Genetic addiction risk score (GARS) ™, a predictor of vulnerability to opioid dependence.

Genetic addiction risk score (GARS) ™, a predictor of vulnerability to opioid dependence. Front Biosci (Elite Ed). 2018 Jan 01;10:175-196 Authors: Blum K, Chen ALC, Thanos PK, Febo M, Demetrovics Z, Dushaj K, Kovoor A, Baron D, Smith DE, Roy Iii AK, Fried L, Chen TJH, Chapman E, Modestino E, Steinberg B, Badgaiyan RD Abstract The interaction of neurotransmitters and genes that control the release of dopamine is the Brain Reward Cascade (BRC). Variations within the BRC, whether genetic or epigenetic, may predispose individuals to addictive behaviors and altered pain tolerance. This discussion authored by a group of concerned scientists and clinicians examines the Genetic Addiction Risk Score (GARS), the first test to accurately predict vulnerability to pain, addiction, and other compulsive behaviors, defined as Reward Deficiency Syndrome (RDS). Innovative strategies to combat epidemic opioid, iatrogenic prescription drug abuse and death, based on the role of dopaminergic tone in pain pathways, are proposed. Sensitivity to pain may reside in the mesolimbic projection system, where genetic polymorphisms associate with a predisposition to pain vulnerability or tolerance. They provide unique therapeutic targets that could assist in the treatment of pain, and identify risk for subsequent addiction. Pharmacogenomic testing of candidate genes like CB1, mu receptors, and PENK might result in pharmacogenomic, personalized solutions, and improved clinical outc...
Source: Frontiers in Bioscience - Elite - Category: Biomedical Science Tags: Front Biosci (Elite Ed) Source Type: research

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New largescale study in the American Journal of Preventive Medicine found overprescription of opioids by dentists common, particularly to patients at high risk for substance abuse, and that almost 1/3 of patients received more powerful drugs than neededElsevierIMAGE: In this cross-sectional analysis of 542,958 dental visits by adult patients, between 1 in 4 and 1 in 2 opioid prescriptions exceeded the recommended morphine equivalents and days'supply for...viewmore Credit: Michelle S. Woods Ann Arbor, February 4, 2020 - Dentists are among top prescribers of opioids in the US, however, whether their opioid prescrib...
Source: Dental Technology Blog - Category: Dentistry Source Type: news
Our ability to feel pain and react to it is both a boon and a curse, simultaneously. The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” This means that pain is highly subjective, and it is informed by a mix of past experiences, our current emotional state, and future expectations. Since pain is an emotional and sensory experience it affects our quality of life immensely, and treatment is complex. Chronic pain management with opioids is not ideal Opioids...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Complementary and alternative medicine Mind body medicine Pain Management Source Type: blogs
Authors: Conti Mica M, Ring D, Hsu JR, Mir H Abstract The opioid epidemic in the United States has changed how medicine is practiced. There are tools and resources available to help the surgeon understand pain and provide appropriate pain management. Understanding pain, setting expectations, and diagnosing underlying medical dispositions that can lead to opioid addiction should become standard practice. Understanding available tools for communication, setting appropriate expectations, and preoperative planning for postoperative pain will provide better pain control. Through physical, mental, and medicinal modalitie...
Source: Instructional Course Lectures - Category: Orthopaedics Tags: Instr Course Lect Source Type: research
Contributors to the ongoing epidemic of prescription opioid abuse, addiction, and death include opioid tolerance, withdrawal symptoms, and possibly opioid-induced hyperalgesia (OIH). Thirty stable chronic non-malignant pain patients entered a six-month long, randomized, double-blind, dose-response, two-center trial of the potent opioid levorphanol, conducted over a decade ago during an era of permissive opioid prescribing. Eleven were taking no opioids at study entry and eleven were taking between 35-122 morphine equivalents (MEQ).
Source: The Journal of Pain - Category: Materials Science Authors: Tags: Original Reports Source Type: research
AbstractKratom, orMitragyna, is a tropical plant indigenous to Southeast Asia, with unique pharmacological properties. It is commonly consumed by preparing the leaves into decoction or tea, or by grinding them into a powder. Recent evidence has revealed that kratom has physiological effects similar to opioids, including pain relief and euphoria, as well as stimulant properties, which together raise potential concern for dependence and addiction. Moreover, growing evidence suggests that the prevalence of kratom use is increasing in many parts of the world, raising important considerations for healthcare providers. This manu...
Source: Pain and Therapy - Category: Anesthesiology Source Type: research
The United States continues to face a public heatlh crisis of epic proportion, with over 500,000 deaths from opioid overdoses since 2000. Medications for opioid use disorder, like buprenorphine, offer patients an effective approach to cessation. Unfortunately many barriers to use of medications for opioid use disorder exist, including insufficient number of programs offering medications for opioid use disorder, inadequate number of addiction specialists to provide these medications, and stigma surrouding patients with opioid use disorders and the medications used to treat them.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
John Kapoor, CEO of Insys Therapeutics, was sentenced yesterday to 5 1/2 years in prison. That's a pretty stiff sentence, right?Well let's see now. What did he do exactly?His company sold fentanyl under the brand name Subsys. As you probably know, fentanyl is an extremely powerful synthetic opioid that is responsible for a high percentage of the overdose deaths in the current epidemic of opioid addiction. As a prescription drug, it was approved by the FDA only for so-called breakthrough pain in cancer patients. But Insys literally bribed doctors to prescribe it inappropriately, resulting in8,000 known deathsand countless m...
Source: Stayin' Alive - Category: American Health Source Type: blogs
ConclusionsA significant number of patients with IC are treated with opioids. Although the overall number of opioid prescriptions associated with IC had declined, the prescription rate per IC diagnosis had not. As part of the national initiative to reduce opioid use, our data suggest that IC treatment strategies should be examined.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
If we can say anything for certain about caring for persons in pain over the past decade is that it has prompted concern and confusion on how to provide the best care. Consider the following: Do we have an opioid epidemic or an opioid crisis in the United States? Does the difference in these words matter? What about the “other” less publicized public health crisis; chronic pain; where did that conversation go? Are opioid analgesics good or bad to treat people in pain? Should nurses be prepared in pain care, addiction care or both? What are the differences in state policies that govern and guide nursing practice...
Source: Pain Management Nursing - Category: Nursing Authors: Tags: Editorial Source Type: research
Opioid addiction has reached epidemic proportions in the United States and it is thought that the problem started with the prescription for legal pain medications by health care professionals, particularly for treating patients who had undergone surgery. To reduce the reliance on opioids in dental pain management, increase use of nonsteroidal anti-inflammatory drugs (NSAIDs) and other adjunctive techniques have emerged. The use of NSAIDs, transdermal and transmucosal patches are presented. Understanding the rational for these different approaches requires a basic knowledge of the molecular biology of dental pain.
Source: Dental Clinics of North America - Category: Dentistry Authors: Source Type: research
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