. I had read on this finding and so wanted to go to Vegas this week. Now I wish I had with Hurricane Irma coming right for us✨
Stay safe dear one !
Yes, this is cutting edge science so badly needed!