It is no secret among those who have long worked to help people overcome addiction that the key to treatment is an individualized treatment plan. Because each person faces a unique set of challenges due to a unique set of circumstances and experience, finding directed treatments and therapies that speak specifically to the person’s needs is critical.
Based on this idea, some Nevada medical professionals are questioning whether or not pharmacogenetics would be a good way to address treatment needs of those in recovery. Essentially, this field of medical study focuses on how an individual’s genes will interact with different medications. Not everyone with the same disorders will respond the same to a certain medication, dose of medication, or combination of drugs, and that is largely due to genetic makeup. Theoretically, swabbing inside a patient’s cheek will acquire enough genetic information to help doctors better understand how that person will respond to different medications. This incredible process has been in use to some degree since the 1950s, but only about 12 percent of doctors take advantage due to time or lack of understanding.
Could pharmacogenetics change how we treat addiction?
For starters, if more doctors made use of pharmacogenetics when they first determine that chronic pain is the issue and that medication is needed, it could help to home in on the right medication, dose, and combination of medications without the dangerous “try this, then that” approach that many doctors take. Too often, in the case of an acute pain issue like a dental procedure or minor surgery, doctors will give too large a dose of painkillers for too long of a time or not require recommended medical follow-up care before refilling a prescription. As a result, a routine pain management issue can turn into substance abuse and ultimately a drug addiction.
With chronic pain, the same thing can happen but on a larger scale. Doctors may start with too high a dose or continue to inch up the dose over months despite the fact that the patient is developing an addiction. Conversely, if the doctor is withholding pain management assistance for fear of inadvertently triggering an addiction, then the patient may turn to the street to buy pills and/or heroin.
Theoretically, pharmacogenetics could remove the guesswork from dosing. With the genetic information, doctors can determine how the body will break down and respond to different substances, and potentially be able to choose a medication regimen that is uniquely suited to that person, eliminating the guesswork of what will be effective. It could also potentially identify people who would not benefit from opiate use at all, avoiding the whole issue.
Pharmacogenetics, when it is used, can determine how quickly someone will metabolize their medication. Depending on that rate, a larger or smaller dose may be effective. While this is important information in the treatment of a number of disorders – for example, it was first used in the treatment of cancer patients – it may also be helpful in determining the course of care for people who are undergoing medication-assisted treatment for addiction. Genetic information could potentially better inform an accurate dosing schedule and make the detox process more efficient and less expensive.
An estimated 60 percent of people living with an addiction disorder are also living with a co-occurring mental health disorder, according to Nora Volkow, Director of the National Institute on Drug Abuse. Both disorders must be treated at the same time in order for the person to stabilize in recovery, and pharmacogenetics has been successfully used to focus on the right medication resources for patients who are experiencing extreme mental health symptoms.
Could this be effectively put to use for those in recovery from both addiction and a mental health disorder? With a swifter stabilization of mental health symptoms, those in recovery would be free to turn their attention to the work that must be done during treatment and early recovery: figuring out their triggers, working on positive communication and relationships, and practicing new coping mechanisms that will carry them through in sobriety.
What Do You Think?
Is pharmacogenetics an area of science that should be more deeply explored in terms of its impact on addiction and recovery? Or, is it better to invest time and resources into other areas of research and intervention?